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Objectives: This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients. Method and materials: Following PRISMA guidelines, health science librarians completed literature searches from inception to 17 March 2023 in seven databases. There were 15,686 items exported to EndNote from Embase.com, CINAHL (EBSCO), Cochrane Library, Ovid MEDLINE-ALL, PubMed, Scopus, and Web of Science. Hand-searching added four more articles. After deduplication, 6,756 items were screened for eligibility. Twenty-nine studies were assessed by full text, of which ten studies, involving 424 subjects, were included in the review. Risk of bias assessment was conducted using the Cochrane risk-of-bias tool and the Newcastle-Ottawa scale. A meta-analysis was performed to synthesize and analyze the collective data from the selected studies. Results: The included studies used diverse methodologies, implant systems, and loading protocols. Most studies reported no significant difference in marginal bone loss between ball and locator attachments. The meta-analysis revealed high heterogeneity. Conclusion: The results of this systematic review suggest that ball and locator attachments exhibit similar performance in terms of marginal bone loss in implant-retained overdentures. However, the limited number, risk of bias, and heterogeneity of studies highlight the need for standardized research designs and larger sample sizes in future investigations to draw more definitive conclusions. [ABSTRACT FROM AUTHOR]

Lithium disilicate (LS) ceramic emerges as a compelling option for customized implant abutments. However, ensuring its safety and reliability requires clarification on key aspects, notably its impact on inflammation and potential for cell adhesion. This study delves into these considerations, examining the influence of LS ceramic on cytokine release and the transcriptional profile of human gingival fibroblasts (hGFs) in direct contact with various LS surfaces. hGFs were cultured on LS disks featuring three distinct surfaces (unpolished, polished, and polished glaze), while titanium disks served as reference material and cells cultured directly on plates as controls. The surface of the disks was analyzed using a scanning electron microscope. The cell metabolism was analyzed by MTT test, cytokine release by MAGPIX and the expression of genes related to cell adhesion was evaluated by qPCR. The disks exhibited similar topography with smooth surfaces, except for the unpolished LS disks, which had an irregular surface. Contact with LS surfaces did not substantially reduce cell metabolism. Moreover, it generally decreased cytokine release compared to controls, particularly pro-inflammatory mediators like IL-1β, IL-6, and TNF-α. Significantly increased expression of genes related to cell adhesion to LS was observed, comparable to titanium, the gold standard material for implant abutments. Significance: This study unveils that LS ceramic not only fails to trigger pro-inflammatory cytokine release, but also significantly enhances gene expression associated with cell adhesion. These mechanisms are closely linked to gene pathways such as PTK2 , SRC , MAPK1 , and transcription factors ELK-1 and MYC. In summary, the findings underscore LS ceramic's potential as a biocompatible material for implant abutments, shedding light on its favorable inflammatory response and enhanced cell adhesion properties. [ABSTRACT FROM AUTHOR]

Purpose: To assess how well torque‐limiting devices (TLDs) are known and used by European dentists, and their adherence to screw tightening protocols and screw loosening occurrence through a survey, including the correlation between the dental specialty‐of‐interest and the recognition, the tightening protocol used, and between the calibration and the occurrence of screw loosening. Materials and methods: A 10‐question survey was distributed to dentists to collect data on their specialty‐of‐interest, TLD usage, knowledge on TLDs, calibration, the term "preload," tightening speed, tightening protocols used, and occurrence of screw loosening. Pearson test was used for correlation analysis between the specialty‐of‐interest and the recognition‐based questions, the tightening protocol used, and between the calibration and the frequency of screw loosening. Results: Of 422 respondents, 24% calibrated their TLDs, 27% knew the term "preload," 76% selected the correct location to read on TLDs, and 6% was aware of the effect of tightening speed. The correlation between the specialty‐of‐interest and the recognition‐based questions was nonsignificant (p <.05) but was significant for used tightening protocol (p <.001). The correlation between the calibration and the occurrence of screw loosening was nonsignificant (p = 0.16). Tightening protocols' effect on screw loosening was similar, which was mostly observed less than once a year (p <.001). Conclusions: A lack in dentists' knowledge was found on calibration, the term preload, and the effect of tightening speed, which were not impacted by the dentists' specialty‐of‐interest, which affected the preferred tightening protocol. The tightening protocol and calibration did not impact the occurrence of screw loosening, which was mostly observed less than once a year. [ABSTRACT FROM AUTHOR]

This study was designed to determine the effect of photobiomodulation therapy on dental implant stability. A complete systematic search was performed in PUBMED/MEDLINE, COCHRANE library databases, EMBASE, SCOPUS, and Google Scholar databases on articles published until June 2024. All the RCTs and CCTs reported the solo impact of photobiomodulation on dental implant stability in humans were included. The means and standard deviation for implant stability and sample size were extracted for the meta‐analysis. The statistical analysis was conducted using Stata 17 software, and random effect models were applied to assess the source of heterogeneity. The I2 statistic was used to estimate the significance of any discrepancies in the therapy result. After a full‐text inspection, 17 articles were qualified for systematic review, and 14 were included in the meta‐analysis. Statically significant differences in implant stability were observed between the laser and the control groups on weeks 2 in ISQ reporting groups (p = 0.01, CI 95%) and weeks 4 and 8 in PTV reporting groups (p < 0.001, CI 95%). Despite limitations, the study suggests that PBM therapy benefits patients with dental implants at different periods, particularly during the early phases of healing. [ABSTRACT FROM AUTHOR]

Background: There is limited knowledge on the fabrication trueness and fit of additively or subtractively manufactured complete‐arch implant‐supported frameworks in recently introduced polymers. Purpose: To evaluate the trueness and marginal fit of additively or subtractively manufactured polymer‐based complete‐arch implant‐supported frameworks, comparing with those of strength gradient zirconia frameworks. Materials and Methods: A typodont model with 4 implants (left first molar (abutment 1), left canine (abutment 2), right canine (abutment 3), and right first molar (abutment 4)) was digitized (ATOS Core 80 5MP) and an implant‐supported complete‐arch framework was designed. This design file was used to fabricate frameworks from 5 different materials: strength gradient zirconia (SM‐ZR), high impact polymer composite (SM‐CR), nanographene‐reinforced PMMA (SM‐GR), PMMA (SM‐PM), and additively manufactured temporary resin (AM) (n = 10). These frameworks were digitized and each scan file was virtually segmented into 4 regions (abutments, occlusal, overall without occlusal, and overall). The surface deviations at these regions, and linear and interimplant distance deviations were evaluated (Geomagic Control X). Marginal gaps were evaluated according to triple‐scan protocol after seating frameworks on the model with the 1‐screw test. Data were statistically analyzed (α = 0.05). Results: Surface deviations of all regions differed among tested materials (p ≤ 0.001). AM frameworks mostly had surface deviations that were similar to or lower than those of other materials (p ≤ 0.031), except for the occlusal surface, where it mostly had higher deviations (p ≤ 0.013). Abutment 4 of SM‐CR had higher linear deviations than abutment 2 (p = 0.025), and material type did not affect the linear deviations within abutments (p ≥ 0.171). Interimplant distance deviations differed within and among materials (p ≤ 0.017), except for those between abutments 1 and 2 among materials (p = 0.387). Marginal gaps of subtractively manufactured materials differed among abutments, while those of abutments 3 and 4 differed among materials (p ≤ 0.003). AM frameworks mostly had lower marginal gaps at abutments 3 and 4 (p ≤ 0.048). Conclusions: Although there was no clear trend among tested materials for measured deviations, marginal gaps of additively manufactured resin were mostly lower than those of subtractively manufactured materials and did not differ among abutment sites. Nevertheless, the differences in measured deviations among materials were small and marginal gaps were within the previously reported acceptability thresholds. [ABSTRACT FROM AUTHOR]

This report of four clinical cases aims to illustrate the use of a lateral implant as a solution for implant overdentures in the mandible in different clinical situations. The first two cases describe the clinical situations of patients wearing two‐implant mandibular overdentures until the failure of one of the implants, one due to implant loss and the other due to a fracture of an abutment screw, and how the conditions were managed. The third case illustrates the placement of a single implant to retain an overdenture, where a midline implant, as originally planned, was not feasible due to anatomic reasons. The final case describes the use of a lateral implant to support and retain a single‐implant mandibular overdenture. The four cases demonstrate that a single lateral implant can be utilized as sole retention in cases of a failing contra‐lateral implant and as an alternative to a single implant in the midline. [ABSTRACT FROM AUTHOR]

Statement of the Problem: The satisfaction of patients with dentures on implants has different points of view that become fundamental aspects for the development of research on the quality of life of these patients, the eventual biomechanical complications to which these prostheses and implants can be subjected, and design considerations for cantilever extensions. Purpose: The objective of research was to assess the implants and prosthesis survival rates, biomechanical complications relative to the length of the distal extensions (cantilevers), and the satisfaction of the patients with a fixed implant-supported full-arch fiber-reinforced composites prosthesis. Materials and Method: A retrospective clinical and radiographic cohort study was developed. Clinical records of a selected cohort were analyzed according to inclusion and exclusion criteria. Data on a patient who underwent to fixed implant-supported full-arch fiber reinforced composites prosthesis at least of five years of function were collected. Data analysis was performed using Kaplan-Meier curves and Fisher's Exact Test. P values less than 0.05 were considered statistically significant. Results: After insertion, 1 of 29 prostheses failed, the overall prosthetic survival rate observed at 5 years was 96.5%. Of the 120 implants placed in 28 patients, only 4 patients experienced loss of an implant during the 5 years of observation; the implant survival rate throughout the observation period was 86.2%. Distal extension seems to negatively affect the prognosis of implant-supported rehabilitation. Regarding the level of satisfaction of the patient with the prosthesis, none reported being uncomfortable or dissatisfied neither with their appearance nor with the taste of food throughout the studied period. Conclusion: No relevant associations were found between the variables involved. The study found the improvement in quality of life following the installation of fixed rehabilitation on the patients. Once the potential benefits of patients are obtained, controlled clinical trials are encouraged. [ABSTRACT FROM AUTHOR]

Statement of the Problem: The satisfaction of patients with dentures on implants has different points of view that become fundamental aspects for the development of research on the quality of life of these patients, the eventual biomechanical complications to which these prostheses and implants can be subjected, and design considerations for cantilever extensions.Purpose: The objective of research was to assess the implants and prosthesis survival rates, biomechanical complications relative to the length of the distal extensions (cantilevers), and the satisfaction of the patients with a fixed implant-supported full-arch fiber-reinforced composites prosthesis.Materials and Method: A retrospective clinical and radiographic cohort study was developed. Clinical records of a selected cohort were analyzed according to inclusion and exclusion criteria. Data on a patient who underwent to fixed implant-supported full-arch fiber-reinforced composites prosthesis at least of five years of function were collected. Data analysis was performed using Kaplan-Meier curves and Fisher's Exact Test. P values less than 0.05 were considered statistically significant.Results: After insertion, 1 of 29 prostheses failed, the overall prosthetic survival rate observed at 5 years was 96.5%. Of the 120 implants placed in 28 patients, only 4 patients experienced loss of an implant during the 5 years of observation; the implant survival rate throughout the observation period was 86.2%. Distal extension seems to negatively affect the prognosis of implant-supported rehabilitation. Regarding the level of satisfaction of the patient with the prosthesis, none reported being uncomfortable or dissatisfied neither with their appearance nor with the taste of food throughout the studied period.Conclusion: No relevant associations were found between the variables involved. The study found the improvement in quality of life following the installation of fixed rehabilitation on the patients. Once the potential benefits of patients are obtained, controlled clinical trials are encouraged.

Background: Angulated screw channel (ASC) abutment allows off-axis dental implants to be used in dental restorations without the need for cementation. As this is a relatively new system, research on its clinical performance is limited. Objectives: To summarize the available in-vitro and in-vivo studies on the mechanical and technical issues associated with the ASC system and compare its clinical performance with that of conventional implant-supported abutments. Methods: A comprehensive literature search in PubMed, Web of Science, and ScienceDirect databases was performed, focusing on articles about angulated (angled) screw channel (ASC) systems published in English between January 2015 and November 2023. Only in-vitro and in-vivo studies were included. Results: After analyzing the recorded articles, 26 studies (11 in vivo and 15 in vitro) were included in the final discussion and review. Conclusion: Although the ASC system is still relatively new, and is presently outperformed by conventional abutment systems in terms of technical and mechanical properties, in short- and medium-term in-vivo studies, it was shown reliable for retaining single or multiple-unit implant restorations in both posterior and anterior zones. Still, further long-term clinical research is needed to fully elucidate the risk factors associated with ASC failures.

Restorative material selection has become increasingly challenging due to the speed of new developments in the field of dental material science. The present narrative review gives an overview of the current indications for implant abutments and restoration materials for provisional and definitive implant‐supported fixed dental prostheses in partially edentulous patients. For single implant restorations, titanium base abutments for crowns are suggested as an alternative to the conventional stock‐ and customized abutments made out of metal or zirconia. They combine the mechanical stability of a metallic connection with the esthetic potential of ceramics. For multiple‐unit restorations, conical titanium bases especially designed for bridges are recommended, to compensate for deviating implant insertion axes and angulations. Even though titanium base abutments with different geometries and heights are available, certain clinical scenarios still benefit from customized titanium abutments. Indications for the definitive material in fixed implant restorations depend on the region of tooth replacement. In the posterior (not esthetically critical) zone, ceramics such as zirconia (3–5‐Ymol%) and lithium‐disilicate are recommended to be used in a monolithic fashion. In the anterior sector, ceramic restorations may be buccally micro‐veneered for an optimal esthetic appearance. Lithium‐disilicate is only recommended for single‐crowns, while zirconia (3–5‐Ymol%) is also recommended for multiple‐unit and cantilever restorations. Attention must be given to the specific mechanical properties of different types of zirconia, as some feature reduced mechanical strengths and are therefore not indicated for all regions and restoration span lengths. Metal‐ceramics remain an option, especially for cantilever restorations. [ABSTRACT FROM AUTHOR]

Angulated screw channel (ASC) abutment allows off-axis dental implants to be used in dental restorations without the need for cementation. As this is a relatively new system, research on its clinical performance is limited. To summarize the available in-vitro and in-vivo studies on the mechanical and technical issues associated with the ASC system and compare its clinical performance with that of conventional implant-supported abutments. A comprehensive literature search in PubMed, Web of Science, and ScienceDirect databases was performed, focusing on articles about angulated (angled) screw channel (ASC) systems published in English between January 2015 and November 2023. Only in-vitro and in-vivo studies were included. After analyzing the recorded articles, 26 studies (11 in vivo and 15 in vitro) were included in the final discussion and review. Although the ASC system is still relatively new, and is presently outperformed by conventional abutment systems in terms of technical and mechanical properties, in short- and medium-term in-vivo studies, it was shown reliable for retaining single or multiple-unit implant restorations in both posterior and anterior zones. Still, further long-term clinical research is needed to fully elucidate the risk factors associated with ASC failures. [ABSTRACT FROM AUTHOR]

Background: This research was designed to carry out a meta-analysis in order to evaluate the dissimilarities in the stability of alveolar bone round dental implants and implant failure between platform switching (PS) and platform mating (PM). Methods: The investigation utilized a comprehensive search strategy that incorporated controlled vocabulary (MeSH) and free-text terms. This search was performed by two reviewers to identify published systematic reviews. Three major electronic databases, including Medline via PubMed, the Cochrane database, and Embase, were searched up to November 2023. Results: Initially, 466 articles were identified, but only twelve studies met the criteria for inclusion in the meta-analysis. The results showed that the pooled mean difference for reducing marginal bone loss (MBL) was −0.60 (95% confidence interval (CI), −0.91 to −0.28; p < 0.01). A sensitivity analysis was conducted by excluding a single study, which yielded a result of −0.46 (95% CI, −0.66 to −0.25; p < 0.01). The test for overall effect was significant (p < 0.01), and it revealed that there were significant differences between subgroups. However, the meta-analysis on implant failure did not show a significant difference between PS and PM implants. Conclusions: In conclusion, the study found that PS implants are more effective in reducing MBL compared to PM implants. Nevertheless, no significant difference was observed in the long-term effectiveness of reducing MBL and implant failure rate. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to do a comprehensive systematic review on the comparison of digital and conventional workflows regarding prosthetic outcomes, accuracy of implant impressions, framework passivity and fit, and clinical fabrication of multi-unit implant-supported fixed restorations. Materials and Methods: The EMBASE, PubMed, Scopus, and Cochrane Library databases were searched for relevant articles published up until April 2020. Results: No in-vivo article was found to compare full digital and conventional workflows regarding the accuracy of implant impressions, passivity and fit of frameworks, and prosthetic outcomes. There was no study to investigate full digital and conventional workflows for clinical fabrication of multi-unit implantsupported fixed restorations. Conclusion: This empty review highlights the need for further research to compare full digital and conventional workflows for implant-supported restorations. [ABSTRACT FROM AUTHOR]

Patients often request oral rehabilitation after surgical resection. Here, a 19-year-old patient developed medication-related osteonecrosis of the jaw after treatment with antiresorptive therapy. After the surgical treatment for osteonecrosis, dental implants were discussed. While there is a known risk of provoking secondary osteonecrosis of the jaw in such cases, other factors should also be taken into account. This case report highlights the importance of close monitoring for patients with a history of medication that incurs a risk osteonecrosis', and the feasibility of dental implants on the surgical site in some conditions. Decisions relative to implant placement were made based on the patient's specific history, their present situation, and the potential options that were available. [ABSTRACT FROM AUTHOR]

Various factors influence marginal bone loss after implant placement. This study explored the association between marginal bone loss and posterior implants positioned at different bone levels. Computer records and radiographs of patients with at least 2 adjacent implants were retrieved. Cases were categorized into nonsplinted prosthesis and splinted prosthesis groups. Radiographic measurements were conducted at the time of abutment placement (T0), 1–3 years follow-up (T1), and the last visit (T2), measuring the vertical distance between adjacent implants. Multilevel linear regression models using generalized estimating equations were employed, with a significance level set at 5% (α = 0.05). Fifty-six patient records were included, comprising 120 implants: 84 nonsplinted (70%) and 36 splinted (30%). In the nonsplinted group, marginal bone loss progression significantly depended on crestal height differences. For the mesial sides of posterior implants, marginal bone loss measured 1.0 ± 0.6 mm from T0 to T1, 2.4 ± 1.1 mm from T1 to T2, and 3.4 ± 1.2 mm from T0 to T2. Similarly, the distal sides of the most anteriorly placed implant exhibited marginal bone loss of 1.0 ± 0.7 mm from T0 to T1, 2.4 ± 1.0 mm from T1 to T2, and 3.5 ± 1.2 mm from T0 to T2. Nonsplinted implants demonstrated a higher progression of marginal bone loss. This study suggests that nonsplinted implants may lead to a more pronounced progression of marginal bone loss, particularly concerning crestal height differences, underscoring the need for further research. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta-analysis aimed to evaluate the efficacy of two different loading methods in implant-supported removable prostheses (partial dentures and full-maxillary dentures). Methods: As of August 2023, three electronic databases and nine oral implant-related journals had been searched. Only randomised controlled trials (RCTs) that compare immediate loading with conventional loading in implant-supported removable prostheses were included. The primary outcome was the implant survival rate. At the same time, a meta-analysis of bone-level changes was performed. Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to evaluate the risk of bias in the included trials. Results: A total of 16 RCTs were included, including 543 participants with 1595 implants. The included trials compared immediate loading and conventional loading in implant-supported removable prostheses. Regarding implants as the statistical unit, the immediate loading group had a statistically significant lower survival rate (RR = 0.950; 95% confidence interval [CI], (0.926, 0.974); P = 0.027; I² = 47%). When patients were regarded as statistical units, a statistically significant lower survival rate was also observed in the immediate loading group (RR = 0.929; 95% CI, (0.897, 0.961); P = 0.590; I² = 0%). When we analysed the bone level changes, a statistically significant decrease was observed in bone level in the immediate loading group compared with the conventional loading group (weighted mean difference [WMD] = −0.127; 95% CI, (−0.195, −0.059); P

Background: Short implants have been used in the restoration of edentulous jaws in the past several years. However, some studies have suggested that short implants are less successful than standard implants. The aim of this study is to investigate the outcome of short implants placed in the posterior maxilla or mandible following one-stage or immediate-function protocols with a follow-up of 7 years (clinically) and 5 years (radiographically). Methods: This study included 127 patients rehabilitated with 217 implants measuring 7 mm and supporting 157 fixed prostheses in the posterior segments of both jaws. Final abutments were delivered at the surgery stage and were loaded after 4 months in 116 patients (199 implants). The primary outcome measure was implant survival measured through life tables. Secondary outcome measures were marginal bone loss and the incidence of biological and mechanical complications at the patient level and implant level (evaluated through descriptive statistics). Results: Twenty-four patients (18.9%) with 45 implants (20.7%) were lost to the follow-up. In total, 32 implants failed (14.8%) in 22 patients (17.3%), resulting in a cumulative survival rate at 7 years of 81.2% for 7 mm implants in the rehabilitation of the posterior regions of the maxilla and mandible. The average (standard deviation) marginal bone loss was 1.47 mm (0.99 mm) at 5 years. The incidence rate of biological complications was 12.6% and 10.6% at the patient and implant levels, respectively. The incidence rate of mechanical complications was 21.3% for patients and 16.1% for implants. A higher failure rate was registered in smokers and in implant arrangements with a sequence of three fixtures in proximity. Conclusions: Within the limitations of this study, it can be concluded that the placement of 7 mm long implants for the partial implant-supported rehabilitation of atrophic posterior jaws is possible in the long term, judging by the survival rate and stable average marginal bone loss. Nevertheless, strict case selection should be performed, especially in smokers and with implant arrangements that provide a minimum of one unit in inter-implant distance. [ABSTRACT FROM AUTHOR]

Abstract Background Ameloblastoma (AM), the benign counterpart of ameloblastic carcinoma, is a benign odontogenic tumor of epithelial origin, naturally aggressive, with unlimited growth potential and a high tendency to relapse if not adequately removed. Patients with AM treated surgically can benefit from dental implant therapy, promoting oral rehabilitation and improving their quality of life. The present study aimed to determine the survival rate of dental implants placed after surgical treatment of patients affected by AM. In addition, there were two secondary objectives: 1) To evaluate which dental implant loading protocols are most frequently used and 2) To determine the type of prosthetic restoration most commonly used in these patients. Methods The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the study. Searches were performed in three databases (PubMed/MEDLINE, Scopus, and Google Scholar) until November 2023. Additionally, the electronic search was enriched by an iterative hand search of journals related to oral pathology and medicine, maxillofacial surgery, and oral prosthodontics and implantology. Only reports and case series in English from January 2003 to date were included. The Joanna Briggs Institute tool (JBI-Case Reports/Case Series) was used for the study quality assessment. Results The total number of patients and implants studied were 64 and 271, respectively, all with surgically treated AM. The patient’s ages ranged from 8 to 79 years, with a mean (SD) age of 37.3 ± 16.4. Fifty-three percent were male and 47% were female. The range of follow-up duration was 1 to 22 years. An implant survival/success rate of 98.1% was reported. In addition, most of them were conventionally loaded (38.3%). Hybrid implant-supported fixed dentures were the most commonly used by prosthodontists (53%). Conclusions Oral rehabilitation with dental implants inserted in free flaps for orofacial reconstruction in surgically treated patients with AM can be considered a safe and successful treatment modality.

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Background: Ameloblastoma (AM), the benign counterpart of ameloblastic carcinoma, is a benign odontogenic tumor of epithelial origin, naturally aggressive, with unlimited growth potential and a high tendency to relapse if not adequately removed. Patients with AM treated surgically can benefit from dental implant therapy, promoting oral rehabilitation and improving their quality of life. The present study aimed to determine the survival rate of dental implants placed after surgical treatment of patients affected by AM. In addition, there were two secondary objectives: 1) To evaluate which dental implant loading protocols are most frequently used and 2) To determine the type of prosthetic restoration most commonly used in these patients. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the study. Searches were performed in three databases (PubMed/MEDLINE, Scopus, and Google Scholar) until November 2023. Additionally, the electronic search was enriched by an iterative hand search of journals related to oral pathology and medicine, maxillofacial surgery, and oral prosthodontics and implantology. Only reports and case series in English from January 2003 to date were included. The Joanna Briggs Institute tool (JBI-Case Reports/Case Series) was used for the study quality assessment. Results: The total number of patients and implants studied were 64 and 271, respectively, all with surgically treated AM. The patient's ages ranged from 8 to 79 years, with a mean (SD) age of 37.3 ± 16.4. Fifty-three percent were male and 47% were female. The range of follow-up duration was 1 to 22 years. An implant survival/success rate of 98.1% was reported. In addition, most of them were conventionally loaded (38.3%). Hybrid implant-supported fixed dentures were the most commonly used by prosthodontists (53%). Conclusions: Oral rehabilitation with dental implants inserted in free flaps for orofacial reconstruction in surgically treated patients with AM can be considered a safe and successful treatment modality. [ABSTRACT FROM AUTHOR]

This article presents the outcomes of prosthetic oral rehabilitation using CAD/CAM telescopic bar overdentures in patients with oral cancer (n = 3), severe facial trauma (n = 2), or various syndromes (n = 1), all suffering from severe tissue deficits and requiring complex and comprehensive oral rehabilitation. The aim was to assess the durability and functionality of implant-retained prosthetic structures, ensuring easy oral hygiene and minimizing specialized follow-up needs. The data for this study were sourced from a retrospective cohort at Helsinki University Hospital. The prosthetic reconstruction encompassed the Atlantis 2in1 and the Createch removable telescopic systems. Thus, 40 implants were placed (4 to 7 per patient), with prosthetic structures in the maxilla (n = 4 patients), in the mandible (n = 1), and in both jaws (n = 1). Two patients experienced no complications, two patients had part of the acrylic resin break, and one patient experienced loosening of the bar structure. All complications associated with prosthetic structures were successfully managed, and none of the implants were lost. The follow-up time ranged from 7 to 126 months. This rehabilitation is proved to be an effective solution for patients with complex oral conditions, facilitating both functional restoration and ease of maintenance. These findings underscore the importance of individualized treatment approaches in cases of tissue deficits. [ABSTRACT FROM AUTHOR]

Objective: Attachments are used for connections between overdentures and dental implants. The maintenance of attachment components plays an important role in optimal clinical service of overdentures. This study aimed to compare the effects of overdenture insertion by hand pressure versus placement by clenching the jaws on the retention and diameter of resilient attachments.Methods: Thirty patients with mandibular overdentures participated in this study. First, the patients were instructed to insert the overdentures with hand pressure. After 6 months, patients were recalled, the nylon matrix components of the attachments were replaced, and the patients were instructed to place the overdentures by clenching for the next 6 months. The retention and internal diameter of matrices were measured at baseline and at 6 and 12 months later. A universal testing machine was used to measure the residual retention, and a coordinate measuring machine was used to assess the matrix diameter. The retention loss and changes in matrix diameter were compared between the two techniques, using paired samples t-test.Results: The results showed that retention loss was lower in the hand placement method than in the clenching method (P

Purpose: The main objective of this study was to assess the influence of bone remodeling on late marginal bone loss in immediately loaded, implant-supported, complete-arch restorations and, secondarily, to determine its relationship to peri-implant disease occurrence using a multilevel analysis. Materials and Methods: A retrospective cohort study of patients treated consecutively in a private clinic with immediately loaded full-arch restorations with at least 12 months of follow-up was conducted. Bone remodeling and marginal bone loss were determined through measurements made on panoramic radiographs by two calibrated examiners. Peri-implant health status was diagnosed in a visit for peri-implant maintenance. Descriptive, bivariate, and multilevel analyses were performed with Stata/IC 15.1 software (StataCorp). Results: A total of 30 patients (11 men and 19 women, mean age: 63.3 ± 10.4 years), with a mean follow-up of 37.7 ± 19.6 months were included. Forty arches (20 maxillary and 20 mandibular) received 207 implants. Bone remodeling had an inversely proportional effect on marginal bone loss (P =.005) but was not related to peri-implantitis (P =.103; hazard rate [HR] = 2.1). Conclusion: Taking into account the limitations of this study, bone remodeling around immediately loaded dental implants supporting complete-arch restorations does not appear to increase marginal bone loss or peri-implantitis. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to compare the radiographic, esthetic, and patient-reported outcome measures (PROMs) between immediate and delayed restorations of immediately placed single implants in the maxillary esthetic zone. Materials and Methods: Forty patients with immediate single dental implants in the anterior maxilla were included in this study. Afterward, they were allocated either for immediate restoration with a provisional restoration (IR: 20 patients) or for a delayed restoration (DR: 20 patients). The evaluations were performed after 1 year of follow-up. Results: No implant and prosthetic failures were observed during the 1-year follow-up. Two minor complications were found in two IR patients; however, no complication was reported in the DR group during the 1 year. Nevertheless, this difference was not statistically significant (P > .05). After 1 year, the mean marginal bone level changes (MBL) were 0.47 ± 0.29 mm and 0.54 ± 0.21 mm for IR and DR, respectively. There was no statistically significant difference between the two groups in terms of MBL (P = .3). Notably, the mean total pink esthetic score (PES) and white esthetic score (WES) after 1 year of follow-up were 11.2 ± 1.1 (PES) and 8 ± 1.02 (WES) for the immediate restoration, and 10.2 ± 0.97 (PES) and 7.65 ± 1.20 (WES) for the delayed restoration. Also, no statistically significant difference was found between IR and DR in terms of esthetic scores (P > .05). The patient satisfaction of these two groups had no statistically significant difference, except for the esthetic factor (P = .04). Conclusion: The immediate restoration and preferred esthetic satisfaction had similar outcomes compared with the delayed restoration. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the clinical performance of implant-supported dental prostheses (ISDPs), this retrospective clinical study observed influencing factors on survival of the prostheses and necessary maintenance treatments during the observation time and complications of the dental implants. Materials and Methods: Patients who were provided either with fixed implant-supported dental prostheses (FISDPs) or telescopic-retained removable implant-supported dental prostheses (TR-RISDPs) were included in this retrospective clinical study. Potential influencing factors on the survival probability of the prostheses were observed using Kaplan-Meier analysis: patient sex, type of prosthesis, location, dentition in opposing arch, participation in follow-up visits, and whether the patient had a previous history of oral cancer. The type and number of maintenance treatments and complications of dental implants were also analyzed. Results: A collective of 473 patients who were provided with either FISDPs (n = 320) or TR-RISDPs (n = 153) and 1,499 implants were included in the study. 6.6% of the prostheses (24 FISDPs and 7 TR-RISDPs) had to be replaced, and 6.3% of the implants (n = 45) were lost. The calculated 5-year survival probabilities were 87.4% for FISDPs and 95.5% for TR-RISDPs. FISDPs in patients who also had ISDPs in the opposing arch showed the lowest survival probabilities (P < .05). TR-RISDPs in patients who regularly attended follow-up visits showed the highest survival rates (P < .05). Maintenance treatments had to be performed at an earlier stage for patients with TR-RISDPs, and especially for TR-RISDPs located in the mandible (P < .05). Conclusion: FISDPs and TR-RISDPs showed good survival rates in this study. However, when planning FISDPs, the dentition in the opposing arch should be considered to prevent possible failure. TR-RISDPs indicate a higher need for aftercare measures, especially in the early years of function. Regular attendance of follow-up visits is still a decisive factor for success. [ABSTRACT FROM AUTHOR]

Background: This research was designed to carry out a meta-analysis in order to evaluate the dissimilarities in the stability of alveolar bone round dental implants and implant failure between platform switching (PS) and platform mating (PM). Methods: The investigation utilized a comprehensive search strategy that incorporated controlled vocabulary (MeSH) and free-text terms. This search was performed by two reviewers to identify published systematic reviews. Three major electronic databases, including Medline via PubMed, the Cochrane database, and Embase, were searched up to November 2023. Results: Initially, 466 articles were identified, but only twelve studies met the criteria for inclusion in the meta-analysis. The results showed that the pooled mean difference for reducing marginal bone loss (MBL) was −0.60 (95% confidence interval (CI), −0.91 to −0.28; p < 0.01). A sensitivity analysis was conducted by excluding a single study, which yielded a result of −0.46 (95% CI, −0.66 to −0.25; p < 0.01). The test for overall effect was significant (p < 0.01), and it revealed that there were significant differences between subgroups. However, the meta-analysis on implant failure did not show a significant difference between PS and PM implants. Conclusions: In conclusion, the study found that PS implants are more effective in reducing MBL compared to PM implants. Nevertheless, no significant difference was observed in the long-term effectiveness of reducing MBL and implant failure rate.

Background: Few studies assessed the effect of coping material (particularly milled metal copings) on the retentive strength of cements and reported contradictory results. Thus, this study aims to assess the marginal leakage and retentive strength of implant-supported milled zirconia and cobalt-chromium (Co-Cr) copings cemented with different temporary cements. Materials and Methods: In this in vitro study, Zirconia and Co-Cr copings were fabricated on 100 straight titanium abutments. Each group of copings was divided into five subgroups (n = 10) for the use of different cements: permanent zinc-phosphate (ZP) cement, temporary zinc oxide eugenol cement (temp bond [TB]), calcium hydroxide-based temporary cement (Dycal [DC]), polymer-based eugenol-free acrylic-urethane temporary cement (Dentotemp [DT]), and methacrylate-based temporary cement (Implantlink [IL]). The retentive strength and marginal leakage of restorations were assessed. Data were analyzed by one-way ANOVA, Tukey, and Fisher's exact tests (α = 0.05). Results: In the Co-Cr group, the retentive strength values (in Newtons) were as follows: ZP (411.40 ± 5.19) >DC (248.80 ± 5.01) >IL (200.10 ± 5.06) >DT (157.90 ± 5.19) >TB (98.50 ± 6.88). This order was as follows in the zirconia group: ZP (388.70 ± 5.35) >DC (226.60 ± 5.08) >IL (179.00 ± 3.71) >DT (136.00 ± 4.88) >TB (78.60 ± 3.50). All pairwise comparisons were statistically significant (P < 0.001). The difference in marginal leakage was not significant among the groups (P = 0.480). Conclusion: The type of coping material and cement type significantly affected retentive strength, but not marginal leakage, of implant restorations. Milled Co-Cr copings showed higher retentive strength than zirconia copings, and ZP cement followed by DC yielded the highest retention. [ABSTRACT FROM AUTHOR]

The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1–LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1—where masticatory forces covered the entire mesio−distal surface of the denture, including the cantilever—was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97–15.87% and 87.96–94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance. [ABSTRACT FROM AUTHOR]

This in vitro study aimed to assess the presence of microgaps at the implant–abutment interface in monolithic zirconia partial implant-supported fixed prostheses on transepithelial abutments versus Ti-base abutments. Methods: Sixty conical connection dental implants were divided into two groups (n = 30). The control group consisted of three-unit bridge monolithic zirconia connected to two implants by a transepithelial abutment. The test group consisted of monolithic zirconia three-unit restoration connected to two implants directly by a titanium base (Ti-base) abutment. The sample was subjected to thermocycling (10,000 cycles at 5 °C to 55 °C, dwelling time 50 s) and chewing simulation (300,000 cycles, under 200 N at frequencies of 2 Hz, at a 30° angle). The microgap was evaluated at six points (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual) of each implant–abutment interface by using a scanning electron microscope (SEM). The data were analyzed using the Mann–Whitney U tests (p > 0.05). Results: The SEM analysis showed a smaller microgap at the implant–abutment interface in the control group (0.270 μm) than in the test group (3.902 μm). Statistically significant differences were observed between both groups (p < 0.05). Conclusions: The use or not of transepithelial abutments affects the microgap size. The transepithelial abutments group presented lower microgap values at the interface with the implant than the Ti-base group in monolithic zirconia partial implant-supported fixed prostheses. However, both groups had microgap values within the clinically acceptable range. [ABSTRACT FROM AUTHOR]

Aim: To compare and report on the performance of implant‐supported fixed dental prostheses (iFDPs) fabricated using additive (AM) or subtractive (SM) manufacturing. Methods: An electronic search was conducted (Medline, Embase, Cochrane Central, Epistemonikos, clinical trials registries) with a focused PICO question: In partially edentulous patients with missing single (or multiple) teeth undergoing dental implant therapy (P), do AM iFDPs (I) compared to SM iFDPs (C) result in improved clinical performance (O)? Included were studies comparing AM to SM iFDPs (randomized clinical trials, prospective/retrospective clinical studies, case series, in vitro studies). Results: Of 2′184 citations, no clinical study met the inclusion criteria, whereas six in vitro studies proved to be eligible. Due to the lack of clinical studies and considerable heterogeneity across the studies, no meta‐analysis could be performed. AM iFDPs were made of zirconia and polymers. For SM iFDPs, zirconia, lithium disilicate, resin‐modified ceramics and different types of polymer‐based materials were used. Performance was evaluated by assessing marginal and internal discrepancies and mechanical properties (fracture loads, bending moments). Three of the included studies examined the marginal and internal discrepancies of interim or definitive iFDPs, while four examined mechanical properties. Based on marginal and internal discrepancies as well as the mechanical properties of AM and SM iFDPs, the studies revealed inconclusive results. Conclusion: Despite the development of AM and the comprehensive search, there is very limited data available on the performance of AM iFDPs and their comparison to SM techniques. Therefore, the clinical performance of iFDPs by AM remains to be elucidated. [ABSTRACT FROM AUTHOR]

Objective: Attachments are used for connections between overdentures and dental implants. The maintenance of attachment components plays an important role in optimal clinical service of overdentures. This study aimed to compare the effects of overdenture insertion by hand pressure versus placement by clenching the jaws on the retention and diameter of resilient attachments. Methods: Thirty patients with mandibular overdentures participated in this study. First, the patients were instructed to insert the overdentures with hand pressure. After 6 months, patients were recalled, the nylon matrix components of the attachments were replaced, and the patients were instructed to place the overdentures by clenching for the next 6 months. The retention and internal diameter of matrices were measured at baseline and at 6 and 12 months later. A universal testing machine was used to measure the residual retention, and a coordinate measuring machine was used to assess the matrix diameter. The retention loss and changes in matrix diameter were compared between the two techniques, using paired samples t-test. Results: The results showed that retention loss was lower in the hand placement method than in the clenching method (P<0.001). The two insertion methods were not significantly different regarding the amount of diameter increase (P=0.074). Conclusions: The residual retention of the matrices was significantly greater in the hand placement of overdentures along the longitudinal attachment axis, which may result in greater efficacy and longevity of implant overdentures. [ABSTRACT FROM AUTHOR]

This patient series reports the outcomes of CAD/CAM prosthetic reconstructions in patients with cleft lip and palate (n = 9, aged 27 to 76) who have experienced significant failure with conventional restorative and fixed prosthodontic treatments. The objective of the protocol is to establish a functional and patient-friendly prosthetic structure for individuals with unilateral/bilateral cleft lip and palate (UCLP/BCLP) while minimising the requirement for specialised follow-up care in the cleft unit. The study data were obtained from a retrospective cohort at Helsinki University Hospital. Prosthetic reconstructions were performed using CAD/CAM bar structures by the Atlantis 2in1 system or Createch removable telescope structures, supported by four to eight maxillary dental implants. Out of the nine patients, seven experienced no complications. One prosthesis fracture occurred after 16 months due to a design error in the original framework, and one patient experienced failure of osseointegration in a dental fixture (specifically, one fixture out of the eight maxillary implants in this patient). In total, 56 implants were successfully placed. The maxillary dentition of elderly patients with cleft lip and palate often poses challenges due to periodontal and reconstructive issues. An implant-supported CAD/CAM bar with a removable telescope suprastructure offers an easily maintained and functional solution for dental rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the effects of two restorative materials with different stiffness on peri-implant bone microstrain and implant micromovements during occlusal loading in implant-supported single and adjacent splinted crowns. Materials and Methods: Two 3 × 10-mm implants were inserted into the tibia of four rabbits. During the osseointegration process, prosthetic restorations were performed. Before suturing the flap, each implant's position and direction were obtained by fastening two splinted transfer abutments, onto which implant analogs were placed and fastened; the splinted transfer abutments were subsequently unfastened. Splinted transfer abutment/analog complexes were cast using type IV plaster to obtain eight different working models. Two single mandibular premolar crowns of monolithic zirconia and acrylate polymer composite were generated using CAD/CAM technology, and 16 adjacent splinted crowns (eight of each material) with the same design were also generated. After 6 weeks of implant osseointegration, the animals were sacrificed. Tibial sections with the implants were extracted, and prosthetic restorations (performed during implant osseointegration) were fastened to the implants. Static loading tests were performed with 100-N force application and an inclination of 6 degrees over the central fossa of the premolars. Implant micromovement was measured using an image analysis technique. Bone microstrain was quantified using two strain gauges placed on the crestal bone around the implants. Data were analyzed using two-way analysis of variance. Results: The mean implant micromovement values were lower for monolithic zirconia single and splinted crowns (61.5 ± 26.3 µm and 57.7 ± 8.8 µm, respectively) than for acrylate polymer composite-based single and splinted crowns (78.9 ± 37.3 µm and 59.61 ± 11.5 µm, respectively). No significant differences between the materials were noted. Bone microstrain around the implants was lower for splinted crowns (303.7 ± 281.3 µe for acrylate polymer composite; 312.4 ± 226.8 µe for monolithic zirconia) than for single crowns (539.7 ± 8.8 µe for acrylate polymer composite; 574.6 ± 271.9 µe for monolithic zirconia). Conclusion: Using restorative materials of different stiffness did not significantly affect the micromovement of already-osseointegrated implants supporting single or splinted crowns. Independent of material stiffness, single crowns transfer significantly more microstrain than splinted crowns. [ABSTRACT FROM AUTHOR]

To evaluate the resistance to fracture in cantilevered fixed dental prostheses (cFDPs) of single implant-supported zirconia cantilevers in the anterior region. Materials and Methods: Thirty-two cemented and solely screw-retained cFDPs consisting of an implant-supported crown replacing the central incisor and an attached cantilever unit in the position of the lateral incisor in the maxilla were constructed by computer-aided design (CAD) and machined by computer-aided manufacturing (CAM). For the cemented solution, a cFDP was designed on top of a customized abutment luted to an adhesive base. For screw-retained cFDPs, abutment, cement gap, and restoration of the cementable design were combined. All cFDPs were veneered manually on the facial side. Half of the samples underwent artificial aging (thermocycling and chewing simulation) before fracture tests were conducted with loads applied to the pontic either parallel to the implant axis (axial loading on the pontic) or tilted lingually by α = 45 degrees (oblique loading on the pontic). Thus, there were eight groups differing in cFDP design, artificial aging, and load application (n = 8/group). If fracture (Fu,total) occurred within the implant components, the adhesive base was replaced by a cast CoCr base, and the cFDP’s fracture resistance (Fu,cFDP) was also determined. Using statistical analyses (SPSS 24, IBM), factors affecting fracture resistance were identified. Results: Fu,total was mainly correlated to screw fractures and therefore not affected by cFDP design. Oblique loading on the pontic (Fu,total = 231 N – 352 N), however, led to a significant (P < .001) decrease in ultimate load compared with axial loading on the pontic (Fu,total = 611 N – 815 N). In relation to Fu,total, Fu,cFDP was approximately twice as high for both loading conditions. Conclusion: When relating the results to maximum occlusal forces exerted in the maxillary anterior region, single implant-supported cFDPs can be a viable restorative treatment option. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the significance of the connector type on stress dissemination within the tooth‐implant‐supported fixed dental prostheses in the mandibular posterior region with different combinations of implant diameter and length by means of finite element analysis (FEA). Materials and Methods: Six models of different designs for tooth‐implant fixed dental prosthesis (FDPs) were simulated and divided into two main groups. Implant lengths were 10, 11.5, and 13 mm while implant diameters were 3.7, 4.7, and 5.7 mm. The main difference between the groups was the connector type. Models were evaluated using 3D FEA (Solidworks Premium 2018 × 64 Edition). Group A tooth‐implant FDPs (5.7 mm × 10 mm) had a mesial and distal rigid connector while group B tooth‐implant FDPs (3.7 mm × 10 mm, 3.7 mm × 11.5 mm, 3.7 mm × 13 mm, 4.7 mm × 10 mm and 5.7 mm × 10 mm) had a mesial non‐rigid connector in their design between the pontic and the tooth. Models were analyzed to determine the magnitude of von Misses Stresses at six specific zones (fixed dental prosthesis, bone around distal implant, bone around tooth, cementum, periodontal ligament, implant) under vertical occlusal loading of 100 N after meshing and assigning the material properties. Results: Stress values around the supporting bone were significantly higher in Group B (tooth‐implant FDP with non‐rigid connection) when compared to Group A (tooth‐implant FDP with rigid connection). Also, the stresses measured at the FDP level showed that the rigid connection group (5.7 mm × 10 mm) exhibited 26% lower stress values when compared to the non‐rigid group (5.7 mm × 10 mm). Conclusions: Implant‐tooth FDPs with rigid connector design using the combination of implant diameter and length (5.7 mm × 10 mm) demonstrated a better design modality thus predicting a higher success rate and more longevity than using the non‐rigid connection option. [ABSTRACT FROM AUTHOR]

Background: Abutment screw loosening is a common complication of implant supported prostheses, especially for single crowns. In engineering, anaerobic adhesives (AA) are used to provide chemical locking between screw surfaces, but their application in implantology remains unclear. Purpose: The purpose of this article is to evaluate, in vitro, the effect of AA on counter‐torque of abutment screws for cemented prosthesis on dental implants with external hexagon connection (EHC) and conical connection (CC). Materials and methods: Sample was composed by 60 specimens, 30 dental implants with EHC and 30 with CC. Abutments (transmucosal 3 mm straight universal abutment) were installed without AA (control group) or with application of AA with two different adhesive strength: medium strength (LOCTITE® 242) and high strength (LOCTITE® 277). The specimens were subjected to mechanical cycling at 37°C, with a load setting of 133 N, a 1.3 Hz frequency, and 1 200 000 cycles. The abutments were removed, and the counter‐torque values were registered. Screws and implants were inspected using a stereomicroscope to verify the presence of residual adhesive and damage the internal structures. The data were analyzed using descriptive statistics and comparison tests (p < 0.05). Results: Comparing to the torque of installation, the medium strength AA kept the counter‐torque values for CC implants and the high strength AA kept the counter‐torque for EHC implants and increased for CC implants. In the intergroup comparisons, control group presented significantly lower counter‐torque values than other groups, both for EHC and CC implants. High strength AA presented similar results to medium strength AA in the EHC implants, but in the CC implants presented higher counter‐torque values. Damage in threads was more frequent in the groups that received high strength AA. Conclusion: The use of AA increased the counter‐torque of abutment screws, both in implants with EHC and CC. [ABSTRACT FROM AUTHOR]

Objectives: To assess dental implant placement accuracy with a dynamic computer‐assisted implant surgery (dCAIS) system and a freehand approach. Secondarily, to compare the patients' perception and quality of life (QoL) with the two approaches. Methods: A double‐arm randomized clinical trial was conducted. Consecutive partially edentulous patients were randomly allocated to the dCAIS or standard freehand approach groups. Implant placement accuracy was evaluated by overlapping the preoperative and postoperative Cone Beam Computer Tomographs (CBCT) and recording linear deviations at the implant apex and platform (in mm) and angular deviations (in degrees). Questionnaires recorded self‐reported satisfaction, pain and QoL during surgery and postoperatively. Results: Thirty patients (22 implants) were enrolled in each group. One patient was lost to follow‐up. A significant difference (p <.001) in mean angular deviation was found between the dCAIS (4.02°; 95% CI: 2.85 to 5.19) and the FH (7.97°; 95% CI: 5.36 to 10.58) groups. Linear deviations were significantly lower in the dCAIS group, except for the apex vertical deviation, where no differences were found. Although dCAIS took 14 min longer (95% CI: 6.43 to 21.24; p <.001), patients in both groups considered the surgical time acceptable. Postoperative pain and analgesic consumption during the first postoperative week were similar between groups and self‐reported satisfaction was very high. Conclusion: dCAIS systems significantly increase the accuracy of implant placement in partially edentulous patients in comparison with the conventional freehand approach. However, they increase the surgical time significantly and do not seem to improve patient satisfaction or reduce postoperative pain. [ABSTRACT FROM AUTHOR]

Aim: Dental implants have been shown to be a safe alternative for the replacement of missing teeth since they present few complications. These are related, among other elements, to the type of connection with which the abutments and attachments are joined to the implant. For this reason, in this study we performed an overview of systematic reviews with FRISBEE methodology on the use of internal connections compared to external connections of dental implants for the treatment of single, partial, or total rehabilitation. Materials and Methods: We performed a systematic search in the Epistemonikos database. We extracted data from the included systematic reviews, reanalyzed data of primary studies, and generated a summary of findings table. We used RevMan 5.3 and GRADEpro for data analysis and data presentation. Eleven systematic reviews were included after full-text screening, which had thirty-three clinical trials. Results: The outcomes were analyzed: mechanical complication (RR: 0.64), biological complications (RR: 1.01), survival (RR: 0.99), and mean marginal bone loss (MD: 0.3 mm lower). Conclusion: The use of internal connections in dental implants could lead to less marginal bone loss and fewer mechanical complications than implants with external connections, however, the confidence in the effect is limited due to a low certainty of evidence for both outcomes. Additionally, results show that different implant connections do not have an impact on dental implant survival and biological complication rates, with a moderate and low certainty of evidence, respectively. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the accuracy of zygomatic implant placement using customized bone-supported laser-sintered titanium templates. Pre-surgical computed tomography (CT) scans allowed to develop the ideal virtual planning for each patient. Direct metal laser-sintering was used to create the surgical guides for the implant placement. Post-operative CT scans were taken 6 months after surgery to assess any differences between the planned and placed zygomatic implants. Qualitative and quantitative three-dimensional analyses were performed with the software Slicer3D, recording linear and angular displacements after the surface registration of the planned and placed models of each implant. A total of 59 zygomatic implants were analyzed. Apical displacement showed a mean movement of 0.57 ± 0.49 mm on the X-axis, 1.1 ± 0.6 mm on the Y-axis, and 1.15 ± 0.69 mm on the Z-axis for the anterior implant, with a linear displacement of 0.51 ± 0.51 mm on the X-axis, 1.48 ± 0.9 mm on the Y-axis, and 1.34 ± 0.9 mm on the Z-axis for the posterior implant. The basal displacement showed a mean movement of 0.33 ± 0.25 mm on the X-axis, 0.66 ± 0.47 mm on the Y-axis, and 0.58 ± 0.4 mm on the Z-axis for the anterior implant, with a linear displacement of 0.39 ± 0.43 mm on the X-axis, 0.42 ± 0.35 mm on the Y-axis, and 0.66 ± 0.4 mm on the Z-axis for the posterior implant. The angular displacements recorded significative differences between the anterior implants (yaw: 0.56 ± 0.46°; pitch: 0.52 ± 0.45°; roll: 0.57 ± 0.44°) and posterior implants (yaw: 1.3 ± 0.8°; pitch: 1.3 ± 0.78°; roll: 1.28 ± 1.1°) (p < 0.05). Fully guided surgery showed good accuracy for zygomatic implant placement and it should be considered in the decision-making process. [ABSTRACT FROM AUTHOR]

Aim: To assess the esthetic and clinical performance of a novel self‐tapping implant system for single‐tooth restorations in the esthetic zone after immediate placement and provisionalization. Materials and Methods: This cross‐sectional study included 52 patients contributing a total of 52 immediately placed and restored implants with ≥12 months after functional loading, comparing two different implant systems: Straumann® BLX (Institut Straumann AG, Basel, Switzerland; 25 patients) and Ankylos® (Dentsply Sirona, Hanau, Germany; 27 patients). As the primary outcome measure, peri‐implant tissue esthetics were assessed by means of pink esthetics score (PES) rated by three independent clinicians. Moreover, as secondary outcome measures, the peri‐implant tissue health was assessed by means of bleeding on probing, probing depth, and suppuration. Apart from that, the modified plaque index, keratinized mucosa width, and the presence of mucosal recessions were also assessed. When clinical signs suggested the possibility of peri‐implantitis, radiographs were indicated to assess progressive bone loss. Results: The mean PES ratings were 12.10 ± 1.10 for Ankylos versus 11.2 ± 1.86 for BLX, both achieving good esthetic results without significant differences (p = 0.143). There were no differences among most clinical parameters (plaque, bleeding on probing, probing depth, peri‐implant mucosal recession), although peri‐implant mucositis was present in one‐third of the cases. The inter‐rater agreement on esthetics was not significant (p < 0.250). Conclusion: Within the limitations of the present study, it was concluded that the use of either BLX or Ankylos implant systems was associated to comparable peri‐implant health and good pink esthetic outcomes during immediate implantation and restoration protocols, for at least 12 months. [ABSTRACT FROM AUTHOR]

Purpose: Implant-supported fixed complete dentures (IFCD) experience failures and complications related to biological and technical risk factors. This study investigated the effect of biomechanical variables of IFCD on 1-year peri-implant bone loss at the buccal, palatal/lingual, mesial, and distal implant sides. A new method was used to measure the geometric biomechanical variables of IFCD using cone beam computed tomography (CBCT). Methods: The study sample consisted of 246 external hexagon implants supporting 48 hybrid IFCD in 44 patients. CBCT images obtained immediately (T0) and 1 year (T1) after prosthesis installation were used to measure the support polygon area, clinical crown/implant (C/I) ratio (vertical lever), anteroposterior power and resistance arms, anterior and posterior cantilevers (horizontal levers), and peri-implant bone remodeling (T1-T0). Data were analyzed using multilevel multivariable models. Results: The average total bone loss in the mandible and maxilla were 0.88 mm, with a loss of 0.62 mm in the mandible and 1.08 mm in the maxilla. The C/I ratio had a significant effect on bone loss on the mesial, distal, and palatal/lingual sides (P <.05). The anterior cantilever had a protective effect on the lingual side of the anterior implant. No effect on bone loss was found for the support polygon area, posterior cantilever, resistance arm, or power arm (P >.05). Conclusions: The results suggest that the C/I ratio and anterior cantilever in IFCD affect peri-implant bone loss according to the implant side and position in the arch. [ABSTRACT FROM AUTHOR]

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Statement of the Problem: In most cases, insertion of single implants with a standard diameter is used to replace a molar tooth but placing two implants with a narrow diameter seems to be a viable treatment modality to withstand functional and biomechanical forces. Purpose: This study aimed to evaluate and compare stress distribution in the bone surrounding a single molar area rehabilitated by a single implant versus two implants with a narrow diameter. Materials and Method: The study was conducted by computer-aided in vitro modeling. The initial model used a single implant, 4.8 mm wide in diameter, inserted with a 3.9-mm distance from both sides and 12.6-mm mesiodistal space. The second model used two 3.3- mm narrow-sized implants with a 3-mm distance from one another, 1.5 mm from both sides, and a 12.6-mm mesiodistal space. Following the completion of these models, a 100-N force was exerted obliquely, once in three locations and once in the mesial aspect of the implant supported crown. Stress distribution was then measured using finite element analysis (FEA) with ANSYS Workbench software package in both models. Results: The maximum stress in the bone around the single implant was less than that around double implants. The maximum stress of cortical bone in three-point loading was lower than mesial loading either in one (146.7 vs. 126.72 MPa) or two implants model (186.8 vs. 139.24). Conclusion: According to the results, because of more cortical bone contact area, the stress of surrounding bone in wide implant was decreased. [ABSTRACT FROM AUTHOR]

Purpose: To determine the survival rate, incidence of prosthetic complications, and patient satisfaction of implant fixed complete dental prostheses (IFCDPs) after a mean observation period of 1.4 years. Materials and methods: Twenty‐eight (28) eligible participants were recruited according to specific inclusion and exclusion criteria. The definitive metal‐acrylic resin IFCDPs consisted of titanium bars veneered with acrylic resin and acrylic denture teeth. Prosthodontic complications, divided into major and minor, were monitored. Parameters such as gender, jaw location, bruxism, and occlusal scheme were evaluated. Moreover, a questionnaire was administered throughout the study to assess patient satisfaction. Poisson regression as well as repeated measures ANOVA were used for statistical analysis. Results: Fourteen (14) males and 14 females were enrolled and followed‐up at 3, 6, and 12 months. All IFCDPs survived (100% survival rate). The most frequent minor complication was the loss of material used to close the screw access hole (20% out of total complications). The most frequent major complication was chipping of the acrylic denture teeth (77.14% out of total complications). Gender (p = 0.008) and bruxism (p = 0.030) were significant predictors for the total major complications (major wear and major chipping) while occlusal scheme was a significant predictor for major chipping events (p = 0.030). Conclusions: While IFCDPs demonstrated high prosthetic survival rates, they also exhibited a high number of chipping events of the acrylic veneering material, especially in males, bruxers, and individuals with canine guidance occlusion. However, the occurrence of these prosthetic complications did not negatively affect patient satisfaction. [ABSTRACT FROM AUTHOR]

Digital applications have changed therapy in prosthodontics. In 2017, a systematic review reported on complete digital workflows for treatment with tooth-borne or implant-supported fixed dental prostheses (FDPs). Here, we aim to update this work and summarize the recent scientific literature reporting complete digital workflows and to deduce clinical recommendations. A systematic search of PubMed/Embase using PICO criteria was performed. English-language literature consistent with the original review published between 16 September 2016 and 31 October 2022 was considered. Of the 394 titles retrieved by the search, 42 abstracts were identified, and subsequently, 16 studies were included for data extraction. A total of 440 patients with 658 restorations were analyzed. Almost two-thirds of the studies focused on implant therapy. Time efficiency was the most often defined outcome (n = 12/75%), followed by precision (n = 11/69%) and patient satisfaction (n = 5/31%). Though the amount of clinical research on digital workflows has increased within recent years, the absolute number of published trials remains low, particularly for multi-unit restorations. Current clinical evidence supports the use of complete digital workflows in implant therapy with monolithic crowns in posterior sites. Digitally fabricated implant-supported crowns can be considered at least comparable to conventional and hybrid workflows in terms of time efficiency, production costs, precision, and patient satisfaction. [ABSTRACT FROM AUTHOR]

This article presents the outcomes of prosthetic oral rehabilitation using CAD/CAM telescopic bar overdentures in patients with oral cancer (n = 3), severe facial trauma (n = 2), or various syndromes (n = 1), all suffering from severe tissue deficits and requiring complex and comprehensive oral rehabilitation. The aim was to assess the durability and functionality of implant-retained prosthetic structures, ensuring easy oral hygiene and minimizing specialized follow-up needs. The data for this study were sourced from a retrospective cohort at Helsinki University Hospital. The prosthetic reconstruction encompassed the Atlantis 2in1 and the Createch removable telescopic systems. Thus, 40 implants were placed (4 to 7 per patient), with prosthetic structures in the maxilla (n = 4 patients), in the mandible (n = 1), and in both jaws (n = 1). Two patients experienced no complications, two patients had part of the acrylic resin break, and one patient experienced loosening of the bar structure. All complications associated with prosthetic structures were successfully managed, and none of the implants were lost. The follow-up time ranged from 7 to 126 months. This rehabilitation is proved to be an effective solution for patients with complex oral conditions, facilitating both functional restoration and ease of maintenance. These findings underscore the importance of individualized treatment approaches in cases of tissue deficits.

Purpose: New solutions need to be developed for cases in which implants that were placed years ago are now presenting prosthetic complications. A conical head screw design for a single-tooth abutment was developed to preserve the initial applied torque. The aim of this study was to assess the preload maintenance of different screw design sets (a conical head screw set and a flat head screw set) for single-tooth abutments in external hexagon implants, verifying whether reverse torque changes after mechanical loading at different crown/implant ratios and to understand if the use of the tested conical head screw set design can help clinicians solve loosening torque. Materials and Methods: Forty external hexagonal implants, 40 single-tooth abutments, 20 conical head screws, and 20 flat head screws were split into four groups with different crown/implant ratios (crown/implant ratio > 1 or crown/implant ratio < 1). The abutments were attached to the implants by applying a torque of 35 Ncm; the specimens were mechanically loaded for 1 million cycles, and the loosening torque was checked and recorded with a digital torque wrench. The Kruskal-Wallis test (P = .05) and Wilcoxon test were performed to assess the results. Results: In all groups, at least one specimen kept 100% of the initial applied torque before mechanical loading (t0). After mechanical loading (t1), all specimens presented torque reduction. The Kruskal-Wallis test was performed, and the flat head screw t0 group presented lower torque maintenance and a significant difference (P < .05) compared with the initial applied torque and with the conical head screw t0 group. The conical head screw t0 group presented a higher torque maintenance and no significant difference (P > .05) compared with the initial applied torque. For the flat head screw, the crown/implant ratio affected the torque maintenance. For the conical head screw, the crown/implant ratio did not affect the torque maintenance (P > .05). Conclusion: The conical head screw set presented a higher maintenance of applied preload than the flat head screw set. As far as reverse torque is concerned, the crown/implant ratio affects the torque maintenance only in association with a flat head screw set. The use of the tested conical head screw set can help clinicians solve loosening torque, mainly in a situation with a crown/implant ratio > 1. [ABSTRACT FROM AUTHOR]

Purpose: This cohort study evaluated patient satisfaction for maxillary implant-retained overdentures (IODs) on two implants up to 4 years and assessed the treatment effect over time. Materials and Methods: Patients encountering problems with their conventional dentures were included and received maxillary IODs on two titanium-zirconium implants and ball anchors in the canine area. Patient satisfaction was assessed using the oral health impact profile (OHIP-20E) questionnaires both for dentures and IODs. Two months after insertion of IODs (baseline), the patients chose the preferred overdenture design with full or reduced palatal coverage. OHIP-20E questionnaires were followed according to the individual choice at 1 and 4 years, and outcomes were compared with baseline. Results: Sixteen out of 21 patients were evaluated at a mean follow-up of 4 years (range: 2.4 to 4.8 years). There was no significant difference in the OHIP domains for IODs at 1 year (OHIP_total_1y: 9.5, SD: 13.0) and 4 years (OHIP_total_4y: 14.2, SD: 19.1) compared with baseline (OHIP_total_BL: 12.4, SD: 14.7). Patients were most satisfied with social disability both for IODs (OHIP_BL: 6.0, SD: 7.6; OHIP_1y: 3.4, SD: 5.4; OHIP_4y: 5.7, SD: 9.5) and dentures (OHIP_CD_old: 28, SD: 29.7; OHIP_CD_new: 25.4, SD: 28.67). Patients were least satisfied with functional limitation both for IODs (OHIP_BL: 6.0, SD: 7.6; OHIP_1y: 3.4, SD: 5.4; OHIP_4y: 5.7, SD: 9.5) and dentures (OHIP_CD_old: 28, SD: 29.7; OHIP_CD_new: 25.4, SD: 28.67). Conclusion: Patient satisfaction with maxillary IODs on two implants did not change from baseline to 4 years and was high at 4 years of function. [ABSTRACT FROM AUTHOR]

This report details the successful prosthetic rehabilitation of a 25-year-old male patient with Papillon Lefèvre Syndrome (PLS) using an implant-supported hybrid prosthesis. Six implants were placed in the maxilla, and four were placed in the mandibular arch. All implants were inserted axially (non-tilted) and were planned to be loaded after a healing period of 6 months. One implant failed due to graft loss during the healing phase, which was removed and the remaining implants were restored with a hybrid prosthesis after 6 months, using the delayed loading protocol. The patient was followed-up for four years and all the remaining implants successfully integrated and remained fully functional during this period. The prosthesis significantly improved the functional, aesthetic, and psychological well-being of the patient. This case report is the first of its kind to use only four axially placed implants for rehabilitation of a PLS patient with a successful four-year follow-up.