Search

OBJECTIVES To assess the efficacy and safety of hyaluronic acid (HA) injections to restore the lost interproximal papilla. MATERIALS AND METHODS A systematic literature search was conducted in PubMed/MEDLINE, Scopus and Cochrane electronic databases with no time restriction up to September 2021. Any clinical study evaluating HA injection into the interproximal papilla loss Class I and II according to Norland & Tarnow, were included based on the following PICO questions (1) Are HA injections effective for the reconstruction of the interproximal papilla loss? (2) What are the side/adverse effects of using HA for the reconstruction of interproximal papilla loss? The risk of bias assessment was performed using the Cochrane Collaboration's the Newcastle Ottawa and Joanna Briggs institute tools. RESULTS A total of 1497 titles were retrieved. From these, eleven were included and underwent full data extraction. However, due to heterogeneity in the data among the included articles, a meta-analysis could not be performed. Three articles reported no-differences in term of papilla tip to contact point distance or the papilla fill reduction. Finally, five studies showed a reduction in the black triangle with a percentage range between 19 and 47%. CONCLUSION The non-surgical use of HA injection seems to have a positive effect on the re-establishment of interproximal papilla lost. However post-operative complications might develop.

Objective To assess the clinical performance of tooth implant–supported removable partial dentures in terms of abutment survival in relation to the attachment system used. Methods An electronic search in MEDLINE/PubMed Web of Science and Cochrane Central Register of Controlled Trials databases was performed. The methodological quality of the studies was assessed using the Newcastle–Ottawa Scale. Survival rates after 3 years and 5 years, loss, and complication rates per 100 years were estimated by Poisson regression. Results A total of twelve studies were included; eleven studies were used for the meta-analysis. Survival analysis for mixed attachments showed an estimated survival rate of 100% after 3 years and 5 years. For uniform attachments, the estimated survival rate was 99.3% after 3 years and 98.8% after 5 years. Tooth abutment survival analysis for mixed attachments estimated a survival rate of 95% after 3 years and 91.7% after 5 years: Uniform attachments reached a survival rate of 97.2% after 3 years and 95.4% after 5 years. The prosthetic survival rate was 100% for mixed and uniform abutments after 3 years and 5 years of function. Conclusions Tooth implant–supported removable partial dentures can be considered as a reliable option with excellent prosthetic and implant survival rates and favorable rates for the abutments after 3-year and 5-year follow-ups. Complications may be reduced when 5 or more abutments are used. Clinical relevance Tooth implant–supported removable partial dentures are a favorable and potential alternative to restore a partially edentulous arch by optimizing the number and distribution of abutments.

To evaluate the clinical performance of zirconia bars with distal extensions supporting mandibular implant overdentures based on biological and prosthodontic outcomes.Fifteen edentulous patients (seven women and eight men) were included in a pilot study. Each patient received two interforaminal implants and a mandibular implant overdenture supported by a CAD/CAM zirconia bar with distal extensions, giving a total of 30 implants. The bar design, biological outcomes (implant survival and peri-implant conditions), peri-implant bone level changes recorded on a panoramic radiograph and prosthodontic maintenance (bar fracture and maintenance of the attachment system) were assessed at a 1-year follow-up.After 1 year, all 15 zirconia bars with their corresponding prostheses and implants were successfully in situ with no prosthodontic maintenance required and no biological complications. One patient showed moderate mucosal hyperplasia around the bar. The peri-implant radiographic measurements revealed a stable marginal bone level, with a mean of 0.20 ± 0.67 mm. The mean total length of the bar segments was 41.9 mm (range 35.0 to 51.0 mm), 8.6 mm (range 7.2 to 10.6 mm) of which came from the length of the distal extension, resulting in a mean increase in rigid support of 71% (range 60% to 99%). The mean distal bar connector area was 9.7 mm2 (range 6.8 to 18.7 mm2).Zirconia bars with distal extensions for implant overdentures appear to be a reliable option for the prosthodontic rehabilitation of edentulous mandibles. A survival rate of 100% was observed for implants, bars and prostheses, with stable peri-implant bone levels, no biological complications and a low risk of prosthodontic maintenance being required.

To analyze the in vitro efficacy of a surface conditioning liquid facilitating ceramic repairs of saliva-contaminated metal-ceramic and all-ceramic restorations.Specimens constructed from nonprecious alloy (NPA), precious alloy (PA), lithium-disilicate (LD), zirconia (ZI), veneering ceramics for zirconia (VZI), veneering ceramics for lithium-disilicate (VLD), and veneering ceramics for metal alloys (VM) were manufactured (total: n = 168; each material n = 24). Veneering ceramic cylinders (thickness: 2 mm) were hand-layered on top of the specimens. Shear bond strength (SBS) tests were performed, measuring the maximum bond strength (MBS) of the cylinders on the specimens. Following this, the specimens were artificially aged and stored in artificial saliva for 30 days at 37°C. After physical cleaning using aluminum oxide air abrasion, a new surface conditioning liquid was applied (test, n = 84) or not (control, n = 84). New ceramic cylinders were hand-layered followed by a second SBS test. Descriptive statistics, linear regression analyses, and a one-sample t-test (α = 0.05) were used to ascertain the differences within (prerepair vs. postrepair) and between the groups.All specimens in the test group could be repaired, whereas 18 repairs in the control group failed. After the repairs, an MBS decrease was observed for the NPA specimens of the control group (-15.5 MPa, p = 0.004) but not among any of the test groups. Comparing the change in MBS between the test and control groups, the reduction was significantly higher in the repaired NPA specimens of the control group (mean difference 11.8 MPa, p = 0.017).Using the analyzed surface conditioning liquid, metal-ceramic and all-ceramic materials can be repaired, while some repairs failed without the liquid. The initial bond strengths between core and veneering materials could be restored in all specimens when the new surface conditioning liquid was applied.

According to the World Health Organization (WHO), the estimated number of older adults is around 962 million and is projected to increase to 2.1 billion by 2050. The oral frailty concept is associated with gradual oral function loss in relation to aging. There is a need to emphasize the improvement of oral function based on an evaluation of masticatory performance in patients with various oral conditions or systemic diseases and especially in the frail elderly. The present narrative review presents an overview of the current state of the assessment and improvement of masticatory performance in frail older people. To fully encompass oral frailty, oro-facial hypofunction, or oro-facial fitness, dental Patient Reported Outcomes (dPROs) should be included; nevertheless, there are limited evidence-based rehabilitation approaches. The concept of oral frailty, oro-facial hypofunction, or oro-facial fitness should involve dental Patient Reported Outcomes (dPROs), and in this sense, there are only a few evidence-based rehabilitation procedures to improve oro-facial hypofunction besides prosthodontics. It must be considered that reduced neuroplastic capacity in old individuals might preclude a positive outcome of these strategies that might need to be accompanied by functional training and nutritional counseling.

Multiple dental impactions not associated with craniofacial syndromes are a rare condition and present the dentist with a therapeutic challenge when it comes to performing surgical/restorative treatments in adult patients. This case report describes a geriatric patient with multiple impacted teeth restored by means of two different protocols. In the second quadrant, an impacted tooth was extracted followed by regeneration and placement of an implant. In the third quadrant, implants were placed though impacted teeth for restoration with a fixed partial prosthesis. Placing dental implants through impacted teeth may offer a possible therapeutic option for implant-supported restorations in middle-aged or elderly patients, for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery.

OBJECTIVE The purpose of this study was to evaluate the perception and role of orofacial esthetics by laypersons, and how attitudes may be correlated with age and gender in Switzerland. MATERIAL AND METHODS Self-administrated questionnaires (SAQ) were distributed both conventionally and digitally to Swiss residents over 16���years of age (range 16-99���years). The participants were identified in the medical practice, at an open house of the ZMK Bern, in elderly care centers, and via the internet (Facebook and Instagram). To verify that the participants were Swiss residents and laypersons, they were checked by an operator (conventional) or were provided an exact description of eligible participants at the beginning of the SAQ (digital). The SAQ included 30 questions with multiple-choice responses and visual analogue scales (0-100) divided into four sections regarding dental appearance with respect to body esthetics, partner selection, employment and career opportunities, and overall health/quality-of-life. For statistical analysis, respondents were segregated into two age groups (

OBJECTIVES To evaluate the effect of different amounts of triangular mesh reduction on the trueness of digitized complete-arch dentate and edentulous maxillectomy defects models. MATERIAL AND METHODS Twenty gypsum maxillectomy defect models (dentate and edentate group: n=10) were digitized using the Trios 3 intraoral scanner, scanning the teeth, mucosa and maxillectomy defect. These datasets (reference, R0) were saved as standard tessellation language (STL) files, and triangular mesh reduction was performed using Meshmixer's reduction tool. Digital test-datasets with file sizes reduced by 50%(R1), 75%(R2), and 90%(R3) were generated (each: n=20). Each test-dataset was compared to the R0 file using 3D evaluation software (GOM Inspect), applying automated pre-alignment followed by a global best-fit alignment, and root mean square (RMS) 3-dimensional (3D) deviations were calculated. Statistical analyses were performed, at a level of significance of ��=0.05. RESULTS The number of triangles, and STL file size were synchronized with each other and inversely proportional to the amount of mesh reduction. The resulting mean percentages of the STL file sizes were 50.00% for R1, 24.93% for R2, and 10.00% for R3. There were no 3D deviations at 50% triangular mesh reduction. The 3D deviations increased with the amount of mesh reduction: at 75% reduction the median deviations were lower (dentate:0.0016mm, IQR:0.0015-0.0018; edentate:0.0016mm, IQR:0.0015-0.0016), than at 90% (dentate:0.004mm, IQR:0.0038-0.0041; edentate:0.003mm, IQR:0.0036-0.0039). A statistically significant increase in 3D deviations was observed with higher degrees of mesh reduction (p

OBJECTIVE To assess the marginal and bacterial microleakage in zirconia and CAD-CAM or cast Co-Cr implant abutments. METHODS Sixty-four conical connection implants with their respective abutments were divided into four groups (Co-Cr (milled, laser-sintered and cast) and Zirconia (milled)). All specimens were subjected to a chewing simulation and thermocycling. After aging process, specimens were submerged in a 0.2% methylene blue solution with Porphyromonas gingivalis (P.g) for 48 h. The marginal microleakage was measured by using a 40× optical microscopy at the internal part of the implant, and when positive microleakage was observed, a DNA isolation with a polymerase chain reaction (PCR) test was used. The microbiological assessment was based on colony forming units (CFUs). RESULTS Thirty (47%) implant-abutments presented microleakage and the PCR was performed on those specimens (1 Zirconia, 1 Co-Cr milled, 14 Co-Cr laser-sintered and 14 cast). Seven specimens (1 Co-Cr laser-sintered and 6 cast) presented values below the PCR detection limit (

Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks of gestation from the University Hospital “Maggiore della Carità”, Novara, Italy. We assessed serum levels of vitamin D and oral health status through the following indexes: Oral Hygiene Index (OHI), Plaque Control Record (PCR), Gingival Bleeding Index (GBI), and Community Periodontal Index of Treatment Needs (CPTIN). Moreover, we assessed the number of PTB and LBW among the newborns. Out of 121 pregnant women recruited, 72 (mean age 29.91 ± 3.64 years) were included. There was a statistically significant correlation between preterm and OHI &gt, 3 (p = 0.033), and between LBW and OHI &gt, 3 (p = 0.005) and CPITN = 3 (p = 0.027). Both pregnant women with vitamin D deficiency ((25-hydroxy-vitamin D) &lt, 30 ng/mL) and PTB plus LBW newborns were significantly correlated (p &lt, 0.05) with poor levels of all oral health status indexes during pregnancy. Furthermore, these conditions (women with hypovitaminosis D and combination of PTB and LBW) were shown to be significantly correlated (p &lt, 0.001). Taken together, our findings reported a high prevalence of PTB and LBW with poor oral health and vitamin D deficiency in pregnant women.

The aim of this clinical report is to describe the use of the photogrammetric system and intraoral scanning as a reliable technique to record the 3-dimensional implant positions of a full-arch maxillary implant–supported fixed rehabilitation in which the implants were unfavorably positioned. The stereo camera of the photogrammetric system was used to capture the 3-dimensional panoramic position of the implants. The information on soft tissues was obtained with an intraoral scanner. Then, the 2 digital files (standard tessellation language [STL] files) were subsequently superimposed using a best-fit alignment function to generate the definitive digital model with information on teeth, soft tissues, and implants.

Background To investigate the preference and perception on intraoral scanning and impression making among dental students. Methods Final-year dental students from the 2019 and 2020 cohorts were invited to complete an online questionnaire via Google-Form. Their preference on the intraoral-scanning/impression making techniques and their perception on these techniques including the ease of defect identification, ease of infection control, need of chairside support, ease to master the technique as a beginner, efficiency in their hands and ease to handle the scanner software (yes/no) were collected. The results were analysed using McNemar tests and binary logistic regression test. All tests were performed at significance level α = 0.05. Results Ninety-seven students participated in this study with a response rate of 96.0 %. Eighty-one students (83.5 %) have tried intraoral scanning on peers. Fifty-three (54.6 %) students preferred intraoral-scanning and were categorized as Pro-scanning group. Forty-four (45.4 %) students either preferred impression-making (n = 21) or not sure (n = 23) were categorized as Others. More than half of students in both groups felt that intraoral-scanning is easier to identify defect, easier in infection control and require less chairside support. Higher proportion of students in the Pro-scanning group felt that intraoral-scanning requires less chairside support, easier to master as a beginner, more efficient in their hands and they can deal well with the scanner software than that in Others (P P = 0.000). Conclusions While intraoral scanning has perceived advantages, many students still prefer impression making that works more efficient to them.

To assess the clinical efficacy of a novel, organic olive oil-based denture adhesive and its effect on Candida albicans growth in maxillary edentulous individuals wearing complete dentures, individuals were selected from two dental schools in Portugal and Spain. Twenty-eight complete dentures were relined, following a standardized protocol. The novel product (test) was compared with a commercialized adhesive (control) and Vaseline (placebo) randomly assigned in a cross-study design. The retention resistance was measured with a gnathometer and a dynamometer. The patients related outcome evaluations with a five-point questionnaire, and the Candida albicans growth in a Sabouraud dextrose agar (SDA) medium was used to evaluate differences between the placebo and experimental product. Twenty-three participants were included. The dynamometer evaluation showed significant differences between not using a denture adhesive and using either (experimental, p = 0.03, control, p = 0.04) and no significant differences between the two adhesives (p &gt, 0.05). In the subjective analysis, the experimental adhesive showed a significantly longer effectiveness (p = 0.001), and the control reported better results in taste (p = 0.03) and in chewing (p = 0.001). The test adhesive showed better (p &lt, 0.001) Candida albicans growth inhibition. The experimental adhesive showed longer effectiveness than the control and the placebo with a better inhibition capacity for the growth of Candida albicans. Patients reported better abilities for speech, chewing, taste, and retirement in the control adhesive.

Simple Summary Traditionally, 4–6 implants have been regarded as the optimal number of implants for supporting mandibular implant-supported fixed complete dental prostheses (ISFCDP). However, several studies have evaluated the clinical behavior and complications of ISFCDPs on three implants considering this option as a potentially valid alternative treatment. Fewer implants will not only reduce the economic cost but can also shorten surgical treatment time and minimize trauma, which will encourage more patients to receive this type of treatment. Abstract This systematic review and meta-analysis set out to assess the clinical behavior of mandibular implant-supported fixed complete dental prostheses (ISFCDP) on three dental implants by analyzing implant and prosthetic survival rates, marginal bone loss, biological/technical complications, and patient-reported outcomes. The review was conducted according to PRISMA guidelines. Electronic searches were conducted in the Medline (PubMed), Web of Science, and Cochrane databases, complimented by a manual search in specialist journals for relevant articles published up to February 2021. The Newcastle-Ottawa Quality Assessment Scale tool was used to assess the quality of evidence in the studies reviewed. The study included 13 articles with 728 patients treated with 2184 implants. A mean implant survival rate of 95.9% (95% CI: 94.6–97.3%) and a prosthetic survival rate of 97.0% (95% CI: 95.7–98.3%) were obtained over 1–6-year follow-up periods. Mandibular implant-supported fixed complete dental prostheses on three dental implants would appear to be a viable option for restoring the edentulous mandible in comparison with mandibular ISFCDP on more than three implants. Further comparative studies are needed, with adequate protocols, as well as sufficient sample sizes and follow-up periods to confirm these findings.

The aim of this in vitro study was to investigate the microgaps at the implant–abutment interface when zirconia (Zr) and CAD/CAM or cast Co–Cr abutments were used. Methods: Sixty-four conical connection implants and their abutments were divided into four groups (Co–Cr (milled, laser-sintered and castable) and Zirconia (milled)). After chewing simulation (300,000 cycles, under 200 N loads at 2 Hz at a 30° angle) and thermocycling (10,000 cycles, 5 to 50 °C, dwelling time 55 s), the implant–abutment microgap was measured 14 times at each of the four anatomical aspects on each specimen by using a scanning electron microscope (SEM). Kruskal–Wallis and pair-wise comparison were used to analyze the data (α = 0.05). Results: The SEM analysis revealed smaller microgaps with Co–Cr milled abutments (0.69–8.39 μm) followed by Zr abutments (0.12–6.57 μm), Co–Cr sintered (7.31–25.7 μm) and cast Co–Cr (1.68–85.97 μm). Statistically significant differences were found between milled and cast Co–Cr, milled and laser-sintered Co–Cr, and between Zr and cast and laser-sintered Co–Cr (p &lt, 0.05). Conclusions: The material and the abutment fabrication technique affected the implant–abutment microgap magnitude. The Zr and the milled Co–Cr presented smaller microgaps. Although the CAD/CAM abutments presented the most favorable values, all tested groups had microgaps within a range of 10 to 150 μm.

Introduction This systematic literature review aimed to evaluate the feasibility of xenogeneic bone blocks for ridge augmentation compared with autogenous blocks by analyzing block survival rates, block resorption, subsequent implant survival rate, post-surgical complications, and histomorphometric findings. Materials and Methods Electronic searches were conducted in the Medline (PubMed), Web of Science and Cochrane databases, complimented by a manual search in specialist journals, for relevant articles published up to March 2020. Inclusion criteria were human studies in which the outcomes of xenogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant survival rates. Results Sixteen articles fulfilled the inclusion criteria and were analyzed. 333 patients were recruited with a total of 337 xenogeneic bone blocks and 82 autogenous bone blocks, showing block failure rates of 6.82% and 6.1%, respectively. Bone gain, in both height and width, was similar among xenogeneic and autogenous bone blocks, but autogenous bone blocks suffered greater resorption. Implant survival rates were slightly lower for xenogeneic bone blocks. Histological and histomorphometric analysis observed more bone formation and less residual bone substitute with autogenous bone blocks than xenogeneic bone blocks. Conclusions Atrophic alveolar crest reconstruction with xenogeneic bone block grafts would appear to offer a viable alternative to autogenous bone block grafts, obtaining similar block graft failure rate, fewer sensitive postoperative complications but a slightly lower implant survival rate. Further investigations generating long term data are needed to confirm the feasibility of xenogeneic bone blocks in different clinical scenarios.

The regeneration of nerve injuries after oral surgery procedures is a quite often attempted procedure in dental medicine. Despite several proposed technical approaches, there is still a lack of consensus on which should be considered the gold standard procedure, even-though in the last decades, the use of collagen-based devices allowing a tension-free direct neurorrhaphy has been used. A systematic search of multiple electronic databases and hand searching was conducted to assess the level of evidence behind the use of type I collagen devices to treat nerve injuries after oral surgery procedures. After screening, four articles (one case series and three retrospective studies) including overall 65 patients suffering from inferior alveolar (IAN)/lingual nerve (LN) injury after mandibular wisdom tooth extraction, met the inclusion criteria and could be included. The Oxford Centre for evidence-based medicine (OCEBM) scaling system was used to evaluate the quality of the included studies. Positive clinical results in terms of sensorial improvements were recorded at least 3 months after surgery, even-though the overall level of evidence is low. The use of collagen membranes to enhance nerve regeneration in oral surgery results in promising results. Nevertheless, additional clinical comparative trials with larger sample sizes are needed.

Fracture or chipping of veneering ceramic is one of the most frequent clinical failures in dentistry in fixed dental and implant-borne prostheses. Due to the friable nature of the ceramic material, chippings may result in an aesthetic and functional problem for the patient requiring a rapid solution. Direct repairs have been indicated for the restoration of function, aesthetics and comfort, especially in cases where the fractured prosthesis presents good adaptation and satisfactory aesthetics. This case report aims to present and discuss the techniques of the direct reveneering method, their advantages and disadvantages, as well as the importance of adhesive procedures in the success of these restorative approaches. Success in repairing the fractured area, regardless of the technique used, is fundamental to establish a strong and stable adhesion between the repaired and the fractured areas, since the longevity of the repair will depend on the quality of the interface generated.

This clinical report describes the treatment of a complex intraoral situation by fabricating a maxillary implant-retained overdenture with a high-performance polymer (polyetherketoneketone) framework and lithium disilicate crowns and mandibular tooth- and implant-supported ceramic restorations. No complications were noted in 2 years, and the patient was satisfied with function and esthetics.

Background Implant-supported prosthetic treatment options are reliable for elderly edentulous patients with systemic health problems. These patients often need cost- and time-efficient solutions to avoid complications. However, it is a challenge for clinicians to treat these patients without surgical interventions, placement of additional implants, or the need to renew existing prostheses. Case presentation A 75-year-old medically compromised caucasian male patient using multiple medications was referred for prosthetic rehabilitation of his edentulous maxilla after several implant failures. Because the patient’s health was compromised, further surgical interventions were ruled out and the treatment was centered on the use of the remaining implants by placing a fixed attachment system and altering the existing prosthesis. The stepwise management of the patient’s situation through the use of a new attachment system and adjustment of existing prosthesis is described in the present case report. Conclusions Although implant therapy is not always contraindicated for medically compromised patients, it is preferable not to perform extensive surgeries to avoid complications. This clinical report describes an alternative, safe option based on a novel fixed attachment system to salvage an existing maxillary implant-supported fixed complete dental prosthesis of a patient with systemic health problems.

Objective: To assess the clinical and esthetic outcomes and patient satisfaction of screw-retained one-piece implant crowns fabricated with zirconia abutments after a 4.5- to 8.8-year follow-up. Material and methods: Thirty-two patients (12 women and 20 men), who received 40 implant single crowns in anterior and premolar sites, were included in this prospective study. All restorations were based on ceramic hand-veneered customized CAD/CAM zirconia abutments. The follow-up consisted of clinical and radiological examinations. The pink esthetic score-white esthetic score (PES-WES) was used to evaluate the esthetic outcome. Patients' satisfaction was assessed via visual analog scale (VAS). Results: Implant and prosthetic survival rates were 100% and 97.5%, respectively. Mean marginal bone loss was -0.17 mm (SD 1.16 mm). Probing depth was ≤4 mm in 98.7% and 5 mm in 1.3% of the sites; 8.3% of them were bleeding on probing positive. No technical or biological complications were observed except for one abutment fracture. The mean PES-WES scores were 7.0 and 7.1, respectively. VAS scores (10-point) of 9.41 for function and 9.26 for esthetics showed high patient satisfaction. Conclusion: After a mean observation period of 6 years and 7 months, screw-retained implant crowns based on veneered customized CAD/CAM zirconia abutments with conical connection showed very good clinical performance and may be recommended for the replacement of missing anterior and premolar teeth. (ClinicalTrials.gov # NCT04370314). Keywords: all-ceramic restorations; dental implant; implant crowns; one-piece implant crowns; screw-retained implant crowns; survival rate; zirconia abutments.

Background Dimensional changes after dental extraction frequently lead to situations in which bone augmentation procedures are required prior to dental implant placement. Bone ring technique (BRT) has been described as a one-stage approach to restore vertical alveolar ridge defects, in which an autogenous or allogeneic cortico-cancellous bone block graft is stabilized with a dental implant inserted simultaneously. The objective of this systematic review was to evaluate the clinical performance of BRT. Materials and methods This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. Results Sixteen studies with a total of 186 patients treated with 219 bone rings bocks were included in the review. The studies showed a mean bone gain of 4.94 mm, mean bone resorption of 0.83 mm, and mean marginal bone loss of 0.57 mm after a mean follow-up period of 13.35 months. A mean bone ring survival rate of 97.26% and implant survival rate of 94.97% were recorded. Conclusions BRT would appear to be an adequate alternative technique for restoring single vertical alveolar ridge defects with simultaneous dental implant placement. However, further studies comparing this technique with other vertical ridge augmentation procedures in different clinical scenarios are needed to confirm the present results.

This work systematically reviews dental implant placement through impacted teeth or residual roots, as an alternative to invasive extraction surgeries, evaluated in terms of survival rates, marginal bone loss, surgical, and prosthetic complications. The authors conducted an electronic search of four databases up to September 2020; also a complementary handsearch was carried out. The quality of the included studies was assessed using a protocol for assessment of risk of bias in exposure studies. Ten studies fulfilled the inclusion criteria and were analysed. A total of 44 patients received 62 dental implants and were monitored for a minimum of 12-months follow-up. An overall mean implant survival rate was 90.32%, reporting 97.56 % for dental implants through impacted teeth and 76.19% through residual roots. No surgical or prosthetic complications were reported. Placing dental implants through impacted teeth may offer a valid therapeutic option for implant-supported restorations in patients for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery. Moreover, additional caution is recommended when placing implants through retained root fragments, as this may involve long-term risk. Further research generating long-term data are needed to confirm these findings.

This article aimed to assess the marginal fit of methacrylate-oligomer-phosphine-oxide curable-resin provisional-fixed dental prostheses made by digital-light-processing (DLP) three-dimensional (3D) printing. A stainless-steel master model with two abutments was scanned, and five three-unit provisional bridges were designed and printed in VITA shade A3.5 curable resin in 50 &mu, m-thick layers. The marginal fit of each abutment was measured at six points using a profile projector. A descriptive data analysis of the fit measurements was performed by descriptive and explorative processes with the SPSS software. The curable-resin provisional restorations made by DLP 3D printing reached values of 46.37 &mu, m (SD: 29.58 &mu, m), which were considered clinically acceptable, with values similar to polyethylene-methacrylate and polyether-ether-ketone provisional restorations.

Purpose: The aim of this comparative in vitro study was to assess the bond strength and mechanical failure of carbon-fiber-reinforced composites against cobalt&ndash, chrome structures with ceramic veneering. Materials and methods: A total of 24 specimens (12 per group) simulating dental prosthetic frameworks were fabricated. The experimental specimens were subjected to a thermocycling aging process and to evaluate bond strength. All specimens were subjected to a three-point bending test to fracture using a universal testing machine. Results: The cobalt&ndash, chrome/ceramic group yielded a bond strength value of 21.71 &plusmn, 2.16 MPa, while the carbon-fiber-reinforced composite group showed 14.50 &plusmn, 3.50 MPa. The failure assessment reported statistical significance between groups. Although carbon-fiber-reinforced composite group showed lower bond strength values, the chipping incidence in this group was as well lower. Conclusions: The chrome&ndash, cobalt/ceramic group showed greater bonding strength compared to the carbon-fiber-reinforced composite, most of the fractures within the cobalt&ndash, chrome/ceramic group, had no possibility of direct clinical repair.

Purpose To systematically review the current evidence on clinical and patient-reported outcomes of implant-supported palatal obturator prostheses. Materials and methods An electronic search of the PubMed, Web of Science, and Cochrane databases was carried out in June 2019. The titles and abstracts of all articles were screened by two independent reviewers. The references of the subsequently selected studies were further screened for potential articles. Assessment of the selected full texts was performed independently according to established inclusion and exclusion criteria. The quality of the selected studies was determined using the Newcastle-Ottawa scale. Interrater agreement on study selection was calculated using Cohen kappa statistic. Results The search yielded a total of 2,797 records. Ten studies were selected for data extraction, with a Cohen kappa value of 0.856. Five studies were prospective, and five were retrospective. The survival rates for conventional implants ranged from 21.42% to 100%, whereas for zygomatic implants, the survival rates varied from 30% to 100%. Four studies reported prosthodontic complications, with screw loosening being the most common. Patient quality of life (QoL) was analyzed in six studies. Conclusion In spite of the limitations of the present review, it can be concluded that the clinical outcomes are acceptable in terms of survival rates, implant and prosthodontic complications, and QoL associated with implant-supported maxillary obturator prostheses. QoL of implant-supported prostheses in these patients are acceptable. The general study design was not homogenous between studies.

The aim of this systematic review and meta-analysis was to evaluate the clinical performance of tooth-borne partial and full-coverage fixed dental prosthesis fabricated using hybrid polymer and ceramic CAD/CAM materials regarding their biologic, technical and esthetical outcomes. PICOS search strategy was applied using MEDLINE and were searched for RCTs and case control studies by two reviewers using MeSH Terms. Bias risk was evaluated using the Cochrane collaboration tool and Newcastle–Ottawa assessment scale. A meta-analysis was conducted to calculate the mean long-term survival difference of both materials at two different periods (≤24, ≥36 months(m)). Mean differences in biologic, technical and esthetical complications of partial vs. full crown reconstructions were analyzed using software package R (p < 0.05). 28 studies included in the systematic review and 25 studies in the meta-analysis. The overall survival rate was 99% (0.95–1.00, ≤24 m) and dropped to 95% (0.87–0.98, ≥36 m), while the overall success ratio was 88% (0.54–0.98; ≤24 m) vs. 77% (0.62–0.88; ≥36 m). No significance, neither for the follow-up time points, nor for biologic, technical and esthetical (88% vs. 77%; 90% vs. 74%; 96% vs. 95%) outcomes was overserved. A significance was found for the technical/clinical performance between full 93% (0.88–0.96) and partial 64% (0.34–0.86) crowns. The biologic success rate of partial crowns with 69% (0.42–0.87) was lower, but not significant compared to 91% (0.79–0.97) of full crowns. The esthetical success rate of partial crowns with 90% (0.65–0.98) was lower, but not significant compared to 99% (0.92–1.00) of full crowns.

Basal cell carcinoma is the most common cause of nasal defects. For large lesions with deep tissue extensions a total rhinectomy may be indicated followed by adjunctive therapies, such as radiotherapy or chemotherapy. Subsequent surgical reconstruction of these defects poses a challenge due to the compromised tissue bed and may require rehabilitation with facial prosthesis. In current case report, patient had basal cell carcinoma, which had involved the nasal cartilages, right inferior turbinate, nasolabial fold, upper lip and adjacent vascular and perineural tissues. Basal cell carcinoma was surgically excised, followed by postoperative radiotherapy. The resulted nasal defect was closed by forehead pedicle flap. Nasal stents were inserted postoperatively to prevent stenosis of nostrils. Prosthetic rehabilitation of a complete nasal defect was done by utilising nasal stents to prevent nasal stenosis, improved stability and precision, in placement of prosthesis over flat nasal defect. Skin adhesive was applied on margins to enhance the retention of prosthesis and to blend the margins of prosthesis with adjacent skin.

BACKGROUND: The aim of this study was to evaluate and compare the postoperative effect of a topic gel containing chlorhexidine, chitosan, allantoine and dexpanthenol versus a placebo for pain and inflammation control after third molar surgery. MATERIAL AND METHODS: A gel combining 0.2% chlorhexdine, 0.5% chitosan, 5% dexpanthenol, 0.15% allantoin and 0.01% sodium saccharin was selected for this split mouth randomized controlled and double-blind trial including 36 patients with bilaterally and symmetrically impacted lower third molars. The teeth (n=72) were randomly divided into two groups before surgical removal: control group (CG; in which a placebo was given) and experimental group (EG). Swelling, trismus, postoperative pain, wound healing and complications were measured and recorded in order to evaluate differences between the placebo and experimental product. RESULTS: Five patients suffered from an alveolitis in the CG (13.9%), and none in the study group (0%), but no statistically significant difference was found (p=0.063). From day 0 to day 7, trismus and swelling were significantly less pronounced in the EG, and wound healing was considered 'good' in 22.2% for the CG and 97.2% for the EG (p

Background The aim of the present study was to analyse the incidence, risk ratio (RR) and prognoses of two types of medication-related osteonecrosis of the jaws (MRONJ): denosumab-related osteonecrosis of the jaws (DRONJ) and Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ) in cancer patients under treatment with denosumab or zoledronic acid (ZA). Material and Methods An electronic and manual search was conducted for randomized controlled trials (RCTs) until May 2019. Assessment of the identified studies, risk of bias and data extraction were performed independently by two reviewers. The incidence of DRONJ and BRONJ and the RR to develop MRONJ were calculated at 1 year, 2 years and 3 years of exposure. It was also calculated the odds ratio (OR) of their respective prognoses. They were calculated normalizing the values of the individual studies to 1 year, 2 years or 3 years when necessary through robust regression models using a statistical program. Results From 1.277 references identified, 8 RCTs were included, which comprised a total of 13.857 patients with a variety of neoplasms. The incidence of DRONJ in cancer patients under treatment with denosumab ranged from 0.5 to 2.1% after 1 year, 1.1 to 3.0% after 2 years, and 1.3 to 3.2% after 3 years of exposure. The incidence of BRONJ in cancer patients under treatment with ZA ranged from 0.4 to 1.6% after 1 year of exposure, 0.8 to 2.1% after 2 years, and 1.0 to 2.3% after 3 years of exposure. Statistically significant differences were found between denosumab and ZA in the risk of developing MRONJ after 1, 2 and 3 years of exposure. Nevertheless, there were no significant differences in terms of patient prognosis. Conclusions Denosumab is associated with a significantly higher risk of developing MRONJ compared to ZA. Nevertheless, no differences were found in its prognoses. Key words:Denosumab, zoledronic acid, bisphosphonate-associated osteonecrosis of the Jaws, medication-related osteonecrosis of the jaws, neoplasms.

Background This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis. Material and Methods An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates. Results Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts. Conclusions Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings. Key words:Allogeneic block, clinical outcome, ridge augmentation, dental implants.

This systematic review was aimed at gathering technical and clinical applications of CAD/CAM technology for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic search was executed. Human studies that utilized digital planning systems for the prosthetic rehabilitation of orbital defects were included. A total of 16 studies of 30 clinical cases, which were virtually planned through various digital planning and designing software, were included. The most common preoperative data required for digital planning were CT scans in 15 cases, the 3DSS-STD-II scanning system in 5 cases, an Artec Color 3D scanner in 3 cases and a NextEngine Desktop 3D laser scanner in 2 cases. Meanwhile, the digital designing software were Ease Orbital Implant Planning EOIPlan software in eight cases, Geomagic software in eight cases, Simplant software in four cases and Artec Studio 12 Professional in three cases. Surgical templates were fabricated for 12 cases to place 41 craniofacial implants in the orbital defect area. An image-guided surgical navigation system was utilized for the placement of five orbital implants in two cases. Digital designing and printing systems were reported for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. The studies concluded that the digital planning, designing and fabrication of orbital prostheses reduce the clinical and laboratory times, reduces patient visits and provide a satisfactory outcome; however, technical skills and equipment costs are posing limitations on the use of these digital systems.

To evaluate the bond strength of different universal adhesives on deciduous tooth dentineand their relationship with the composition and potential of hydrogen (pH). Methods: An in vitromicro push-out test on 150 samples (n = 50) per group per adhesive, namely, Adhese Universal(ADH; Ivoclar Vivadent), Futurabond U (FUT; Voco GmbH) (Test), and Scotchbond Universal withpre-conditioning (SCO; 3M) (Control), to record bond strength (BS) and type of adhesive failure.Results: The results of the different adhesives (megapascals (MPa)) varied, showing no statisticalsignificance. The corresponding averages are in MPa: ADH, 13.66 2.81; FUT, 14.48 2.88; SCO,14.98 3.96. Additionally, the frequency of type of failure was as follows: mixed (60.7%), adhesive(27.3%), and cohesive (12%). Conclusions: SCO, with a pH of 2.7, showed greater resistance tofracture, while FUT, with a pH of 2.3 and no pre-conditioning, approached the same values, being aone-step adhesive. No relationship was found between failure and type of adhesive.

Resumen Introduccion La utilizacion de implantes cigomaticos es actualmente una alternativa terapeutica predecible y consolidada en la rehabilitacion de pacientes con maxilares atroficos. Sin embargo, como toda tecnica quirurgica, presenta una serie de complicaciones que no deben obviarse. Objetivo El objetivo de este estudio es analizar la frecuencia y las causas de sinusitis maxilar producida por el tratamiento con implantes cigomaticos. Material y metodo Se realizo una revision bibliografica en diferentes bases de datos analizando la prevalencia y las causas de la sinusitis maxilar tras el tratamiento con implantes cigomaticos. Resultados La mayoria de los estudios citan la sinusitis como la complicacion postoperatoria que aparece con mayor frecuencia, con una frecuencia de 4,93 por cada 100 implantes colocados. Discusion El hecho de que la sinusitis se relacione con la tecnica intrasinusal ha supuesto el desarrollo de tecnicas con el fin de evitarla, tales como la colocacion extrasinusal de los implantes o la utilizacion de tecnicas quirurgicas combinadas como la elevacion de seno simultanea a la colocacion del implante o la cobertura con la bola adiposa de Bichat. Conclusiones A pesar de ser la complicacion mas frecuente, la prevalencia es bastante baja, hecho que corrobora el exito del tratamiento con implantes cigomaticos.

The authors aimed to compare the survival and complication rates of zirconia-ceramic (ZC) versus metal-ceramic (MC) restorative material in multiunit tooth-supported posterior fixed dental prostheses (FDP).The authors conducted a systematic search of randomized controlled trials (RCTs), with no time or language restrictions, up to May 2019 using the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases, followed by a manual search.The authors included 7 RCTs in the review and 5 RCTs in the meta-analysis. All studies had a low risk of bias. The authors included 330 participants (177 ZC and 173 MC tooth-supported FDP) in the meta-analysis, which revealed a medium-term survival rate of 95.4% (95% confidence interval [CI], 90.5% to 99.1%) for ZC FDP compared with 96.9% (95% CI, 94.3% to 99.4%) for MC FDP, with no significant differences (P = .364). The biological or technical complications did not show statistically significant differences, except in the global ceramic veneering chipping analysis (P = .023; risk difference [RD], 22.3%; 95% CI, 3.0% to 41.6%) and their subanalysis: minor chipping or chipping that can be solved with polishing (P = .044; RD, 19.5%; 95% CI, 0.5% to 38.4%), and major chipping or chipping that needs repair in the laboratory (P = .023; RD, 6.0%; 95% CI, 0.8% to 11.3%).Posterior multiunit ZC restorations are considered a predictable treatment in the medium term, although they are slightly more susceptible to chipping of the veneering ceramic than MC restorations.

In the computer-aided design and manufacturing (CAD/CAM) dentistry, intra-oral scanners (IOS) are usually used to capture the teeth/implants position and adjacent soft tissues for fabrication of prostheses. However, scanning errors are associated with IOS for full arch impressions and teeth/implants with divergent alignments. While small degree of errors may be absorbed by the periodontal ligament of abutment teeth and the cement layer under the cement-retained prostheses, passive seating is particularly difficult to achieve for implant supported screw-retained prostheses in which implants are ankylosed and little leeway allowed for screw system. In this clinical report, five patients requested prosthodontic treatment for her compromised functional and aesthetic situation. Photogrammetry system and a conventional irreversible hydrocolloid impression were used to capture the three-dimensional implant position and the associated soft tissue topography, respectively. The two digital files were subsequently superimposed using a best-fit alignment function to generate the definitive digital model with information on teeth, soft tissues, and implants. An immediately digital set up was designed and a poly (methyl methacrylate) wax try-in was milled to check the esthetics parameters, the occlusal relations and to evaluate its passive fit. After this, the framework was manufactured using a milled-sintered cobalt-chromium and then coated with ceramic. A CAD/CAM implant supported screw-retained prosthesis with a good fit and esthetic was manufactured. The described technique suggests certain advantages over conventional techniques, however further studies and long-term clinical data are needed to evaluate the accuracy of photogrammetry in comparison with the other available techniques.