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This clinical report with an 8-year follow-up describes the multidisciplinary management of a patient diagnosed with amelogenesis imperfecta. The rehabilitation included horizontal-guided bone regeneration, implant placement, use of a fixed interim prosthesis to preview the correction of occlusal disharmonies, and placement of a custom screw-retained definitive implant-supported restoration with a design that was retrievable and minimized maintenance problems.

Screw-retained implant-supported ceramic restorations have shown increased rates of technical complications compared with their cemented counterparts, including fracture and chipping of the ceramic structures. The present clinical report identified the causes leading to the catastrophic failure of a screw-retained lithium disilicate veneered crown cemented to a zirconia abutment with a titanium base by using a systematic fractographic approach. A combination of occlusal overloading, a deficient design and inadequate material selection was identified as being responsible for the fracture. These findings highlight the importance of a thorough analysis of the anatomic conditions and loading scenario of screw-retained implant-supported restorations.

A comparative study was done regarding patient satisfaction between telescopic retained implant supported and retained over-denture prosthesis on four implants and a screw retained hybrid prosthesis rehabilitation also retained by four implants in patients with a completely edentulous mandible. Twenty patients were evaluated in this study, split into two groups. Regarding the evaluation of the patient satisfaction it was tested using a quantitative method, by asking the twenty patients different questions in a questionnaire. After an appropriate follow –up period from 2 weeks, to 12 months in both groups (telescopic retained overdenture and screw retained hybrid restoration), the results revealed the following; there was no statistically significant difference after 3 months as well as from 3 to 6 months and also from 6 to 9 months. Also there was a none statistically significant difference from 9 to 12 months, regarding patient satisfaction. In conclusion patients were equally satisfied with both prosthetic options.

With the help of dental implants, an oral rehabilitation can be performed not only very complex, but also very complete of various types of edentulous spaces. After insertion of the dental implants, they can be subsequently prosthetically restored through a wide range of implant-supported prosthetic restorations. In this material, we tried to highlight some particular aspects from the point of view of the laboratory stages of dental technique, which intervene in the technological flow of making implant-supported prosthetic restorations from ceramic masses on Zirconia structure.

Objectives This study compared full-arch screw-retained implant-supported fixed dental prostheses (FSI-FDPs) and full-arch telescopic-retained implant-supported fixed dental prostheses with a professional retrieval system (FTI-FDPs) on marginal bone loss (MBL), the risk indicators and peri-implantitis rate after 7-13 years. Material and methods Sixty five edentulous patients were treated with 86 prostheses and 592 implants. The FSI-FDP group comprised 26 patients (32 prostheses, 202 implants), and the FTI-FDP group comprised 39 patients (54 prostheses, 390 implants). MBL and the risk indicators of MBL ≥1 mm were assessed. Peri-implantitis rates at 13 years were also calculated. Results Full-arch screw-retained implant-supported fixed dental prostheses and FTI-FDP implants exhibited comparable mean MBLs of 0.60 ± 0.51 and 0.41 ± 1.03 mm, respectively. MBL ≥1 mm was noted for 25% of FSI-FDP implants and 6.9% of FTI-FDP implants. Superstructure-abutment connection (screw retention:FSI-FDPs >telescopic retention:FTI-FDPs) and implant-abutment connection (External butt joint, Internal butt joint >Morse taper joint) were associated with MBL ≥1 mm. Peri-implantitis rates at the implant level were 3.99% (95%CI = 3.93-20.5) in FSI-FDP group and 3.85% (95%CI = 3.85-34.3) in FTI-FDP group with no significance. Conclusions It was concluded that FSI-FDP and FTI-FDP implants exhibited comparable MBL; however, the risk of MBL ≥1 mm in FTI-FDPs was lower than in FSI-FDPs. Besides, implant-abutment connection was the risk indicator of MBL ≥1 mm. In peri-implantitis rate, FSI-FDPs and FTI-FDPs behave similarly.

The purpose of this cone beam computed tomography (CBCT) study was to investigate the probability of using straight screw-channel screw-retained restorations following an immediate implant placement and provisionalization protocol in maxillary anterior teeth utilizing implant planning software. Materials and methods: A retrospective review of CBCT images was done. The midsagittal images of maxillary anterior teeth (right canine to left canine) were created in implant planning software, screen-captured, and transferred to a presentation program. The digital implant templates were created for 3.5-mm-diameter (used for central and lateral incisors) and 4.5-mm-diameter (used for central incisors and canines) tapered implants with lengths of 13, 15, and 18 mm. The frequency percentages of immediate implant placement and provisionalization and immediate implant placement and provisionalization with straight screw-channel screw-retained restorations were recorded and compared among all maxillary anterior teeth. Results: CBCT images from 1,200 teeth were evaluated. The overall frequency percentages of immediate implant placement and provisionalization and immediate implant placement and provisionalization with straight screw-channel screw-retained restoration were 84% (range = 74% to 92%) and 14% (range = 10% to 24%), respectively. Conclusion: Although the probability of being able to employ immediate implant placement and provisionalization with a straight screw-channel screw-retained restoration in the esthetic zone is low, the use of smaller-diameter implants can substantially increase the probability.

The aim of the study is to compare the prosthetic maintenance requirements between implant-retained ball overdentures versus fixed screw-retained implant prosthesis. Clinical and radiographic changes in peri-implant tissue with using PGE2 as a peri-implant crevicular fluid (PICF) biomarker were also evaluated. 54 completely edentulous patients were enrolled: group I, 27 patients were rehabilitated with fixed screw retained restorations; group II, 27 patients with ball retained implant overdenture. Prosthodontic complications were calculated. The clinical parameters were recorded and PICF was collected at baseline, 6- and 12-months postoperatively. There was no statistically significance difference between group I and group II regarding the frequency of maintenance of prosthetic parts of both types of restorations. There was a statistically significance difference between group I and group II regarding the frequency of maintenance of implant components. At 6‐ and 12‐month observation periods, group I showed statistically significant lower mean plaque index, gingival index, and pocket depth compared with group II (P .05). There was no difference in the frequency of maintenance of prosthetic parts between fixed screw retained restorations and ball retained over denture while the fixed screw retained restorations showed lower rate of maintenance of implant components. The screw retained group was more vulnerable than the ball group with respect to maintaining peri-implant tissue health.

Aim This clinical technique report aimed to describe a composite resin repair technique performed in an implant-supported prosthesis. Background Veneering ceramic fracture or chipping is one of the most frequent clinical failures in dentistry. Therefore, the use of less time- and cost-consuming ceramic repair techniques is helpful in clinical practice. Technique Briefly, to treat the ceramic surface, the glaze was removed at the margins of the fracture area, then, air-abrasion and acid-etching were performed. To promote chemical adhesion, a silane coupling agent and adhesive system were applied over the ceramic surface, and the composite resin was applied by incremental technique. Finally, the polish was performed. Conclusion In conclusion, the applied composite resin repair of feldspathic porcelain chipping in implant-supported prosthesis was a simple, easy, affordable, and minimally invasive treatment. Clinical significance The causes of veneer materials failures in metal-ceramic crowns are considered a challenge for the dentist and a problem that displeases patients. Repairs are indicated to prevent cracks from spreading and to prevent the accumulation of biofilm on the damaged surface. Therefore, different repair protocols have been proposed to enhance the esthetic, functionality, and longevity of the implant-supported prosthesis. Additionally, the success of the clinical cases depends on the capability to identify ceramic failures and the ability to indicate/perform the correct repair protocol. Since the described repair technique of the fractured screw-retained implant-supported prosthesis was a simple, easy, affordable, and minimally invasive treatment, with excellent esthetic and masticatory results, it represents an interesting clinical option.

Tooth loss is a common problem in adults. the negative effects of tooth loss are decreased chewing and speech function, reduced aesthetics, and migration of adjacent teeth. Many types of dental prosthetics can be used to prevent these negative effects, such as removable partial dentures, adhesive resin dentures, fixed partial dentures, and dental implants each prosthesis had its advantages and disadvantages. In this case report the clinician will discuss about single tooth implants. The aim of this case report is to provide information about the procedure for placement single tooth implants to the posterior mandibular teeth using the screw retained implant technique.

Total rehabilitation is one of the most sophisticated kinds of dental implant-supported prosthetics. The usage of multiunit abutment system allows the clinician an accurate and passive fitting of screw-retained full-arch construction. In addition, it retains a condition of soft and bone tissues around prosthetic construction. The aim of this case is to demonstrate a modern approach in planning and realisation of full-mouth screw-retained dental implant prosthetics. A 59-year-old patient had an extraction of all failed teeth on upper and lower jaws with immediate 16 implant placement (8 implants on maxilla and 8 implants on mandible) using surgical template. Multiunit abutments were installed intraoperatively. Temporary constructions were fixed immediately after surgery. After 3 months of dental impressions, plaster models and their scan were prepared to make final screw-retained zirconium dioxide constructions. Reevaluation of functional and aesthetic result of the treatment was made after 12 months.

To evaluate the esthetic and functional rehabilitation of single implants delivering the final crown during second-stage surgery. In 26 single-tooth implants, the impressions were taken immediately after implant placement to fabricate the final crowns. During the second-stage surgery, the screw-retained hybrid crowns were delivered. Six months to 3 years after placement of the crown, a modified pink esthetic score (PES) was measured. Additionally, the number of treatment sessions was recorded. The mesial and distal contact points and the static and dynamic occlusion were examined. Patients’ satisfaction was measured using a questionnaire. In this retrospective study, 21 posterior and 5 anterior implants were included. The average pink esthetic score was 11.3 out of 14. The most frequent limitations were incomplete papillae and deficits of the alveolar ridge. The average number of appointments was three, consisting of impression taking and surgery consent, implant placement, and crown delivery. Average patients’ satisfaction was 46.7 out of 50 and thus, extremely high. The presented approach allows the second-stage surgery and delivery of the final restoration for single-tooth implants in the same session. As the peri-implant mucosa is adapted to the final restoration in the first place, a more natural emergence profile is achieved. However, there is an increasing risk for reduced or missing papillae. Patients’ satisfaction is generally very high. A method for direct definitive prosthetic restoration during the exposure of single-tooth implants is examined, advantages and disadvantages will be described, and patient acceptance is validated.

A reabilitação oral implanto suportada, pode ser feita mediante coroas aparafusadas (CA) ou cimentadas (CC). O objetivo deste trabalho consiste em analisar algumas características mecânicas e biológicas de ambas as opções tais como: o índice de placa (IP), índice de sangramento (IS), mucosite, periimplantite, perda óssea (PO), fratura (F), chipping e o desaperto do parafuso. Realizou-se uma pesquisa bibliográfica na pubmed usando uma restrição temporal de 10 anos incidindo nos estudos clínicos, em inglês e em humanos. Relativamente aos resultados: o IP foi superior em CC devido à dificuldade de remoção e como consequência acumula mais placa bacteriana. Em relação ao IS foi igual nas CC e CA, a mucosite e a perimplantite foi mais frequente em CC derivado à inflamação dos tecidos, devido ao excesso de cimento. O aspeto biológico PO foi mais frequente em CA. O desaperto do parafuso e a F da cerâmica foi mais frequente em CA, em relação ao chipping foi mais frequente em CC, sendo que os valores não são estatisticamente significativos. Cada método de retenção tem as suas vantagens e desvantagens fazendo com que a sua escolha dependa das caraterísticas e necessidades de cada paciente. Com este trabalho foi possível concluir que não é possível determinar qual a melhor alternativa protética para as próteses fixas sobre implantes. A resposta a esta discussão só é possível de ser obtida após uma exaustiva avaliação de cada caso de reabilitação, ponderando as vantagens e desvantagens de cada técnica, não havendo uma resposta geral para qual o melhor tipo de retenção, podendo levar a diferentes tipos de conclusões. Implant-supported oral rehabilitation can be performed using screw-retained or cemented crowns. The objective of this work is to analyze some mechanical and biological characteristics of both options, such as: plaque index, bleeding index, mucositis, periimplantitis, bone loss, fracture, chipping, and screw loosening of the prosthetic abutment. A literature search was performed at pubmed using a 10-year time restriction focusing on clinical trials in English. Regarding the results. The PI was higher in CC because they are difficult to remove and, as a consequence, accumulate more bacterial plaque. In relation to IS, it was the same in CC and AC, and the lack of oral hygiene was due to the accumulation of cement. In this study, we also evaluated mucositis and periimplantitis, where tissue inflammation was more frequent in CC due to excess cement. The PO biological aspect was more frequent in CA. In the present studies, screw loosening and ceramic F was more frequent in AC, compared to chipping it was more frequent in CC, but always bearing in mind that, in general, the values are not statistically significant. Each retention method has its advantages and disadvantages, so that the choice of the best method depends on the characteristics and needs of each patient. With this work, it was possible to conclude that it is not possible to specify the best prosthetic alternative for fixed prostheses on implants. The answer to this discussion can only be obtained after an exhaustive evaluation of each rehabilitation case, weighing the advantages and disadvantages of each technique, with no general answer for which is the best type of retention, which may lead to different types of conclusions .

Objectives: The purpose of this randomized clinical trial was to compare the required time of potential clinical adjustments of posterior screw-retained monolithic zirconia implant retained crowns based on intraoral optical scanning (IOS) or conventional impressions. Materials and methods: Patients with posterior tissue level implants (Straumann RN) replacing solitary teeth were recruited. Of all patients, impressions were taken with both an IOS (3M™ TDS) and a conventional (polyether) pick-up impression. Randomization was performed after impression taking and patients were to receive either a crown based on the digital or the conventional impression. The time required for adjustments at placement was recorded. Additionally, restoration survival and mechanical complications with a follow-up of one year were documented. Results: Thirty two patients with 45 implants were included: 23 restorations in the test (IOS) and 22 in the control (conventional) group. The average adjustment time was 3.35 min (SD ± 3.38, range: 0–11 min) for the digital versus 6.09 min (SD ± 4.63, range: 0–18 min) for the conventional impressions (p =.039). A proper fit (no adjustments required) was achieved 39,1% in the digital and 18,2% conventional group respectively. All 45 restorations could be placed within the two planned appointments and only two minor mechanical complications occurred during the first year of function. Conclusions: The use of IOS resulted in shorter adjustment times at try-in than conventional impressions for solitary CAD/CAM implant restorations. Screw-retained solitary monolithic zirconia restorations on ti-base abutments show low complication- and survival rates in the short term.

Achieving both esthetics and a perfect seal of the screw-access hole in a screw-retained implant-supported fixed dental restoration is a great challenge. From a functional point of view, a perfect seal needs to be obtained to prevent bacterial contamination along the screw access canal and the occlusion shall be addressed. Such a challenging procedure has to be based on a rational analysis of the different materials used. Screw-retained zirconia-based restorations offer a new perspective for esthetic and biocompatible results. The aim of this article is to describe an easy and reproducible clinical procedure to esthetically seal the screw-access hole of screw-retained implant-supported fixed dental restorations.

Objective To assess the prostheses and implants survival rate and peri-implantitis rate in edentulous patients treated with full-arch screw-retained implant-supported fixed dental prostheses (FSIFDPs) and full-arch telescopic-retained implant-supported fixed dental prostheses (FTIFDPs) over an observation period of at least 5 years. Materials and methods From 2004 to 2012, 696 implants were inserted into 78 patients with 102 prostheses. The FSIFDP group comprised 31 patients (37 prostheses, 232 implants), whereas the FTIFDP group comprised 47 patients (65 prostheses, 464 implants). Prosthesis and implant estimated cumulative survival rates (ECSR) and estimated cumulative peri-implantitis rates (ECPR) were assessed. The follow-up period was 5-12 years. Kaplan-Meier survival curves with the log-rank test were used to evaluate outcomes. Results The 12-year prosthesis ECSR was 96.8% (95% CI: 79.2-99.5, 36/37 prostheses) in the FSIFDP group and 96.4% (95% CI: 86.3-99.1, 63/65 prostheses) in the FTIFDP group, whereas the 12-year implant ECSR was 99.5% (95% CI: 96.4-99.9, 231/232 implants) in the FSIFDP group and 98.7% (95% CI: 96.9-99.5, 459/464 implants) in the FTIFDP group. The 12-year ECPR at the prosthesis level was 12.8% (95% CI: 12.7-47.6, 4/37 prostheses) in the FSIFDP group and 12.8% (95% CI: 11.4-24.1, 6/65 prostheses) in the FTIFDP group. The 12-year ECPR at the implant level was 4.4% (95% CI: 4.3-23.0, 6/232 implants) in the FSIFDP group and 2.2% (95% CI: 2.0-12.3, 7/464 implants) in the FTIFDP group. Conclusion FTIFDPs have clinical results comparable to those of FSIFDPs. Therefore, FTIFDPs can be useful.

OBJECTIVES To analyse whether there is a difference in marginal bone levels (MBL) and the respective changes between cemented and screw-retained reconstructions at 3 and 5 years of loading. METHODS Radiographic data from 14 prospective multicentre clinical trials following implant loading with fixed cemented (CEM) or screw-retained (SCREW) reconstructions with a 3- to 5-year follow-up were retrieved from a database. MBL and MBL changes were assessed at initiation of implant loading (BL), at 3 (FU-3) and 5 years (FU-5) thereafter. The presence of peri-implantitis was also determined. RESULTS Data from 1,672 implants at BL, 1,565 implants at FU-3 and 1,109 implants at FU-5 were available. The mean MBL amounted to 0.57 mm (SD 0.87) at BL, 0.55 mm (SD 0.86) at FU-3 and 0.65 mm (SD 1.18) at FU-5. At FU-3, the mean MBL was 0.44 mm (SD 0.65) in group CEM and 0.63 mm (SD 0.99) in group SCREW showing a significant difference between the groups (intergroup

Obtaining the most accurate 3-dimensional location of the implant positions, facilitates the fabrication of a prosthesis that, not only conforms to the biomechanics of the rehabilitation in relation to the TM joint and surrounding musculature but also lays minimal stresses imparted onto the implant-bone interface, maximizing the longevity of any prosthetic superstructure. The passive fit concept accentuates the need for this ‘minimal-stress’ interface in order to prevent any mechanical or, biological eventualities while the prosthesis is under masticatory load in the oro-facial environment. A wide horizon of techniques have been studied and devised upon, to achieve this ‘un-eventual fit’ and also methods developed, to assess and evaluate the misfit that the prosthetic superstructure bears in relation to the implants or, the abutments into which they are screwed. This article aims to define the concept, elaborate upon the need of the same and the methods to evaluate them in a clinical and laboratory set-up.

Purpose The aim of this in vitro study was to evaluate the effect of crown height on the screw stability of screw-retained titanium implant crowns subjected to cyclic loading conditions. Materials and methods Twenty-one implants with internal hex connections were placed in epoxy resin holders. Mandibular first molar screw-retained titanium implant crowns with UCLA type, crown-abutment connections were CAD/CAM fabricated. Seven crowns of 3 different heights (6 mm, 10 mm, and 14 mm) were made. The crowns were seated onto the implants and screws were tightened to 30 Ncm. The implants were clamped into holders and stepwise cyclic loads were applied to the occlusal surface at 30-degree angles to the long axes of the crowns. The detorque values were measured after each 5 million cycles. Before increasing the applied load, the crowns were secured with new screws and tightened to 30 Ncm. Failure times, survival estimates and detorque values were then analyzed. (alpha = 0.05). Results Crown height did not significantly affect detorque values. However, five 14-mm crowns failed with varying fractures during the 475 N loading condition. Overall, a significantly lower survival for 14 mm crowns was found compared to 6 mm and 10 mm crowns (p = 0.004). Conclusions Crown heights of one-piece screw-retained titanium implant crowns did not significantly affect detorque values. Screw fracture, however, was greater for crown height of 14 mm than those of 6 mm and 10 mm.

Implant design factors and the abutment connection are correlated with crestal bone stability. The aim of the present study was to evaluate a new type of screw-retained prostheses delivered on tissue-level implants with conical external vertical seal and internal hexagon connection. Implants 4.25 mm in diameter and 10 mm in length (Prama, Sweden and Martina) were placed in partially edentulous patients needing at least one implant in the healed site, having sufficient bone volume. The implant neck was positioned above the bone crest. A healing abutment was placed according to a one-stage approach. Outcome measures were implant and prosthesis survival rate, any complications, marginal bone loss (MBL), periodontal parameters, and pink esthetic score (PES). Overall, 13 patients (4 women and 9 men, mean age 50 ± 22 years) with the same number of implants were treated and followed for one year after loading. At the 12-month follow up, no implant and no prosthesis failed, and no complications were experienced. The mean MBL experienced at the one year follow-up was 0.65 ± 0.48 mm. One year after loading, 2 out of 13 implants present bleeding on probing (15.4%), 4 out of 13 patients presented with plaque at the one year of follow-up (30.8%) and the PES was 10.5 ± 2.3 mm. Within the limitations of the present study, the analyzed implants seem to be a viable treatment option for the rehabilitation of a single tooth gap.

Clinical oral implants research 32(12), 1484-1495 (2021). doi:10.1111/clr.13849, Published by Wiley-Blackwell, Oxford

Objectives: This research aimed to compare the oral health-related quality of life (OHRQoL) between fully dentate subjects and edentulous patients wearing implant-supported fixed partial dentures (i-FPDs). The clinical conditions of both types of restorations were evaluated. Methods: Participants were assigned to: Group-1 (SR, n = 50): screw-retained i-FPD wearers; Group-2 (CR, n = 50): cement-retained i-FPD wearers; and Group-3 (ND, n = 50): dentate subjects with a healthy natural dentition (controls). Patients answered the OHIP-14sp and QoLIP-10 questionnaires. Data related to sociodemographics, prosthesis features, peri implant status, complications, and subjective evaluations, were compiled. Potential modulators of the OHRQoL and the i-FPDs’ clinical conditions were assessed using non-parametric tests (α= 0.05). Results: ND individuals were the least satisfied (OHIP-14sp; p< 0.001). Both prosthodontic groups reported similar levels of wellbeing, excluding the speaking difficulties, which were lower for SR wearers as shown by both scales (p = 0.001). The most discontented patients (OHIP-14sp) were: women (p = 0.022), under 65 years (p = 0.03), without partner (p< 0.001) and having a crown (p = 0.033). The level of education/schooling also affected the OHIP-14sp scores (p< 0.001). Implant mobility and peri implantitis were more frequent among CR wearers (p-values= 0.008 and 0.05, respectively). Conclusions: The OHRQoL of both prosthodontic groups was comparably higher than that of the dentate subjects, who were the most nonconformist. The self-perceived satisfaction was mainly modulated by sociodemographic factors. Clinical significance: Overall, the retention system did not impact the OHRQoL, prosthetic problems, and subjective evaluations of i-FPD wearers. However, the cementation may increase the risk of peri implant diseases.