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

Autogenous particulate bone grafts are being utilized in oral implantology for minor grafting procedures. This study aimed to investigate the influence of the bone-harvesting technique, donor age, and donor site on proliferation and differentiation of human primary osteoblastlike cells in the cell culture. Autogenous bone particles (20 samples) were harvested from the maxilla and mandible during surgery using two different protocols, and two types of particulate bone grafts were collected: bone chips and bone sludge. Bone samples were cultured in growth medium and, after 2 to 3 weeks, the cells that grew from bone grafts were cultured in the normal and osteogenic medium for 0, 4, 7, and 20 days. DNA, alkaline-phosphatase (ALP), calcium-content measurements, and Alizarin red/toluidine blue staining were performed. Data were analyzed by repeated-measures analysis of variance with Bonferroni test. The level of statistical significance was set at 5% (P < .05). Total DNA, ALP, and calcium content were significantly higher for the bone chip samples compared to the bone sludge samples. Total DNA and ALP content were significantly higher for the patients in age group 1 (= 60 years) compared to age group 2 (> 60 years) and was significantly higher for mandibular samples than maxillary samples on day 20. However, the calcium measurement showed no significant difference concerning donor age and donor site. Data analysis revealed that harvesting technique (bone chips vs bone sludge), donor age (= 60 years vs > 60 years), and donor site (maxilla vs mandible) influenced the osteogenic potential of the collected particulate bone graft. The bone chips were superior in terms of osteogenic efficacy and should be considered a suitable option for particulate bone graft collection. [ABSTRACT FROM AUTHOR]

Purpose: To compare the fit and clinical performance of screw-retained monolithic zirconia implant fixed dental prostheses (FDPs) fabricated based on either intraoral optical scanning (IOS) or conventional impressions. Materials and Methods: Patients with two posterior tissue-level implants (Regular Neck, Straumann) replacing two or three adjacent teeth were recruited. Impressions were taken with both IOS (True Definition Scanner, 3M Espe) and a conventional (polyether) pick-up impression. Double-blind randomization was performed after impression-taking, and patients were to receive an FDP based on either the digital or the conventional impression. The fit was evaluated, and the time required for adjustments was recorded. Additionally, survival and technical complication rates with a follow-up of 1 year were documented. Results: A total of 38 patients requiring 45 FDPs were included: 24 FDPs in the test (IOS) and 21 in the control (conventional) group. The average adjustment time was 6.92 minutes (SD: ± 10.84; range: 0 to 49) for digital vs 12.38 minutes (SD: ± 14.52, range: 0 to 54) for conventional impressions (P = .090). A proper fit (no adjustments) was achieved in 33.3% of the digital and 28.6% of the conventional group. Forty-two FDPs could be placed within the two planned appointments, and 3 FDPs exhibited an unacceptable fit and required an extra appointment. Eight technical complications occurred during the first year of function. The overall restoration survival rate was 100%. Conclusion: The clinical fit of CAD/CAM FDPs based on digital impressions is comparable to conventional impressions. Screw-retained monolithic zirconia FDPs on Ti-base abutments show low major complication and 100% survival rates in the short term. [ABSTRACT FROM AUTHOR]

Purpose: There is a substantial need to perform studies to evaluate crestal bone loss (CBL) and implant success when using a newly introduced low-speed drilling protocol. Therefore, this study aimed to evaluate the mean CBL and implant success rate by placing implants utilizing two drilling protocols, ie, standard and low-speed drilling protocols. Materials and Methods: A randomized controlled clinical trial was carried out in patients who required dental implants to restore their esthetics and function. The patients were recruited from a university hospital (Academic Centre for Dentistry Amsterdam [ACTA], the Netherlands). Based on the inclusion criteria, patients were randomized to two study groups: (1) control group, standard drilling protocol; and (2) test group, low-speed drilling protocol without saline irrigation. The mean CBL and the implant success rate were evaluated after 12 months of implant placement. Results: Twenty-three patients (15 men and 8 women with a mean age of 57.5 ± 10.7 years) contributed to the study. Forty Camlog screw-line implants were placed (20 implants per study group). After 12 months of implant placement, the mean CBL of implants placed with the standard protocol and the low-speed protocol was 0.206 ± 0.251 mm and 0.196 ± 0.178 mm, respectively. No statistically significant difference could be recorded among both groups (P = .885). Concerning implants placed in the maxilla, the standard drilling group and low-speed drilling group showed a mean CBL of 0.252 ± 0.175 mm and 0.251 ± 0.175 mm, respectively, compared with 0.173 ± 0.210 mm and 0.141 ± 0.172 mm in the mandible, with no significant difference. The success rate of dental implants at 12 months was 95% in the control group and 90% in the test group. Conclusion: Within the limitations of this study, it can be concluded that implants placed with the low-speed drilling protocol without saline irrigation exhibited a similar CBL compared with implants placed with the standard drilling protocol. However, a higher success rate was recorded especially in type 1–quality bone for the control group compared with the test group. Further randomized clinical trials with greater sample sizes and extended follow-up times should be performed to obtain stronger evidence and a better understanding of the influence of drilling speed on mean CBL and long-term implant success. [ABSTRACT FROM AUTHOR]

Objectives: To report a summary of published patient‐reported esthetic outcome measures (PROMs) of implant‐supported single crowns (SCs) compared with those of tooth‐supported SCs. Materials and Methods: Cochrane, Medline (PubMed), and EMBASE database search was performed by three reviewers on reports with patient‐reported esthetic outcomes of tooth‐ and implant‐supported SCs. Clinical studies with at least 12 months of mean follow‐up period and a minimum of 10 patients, and English, French, or German reports were included. To compare the subgroups, for aggregate‐level data, random‐effects meta‐regression was used. Results: Two thousand fifteen titles were identified (initial search) and screened independently concluding 53 full‐text articles to include in data extraction. Twenty‐two studies with 29 study cohorts were included. Patients were satisfied with the esthetics of implant‐ and tooth‐ supported crowns Mean visual analogue scale (VAS) value from the PROMs data of 1270 implant‐supported SCs evaluated by 1051 patients was 89.6% (80.0%–94.1%). The mean VAS value of patients (n = 201), who evaluated the esthetic outcome of 486 tooth‐supported SCs was 94.4% (92.3%–96.0%). VAS scores of patients regarding their perception of esthetics did not show any difference among different crown materials or type of implant used. The patients' perception of esthetics focusing on SC had a tendency to be higher when the crowns were supported by teeth, however, no statistical difference was found when compared with implant‐supported crowns (p = 0.067). Conclusions: Patient perception of esthetics in SCs was not affected by the type of support, crown material, implant, and presence of provisional crown for both implant‐ and tooth‐supported SCs. Clinical Significance: Despite that patient's expectations are increasing overall Patients are satisfied with with esthetic outcome of implant‐ and tooth‐supported crowns. [ABSTRACT FROM AUTHOR]

Purpose: Autogenous bone grafts are considered a "gold standard." The success of autografts mainly depends on their ability to promote an osteogenic response. The aim of this study was to collect autogenous bone during implant osteotomy preparation using two different drilling protocols and to evaluate and compare the proliferation and differentiation ability of the collected bone particles. Materials and Methods: Autogenous bone particles were harvested from 20 patients during implant osteotomy preparation using two different drilling protocols: (1) standard drilling protocol with saline irrigation (according to the manufacturer's recommendation) and (2) low-speed drilling protocol without saline irrigation (speed < 200 rpm). Collected bone samples were cultured in growth medium, and after 2 to 3 weeks, cells that grew out from bone grafts were cultured in the normal medium as well as in osteogenic medium for days 0, 4, 7, and 20. Scanning electron microscopy, alizarin red/toluidine blue staining, DNA, ALP, and calcium content measurements were performed. Repeated measures analysis of variance (ANOVA) with Bonferroni's test was employed to analyze the data of this study. Results: The total DNA content was significantly higher for the low-speed drilling samples compared with the standard drilling on day 4 (P < .05), day 7 (P < .01), and day 20 (P < .001) in the normal medium and on day 7 (P < .01) and day 20 (P < .01) in the osteogenic medium. Besides, calcium measurements and mineralized matrix formation observed with alizarin red/toluidine blue staining were significantly higher for the low-speed drilling group compared with the standard drilling group. Conclusion: Osteogenic efficacy (differentiation and proliferation) of autogenous bone particles collected using low-speed drilling was superior compared with standard drilling samples. [ABSTRACT FROM AUTHOR]

This study aimed to histologically investigate the bone tissue response to zirconia implants functionalized with a biomimetic calcium phosphate (CaP) coating incorporated with bone morphogenetic protein-2 (BMP-2). Zirconia implants coated with biomimetic CaP were prepared with and without BMP-2. Untreated zirconia implants served as a control. These three groups of implants were placed randomly in the mandibles of six beagle dogs (n = 6). Three months later, samples were harvested for histomorphometric analysis. The present study showed that the application of a biomimetic CaP coating incorporated with BMP-2 enhanced the peri-implant osteogenesis for zirconia implants. [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]

Purpose: To evaluate the feasibility of a commercially available immediate root analog implant system Replicate (Natural Dental Implants). Materials and Methods: Five consecutive patients in need of an implant in the premolar region were recruited for this pilot study. Following clinical examination, a cone beam computed tomography scan was made and the dental impressions digitized. On the basis of the superimposition of these datasets, a three-dimensional (3D) envelope was created for the selected tooth. Subsequently, the tooth root at the prospective implant site was segmented to create a 3D surface, and the obtained mesh data were used as the basis for designing a single-piece root analog implant within the 3D envelope. The designed root analog implant was fabricated using a five-axis computer-aided manufacturing machine. The root analog implants were inserted following flapless minimally invasive root extraction. Following 3 months of uninterrupted healing, definitive restorations were fabricated. Peri-implant clinical and radiographic measurements were obtained up to 12 months follow-up. Results: All patients functioned well following 12 months of functional loading. Within one patient, one of the two root analog implants failed early. Peri-implant clinical and radiographic measurements demonstrated a stable situation after 12 months of functional loading. Conclusion: A novel digital approach for immediately restoring single teeth using root analog implants was introduced. In the future, long-term evaluation of the root analog implant technique is necessary to evaluate the success and survival of implants that were inserted using this technique. [ABSTRACT FROM AUTHOR]