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Purpose: To assess the complications, satisfaction, and quality of life of patients rehabilitated with delayed and immediate loading of single crowns. Materials and Methods: An electronic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase databases up to February 2023. Only prospective studies and randomized and nonrandomized clinical trials comparing immediate and delayed loading were included. For the quantitative analysis, dichotomous and consistent variables were evaluated with a 95% confidence interval. Results: A total of 20 studies were evaluated. No statistically significant difference was observed between protocols: satisfaction (I²: 0%; P = .42), quality of life (I²: 0 %; P = .05), biologic complications (I²: 9%; P = .17), mechanical complications (I²: 58%; P = .84), and survival rate (I²: 0%; P = .38). The subgroup analysis showed significant differences only for marginal bone loss (MBL) when immediate implants were placed in the mandible (I²: 15%; P = .01) and posterior zone (I²: 0%; P = .001). Conclusions: Complications and patient-centered outcomes for immediate single-implant crowns were comparable to delayed loading. Scientific evidence showed no significant difference between loading protocols for survival rates. Note that several factors could interfere with the complication events, implant failures, and MBL. The subgroup analysis showed that only immediate implants placed in the posterior mandible had a higher and statistically significant mean MBL. [ABSTRACT FROM AUTHOR]

Objectives: One stage functional jaw reconstruction is defined as the resection and reconstruction of segmental defects in conjunction with the placement of dental implants in an ideal prosthetic position and loaded with a provisional restoration, during one surgical procedure. The aim of the study is to describe clinical outcomes of patients who underwent one stage functional jaw reconstruction. Methods: Patients who underwent one‐stage functional jaw reconstruction, from January 2013 to March 2016 were recalled in 2022 and 2023. Planning and execution for the reconstruction utilized either analogue or digital techniques. Outcome parameters recorded were treatment‐related outcomes at patient level, implant‐related outcomes and patient‐reported outcome measures. Results: Eighteen patients underwent one‐stage jaw reconstruction with a total of 57 implants. Four patients had maxillary and 14 had mandibular reconstructions. Ten patients underwent postoperative radiotherapy. Ten patients were planned using analogue and eight by digital planning. Three patients had partial flap necrosis, three patients had plate fractures, implant loss was seen in one patient and four patients died during the period. A functional prosthesis was provided in 16 out of the 18 patients. Conclusion: One‐stage functional jaw reconstruction is a predictable method for providing rehabilitation with successful outcomes at 7–11 years. However, caution should be exercised when the treatment modality is carried out in patients with malignant pathologies who have undergone radiotherapy. [ABSTRACT FROM AUTHOR]

Objective: To compare the implant–abutment connection microgap between computer‐aided design and computer‐aided manufacturing (CAD/CAM) milled or laser‐sintered cobalt–chrome custom abutments with or without ceramic veneering and titanium stock abutments with or without crown cementation. Material and Methods: Six groups of six abutments each were prepared: (1) CAD/CAM cobalt–chrome custom abutments: milled, milled with ceramic veneering, laser‐sintered, and laser‐sintered with ceramic veneering (four groups: MIL, MIL‐C, SIN, and SIN‐C, respectively) and (2) titanium stock abutments with or without zirconia crown cementation (two groups: STK and STK‐Z, respectively). Abutments were screwed to the implants by applying 30 Ncm torque. All 36 samples were sectioned along their long axes. The implant–abutment connection microgap was measured using scanning electron microscopy on the right and left sides of the connection at the upper, middle, and lower levels. Data were analyzed using the Kruskal–Wallis test (p <.05). Results: Mean values (μm) of the microgap were 0.54 ± 0.44 (STK), 0.55 ± 0.48 (STK‐Z), 1.53 ± 1.30 (MIL), 2.30 ± 2.2 (MIL‐C), 1.53 ± 1.37 (SIN), and 1.87 ± 1.8 (SIN‐C). Although significant differences were observed between the STK and STK‐Z groups and the other groups (p <.05), none were observed between the milled and laser‐sintered groups before or after ceramic veneering. The largest microgap was observed at the upper level in all groups. Conclusions: Titanium stock abutments provided a closer fit than cobalt–chrome custom abutments. Neither crown cementation nor ceramic veneering resulted in significant changes in the implant–abutment connection microgap. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the accuracy of the Implant Disease Risk Assessment (IDRA) tool in predicting the occurrence of peri-implantitis in patients who have received at least one implant, with a follow-up of up to 8 years. The records of patients who received one or more implants in the periodontology or oral surgery department of Saint Joseph University of Beirut between 2014 and 2018 were collected. Parameters related to the IDRA tool were obtained and the risk level calculated. Patients were recalled to assess their peri-implant status. The association between the IDRA risk level and the incidence of peri-implantitis was estimated. Overall, 145 patients were included in the study. A statistically significant association was found between the IDRA risk levels and the incidence of peri-implantitis (P = 0.003). High risk patients had 5.2 times higher odds of developing peri-implantitis than low-to-moderate risk patients (P < 0.001). Receiver operating characteristic curve analysis demonstrated a 69% probability that IDRA can identify patients at risk of developing peri-implantitis (P = 0.003). Further analysis found the percentage bleeding on probing to be the only significant IDRA vector. Within the limitations of this study, the IDRA tool is considered potentially useful for identifying patients at risk of developing peri-implantitis. It may serve as one component of a comprehensive peri-implant assessment, pending further enhancement of its predictive precision. Moreover, this tool can be considered before implant placement and during the periodontal maintenance phase. ClinicalTrials.gov: NCT04888572. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this in vitro investigation was to assess how implant depth could affect the three‐dimensional positional accuracy of digital impressions made from angulated implants. Materials and Methods: Four modified maxillary models were printed and divided into four study groups. In each model, two angulated implant analogs were placed at the sites of the first premolar and first molar at four different depths of 1 (G1), 2 (G2), 3 (G3), and 4 (G4) mm from the models' edentate area. Scan bodies were connected to the analogs, and one operator made 10 full‐arch scans for each master model using an intraoral scanner. Afterward, the marginal gingival part of all models was removed, and digital scans were performed for each model using a laboratory scanner to achieve a reference STL file as the control group. One‐way ANOVA and Leven's tests were used to measure and compare the 3D distance deviations across research groups after the superimposing test and control scans. Results: A significant difference between research groups was revealed by trueness and precision analysis (p < 0.001). The trueness and precision results obtained for G1 and G4 were significantly better than those for G2 and G3 (p < 0.05). Conclusion: This study demonstrated that implant depth could affect the digital implant impressions' 3D positional accuracy. [ABSTRACT FROM AUTHOR]

Aims: In the literature, it is still unclear if the decisions for selecting the type of implant crown‐retaining system are based on scientific‐based research or if the Universities' choices, Implant marketing trends, or finances could have a major influence on the private dentists' decisions. Objectives: Therefore, this study aimed to evaluate the crown‐retaining system (cement‐ or screw‐retained) used in dental schools and private dental practices. Methods: A 13‐item questionnaire was sent to Canadian dental schools (n = 10) and dental offices in London (n = 298), Canada. The questionnaire included demographic questions and questions to reveal the dentists' perspectives on prosthetic implant treatment between the two‐retaining systems. Results were analyzed using descriptive statistics and multinomial logistic regression (p = 0.05). Results: Twenty‐four private dentists and five dental schools responded to the survey – 62.5% of private practitioners and 60% of universities reported using both systems. A trend was observed in using screw‐retained systems by dentists who graduated 5–10 years ago. Straumann, Astra, and Nobel Biocare were the private practices and dental schools' preferred implant systems. The use of platform switching for all cases was selected by 54.2% of the private practitioners and 40% of the dental schools. Resin cement was the private practice's preferred cementation method; the dental schools used glass ionomer and zinc phosphate cement. The multinomial logistic regressions showed no statistical difference between the crown‐retaining system chosen and the decision factors. The laboratory technician's recommendations and cost influenced the decision‐making process for private dentists. For the universities, perio‐restorative outcome, implant position, survival rates, institute preferences, and evidence‐based research influenced the crown‐retaining system's decision‐making process. Conclusion: The Canadian dental schools and private practice reported using both screw‐ and cement‐retaining systems. However, there was a difference in the selection criteria as the universities showed a tendency towards a more research‐based approach in their decision, while for the private practices, the technicians' recommendations and cost played a major role in the decision process. It was noted that the implant systems preconized by the Universities were observed to be used in private practices. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this retrospective study was to evaluate the effect of the interproximal contour of single external hexagon implant restorations on the prevalence of peri‐implantitis. Material and Methods: Records of 96 patients and 148 external hexagon (EH) implants with time in function ranging from 1 to 17 years were included in the study. The most recent clinical and radiographic data were collected from records and the prevalence of peri‐implantitis was defined according to the 2017 World Workshop on the Classification of Periodontal and Peri‐implant Diseases and Conditions. Marginal bone level (MBL), emergence angle (EA), emergence profile (EP), and crown/implant platform horizontal ratio (CIHR) were obtained from periapical radiographs. Dichotomous variables at the patient‐ and implant level were compared with association tests. Mann‐Whitney U‐Test was performed to compare continuous quantitative values between the studied groups. Binomial logistic regression was conducted to identify risk indicators associated with the peri‐implantitis event at the patient‐ and implant level, with the significance level set at 5% for all tests. Results: Nineteen patients (19.2%) and 24 implants (16.2%) with a mean time in function of 5.0 ± 4.7 years were classified as having peri‐implantitis. No statistically significant differences concerning gender, mean age, implant location in the jaw, or time in function were observed between patients with or without peri‐implantitis (p > 0.05). Of 24 implants with peri‐implantitis 10 (41.7%) displayed EA ≤ 30° (16.4%) while 14 (58.3%) presented EA > 30° with no statistical difference between the groups (p > 0.05). No statistically significant associations were identified between EA, EP, or CIHR and the prevalence of peri‐implantitis. Conclusion: The findings seem to indicate that the EA, EP, and CIHR of single restorations over external hexagon implants are not associated with the presence of peri‐implantitis. However, prospective studies with larger samples are required to better ascertain such an association in the long term. [ABSTRACT FROM AUTHOR]

Abstract Background Focal and florid cemento-osseous dysplasia are benign fibro-osseous lesions affecting the quality and quantity of the jawbones. This study aimed to determine the viability of implant-based approaches in the affected patients. Main text Different scientific databases, including PubMed/MEDLINE, Scopus, Web of Science, Embase, the Cochrane Library, and Google Scholar, were searched until October 8, 2023, using a pre-determined search strategy. Two reviewers screened the retrieved reports and extracted the required information from the included studies. The eligibility criteria included English-language case reports/series or clinical trials. The JBI critical appraisal checklist for case reports was used to assess the methodological quality of the included studies. Three studies were deemed eligible to be included in this study out of the initial 202 records found. Five implants were placed in three patients, positioned in the proximity of the lesion area, without any additional treatment to remove the pathology. The mandibular posterior area was the affected site in all patients. Only one implant failed in one patient after 16 years, which was attributed to peri-implantitis and not the lesion. Other implants demonstrated successful maintenance over follow-up periods. Conclusions Although the number of the included records was relatively low to draw firm conclusions, it seems that implant-based treatments in patients with focal/florid cemento-osseous dysplasia could be viable, considering a conservative and well-planned approach.

Background: Focal and florid cemento-osseous dysplasia are benign fibro-osseous lesions affecting the quality and quantity of the jawbones. This study aimed to determine the viability of implant-based approaches in the affected patients. Main text: Different scientific databases, including PubMed/MEDLINE, Scopus, Web of Science, Embase, the Cochrane Library, and Google Scholar, were searched until October 8, 2023, using a pre-determined search strategy. Two reviewers screened the retrieved reports and extracted the required information from the included studies. The eligibility criteria included English-language case reports/series or clinical trials. The JBI critical appraisal checklist for case reports was used to assess the methodological quality of the included studies. Three studies were deemed eligible to be included in this study out of the initial 202 records found. Five implants were placed in three patients, positioned in the proximity of the lesion area, without any additional treatment to remove the pathology. The mandibular posterior area was the affected site in all patients. Only one implant failed in one patient after 16 years, which was attributed to peri-implantitis and not the lesion. Other implants demonstrated successful maintenance over follow-up periods. Conclusions: Although the number of the included records was relatively low to draw firm conclusions, it seems that implant-based treatments in patients with focal/florid cemento-osseous dysplasia could be viable, considering a conservative and well-planned approach. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of extra-short implants compared to standard-length implants in graft regions at different longitudinal follow-up times. Materials and Methods: A systematic review was performed, following PRISMA criteria. LILACS, MEDLINE/PubMed, Cochrane Library, and Embase databases, including gray literature and manual searches, were conducted without language or date restrictions. Study selection, risk of bias (Rob 2.0), quality of evidence (GRADE), and data collection were performed by two independent reviewers. Disagreements were resolved by a third reviewer. Data were combined using the random-effects model. Results: A total of 1,383 publications were identified, including 11 publications from 4 randomized clinical trials that evaluated 567 implants (276 extra-short and 291 regular implants with graft) in 186 patients. The meta-analysis showed that losses (risk ratio [RR]: 1.24; 95% CI: 0.53 to 2.89; P = .62; I2: 0%) and prosthetic complications (RR: 0.89; 95% CI: 0.31 to 2.59; P = .83; I2: 0%) were similar in both groups. Biologic complications were significantly higher in regular implants with graft (RR: 0.48; CI: 0.29 to 0.77; P = .003; I2: 18%), which also had lower peri-implant bone stability in the mandible at the 12-month follow-up (mean deviation [MD]: -0.25; CI: -0.36 to 0.15; P < .00001; I2 = 0%). Conclusion: Extra-short implants showed similar effictiveness compared to standard-length implants placed in grafted regions at different longitudinal follow-up times and present reduced biologic complications, shorter treatment times, and greater peri-implant bone crest stability. [ABSTRACT FROM AUTHOR]

Background: A key point in assessing dental implant prosthetic joints is their mechanical strength and biological response under the masticatory loading. The aim of the present systematic review was to evaluate the marginal bone loss and prosthetic behaviour of different internal/external bi-phasic implants. Methods: Randomized Clinical Trials (RCTs) have been considered for analytic purposes. The article screening was conducted on the Pubmed/MEDLINE, EMBASE and Google Scholars databases through an electronic process. Eligibility and risk of bias assessments were conducted for an article to be included in the data process. A series of pairwise meta-regressions for continuous variables was conducted considering the mean differences and 95% CI at two different timepoints: baseline and 1-year follow-up. The meta-analysis was performed comparing the following groups: internal conical prosthetic joint with index (IC), external hexagon bone level position (EI), internal tri-channel connection bone level position (ITC), internal hexagon 1 mm below the bone level (HI), internal hexagon bone level position (HI crest), cone morse 1 mm below the bone level (CM), cone morse bone level position (CM crest) and internal octagon bone level position (IO). The following parameters were considered for descriptive data synthesis: sample size, implant manufacturer, prosthetic joint type, prosthetic complications, marginal bone loss, study outcomes. Results: A total of 247 papers were identified by the electronic screening and 241 were submitted for the full text assessment. The eligibility process excluded 209 articles, and 32 studies with a low risk of bias were considered for the qualitative synthesis and further statistical methods. At the baseline, the CM showed a more effective efficiency and reduced marginal bone loss compared to IC, EI, ITC, internal hexagon, cone morse and internal octagon (p < 0.05). CM showed the lower rate of prosthetic complications and structural device failure including abutments and joint components under the loading compared to other joint types. Conclusion: Within the limits of the present investigation, the heterogeneity, the weight of the study model considered and the inherent differences between the dental implant properties, the pure CM showed a more consistent control of marginal bone loss at short- and medium-term follow-up. Despite the low rate of cumulative complications for all joints considered, the CM abutment joints were less prone to prosthetic failure at an early and medium-term follow-up.

Objective: Evaluate the long‐term outcomes of full‐arch rehabilitation using immediate dental implant placement and continuous functional loading with full‐fixed dental prostheses (FFDPs). Materials and Methods: Fifty‐six patients received temporary implants (n = 327) at maxillary augmentation with calvarial bone. A provisional acrylic FFDP was immediately loaded onto these implants. After 6 months, the temporary implants were replaced with definitive implants (n = 326) and immediately loaded with a second provisional FFDP (N = 55). Subsequently, a baseline radiograph was taken following a 6‐month healing period. The second bridge was then substituted with a definitive FFDP. Primary outcomes included peri‐implant marginal bone level (MBL) and definitive implant survival. Secondary outcomes evaluated provisional implant and prostheses survival, complications, and patient satisfaction. Results: The provisional implants had a survival rate of 97.9%. One patient was excluded from further analysis due to loss of temporary implants and first FFDP. The definitive implant survival rate after 10 years was 92.2%, with a moderate but significant decrease in MBL between baseline radiography and 10 years later (−0.08 ± 0.18 vs. −0.24 ± 0.44). However, large individual variations were observed, with 65.8% of implants showing no bone loss and 9.2% showing loss ≥0.5 mm. Sinusitis was experienced by 14.3% of patients upon surgery. Patient satisfaction was high or reported no issues after protocol completion (80%). One patient lost all six definitive implants and definitive FFDP 8.2 years after implant placement. Conclusions: The described protocol can be regarded as a long‐term, highly successful method for full‐arch rehabilitation of atrophied maxillae while enabling continuous masticatory and speaking functionality. [ABSTRACT FROM AUTHOR]

Resin coating in implants rehabilitation cannot always be aesthetic, durable and comfortable for the patient mainly due to the limited dimensions of the final structure. Intraoral welding technique and computer-aided designed prosthetic shells may be a solution. This in vitro study evaluates the capacity of load and the weakest point of implant-supported provisional prosthesis using welded titanium framework. Twelve samples were produced to simulate an implant supported fixed prosthetic bridge. Two implants (Ankylos; Dentsply Sirona Implants; Germany) were inserted inside blocks of nanoceramic material produced with a stereolithographic 3D printer. A polymethylmethacrylate (PMMA) resin shell was performed with CAD/CAM and relined on welded framework. Six samples were produced with the same procedure reducing resin thickness. The samples were subjected to fatigue test (6,500,000 cycles) using ElectroForce 3310 fatigue machine (t 1); subsequently a mechanical compression test using a universal Shimadzu AGS-X 10 machine (t 2). The samples were analyzed with a photographic and radiographic documentation at t 0, t 1 and t 2. The samples survived mechanical fatigue test without evidence of failure. The radiographic and photographic evaluation revealed the fracture of resin coating after the mechanical compression test. The samples with minimal resin thickness fractured first. Adequate assessment of the resin thickness is mandatory to improve the longevity of these rehabilitations. CAD-CAM digital prosthetic design allows us to optimize the thicknesses and the prosthetic shapes, allowing us to obtain good degrees of resistance even in the presence of reduced prosthetic spaces. [ABSTRACT FROM AUTHOR]

Background: A key point in assessing dental implant prosthetic joints is their mechanical strength and biological response under the masticatory loading. The aim of the present systematic review was to evaluate the marginal bone loss and prosthetic behaviour of different internal/external bi-phasic implants. Methods: Randomized Clinical Trials (RCTs) have been considered for analytic purposes. The article screening was conducted on the Pubmed/MEDLINE, EMBASE and Google Scholars databases through an electronic process. Eligibility and risk of bias assessments were conducted for an article to be included in the data process. A series of pairwise meta-regressions for continuous variables was conducted considering the mean differences and 95% CI at two different timepoints: baseline and 1-year follow-up. The meta-analysis was performed comparing the following groups: internal conical prosthetic joint with index (IC), external hexagon bone level position (EI), internal tri-channel connection bone level position (ITC), internal hexagon 1 mm below the bone level (HI), internal hexagon bone level position (HI crest), cone morse 1 mm below the bone level (CM), cone morse bone level position (CM crest) and internal octagon bone level position (IO). The following parameters were considered for descriptive data synthesis: sample size, implant manufacturer, prosthetic joint type, prosthetic complications, marginal bone loss, study outcomes. Results: A total of 247 papers were identified by the electronic screening and 241 were submitted for the full text assessment. The eligibility process excluded 209 articles, and 32 studies with a low risk of bias were considered for the qualitative synthesis and further statistical methods. At the baseline, the CM showed a more effective efficiency and reduced marginal bone loss compared to IC, EI, ITC, internal hexagon, cone morse and internal octagon (p < 0.05). CM showed the lower rate of prosthetic complications and structural device failure including abutments and joint components under the loading compared to other joint types. Conclusion: Within the limits of the present investigation, the heterogeneity, the weight of the study model considered and the inherent differences between the dental implant properties, the pure CM showed a more consistent control of marginal bone loss at short- and medium-term follow-up. Despite the low rate of cumulative complications for all joints considered, the CM abutment joints were less prone to prosthetic failure at an early and medium-term follow-up. [ABSTRACT FROM AUTHOR]

In order to treat edentulous patients with fixed implant prosthesis, the final prosthesis form should be predetermined based on the anatomic structures of the arch, the opposing dentition, and the occlusal plane. The design and occlusion of the interim prosthesis can provide useful information when fabricating the definitive prosthesis. In this case report, scan data of the edentulous region and the interim prosthesis were superimposed through an intraoral scanning digital workflow. In this way, the interim prosthesis information was incorporated into the design of the final prosthesis. Furthermore, the interim prosthesis data acquired through intraoral scanning was utilized to plan the positions and angles of the implants based on the final prosthesis design. Surgical guides were used to accurately place the implants in the planned three-dimensional positions. In this case report, satisfactory esthetic and functional clinical outcomes were achieved through application of digital techniques. [ABSTRACT FROM AUTHOR]

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Objectives: To determine the association between tobacco and peri‐implant diseases in a sample of patients who had received implant‐supported restorations in a university dental clinic. Furthermore, the study aimed to investigate patient‐ and implant‐related variables associated with peri‐implant diseases. Materials and Methods: The present retrospective study analyzed data from 117 patients treated with implant‐supported restorations from 2001 to 2013. A total of 450 implants were evaluated. Patients were selected from an electronic database, and patient‐ and implant‐related variables were evaluated. Detailed information regarding the smoking history (i.e., smoking status, lifetime cumulative dose, duration of exposure, intensity of the habit, and smoking cessation) was recorded. The primary study outcome was peri‐implant status [i.e., health (H), peri‐implant mucositis (PM) and peri‐implantitis (PI)]. Univariate and multinomial regression models comparing PM and PI versus peri‐implant health were conducted. Results: A total of 117 subjects [55 (47%) females and 62 (53%) males] with a mean age at examination of 64.2 years (SD 11.6) and rehabilitated with 450 implants were included. The average number of implants per patient was 4.6 (SD 3.3) with a mean time in function of 8.0 years (SD 1.9). Fifty‐six patients (47.9%) were non‐smokers, 42 (35.9%) were former‐smokers, and 19 (16.2%) were current‐smokers. Thirty‐nine subjects (33.4%) were H, whereas 41 (35%) and 37 (31.6%) exhibited PM and PI, respectively. At implant level, the corresponding values were 142 (31.6%), 230 (51.1%) and 78 (17.3%). In the multinomial regression model, significant associations for peri‐implant diseases were observed for the mean number of implants per patient (p =.016), function time (p =.048), implants placed simultaneously with guided bone regeneration (p =.016), implant surface (p =.020), keratinized mucosa at the buccal aspect (p =.032), and access to interproximal hygiene (p <.001). In addition, ever smokers >23 pack‐years exhibited a significantly higher risk for peri‐implantitis (p =.002). Finally, the multinomial regression analysis revealed that subjects who had stopped smoking more than 21 years before the last examination presented a significantly lower risk of peri‐implant diseases than a smoking cessation of ≤21 years (p =.028). Conclusions: Smoke intensity was associated with an increased risk of the development of peri‐implantitis. Moreover, the risk of peri‐implant diseases might be similar in those subjects who had stopped smoking for more than 21 years with respect to never‐smokers. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this cone beam computed tomography (CBCT) study was to determine the frequency percentage of screw‐retained crown using angulated screw channel (ASC) abutment for single immediate implant placement and provisionalization (IIPP) in the esthetic zone. Methods: The CBCT images of 200 patients without disease and without metal restorations in maxillary anterior teeth were evaluated. The mid‐sagittal‐sectional CBCT images of maxillary anterior teeth (#6–#11) were created in an implant planning software, screen‐captured, and transferred to a presentation program. Template of tapered implants with diameter of 3.5 mm (for central and lateral incisors) and 4.3 mm (for central incisors and canines) and lengths of 13, 15, and 18 mm were applied to the sagittal images to identify the IIPP cases. To qualify for IIPP, the implant must engage >35% bone with at least 1 mm of surrounding bone and no perforations. The IIPP cases were further divided into straight screw channel (IIPPSSC) abutment or 25‐degree angulated screw channel abutment (IIPPASC), based upon its restorability. The frequency percentages of possible IIPP, IIPPSSC, and IIPPASC were reported and compared among all maxillary anterior teeth. Results: A total of 1200 maxillary anterior teeth sagittal images from 200 patients (88 male and 112 female) with a mean age of 51.3 years (range 20–83 years) were evaluated in this study. The overall frequency percentages of IIPP, IIPPSSC, and IIPPASC possibility were 84% (74%–92%), 14% (10%–24%), and 75% (66%–87%), respectively. Conclusion: Within the limitations of this CBCT study, 90% of single IIPP in the esthetic zone can be restored with screw‐retained crown when utilizing ASC. In addition, the possibility of using a screw‐retained restoration following IIPP increases about five times with ASC abutment compared to the SSC abutment. [ABSTRACT FROM AUTHOR]

Incomplete orthodontic therapy can lead to severe root resorption, resulting in mobile and non-re-storable teeth. This clinical report presents the diagnosis, treatment planning and oral rehabilitation of a young woman with failing dentition in the anterior maxilla due to orthodontically induced root resorption. The patient's chief complaint was mobile maxillary anterior teeth 2 years after discontinuing orthodontic treatment. Radiographic and clinical evaluations revealed a missing right first premolar and left premolars and grade III mobility from the right canine to the left lateral incisor. Due to a hopeless prognosis, extraction of the maxillary anterior teeth was planned, followed by grafting procedures. Four implants were immediately placed in the fresh sockets of the canine and central sites, and a removable provisional appliance was delivered to contour the soft tissues involved. The final restorations consisted of two three-unit layered zirconia implant-supported fixed dental prostheses. Well-planned immediate implant therapy and zirconia restorations can successfully replace mobile teeth with severe root resorption caused by external surface resorption from incomplete orthodontic treatment. Combining grafting procedures during implant placement can replace hard tissue lost due to extractions, whereas provisional restorations can re-establish optimal tissue architecture in the aesthetic zone. The present case offers insight into effective strategies for treating non-compliant or uncooperative patients with failing dentition due to orthodontically induced root resorption. [ABSTRACT FROM AUTHOR]

Short dental implants with platform matching connection have been used for the rehabilitation of atrophic jaws whenever standard-length dental implants cannot be placed without prior bone augmentation. Yet, there remains a lack of data regarding the risk of technical failures when the all-on-4 configuration is performed in atrophic jaws with platform-switching distal short dental implants. Thus, the current study used the finite element method to evaluate the mechanical behavior at the level of the prosthetic components of the all-on-4 concept performed in atrophic mandible using short-length distal implants with platform switching (PSW) connection. Three models of the all-on-4 configuration were generated in human atrophic mandibles. The geometric models consisted of PSW connection tilted standard (AO4T; θ = 30 deg; 11 mm-length), straight standard (AO4S; θ = 0 deg; 11 mm-length) and straight short (AO4Sh; θ = 0 deg; 8 mm-length) distal implants. A resultant force of 300 N was performed obliquely in the left side and posterior region of the prosthetic bar. The von Mises equivalent stress (σvm) and maximum and minimum principal stresses (σmax and σmin) were performed at level of the prosthetic components/implants and peri-implant bone crest, respectively. The general displacement of the models was also evaluated. The stress analysis was performed on the side of load application. The AO4S configuration showed the lowest values of σvm in the mesial left (ML) and distal left (DL) abutments (37.53 MPa and 232.77 MPa, respectively) and dental implants (91.53 MPa and 231.21 MPa, respectively). The AO4Sh configuration showed the highest values of σvm in the bar screw (102.36 MPa), abutment (117.56 MPa), and dental implant (293.73 MPa) of the ML area. Among the models, the highest values of σmax and σmin were noticed in the peri-implant bone crest of the AO4T design (131.48 MPa and 195.31 MPa, respectively). All models showed similar values of general displacements, which were concentrated in the mandible symphysis. The all-on-4 configurations designed with PSW connection and tilted standard (AO4T; θ = 30 deg; 11 mm-length), straight standard (AO4S; θ = 0 deg; 11 mm-length) or straight short (AO4Sh; θ = 0 deg; 8 mm-length) distal implants were not associated with higher odds of technical failures. The AO4Sh design may be a promising option for the prosthetic rehabilitation of atrophic jaws. [ABSTRACT FROM AUTHOR]

Objective: The objectives of the study were to assess the survival, failure, and technical complication rates of implant‐supported fixed dental prosthesis (iFDPs) with pontic or splinted crown (iSpC) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes. Methods: Electronic and manual searches were performed to identify randomized‐, prospective‐, and retrospective clinical trials with follow‐up time of ≥12 months, evaluating the clinical outcomes of posterior iFDPs with pontic or iSpCs. Survival and complication rates were analyzed using robust Poisson's regression models. Results: Thirty‐two studies reporting on 42 study arms were included in the present systematic review. The meta‐analysis of the included studies indicated estimated 3‐year survival rates of 98.3% (95%CI: 95.6–99.3%) for porcelain‐fused‐to‐metal (PFM) iFDPs, 97.5% (95%CI: 95.5–98.7%) for veneered zirconia (Zr) iFDPs with pontic, 98.9% (95%CI: 96.8–99.6%) for monolithic or micro‐veneered zirconia iFDPs with pontic, and 97.0% (95%CI: 84.8–99.9%) for lithium disilicate iFDPs with pontics. The survival rates for different material combination showed no statistically significant differences. Veneered restorations, overall, showed significantly (p <.01) higher ceramic fracture and chipping rates compared with monolithic restorations. Furthermore, there was no significant difference in survival rates (98.3% [95%CI: 95.6–99.3%] vs. 99.1% [95%CI: 97.6–99.7%]) and overall complication rates between PFM iFDPs with pontic and PFM iSpCs. Conclusions: Based on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iSpCs showed similarly high short‐term survival rates in the posterior area. Veneered restorations exhibit ceramic chipping more often than monolithic restorations, with the highest fracture rate reported for veneered Zr iFDPs. [ABSTRACT FROM AUTHOR]

Objective: Marginal bone loss (MBL), a prognostic parameter for implant success, is associated with implant- and patient-related variables. The purpose of this study was to analyze the effects of the crown-to-implant ratio and independent factors of implant diameter, implant length, implant type, location, and platform switching on distal and mesial MBLs at the 6-, 12-, 24-, and 36-month recall sessions of single crown implant-supported restorations. Method and materials: Radiographic and clinical data of patients treated with single crown implants were collected. MBL was measured at the baseline and recall sessions on panoramic radiographs. The crown-to-implant ratio was calculated by dividing the length of the crown by that of the dental implant. Results: The crown-to-implant ratio had a moderately positive correlation with distal MBL at the 6-month recall session (P < .05, r = 0.469) and a weakly positive correlation at the 12- (P < .05, r = 0.220), 24- (P < .05, r = 0.214), and 36- (P < .05, r = 0.250) month recall sessions. Distal and mesial MBL did not significantly differ among the four implant types at any recall session (P > .05). The crown-to-implant ratio had no significant correlation with mesial MBL at the 12-, 24-, or 36-month recall session (P > .05), and a moderately positive correlation at the 6-month recall session (P < .001, r = 0.434). Conclusions: MBL was similar among different implant types in the short and medium terms. There was a positive correlation between distal MBL and the crown-to-implant ratio. [ABSTRACT FROM AUTHOR]

When restoring with a dental digital system for implant-supported prosthesis, a double digital scanning technique is required: an intraoral scan of the three-dimensional implant location and intraoral scan after placement of temporary denture or provisional prosthesis. During the intraoral scan, the use of scan body as a stable landmark can improve the accuracy of digital impression and simplify laboratory process. In this case, a full-digital system was used to plan and fabricate a custom abutment, provisional prosthesis, and definitive prosthesis. After implant placement, the scan area of the intraoral scan body connected with implant and the intraoral scan body marked on the inside of temporary denture were superimposed. Out of the superimposed files, a custom abutment and provisional prosthesis were fabricated which match the vertical dimension of temporary denture, and definitive prosthesis was fabricated based on provisional prosthesis. We report this case because result has been functionally and esthetically satisfactory by using vertical dimension and central relation set during the fabrication of temporary denture to the definitive prosthesis. [ABSTRACT FROM AUTHOR]

Aim: The conometric concept was proposed as a possible connection between the abutment and the prosthetic coping. This research aimed to review the features and possible clinical uses of this connection in an implant-supported fixed prosthesis. Methods: An electronic search was conducted on an online database for the topic in object; articles published in international literature were considered and the research gave 17 results, and 6 parameters were analyzed. Results: This connection eliminated the possibility of cement residues in the subgingival region, reducing the risk of inflammation of peri-implant soft and hard tissues; not having to remove the cement residues, it is possible to place the margins in more apical portions, improving the aesthetics outcomes of the rehabilitations. It is also known that the retention by means of a screw causes a weakening of the restoration. The retentive force is adequate for fixed rehabilitation even after a high number of insertion–disengagement cycles; in vitro studies have also shown a high bacterial sealing. Implant rehabilitation using preformed components, such as conometric hoods, is helpful for CAD/CAM, so a digital workflow is possible. Several types of prosthesis were presented, all of which demonstrated adequate clinical performance in the follow-up observation. Conclusions: This type of connection seems to be suitable to support fixed implant rehabilitations, but long-term clinical studies are needed to validate this system.

Objective: The aim of this retrospective study was to investigate the influence of vertical platform discrepancies for splinted and non‐splinted adjacent implants on radiographic marginal bone loss (RMBL). Methods: Data from January 2000 to February 2021 were collected from the electronic charts of 156 patients with 337 implants at the UCSF School of Dentistry. Five different implant restoration categories were evaluated for radiographic evidence of proximal RMBL. Patients with (1) two adjacent single crowns, (2) two adjacent splinted crowns, (3) three‐unit bridges supported by two implants, (4) three adjacent single crowns, and (5) three adjacent splinted crowns. Inclusion required baseline radiograph taken at the time of prosthesis delivery or final impression, and follow‐up radiographs at least 12 months after restorations have been in function. Measurements assessed included vertical distance between adjacent implant platforms and proximal RMBL around implants. Odds ratios (ORs) and 95% confidence interval (95% CI) of implants with ≥1 mm RMBL between different type of restorations were calculated. Results: In general, prostheses supported by splinted adjacent implants demonstrated a significant association with the presence of ≥1 mm RMBL (OR = 2.55, 95% CI = 1.17–5.17, p = 0.018) when compared to prostheses supported by non‐splinted adjacent implants. In addition, prostheses with a vertical platform discrepancy ≥0.5 mm demonstrated a significant association with the presence of ≥1 mm RMBL (OR = 4.30, 95% CI = 1.85 to 10.01, p = 0.007) when compared to prostheses with a vertical platform discrepancy <0.5 mm. When adjacent implants had ≥0.5 mm vertical platform discrepancy, the majority (66.67%) of three splinted adjacent crowns had at least one implant with ≥1 mm RMBL. This was followed by two splinted adjacent crowns (58.97%), three‐unit bridge (25.93%), two single adjacent crowns (24.24%), and three single adjacent crowns (18.18%). When adjacent implants had ≥1 mm vertical platform discrepancy, there was an increased percentage of implants with ≥1 mm RMBL. The restorative design associated with the highest percent of implants with bone loss was three splinted adjacent crowns (70%), two splinted adjacent crowns (61.11%), three single adjacent crowns (40%), and three‐unit bridge and two single adjacent implants (21.05%). Three splinted adjacent crowns were significantly associated with ≥1 mm RMBL when compared to three‐unit bridge (OR 6.56, 95% CI 1.59–27.07). Similarly, two splinted crowns were significantly associated with ≥1 mm RMBL when compared to two single crowns (OR = 2.50, 95% CI = 1.08–5.79). Conclusion: Two or three adjacent implants placed with a vertical platform discrepancy, when splinted together, are associated with higherincidence of ≥1 mm RMBL than non‐splinted restorations. [ABSTRACT FROM AUTHOR]

Single-implant overdentures (SIOs) represent a major biomechanical challenge in terms of prosthetic retention. The Novaloc attachment system has the potential to overcome those challenges when used for SIOs, due to the use of PEEK matrices. This study compared the retentive force of the Novaloc attachment to the traditional Locator system, before and after cyclic insertion–removal cycles. Three Novaloc matrices (white, yellow, and green, corresponding to low, medium, and high retention, respectively) and Locator (medium retention) were tested, totalling four groups. Retentive force was measured using an Imada force gauge before and after 1095 insertion–removal cycles, corresponding to a year of SIO wearing. Retention was tested with the implants angulated at 0, 10, and 20°. Data for the different groups, angles, and cycling periods were tested via linear regression analysis and two-way ANOVA (α = 0.05). Although the Locator system yielded higher retention forces in general, it lost a much higher percentage of retention with cycling. This trend was similar with the three angles, with forces being inversely proportional to the implant angulation. The authors conclude that Novaloc may provide more reliable retention for SIOs due to their higher resistance to insertion–removal cycling. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effect of a novel interocclusal recording method on the occlusal accuracy of implant‐supported fixed prostheses for partially dentate patients with distal extension. Materials and Methods: Twenty patients with two or more adjacent teeth missing in the distal extension and scheduled to receive implant‐supported fixed prostheses were enrolled. Two interocclusal recording methods were used: placing polyvinyl siloxane (PVS) on the interocclusal recording caps (test), and placing PVS on healing abutments (control). The intraoral occlusal contacts in maximal intercuspal position (MIP) were compared with those in the mounted casts to calculate sensitivity and positive predictive value (PPV). Then, patients were randomly allocated into two groups to determine which interocclusal record would be used. The implant prostheses' evaluations mainly included occlusal adjustment height, volume, and time, occlusal contact score based on articulating paper examination. Paired‐samples t‐test, Mann–Whitney U test, and least squares regression analyzed the statistic differences. Results: The test method had higher sensitivity to detect intraoral occlusal contacts than the control method (p =.002), but similar PPV (p =.10). During the prostheses' evaluations, the occlusal adjustment height in the test group was significantly lower than that in the control group [99.4 (53.2, 134.2) vs. 159.0 (82.3, 247.8) μm, p =.03], while the occlusal contact score before adjustment was higher (p =.006). The groups had similar occlusal adjustment volume and time. Conclusions: The novel interocclusal recording method for implant‐supported fixed prostheses was more accurate and could reduce the occlusal adjustment. [ABSTRACT FROM AUTHOR]

Objective: To assess the influence of systemic sclerosis (SSc) on the survival rate of dental implants in SSc patients receiving implant‐supported treatments. Methods: The Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) Statement and the Cochrane Collaboration's guiding principles were followed during the study's execution. The data from three databases, PubMed, Google Scholar, and Scopus, available until January 2023, were used to compile the material for our research. Only English‐language publications were submitted for this research and evaluated based on their titles, abstracts, and full texts. For performing a quality assessment, quality scores were calculated. Results: The total number of patients and implants studied were 37 and 153, respectively, all having had scleroderma. The patients' ages ranged from 28 to 77 years old, with a mean (SD) age of 58.16 (12.88). All the patients in the case reports and most in the case series study were female. The range of follow‐up duration was from 1 to 10 years. In case report studies, the survival rate was 100%; in case series, it was 89.2%. Conclusion: The SSc status had no discernible impact on the implant survival rate. Implant‐based treatments in SSc patients should not worsen the overall morbidity and should not conflict with systemic treatments. Before starting implant therapy, a thorough risk assessment is essential, though. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the gingival thickness and biologic width in the aesthetic zone (maxillary central and lateral incisors) in an Asian population using cone beam computed tomography (CBCT) as a non-invasive measurement method, prior to immediate implant placement. The gingival geometric ratio is introduced as a new parameter for assessing soft tissue stability and hence predicting the aesthetic outcome. The gingival thickness, biologic width category (normal, high, and low crest), and gingival geometric ratio (shape and configuration of the gingival tissues) were assessed for 171 central and 175 lateral incisors on high-resolution CBCT images. Thick gingivae were found in 93.6% of the central incisors and 64% of the lateral incisors (P < 0.001). The difference in thickness between the central and lateral incisors was statistically significant (P < 0.001). Regarding the biologic width of the facial gingival tissue, the majority of central (64.8%) and lateral (64.3%) incisors were categorized as low crest (>3 mm). The study found that most of the gingivae of the maxillary central incisors were thick, while thin gingivae were more prevalent in the lateral incisors. Therefore, an individual patient may have different gingival thickness types, and 'one individual, one gingival biotype' may not be true. Furthermore, the majority of the facial gingival tissues of the maxillary incisors were found to be low crest. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate axial displacement in cement-retained prostheses using computer-aided design/computer-aided manufacturing (CAD/CAM) abutments with three different types of implant-abutment connections. Materials and Methods: CAD/CAM abutments made with two types of titanium blocks (made by the same manufacturer as the implant manufacturer and by a manufacturer with a patent for CAD/CAM abutment fabrication) were connected with three types of implant connections: external, internal butt, and internal conical connection. Titanium custom abutments and zirconia prostheses were fabricated using the CAD/CAM system for each specimen. The geometries and surface morphologies of CAD/CAM abutments and ready-made abutments were comparatively evaluated using scanning electron microscopy. Cemented prostheses on abutments were mounted on a universal testing machine and subjected to 250-N sine wave cyclic loads. Cumulative axial displacement was measured at 3, 10, 100, and 106 loading cycles and analyzed by repeated measures analysis of variance (ANOVA). Results: Surface geometries and morphologies of CAD/ CAM abutments varied by the implant-abutment connections and manufacturers of the titanium block. The internal conical connection exhibited the greatest axial displacement, while the external connection showed the lowest axial displacement. The CAD/CAM abutment made with a compatible titanium block exhibited a greater axial displacement than that exhibited by the abutment fabricated using a titanium block made by the implant manufacturer. Conclusion: In implant connections with a vertical stop, axial displacement occurred primarily in the early loading period and was self-limited. However, long-term axial displacement can occur with internal conical connection implants. Therefore, in internal conical connection implants, axial displacement should be managed more carefully using a provisional restoration, with consideration of the abutment fabrication method. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the influence of the crown-to-implant ratio (CI) on marginal bone loss (MBL) around short dental implants placed in the posterior mandible. Materials and Methods: All patients treated with short implants (7-mm length) in the posterior mandible between 1994 and 2003 at the Dental Clinic of the Department of Neuroscience of the University of Padua (Italy) were retrospectively included in the analysis. MBL and clinical CI (cCI) were measured on the radiographs. Implant characteristics including implant diameter, prosthetic type, retention mode, antagonist type, veneering material, and implant surfaces were retrieved from local medical records. A generalized linear mixed model was estimated to identify the predictors of MBL. Results: A total of 108 dental implants placed in 51 patients were included in the analysis. Mean follow-up was 16 years (range: 11 to 20 years). Mean cCI was 2.21 (SD = 0.31) with a mean crown height of 10.86 mm (SD = 0.99). Mean MBL was 1.42 mm (SD = 0.38). At multivariable analysis, cCI ≥ 2 was associated with higher MBL (regression coefficient: 0.27; 95% CI: 0.15 to 0.40), while implant characteristics, follow-up, and site were not associated with MBL. The effect of a cCI ≥ 2 was estimated in an increase of 0.28 mm in MBL (95% CI: 0.14 to 0.43 mm). Conclusion: Higher cCI was associated with greater MBL of implant-supported fixed dental prostheses in short dental implants placed in the posterior mandible, while implant characteristics, follow-up, and site were not associated with MBL. However, the increase of 0.28 mm of MBL in patients with a cCI ≥ 2 may not be clinically relevant. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical and radiographic outcomes of full-arch mandibular rehabilitation with fixed prostheses supported by three immediately loaded implants after at least 5 years of follow-up. Materials and Methods: The sample comprised 58 patients who underwent treatment with immediate loading. Radiographic evaluation of bone loss was carried out in Adobe Photoshop CS5 by a single calibrated examiner using digitized panoramic radiographs. Clinical examination of the technical conditions of the prosthetic device assessed the condition of the acrylic resin base, dental occlusion, metal framework, presence of cover screws, screw fixation of the prosthesis and abutments, and length of cantilever and resistance arms. Results: Five implants in four patients failed, for an overall success rate of 97.13%. Mean bone loss was 2.65 ± 1.06 mm around central implants and 2.11 ± 0.84 mm around distal implants. The most common complication was loss of abutment torque. Half of all patients in the sample experienced some prosthetic complication. There was no evidence of a statistically significant relationship of cantilever length with bone loss or prosthetic complications. Conclusion: The immediately loaded three-implant-supported fixed prosthesis protocol tested in this study proved to be a viable therapeutic strategy for mandibular rehabilitation in edentulous patients, with favorable outcomes after 5 years of clinical and radiographic follow-up. [ABSTRACT FROM AUTHOR]

Abstract Objective To assess the influence of systemic sclerosis (SSc) on the survival rate of dental implants in SSc patients receiving implant‐supported treatments. Methods The Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) Statement and the Cochrane Collaboration's guiding principles were followed during the study's execution. The data from three databases, PubMed, Google Scholar, and Scopus, available until January 2023, were used to compile the material for our research. Only English‐language publications were submitted for this research and evaluated based on their titles, abstracts, and full texts. For performing a quality assessment, quality scores were calculated. Results The total number of patients and implants studied were 37 and 153, respectively, all having had scleroderma. The patients’ ages ranged from 28 to 77 years old, with a mean (SD) age of 58.16 (12.88). All the patients in the case reports and most in the case series study were female. The range of follow‐up duration was from 1 to 10 years. In case report studies, the survival rate was 100%; in case series, it was 89.2%. Conclusion The SSc status had no discernible impact on the implant survival rate. Implant‐based treatments in SSc patients should not worsen the overall morbidity and should not conflict with systemic treatments. Before starting implant therapy, a thorough risk assessment is essential, though.

Objectives: This prospective study aimed to compare the oral functions of removable partial dentures (RPDs) with those of implant‐assisted removable partial dentures (IARPDs) with short implants and magnetic attachments in patients with mandibular Kennedy class I and II. Material and Methods: Thirty participants with mandibular Kennedy class I or II and at least three distal missing teeth were recruited. Oral functions, including mixing ability, comminuting ability, maximum bite force, and occlusal contact area, were assessed for RPDs (stage 0), IARPDs with healing caps (stage 1), and IARPDs with magnetic attachments (stage 2). The implants were loaded with occlusal force in stages 1 and 2. Finally, the data of the 27 participants who completed the evaluation at stage 2 were analyzed. The Wilcoxon signed‐rank test with Bonferroni correction was used to assess the differences in the oral functions among the different stages. Results: The implant survival rate was 93.8%. There were significant differences in the comminuting ability and occlusal contact area between stages 0 and 2 (p <.001 and p =.036, respectively) and stages 1 and 2 (p =.003 and p =.015, respectively). Regarding the maximum bite force, there was a significant difference between stages 1 and 2 (p =.018). However, there was no significant difference in the mixing ability between the three stages. Conclusions: Within the limitations of this study, it was concluded that IARPDs in the mandible with short implants and magnetic attachments may improve oral functions. [ABSTRACT FROM AUTHOR]

Introduction: Dental implant treatment is considered the gold standard today for the elimination of tooth loss. In this study, it was aimed to evaluate the level of knowledge about dental implant treatments of patients referred to Tokat Gaziosmanpaşa University Faculty of Dentistry Prosthetic Dentistry Clinic. Material and Method: A total of 296 patients, 166 women and 130 men, participated in the study. The multiple choice standardized questionnaire form including demographic information was filled out by the patients. Results: 42.2% of the patients obtained information about implants from doctors or dentists. 74.7% of the participants preferred to have the implant surgery phase done by a maxillofacial surgeon, and 66.2% preferred to have prosthesis over the implant done by a prosthesis specialist. When the questionnaire responses of the patients were evaluated with the age variable, it was observed that the awareness level of the individuals under the age of 35 about dental implants was statistically significantly higher (p lt;0.05). Conclusion: When the results of the present study were evaluated, it was seen that individuals who needed prosthetic dental treatment due to tooth deficiency did not have sufficient knowledge about dental implants. In order to provide more accurate information about dental implants to patients, the resources that patients use to obtain information should be reached.

Introduction: Since first molars are among the first lost teeth, is it common to restore them with dental implants. Considering the amount of remaining mesiodistal space, a wide/medium-diameter implant or two medium/narrow-diameter implants are used in this region. However, the impression procedure can be complicated when two closely adjacent implants are placed.Technical Report: A patient with two narrow-diameter implants placed in the mandibular right first molar referring for prosthetic restoration. It was not possible to secure both impression copings simultaneously for conventional impression making due to the proximity of implants and the width of impression copings. Therefore, it was decided to follow the altered cast procedure after making two implant impressions, preparing casts, and selecting abutments separately. The preparation of the index for the final cast is possible via using two methods of splinting the final abutments or resin copings intraorally. Conclusion: In case that the position of the implants is not ideal, the selection of the proper impression technique is important for achieving a successful prosthetic outcome. The use of the altered cast impression technique in the presence of two adjacent implants in the molar area is helpful for a successful treatment.

Purpose: Implant-retained mandibular overdentures are a proven treatment modality for edentulous patients. Low-profile stud attachments may allow divergence between the abutments up to 40 degrees. The purpose of this study was to investigate load transfer characteristics of various locations and nylon male configurations of low-profile stud attachment–retained overdentures. Materials and Methods: Three tapered dental implants were placed into three photoelastic mandibular models. The center implants were placed vertically onto the midline, and the distal implants were inclined 20 degrees corresponding to centralized implants. Three different distances (11, 18, and 25 mm) between the centralized and the distal implants were set on the models. Low-profile stud attachment (Locator)–retained mandibular overdentures were fabricated for each photoelastic model. Five different nylon male configurations of this stud attachment were established. The load transfer characteristics of the configurations were tested using a circular polariscope. Results: The observed stress levels for the tested configurations were moderate except for group 25C (photoelastic model with 25-mm interimplant distances and clear nylon male), which illustrated a high stress level. For the 11-mm photoelastic model, little or no discernible stress was noted around the dental implants for group 11R (red nylon male), group 11G (green nylon male), and configurations of clear and red or green nylon males (group 11CR [clear and red nylon males] and group 11CG [clear and green nylon males]). Conclusion: The applied loads were distributed to the supported dental implants and denture-bearing areas for tested designs. Equitable load distribution and less stress may be gathered using nylon males for angulated implants (red and green) when dental implants are placed inclined. [ABSTRACT FROM AUTHOR]

Purpose: To assess studies on edentulous patients rehabilitated using mandibular implant-supported profile prostheses and analyze the impact of different numbers of implants used on the implant survival rate, peri-implant bone loss, and prosthesis survival rate. Materials and Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement and was registered on PROSPERO. The PubMed/MEDLINE database was searched for articles published before July 18, 2016. The study attempted to answer the following PICO question: In edentulous patients, do full-arch fixed prostheses supported by three implants have a satisfactory implant survival rate, marginal bone loss, and prosthesis survival rate compared with those supported by different numbers of implants? Evidence levels of each study were evaluated using the Oxford Centre for Evidence-Based Medicine (OCEBM); methodologic quality was evaluated using the Methodological Index for Nonrandomized Studies (MINORS) scale and Cochrane Risk of Bias Tool. Descriptive statistics were performed when applicable. Implant survival curves were constructed using the Kaplan-Meier method, and marginal bone loss was analyzed using the Kruskal-Wallis, Dunn’s, and Mann-Whitney tests. Results: This analysis included 21 published studies of 4,712 implants and 1,245 mandibular implant-supported profile prostheses in 1,245 patients. The patients were grouped by the number of implants used: group 1 (three implants) had an implant survival rate of 90%; group 2 (four implants) had a rate of 95%; and group 3 (five implants) had the lowest rate, 74%. Groups 1 and 3 had the lowest first-year bone losses (median: 0.73 and 0.70 mm, respectively), and were significantly different from group 2 (median: 1.31 mm; P < .001). Conclusion: Despite the limitations in the studies with low levels of evidence and the methodology of MeSH term research, it was concluded that the implant survival rate and first-year bone loss of full-arch fixed prostheses supported by three implants were satisfactory. However, the prosthesis survival rate was inferior to that of other groups, which suggests a longer follow-up of these rehabilitations. [ABSTRACT FROM AUTHOR]

Purpose: To investigate if the presence of a cantilever influences the survival and success of partial fixed implant-supported prostheses, through a systematic review and meta-analysis, with additional analysis of the survival and marginal bone loss rates and prosthesis complications. Materials and Methods: The register protocol of the review in the PROSPERO database is CRD42016052008. The MEDLINE and Scopus databases were used for an electronic search of relevant studies up to November 2016, by means of two independent reviewers. The keywords included the combinations “fixed partial denture” with “dental implants”, and with “extension” or “cantilever”; and “implant-supported dental prosthesis” with “extension” or “cantilever”. The inclusion criteria were randomized clinical trials and prospective and retrospective clinical studies in English that addressed the comparison of success and survival of the use of implant-supported fixed prostheses, with and without cantilevers. Data from the selected studies were used to perform the statistical analysis. Results: Among the 408 articles identified, 4 articles met the eligibility criteria. The presence of a cantilever did not compromise marginal bone loss or the survival of the prostheses. However, minor complications were encountered for the group of partial fixed prostheses without cantilevers, with a statistical difference (P = .008). Conclusion: Cantilevers can be used in fixed prostheses and do not interfere negatively in the survival or success of the prosthesis or the marginal bone loss. However, there are minor complications when prostheses without cantilevers, or short cantilevers, are used. [ABSTRACT FROM AUTHOR]

Aim: To review available evidence in scientific literature on oral implants of severely reduced length or diameter. Materials and methods: Electronic and hand searches up to May 2017 were performed in order to identify clinical investigations providing implant survival and/or marginal bone resorption data for extra-short implants < 7.0 mm in length and extra-narrow implants < 3.5 mm in diameter (excluding one-piece mini-implants). Results: A total of 2929 extra-short implants and 3048 extra-narrow diameter implants were investigated in 53 and 29 clinical studies, respectively. Shorter implants between 4.0 mm and 5.4 mm in length showed comparable results to implant lengths of 5.5 mm to 6.5 mm (95.1% vs. 96.4%, P = 0.121) and no difference regarding marginal bone resorption (0.7 mm vs 0.5 mm, P = 0.086). Implant lengths of 5.5 mm to 6.5 mm, however, performed significantly better in the mandible compared with the maxilla (P = 0.010). Smaller diameters between 3.0 mm and 3.25 mm yielded a significantly lower survival rate of 94.3% than wider implants of 3.3 mm to 3.4 mm diameter (97.7%, P < 0.001), while marginal bone resorption did not differ (0.4 mm vs 0.5 mm, P = 0.447). Conclusions: The results of the present literature review suggest that extra-short and extra-narrow-diameter implants show satisfactory survival rates of around 95% and little marginal bone resorption of around 0.5 mm after a mean follow-up of 3 years. However, implant lengths < 7 mm in the maxilla and < 5.5 mm in the mandible as well as diameters < 3.3 mm may increase early failure rates. [ABSTRACT FROM AUTHOR]

Aim: The conometric concept was proposed as a possible connection between the abutment and the prosthetic coping. This research aimed to review the features and possible clinical uses of this connection in an implant-supported fixed prosthesis. Methods: An electronic search was conducted on an online database for the topic in object; articles published in international literature were considered and the research gave 17 results, and 6 parameters were analyzed. Results: This connection eliminated the possibility of cement residues in the subgingival region, reducing the risk of inflammation of peri-implant soft and hard tissues; not having to remove the cement residues, it is possible to place the margins in more apical portions, improving the aesthetics outcomes of the rehabilitations. It is also known that the retention by means of a screw causes a weakening of the restoration. The retentive force is adequate for fixed rehabilitation even after a high number of insertion–disengagement cycles; in vitro studies have also shown a high bacterial sealing. Implant rehabilitation using preformed components, such as conometric hoods, is helpful for CAD/CAM, so a digital workflow is possible. Several types of prosthesis were presented, all of which demonstrated adequate clinical performance in the follow-up observation. Conclusions: This type of connection seems to be suitable to support fixed implant rehabilitations, but long-term clinical studies are needed to validate this system. [ABSTRACT FROM AUTHOR]

This case report presents the conservative management of a malposed implant in the maxillary anterior region caused by craniofacial bone remodeling. The patient expressed dissatisfaction with the position and shade of an implant that was placed almost three decades previously. After evaluating different treatment options, the patient opted to replace the implant prosthesis. The selected treatment consisted of a zirconia crown layered with feldspathic porcelain (including pink porcelain) cemented onto a screw-retained customized zirconia abutment with an angled screw channel for the single-unit permanent fixed implant prosthesis. The report highlights the importance of informed decision making and patient preferences in treatment option selection. It emphasizes the conservative approach of replacing a malposed implant prosthesis with pink porcelain to address the patient's esthetic concerns. Dental photographs and shade-matching protocols were crucial in achieving satisfactory esthetic outcomes. The report also underscores the potential for infraocclusion as well as proclination caused by craniofacial growth in implant therapy, and emphasizes the significance of patient education regarding long-term considerations.

Objectives: To compare miniscrew versus bone tracing registration methods on dental implant placement accuracy and time efficiency in edentulous jaws using a dynamic computer-assisted implant surgery (d-CAIS) system., Methods: Twelve fully edentulous maxillary models were allocated into two groups: miniscrew tracing (MST) group, where registration was performed by tracing four miniscrews; and bone tracing (BT) group, where registration was conducted by tracing maxillary bone fiducial landmarks. Six implants were placed on each model using the X-Guide® d-CAIS system. Pre- and postoperative cone-beam computed tomography (CBCT) scans were superimposed to evaluate implant placement accuracy. The time required for registration and the overall surgery time were also recorded., Results: Thirty-six implants were placed in each group. The MST group showed significantly lower mean angulation deviations (mean difference (MD): -3.33°; 95 % confidence interval (CI): -6.56 to -0.09); p = 0.044), 3D platform deviations (MD: -1.01 mm; 95 % CI: -1.74 to -0.29; p = 0.006), 2D platform deviations (MD: -0.97 mm; 95 % CI: -1.71 to -0.23; p = 0.010), and 3D apex deviations (MD: -1.18 mm; 95 % CI: -1.92 to -0.44; p = 0.002) versus the BT group. The overall surgery time was similar for both groups (MD: 6.10 min.; 95 % CI: -0.31 to 12.51; p = 0.06), though bone tracing required significantly more time compared with miniscrew registration (MD: 4.79 min.; 95 % CI: 2.96 to 6.62; p < 0.05)., Conclusions: Registration with MST increases the accuracy of implant placement with a d-CAIS system in edentulous jaws compared with the BT method, and slightly reduces the overall surgery time., Clinical Significance: Miniscrew tracing registration improves implant placement accuracy in comparison with bone tracing registration., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors declare that they have no known competing financial interests or personal relationships directly related with this study. However, they would like to declare the following interests outside the submitted work: Dr. Octavi Camps-Font reports grants and non-financial support from Avinent (Santpedor, Spain), and non-financial support from Nobel Biocare (Zürich, Switzerland) outside the submitted work. Dr. Rui Figueiredo reports grants, personal fees, and non-financial support from MozoGrau (Valladolid, Spain), Avinent (Santpedor, Spain), Inibsa Dental (Lliçà de Vall, Spain), Dentaid SL (Cerdanyola del Vallés, Spain), non-financial support from Nobel Biocare (Zürich, Switzerland), personal fees from Geistlich Pharma AG (Wolhusen, Switzerland), BioHorizons Iberica (Madrid, Spain), Araguaney Dental (Barcelona, Spain), Septodont (Saint-Maur-des-fossés, France) and Laboratorios Silanes (Mexico city, Mexico) outside the submitted work. Dr. Figueiredo has also participated as a principal investigator in a randomized clinical trial sponsored by Mundipharma (Cambridge, UK) and in another clinical trial as a sub-investigator for Menarini Richerche (Florence, Italy). Dr. Eduard Valmaseda-Castellón reports grants, personal fees, and non-financial support from MozoGrau (Valladolid, Spain), Avinent (Santpedor, Spain), Inibsa Dental (Lliçà de Vall, Spain), Dentaid SL (Cerdanyola del Vallés, Spain), and personal fees from BioHorizons Iberica (Madrid, Spain) and Laboratorios Silanes (Mexico city, Mexico) outside the submitted work. Dr. Eduard Valmaseda-Castellón has also participated as a principal investigator in a randomized clinical trial sponsored by Geistlich Pharma AG (Wolhusen, Switzerland) and in another clinical trial as a sub-investigator for Mundipharma (Cambridge, UK)., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To assess the clinical performance of monolithic screw-retained implant-supported zirconia crowns (MSI) bonded or mechanically retained on prefabricated Ti-bases using a complete digital workflow., Methods: A retrospective analysis was conducted on patients who underwent single dental implant procedures between January 2017 and May 2018. Inclusion criteria were: patients over 18 years of age; implants placed in posterior sites; MSI on prefabricated Ti-base realized by using a complete digital workflow; a minimum follow-up period of 2 years. Cemented crowns and fixed dental prosthesis were excluded. Mechanical complications included: fracture of Ti-base; loss of retention; loosening of Ti-base screws. Technical complications included: fracture and debonding of monolithic zirconia. Biological complication was set strictly at a probing pocket depth of 5 mm and bleeding on probing or pus secretion., Results: A total of 144 dental implants placed in 127 patients were included, 73 with a fully tapered implant system (BLX) and 71 with a conical connection system (Nobel Parallel CC). Of the 73 BLX implants, 4 experienced loosening of the Ti-base screw, while 3 Nobel Parallel CC implants experienced the same problem. In addition, 4 fractures of the Ti-base and 6 fractures of the inner surface of the monolithic zirconia were observed in the Nobel Parallel CC implants. Cumulative survival was 100 % for bonded crowns and 85 % for mechanically retained crowns. Radiographic evaluation revealed a mean CBL of 0.12 mm for the BLX and 0.13 mm for the Nobel Parallel CC implants with no statistically significant differences between the Ti-base types. There was no evidence of bleeding on probing or pus secretion. All probing pocket depths were <3 mm., Conclusion: The use of a prefabricated Ti-base remains a clinically acceptable choice, however, MSIs bonded to prefabricated Ti-bases had fewer mechanical and technical complications than the MSI mechanically retained to a prefabricated Ti-base., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: This study aimed to assess the effect of the "cut-out rescan" strategy on the accuracy of intraoral digital scans from 25° convergent implants positioned at two distinct depths., Material and Methods: Two customized models were fabricated, each designated to receive two posterior converged implant fixtures: one at a depth of 1 mm and the other at a depth of 4 mm. Initially, the models were scanned as reference casts using a lab scanner. The test group was involved in scanning the 1-mm and 4-mm implant models using an intraoral scanner in the following order: (1) scanning the 1-mm (T1; n = 10) and (2) 4-mm (T4; n = 10) implant groups with scan bodies connected to both fixtures in each model; (3) cut-out rescan (COR) in the 1-mm (COR1; n = 10) and (4) 4-mm (COR4; n = 10) models, leading to 40 digital files in standard tessellation language format. The mean absolute deviation (MAD), in terms of trueness and precision, between the experimental and control scans was assessed through the alignment of their respective datasets using three-dimensional analysis software. Two-way analysis of variance (ANOVA) and Levene's tests were used to analyze the data., Results: The COR4 group exhibited the highest MAD, indicative of both trueness and precision (Mean ±SD: 55.659 ±34.802). In contrast, the T1 group demonstrated the lowest MAD (Mean ±SD: 43.225 ±19.237). However, the ANOVA analysis showed no significant influence of depth (P = 0.506) or type of scan (P = 0.442) on the MAD. Precision also did not differ significantly across groups (P = 0.071)., Conclusions: The cut-out rescan approach demonstrated an accuracy comparable to that of the one-time scan method., Clinical Significance: Digital intraoral scanning provides clinicians with a range of tools to navigate challenging conditions in which conventional methods may prove difficult, such as cases involving angled adjacent implants. In these scenarios, the cut-out rescan tool serves as a valuable resource, aiding clinicians in overcoming the challenges associated with impression-making owing to the convergence of placed implants., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: To compare the accuracy and operative time of implant placement using a dynamic computer assisted implant surgery (dCAIS) system based on a cone beam computer tomography (CBCT) image, with and without superimposing a standard tessellation language (STL) file of an intraoral scan of the patient., Methods: Ten identical resin models simulating an upper maxilla with posterior edentulism were assigned to two groups. In the CBCT+STL group, a CBCT file and an intraoral STL file were superimposed and used for registration; in the CBCT group, registration was performed using CBCT images. Six implants were placed in each model using the Navident® dynamic navigation system. Anatomy registration was performed by tracing fiducial points on the CBCT or STL image, depending on the group. Preoperative and postoperative CBCT images were overlaid to assess implant placement accuracy., Results: Sixty implants were analyzed (30 implants in each group). 3D platform deviation was significantly lower (mean difference (MD): 0.17 mm; 95 % confidence interval (CI): 0.01 to 0.23; P = 0.039) in the CBCT+STL group (mean: 0.71 mm; standard deviation (SD): 0.29) than in the CBCT group (mean: 0.88 mm; SD: 0.39). The remaining accuracy outcome variables (angular deviation MD: -0.01; platform lateral deviation MD: 0.08 mm; apex global MD: 0.01 mm; apex depth MD: 0.33 mm) and surgery time (MD: 3.383 min.) were similar in both groups (p > 0.05)., Conclusions: The introduction of an intraoral scan (STL) seems to reduce deviations slightly in dental implant placement with dCAIS systems. However, the clinical repercussion of this improvement is questionable., Clinical Significance: Superimposing an intraoral scan on the CBCT image does not seem to increase the accuracy of dCAIS systems but can be useful when radiographic artifacts are present., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors declare no conflict of interest directly related with this study. However, the authors would like to state the following conflicts outside the submitted work: Dr. Rui Figueiredo reports grants, personal fees, and non-financial support from MozoGrau (Valladolid, Spain), Avinent (Santpedor, Spain), Inibsa Dental (Lliçà de Vall, Spain), Dentaid SL (Cerdanyola del Vallés, Spain), non-financial support from Nobel Biocare (Zürich, Switzerland), personal fees from Geistlich Pharma AG (Wolhusen, Switzerland), BioHorizons Iberica (Madrid, Spain), Araguaney Dental (Barcelona, Spain), Septodont (Saint-Maur-des-fossés, France) and Laboratorios Silanes (Mexico city, Mexico) outside the submitted work. Dr. Figueiredo has also participated as a principal investigator in a randomized clinical trial sponsored by Mundipharma (Cambridge, UK) and in another clinical trial as a sub-investigator for Menarini Richerche (Florence, Italy). Dr. Eduard Valmaseda-Castellón reports grants, personal fees, and non-financial support from MozoGrau (Valladolid, Spain), Avinent (Santpedor, Spain), Inibsa Dental (Lliçà de Vall, Spain), Dentaid SL (Cerdanyola del Vallés, Spain), and personal fees from BioHorizons Iberica (Madrid, Spain) and Laboratorios Silanes (Mexico city, Mexico) outside the submitted work. Dr. Eduard Valmaseda-Castellón has also participated as a principal investigator in a randomized clinical trial sponsored by Geistlich Pharma AG (Wolhusen, Switzerland) and in another clinical trial as a sub-investigator for Mundipharma (Cambridge, UK)., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: To assess the complications, satisfaction, and quality of life of patients rehabilitated with delayed and immediate loading of single crowns., Materials and Methods: An electronic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase databases up to February 2023. Only prospective studies and randomized and nonrandomized clinical trials comparing immediate and delayed loading were included. For the quantitative analysis, dichotomous and consistent variables were evaluated with a 95% confidence interval., Results: A total of 20 studies were evaluated. No statistically significant difference was observed between protocols: satisfaction (I2: 0%; P &#61; .42), quality of life (I2: 0 %; P &#61; .05), biologic complications (I2: 9%; P &#61; .17), mechanical complications (I2: 58%; P &#61; .84), and survival rate (I2: 0%; P &#61; .38). The subgroup analysis showed significant differences only for marginal bone loss (MBL) when immediate implants were placed in the mandible (I2: 15%; P &#61; .01) and posterior zone (I2: 0%; P &#61; .001)., Conclusions: Complications and patient-centered outcomes for immediate single-implant crowns were comparable to delayed loading. Scientific evidence showed no significant difference between loading protocols for survival rates. Note that several factors could interfere with the complication events, implant failures, and MBL. The subgroup analysis showed that only immediate implants placed in the posterior mandible had a higher and statistically significant mean MBL.

Purpose: The aim of this study was to evaluate the effectiveness of fabrication methods (computer-aided design/ computer-aided manufacture [CAD/CAM], copy-milling, and conventional casting) in the fit accuracy of three-unit, screw-retained fixed dental prostheses. Materials and Methods: Sixteen three-unit implant-supported screw-retained frameworks were fabricated to fit an in vitro model. Eight frameworks were fabricated using the CAD/CAM system, four in zirconia and four in cobalt-chromium. Four zirconia frameworks were fabricated using the copy-milled system, and four were cast in cobalt-chromium using conventional casting with premachined abutments. The vertical and horizontal misfit at the implant-framework interface was measured using scanning electron microscopy at ×250. The results for vertical misfit were analyzed using Kruskal-Wallis and Mann-Whitney tests. The horizontal misfits were categorized as underextended, equally extended, or overextended. Statistical analysis established differences between groups according to the chi-square test (α = .05). Results: The mean vertical misfit was 5.9 ± 3.6 μm for CAD/CAM-fabricated zirconia, 1.2 ± 2.2 μm for CAD/CAM-fabricated cobalt-chromium frameworks, 7.6 ± 9.2 μm for copy-milling–fabricated zirconia frameworks, and 11.8 (9.8) μm for conventionally fabricated frameworks. The Mann-Whitney test revealed significant differences between all but the zirconia-fabricated frameworks. A significant association was observed between the horizontal misfits and the fabrication method. The percentage of horizontal misfits that were underextended and overextended was higher in milled zirconia (83.3%), CAD/CAM cobalt-chromium (66.7%), cast cobalt-chromium (58.3%), and CAD/CAM zirconia (33.3%) frameworks. Conclusion: CAD/CAM-fabricated frameworks exhibit better vertical misfit and low variability compared with copy-milled and conventionally fabricated frameworks. The percentage of interfaces equally extended was higher when CAD/CAM and zirconia were used. [ABSTRACT FROM AUTHOR]