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Background: Dental implant abutment screw loosening is an increasingly common problem, as evidenced by multiple studies that have investigated its causes. The objective of this study was to compare the screw loosening torque values before and after cyclic loading and to determine whether they are affected by the CAD/CAM abutment manufacturing technique (machined or laser-sintered) and abutment angulation. Materials and Methods: Ninety implants were used and divided into two groups: 45 implants received machined abutments (group A) and 45 implants received laser-sintered abutments (group B). Each group was further divided into three subgroups, with 15 implants each, based on the abutment angulation involved (0°, 15° and 20°). The abutments were tightened to the torque recommended by the manufacturer, and the reverse torque value was measured before and after cyclic loading (300,000 cycles). Data analysis was performed using one-way ANOVA and Wilcoxon signed-rank tests. Results: Statistically significant differences were observed between the laser-sintered and machined groups (p < 0.01). Additionally, differences were observed between subgroups with different angulations for both machined (16.2 ± 1.75, 14.7 ± 1.74 and 13.4 ± 1.08 Ncm) and laser-sintered abutments (14.6 ± 1.25, 12.7 ± 1.2 and 11.1 ± 1.35 Ncm) (0°, 15° and 20°, respectively). Conclusions: The final screw loosening torque after cyclic loading was lower than the initial loosening torque. Both abutment angulation and the CAD/CAM manufacturing method exerted a statistically significant influence on the final loosening torque. The abutment angulation factor was estimated to have an influence of 34.5%, while the abutment manufacturing method was estimated to have an influence of 21%.

Background: With CAD-CAM, dental models are often fabricated by additive manufacturing (AM) methods. Dental models for implant prostheses involve the manual placement of analogs, which could affect their final fit. Therefore, in this experimental in vitro study, the accuracy of the analogs’ position in models printed using AM methods was examined by comparing three different printing orientations. Methods: An STL file was obtained by scanning a master model with an implant placed in the maxillary left central incisor position. Three study groups (n = 10) with varying printing orientation parameters were obtained (0, 45, and 90 degrees). They were digitalized with a laboratory scanner and evaluated with an analysis metrology program. Differences between 3D datasets were measured using the RMS for trueness and SD RMS for precision. The data were statistically analyzed using the ANOVA test at a significance level of p < 0.05, followed by the Bonferroni post hoc test. Results: The 45-degrees group showed the best results. Regarding trueness, statistically significant differences were found between the 45- and 90-degrees groups (p < 0.005). In terms of precision, statistically significant differences appeared between the 45- and 0-degrees groups (p < 0.011) and between the 45- and 90-degrees groups (0.003). Conclusions: The printing angulation parameter affects the accuracy of 3D-printed models. Implant models manufactured at 45 degrees of printing angulation are more accurate than those printed at 0 or 90 degrees.

The roughness of the intra-oral surfaces significantly influences the initial adhesion and the retention of microorganisms. The aim of this study was to analyze the surface texture of four different CAD-CAM materials (two high-performance polymers and two fifth-generation zirconia) used for complete-arch implant-supported prostheses (CAISPs), and to investigate the effect of artificial aging on their roughness. A total of 40 milled prostheses were divided into 4 groups (n = 10) according to their framework material, bio.HPP (B), bio.HPP Plus (BP), zirconia Luxor Z Frame (ZF), and Luxor Z True Nature (ZM). The areal surface roughness “Sa” and the maximum height “Sz” of each specimen was measured on the same site after laboratory fabrication (lab as-received specimen) and after thermocycling (5–55 °C, 10,000 cycles) by using a noncontact optical profilometer. Data were analyzed using SPSS version 28.0.1. One-way ANOVA with multiple comparison tests (p = 0.05) and repeated measures ANOVA were used. After thermocycling, all materials maintained “Sa” values at the laboratory as-received specimen level (p = 0.24). “Sz” increased only for the zirconia groups (p = 0.01). B-BP exhibited results equal/slightly better than ZM-ZF. This study provides more realistic surface texture values of new metal-free materials used in real anatomical CAISPs after the manufacturing and aging processes and establishes a detailed and reproducible measurement workflow.

Background: Dental implant abutment screw loosening is an increasingly common problem, as evidenced by multiple studies that have investigated its causes. The objective of this study was to compare the screw loosening torque values before and after cyclic loading and to determine whether they are affected by the CAD/CAM abutment manufacturing technique (machined or laser-sintered) and abutment angulation. Materials and Methods: Ninety implants were used and divided into two groups: 45 implants received machined abutments (group A) and 45 implants received laser-sintered abutments (group B). Each group was further divided into three subgroups, with 15 implants each, based on the abutment angulation involved (0°, 15° and 20°). The abutments were tightened to the torque recommended by the manufacturer, and the reverse torque value was measured before and after cyclic loading (300,000 cycles). Data analysis was performed using one-way ANOVA and Wilcoxon signed-rank tests. Results: Statistically significant differences were observed between the laser-sintered and machined groups (p < 0.01). Additionally, differences were observed between subgroups with different angulations for both machined (16.2 ± 1.75, 14.7 ± 1.74 and 13.4 ± 1.08 Ncm) and laser-sintered abutments (14.6 ± 1.25, 12.7 ± 1.2 and 11.1 ± 1.35 Ncm) (0°, 15° and 20°, respectively). Conclusions: The final screw loosening torque after cyclic loading was lower than the initial loosening torque. Both abutment angulation and the CAD/CAM manufacturing method exerted a statistically significant influence on the final loosening torque. The abutment angulation factor was estimated to have an influence of 34.5%, while the abutment manufacturing method was estimated to have an influence of 21%. [ABSTRACT FROM AUTHOR]

Background: With CAD-CAM, dental models are often fabricated by additive manufacturing (AM) methods. Dental models for implant prostheses involve the manual placement of analogs, which could affect their final fit. Therefore, in this experimental in vitro study, the accuracy of the analogs' position in models printed using AM methods was examined by comparing three different printing orientations. Methods: An STL file was obtained by scanning a master model with an implant placed in the maxillary left central incisor position. Three study groups (n = 10) with varying printing orientation parameters were obtained (0, 45, and 90 degrees). They were digitalized with a laboratory scanner and evaluated with an analysis metrology program. Differences between 3D datasets were measured using the RMS for trueness and SD RMS for precision. The data were statistically analyzed using the ANOVA test at a significance level of p < 0.05, followed by the Bonferroni post hoc test. Results: The 45-degrees group showed the best results. Regarding trueness, statistically significant differences were found between the 45- and 90-degrees groups (p < 0.005). In terms of precision, statistically significant differences appeared between the 45- and 0-degrees groups (p < 0.011) and between the 45- and 90-degrees groups (0.003). Conclusions: The printing angulation parameter affects the accuracy of 3D-printed models. Implant models manufactured at 45 degrees of printing angulation are more accurate than those printed at 0 or 90 degrees. [ABSTRACT FROM AUTHOR]

Objective: Immediate implants and immediate alveolar sealing have been a widely utilized treatment with high predictability and biological advantages. The improvement in technology has made it possible to simplify clinical processes. The aim of the present report was to describe the complete digital workflow of the Biologically oriented preparation technique for immediate posterior implant, immediate provisionalization and fabrication of definitive implant crowns. Clinical Considerations: The surgical process and prosthetic management to preserve the gingival contours of the extracted natural tooth during immediate implant placement and provisionalization are described. Additionally, during the same clinical intervention, the definitive intraoral digital implant scans for capturing the implant position, peri‐implant tissue contours, adjacent and antagonist dentition, and profile emergence of the interim implant crown are captured for the fabrication of the definitive crown. Conclusions: Based on the technique described, the immediate implant placement and provisionalization in the posterior area provides biological and clinical advantages, reducing the number of abutment‐implant disconnections and the number of clinical appointments, as well as increases patient comfort. Clinical Significance: The present article describes a technique for an immediate implant placement and provisionalization in the posterior region for maintaining the gingival architecture of the extracted tooth. During the same appointment, the implant position, peri‐implant tissue contours, and adjacent and antagonist dentition, and profile emergence of the interim implant crown are captured by using an intraoral scanner and used for the fabrication of the definitive crown. This technique aims to reduce the number of abutment‐implant disconnections and clinical appointments. [ABSTRACT FROM AUTHOR]

The roughness of the intra-oral surfaces significantly influences the initial adhesion and the retention of microorganisms. The aim of this study was to analyze the surface texture of four different CAD-CAM materials (two high-performance polymers and two fifth-generation zirconia) used for complete-arch implant-supported prostheses (CAISPs), and to investigate the effect of artificial aging on their roughness. A total of 40 milled prostheses were divided into 4 groups (n = 10) according to their framework material, bio.HPP (B), bio.HPP Plus (BP), zirconia Luxor Z Frame (ZF), and Luxor Z True Nature (ZM). The areal surface roughness "Sa" and the maximum height "Sz" of each specimen was measured on the same site after laboratory fabrication (lab as-received specimen) and after thermocycling (5–55 °C, 10,000 cycles) by using a noncontact optical profilometer. Data were analyzed using SPSS version 28.0.1. One-way ANOVA with multiple comparison tests (p = 0.05) and repeated measures ANOVA were used. After thermocycling, all materials maintained "Sa" values at the laboratory as-received specimen level (p = 0.24). "Sz" increased only for the zirconia groups (p = 0.01). B-BP exhibited results equal/slightly better than ZM-ZF. This study provides more realistic surface texture values of new metal-free materials used in real anatomical CAISPs after the manufacturing and aging processes and establishes a detailed and reproducible measurement workflow. [ABSTRACT FROM AUTHOR]

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

Objectives: To measure the influence of arch location and scanning pattern on the accuracy, scanning time, and number of photograms of complete‐arch implant scans acquired using an intraoral scanner (IOS). Materials and Methods: A maxillary (maxillary group) and mandibular (mandibular group) model with 6 implant abutments on each cast was digitized using a desktop scanner (control scans). Six subgroups were created based on the scanning pattern used to acquire the scans using an IOS (Trios 4): occluso‐buccal‐lingual (OBL subgroup), occluso‐linguo‐buccal (OLB subgroup), bucco‐linguo‐occlusal (BLO subgroup), linguo‐buccal‐occlusal (LBO subgroup), zigzag (ZZ subgroup), and circumferential (C subgroup). The control scans were used as a reference to measure the discrepancy with the experimental scans calculating the root mean square error. Two‐way ANOVA and the pairwise comparison Tukey tests were used to analyze the data (α =.05). Results: Significant discrepancies in trueness (p <.001), precision (p <.001), scanning time (p <.001), and number of photograms (p <.001) were found. The maxillary group obtained poorer trueness and precision values, higher scanning times, and a larger number of photograms than the mandibular group. The C subgroup obtained the best trueness and precision values, but was not significantly different from the OLB, BLO, and LBO subgroups. The ZZ subgroup obtained the worst trueness and precision values (p <.05). The C subgroup obtained the lowest scanning time and number of photograms (p <.05). Conclusions: Arch location and scanning pattern influenced scanning accuracy, scanning time, and number of photograms of complete‐arch implant scans. [ABSTRACT FROM AUTHOR]

(1) Background: Facial scanners are used in different fields of dentistry to digitalize the soft tissues of the patient's face. The development of technology has allowed the patient to have a 3-dimensional virtual representation, facilitating facial integration in the diagnosis and treatment plan. However, the accuracy of the facial scanner and the obtaining of better results with respect to the manual or two-dimensional (2D) method are questionable. The objective of this clinical trial was to evaluate the usefulness and accuracy of the 3D method (a dual-structured light facial scanner) and compare it with the 2D method (photography) to obtain facial analysis in the maximum intercuspation position and smile position. (2) Methods: A total of 60 participants were included, and nine facial landmarks and five interlandmarks distances were determined by two independent calibrated operators for each participant. All measurements were made using three methods: the manual method (manual measurement), the 2D method (photography), and the 3D method (facial scanner). All clinical and lighting conditions, as well as the specific parameters of each method, were standardized and controlled. The facial interlandmark distances were made by using a digital caliper, a 2D software program (Adobe Photoshop, version 21.0.2), and a 3D software program (Meshlab, version 2020.12), respectively. The data were analyzed by SPSS statistical software. The Kolmogorov–Smirnov test revealed that trueness and precision values were normally distributed (p > 0.05), so a Student's t-test was employed. (3) Results: Statistically significant differences (p ≤ 0.01) were observed in all interlandmark measurements in the 2D group (photography) to compare with the manual group. The 2D method obtained a mean accuracy value of 2.09 (±3.38) and 2.494 (±3.67) in maximum intercuspation and smile, respectively. On the other hand, the 3D method (facial scanner) obtained a mean accuracy value of 0.61 (±1.65) and 0.28 (±2.03) in maximum intercuspation and smile, respectively. There were no statistically significant differences with the manual method. (4) Conclusions: The employed technique demonstrated that it influences the accuracy of facial records. The 3D method reported acceptable accuracy values, while the 2D method showed discrepancies over the clinically acceptable limits. [ABSTRACT FROM AUTHOR]

This article describes a technique to assist with intraoral digital scans for fabricating tooth‐supported prostheses by using a custom intraoral scan body when the extension of the scan or the clinical characteristics might compromise the reliability of the intraoral digital scan. A preliminary intraoral scan of the tooth preparations is used to design a custom intraoral scan body which is manufactured using polymethylmethacrylate and a 5‐axis milling machine. A low‐viscosity polyvinyl siloxane impression of the tooth preparations is obtained using the custom intraoral scan body. Subsequently, the custom intraoral scan body is digitized using an intraoral scanner. A design software program is used to align the digitized custom intraoral scan body with the preliminary intraoral scan to obtain the definitive virtual cast. This technique aims to reduce manual conventional laboratory procedures such as pouring dental impression or die trimming which might minimize inaccuracies on the virtual definitive cast. [ABSTRACT FROM AUTHOR]