Implant survival rates and biologic complications with implant-supported fixed complete dental prostheses: A retrospective study with up to 12-year follow-up.

OBJECTIVES: To assess the rate of biologic complications and implant survival in edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.2 years (range: 1-12 years). MATERIALS AND METHODS: A single-visit clinical and radiographic examination was performed to assess types and rates of biologic complications with ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). RESULTS: Of 457 rough surface dental implants supporting 71 IFCDPs (52 patients), six had failed, yielding an implant survival rate of 98.7% after a mean observation period of 5.2 years after definitive prosthesis insertion. The most frequent minor biologic complication was soft tissue recession (7.7% annual rate), inflammation under the IFCDP (7.4% annual rate), and peri-implant mucositis (6.3% annual rate). The most frequent major biologic complication was peri-implantitis (2.0% annual rate), in 46/457 implants (10.1%) supporting 19 IFCDPs and late implant failure (0.3% annual rate). The frequency of biologic complications was not statistically different between Group 1 and Group 2. The presence of high plaque index had significant effect on bone loss. CONCLUSIONS: After a mean exposure time of 5.2 years postdefinitive prosthesis insertion (range: 1-12 years), implant survival rate of 98.7% was achieved. The six implant failures in three patients occurred after 5 years and affected the prosthesis survival. Soft tissue recession was the most frequent minor biologic complication, whereas peri-implantitis was the most frequent major biologic complication. A 10-year implant-based mucosal recession rate of 77% (95% CI: 68.2-87.9) and a 10-year implant-based peri-implantitis rate of 20% (95% CI: 16.9-24.9) were found.

Digital workflow in full-arch implant rehabilitation with segmented minimally veneered monolithic zirconia fixed dental prostheses: 2-year clinical follow-up.

OBJECTIVE: To illustrate a digital workflow in full-arch implant rehabilitation with minimally veneered monolithic zirconia and to report the outcomes including technical complications. CLINICAL CONSIDERATIONS: Three patients (5 edentulous arches) received full-arch fixed implant rehabilitation with monolithic zirconia and mild facial porcelain veneering involving a digital workflow. The incisal edges and occluding surface areas were milled out of monolithic zirconia to reduce the possibility of chipping. Porcelain veneering was applied on the facial aspect to improve the esthetic result. Outcomes and technical complications are reported after 2 years of clinical and radiographic follow-up. CONCLUSION: Implant and prosthesis survival rates were 100% after a short-term follow-up of 2 years. Technical complications were encountered in one patient. They did not adversely affect prosthesis survival or patient satisfaction and were easily addressed. A digital workflow for the design and fabrication of full-arch monolithic zirconia implant fixed implant prostheses has benefits, but caution is necessary during CAD planning of the prosthesis to ensure a successful outcome. Long-term clinical studies are needed to corroborate the findings discussed in this report. CLINICAL SIGNIFICANCE: This article presents an integrated digital workflow that was implemented for the implant-prosthodontic rehabilitation of three edentulous patients with monolithic zirconia prostheses. Monolithic zirconia has been successfully incorporated in implant prosthodontics in an effort to reduce the technical complications associated with bilayered ceramics. This workflow simplifies design and fabrication of the zirconia prostheses. However, caution should be taken during CAD planning of the prosthesis to make sure the zirconia cylinder is sufficiently thick at the interface with the titanium insert. Additionally, when cutback is planned for facial porcelain veneering, the functional occluding cusps and incisal edges should be fabricated in monolithic zirconia to avoid chipping.

Shear bond strength of seventh generation bonding agents on dentin of primary teeth--an in vitro study.

This controlled, randomized, in vitro study evaluated the shear bond strength of several seventh generation bonding agents on the dentin of primary teeth. Six different adhesives were used: Xeno IV, Clearfil S3 Bond, Adper Prompt-L-Pop, AdheSE One, Bond Force, and Optibond (control). Ninety primary teeth were prepared by wet grinding with a 320-grit silicon carbide paper on a polishing wheel running at 110 RPM. After 24 hours of storage in water, shear bond strengths of each group were determined. The mean shear bond strength of the tested adhesive systems to primary dentin was 12.27 MPa. One-way ANOVA testing showed a statistically significant difference between adhesive products (P < 0.001). Tukey HSD post hoc tests were used to assess which means were significantly different from one another. There was no statistically significant difference between the fifth generation adhesive system (Optibond) and the two seventh generation systems (Xeno IV and Bond Force), with Optibond exhibiting a lower mean shear bond strength compared to Bond Force. Within the limitations of this study, there is a significant difference between seventh generation bonding materials. Bond Force and Optibond appear to exhibit higher shear bond strengths than the other products.

Management of a Malpositioned Implant in the Anterior Maxilla.

The surgical and prosthodontic management of patients with multiple missing teeth in the anterior maxilla can be challenging. The purpose of this clinical report is to illustrate the 2-year outcome after immediate implant placement in unintentional close proximity with the adjacent root. Following uneventful healing, the definitive implant rehabilitation was done with a modified monolithic zirconia framework and porcelain veneers bonded to the framework. The patient's satisfaction with the functional and esthetic outcomes remained high throughout the observation time, with no symptoms or biologic and technical complications.