Vertical eruption of anterior maxillary teeth adjacent to single-implant-supported crowns: An assessment after a 3-year follow-up period.

STATEMENT OF PROBLEM: Vertical eruption of teeth adjacent to an implant has been reported clinically and might affect the esthetic outcome over time. The prevalence of the problem is unclear. PURPOSE: The purpose of this prospective clinical trial was to evaluate the vertical eruption of anterior maxillary teeth adjacent to single-implant crowns after a 3-year follow-up period. MATERIAL AND METHODS: Thirty single dental implants were inserted in maxillary anterior sites including the first premolar. The mean age of the participants at implant-supported crown insertion was 48.4 years (range 23 to 79 years). Each implant was restored with a 1-piece screw-retained ceramic single crown. The vertical changes of 60 adjacent anterior maxillary teeth were evaluated from periapical radiographs and casts at baseline, 6, 12, and 36 months. RESULTS: A global ANOVA test showed statistically significant differences for the outcomes of the distance-implant platform and cement-enamel junction (DPC) (P<.001), crown length distal (P=.021) and mesial (P=.035), implant crown length (P=.022), and incisal edge to edge (P<.001). CONCLUSIONS: Continuous vertical tooth eruption next to a single dental implant was observed in adult participants.

Attitudes of dental students towards treating elderly patients. Dental students' attitudes on geriatric patients

The purpose of this questionnaire-based survey was to evaluate the attitudes of the undergraduate dental students towards elders. The 14-item Geriatric attitudes scale (GAS) questionnaire, along with a 9-item questionnaire with specific questions on the current geriatric dental curriculum, confidence, and preference in treating the elderly patients were administered to the undergraduate dental students (3rd bachelor, 1st master, and 2nd master) in the four Swiss university dental schools. Mean GAS scores were calculated and inter- and intra-group differences were analyzed with ANOVA and post hoc tests (level of significance set at α=0.05). Responses to the 9-item questionnaire were reported descriptively. Further analyses were performed to evaluate the effect of demographic factors on the GAS scores. 305 students (meanage: 25.8±4.0y) participated in this study. The mean overall GAS score of the students was 3.5±0.4. There were no significant differences in the GAS scores between the centers [F(3, 300)=2.266, p=0.081] or between the year of training [F(2, 301)=1.884, p=0.154]. Demographic factors did not influence the GAS scores. Students considered geriatric dentistry as an important part of their dental undergraduate education. The current geriatric curriculum was perceived to be on an adequate level. Hands-on experience in treating geriatric patients in the undergraduate curriculum was positively opinionated, and mobile dental services for elders with limited access to care was considered a good solution. In conclusion, the attitudes of the Swiss undergraduate dental students towards an elderly patient seem acceptable but could still be improved.

Mandibular implant-supported fixed complete dental prostheses on implants with ultrashort and standard length: A pilot treatment.

Edentulous patients may be restored with complete-arch implant-supported fixed complete dental prostheses (IFCDPs) on angled distal implants or on parallel implants distributed equally across the mandible to increase the area of support. A treatment is presented to introduce the clinical concept of providing edentulous patients with an implant-supported fixed complete dental prosthesison parallel tissue-level implants in the mandible with standard length implants interforaminally and ultrashort implants distally. A structured prosthetic approach was used for the tooth arrangement with a modified workflow as per the Biofunctional Prosthetic System adapted for static computer-aided implant surgery (s-CAIS) and computer-aided design and computer-aided manufacturing (CAD-CAM) of the screw-retained implant-supported fixed complete dental prosthesis. The concept offered advantages in challenging anatomic, surgical, and prosthetic conditions; providing distal nonangled abutments and implant platforms, which were straightforward to clean. If necessary, the prosthesis could have been easily converted into a removable overdenture using the existing digital prosthetic arrangement. Should implant removal be required, the extrashort implants can be removed with minimal surgical risk or morbidity.

Quality Evaluation of Zirconium Dioxide Frameworks Produced in Five Dental Laboratories from Different Countries.

PURPOSE: The aim of this study was to assess and compare quality as well as economic aspects of CAD/CAM high strength ceramic three-unit FDP frameworks ordered from dental laboratories located in emerging countries and Switzerland. MATERIAL AND METHODS: The master casts of six cases were sent to five dental laboratories located in Thailand (Bangkok), China (Peking and Shenzhen), Turkey (Izmir), and Switzerland (Bern). Each laboratory was using a different CAD/CAM system. The clinical fit of the frameworks was qualitatively assessed, and the thickness of the framework material, the connector height, the width, and the diameter were evaluated using a measuring sensor. The analysis of the internal fit of the frameworks was performed by means of a replica technique, whereas the inner and outer surfaces of the frameworks were evaluated for traces of postprocessing and damage to the intaglio surface with light and electronic microscopes. Groups (dental laboratories and cases) were compared for statistically significant differences using Mann-Whitney U-tests after Bonferroni correction. RESULTS: An acceptable clinical fit was found at 97.9% of the margins produced in laboratory E, 87.5% in B, 93.7% in C, 79.2% in A, and 62.5% in D. The mean framework thicknesses were not statistically significantly different for the premolar regions; however, for the molar area 4/8 of the evaluated sites were statistically significantly different. Circumference, surface, and width of the connectors produced in the different laboratories were statistically significantly different but not the height. There were great differences in the designs for the pontic and connector regions, and some of the frameworks would not be recommended for clinical use. Traces of heavy postprocessing were found in frameworks from some of the laboratories. The prices per framework ranged from US$177 to US$896. CONCLUSIONS: By ordering laboratory work in developing countries, a considerable price reduction was obtained compared to the price level in Switzerland. Despite the use of the standardized CAD/CAM chains of production in all laboratories, a large variability in the quality aspects, such as clinical marginal fit, connector and pontic design, as well as postprocessing traces was noted. Recommended sound handling of postprocessing was not applied in all laboratories. Dentists should be aware of the true and factitious advantages of CAD/CAM production chains and not lose control over the process.