Accuracy in static guided implant surgery: Results from a multicenter retrospective clinical study on 21 patients treated in three private practices.

PURPOSE: To evaluate the accuracy of a static computer-assisted implant surgery (s-CAIS) system across different private practices. METHODS: This retrospective clinical study was based on data retrieved from 21 patients who received 61 implants between 2018 and 2020 in 3 private practices run by surgeons with extensive experience with s-CAIS. All patients were treated using the same s-CAIS system, planning software, template manufacturing process, and surgical guides. The standard tessellation language (STL) file of the intraoral scan of the fixture taken immediately after implant placement was matched with that of the preoperative plan for comparisons of preoperative and planned implant positions with postoperative and actual implant positions. The study outcomes were linear and angular deviations between the planned and actual implant positions. RESULTS: No surgical or postsurgical complications occurred. The overlap of the two STL files resulted in a mean angular deviation of 2.94° The mean linear deviation at the implant shoulder was 0.73 mm, and that at the apex was 1.06 mm. The mean vertical deviations at the implant shoulder and the apex were 0.29 mm and 0.01 mm, respectively. CONCLUSION: All cases showed satisfactory accuracy within the limits of this study (small number of patients and retrospective design). These results might be related to the use of a standardized digital workflow by experienced operators. STATEMENT OF CLINICAL RELEVANCE: The study shows that careful control of each step, from data acquisition to final execution, is key for the accuracy of stent-guided systems.

Custom-made computer-aided-design/ computer-assisted-manufacturing (CAD/CAM) synthetic bone grafts for alveolar ridge augmentation: A retrospective clinical study with 3 years of follow-up.

PURPOSE: To report on the results obtained with computer-aided-design/ computer-assisted-manufacturing (CAD/CAM) custom-made synthetic hydroxyapatite/beta-tricalcium-phosphate (HA/beta-TCP) bone grafts in alveolar ridge augmentation for dental implant placement. METHODS: The procedure included: (1) cone-beam computed tomography (CBCT) of the bone defect; (2) virtual design of the custom-made onlay bone grafts; (3) milling of grafts from a pre-formed block of synthetic HA/beta-TCP; and (4) bone reconstructive surgery. Implants were placed 8 months later. The patients were followed for 3 years. The study outcomes were: (1) intra- and immediate post-operative complications; (2) 8-month vertical and horizontal bone gain; (3) implant survival; (4) implant-crown success; and (5) peri-implant marginal bone loss (MBL). RESULTS: Twenty-six patients underwent ridge augmentation with custom-made CAD/CAM HA/beta-TCP onlay grafts. Eight months later, these patients were rehabilitated with dental implants. During surgery, 25/26 (96.1%) of the grafts adapted well to the bone defect. Immediate post-operative complications were pain and swelling (2/26 patients: 7.6%), and bone graft exposure (3/26: 11.5%); one exposure led to infection, removal of the graft, and failure of the procedure. Excellent integration of the other grafts was observed 8 months after the regenerative procedure, with mean vertical and horizontal bone gains of 2.10 mm (± 0.35) and 2.96 mm (± 0.45), respectively. Twenty-five implants were placed and restored with single crowns. Three years later, all implants were in function. The 3-year implant crown success rate and peri-implant MBL were 92.0% and 0.7 mm (±0.19), respectively. CONCLUSIONS: With custom-made CAD/CAM synthetic HA/beta-TCP onlay grafts reconstruction of small vertical and/or horizontal defects of the alveolar ridge was obtained; this enabled implant placement, with high implant-crown success rate after 3 years. Further studies are needed to validate this technique. STATEMENT OF CLINICAL RELEVANCE: Custom-made CAD/CAM synthetic HA/beta-TCP onlay grafts may represent an option for regeneration of small bone defects prior to implant placement.

Graphene-Silicon Device for Visible and Infrared Photodetection.

The fabrication of a graphene-silicon (Gr-Si) junction involves the formation of a parallel metal-insulator-semiconductor (MIS) structure, which is often disregarded but plays an important role in the optoelectronic properties of the device. In this work, the transfer of graphene onto a patterned n-type Si substrate, covered by Si3N4, produces a Gr-Si device, in which the parallel MIS consists of a Gr-Si3N4-Si structure surrounding the Gr-Si junction. The Gr-Si device exhibits rectifying behavior with a rectification ratio up to 104. The investigation of its temperature behavior is necessary to accurately estimate the Schottky barrier height (SBH) at zero bias, φb0 = 0.24 eV, the effective Richardson's constant, A* = 7 × 10-10 AK-2 cm-2, and the diode ideality factor n = 2.66 of the Gr-Si junction. The device is operated as a photodetector in both photocurrent and photovoltage mode in the visible and infrared (IR) spectral regions. A responsivity of up to 350 mA/W and an external quantum efficiency (EQE) of up to 75% are achieved in the 500-1200 nm wavelength range. Decreases in responsivity to 0.4 mA/W and EQE to 0.03% are observed above 1200 nm, which is in the IR region beyond the silicon optical band gap, in which photoexcitation is driven by graphene. Finally, a model based on two parallel and opposite diodes, one for the Gr-Si junction and the other for the Gr-Si3N4-Si MIS structure, is proposed to explain the electrical behavior of the Gr-Si device.

Tolerances in the production of six different implant scanbodies: a comparative study.

PURPOSE: To investigate and compare the production tolerances of six different commercially available implant scan bodies (SBs), with the null hypothesis that there would be no tolerances in the production or significant differences between the different SBs. MATERIALS AND METHODS: Six different implant SBs (IO 6A-B and IO 2B-B, Nobel Biocare; RC 4.1 mm 025.4915 and RN 4.8 mm 048.168, Straumann; KR 352KR1A0, BTK BIOTEC; and AANISR4013T, MegaGen) were evaluated. Five specimens of each SB type (a total of 30 samples) were screwed onto the corresponding implant analogs and underwent dimensional analysis with optical microscopy (QVI Smartscope Flash 200, Optical Gaging Products) and precision probing (R 0.25, Renishaw). The outcome variables were SB height, diameter, and angle of the flat face on the top (plane). All measurements were compared with the corresponding computer-assisted design library measurements used as a reference to assess the manufacturing tolerances. Statistical analyses were performed to compare the results obtained with the different SBs. RESULTS: Tolerances in the manufacture of the SBs were reported in height, diameter, and plane measurements, and statistically significant differences between the different types of SBs were found. Therefore, the null hypothesis was rejected. Most of the deviations and tolerances were reported in height measurements with conical connection implants. CONCLUSIONS: Tolerances in the production and statistically significant differences were found among the six commercially available SBs evaluated in this study. Additional studies with larger sample sizes and other types of SBs are needed.

A Prospective Longitudinal Clinical Trial Evaluating the Preservation of the Peri-implant Hard and Soft Tissues.

This prospective longitudinal clinical trial aimed to evaluate the success of a bone-level implant with an integrated platform-switched connection by assessing peri-implant soft tissue and marginal bone level. Twenty-six patients were treated in two different centers with implants placed in healed partially edentulous ridges. Implant success rate and marginal bone level were evaluated with photographs, radiographs, and clinical measurements, with a 6-month postloading follow-up. The esthetic appearance of the photographed peri-implant soft tissue was evaluated at 6 months via the Pink Esthetic Score applied by two calibrated operators. All of the implants except for one placed in the mandible demonstrated successful osseointegration, resulting in a success rate of 97.8% at the 6-month follow-up. Compared to historical controls, no detectable differences in peri-implant marginal bone loss or esthetic outcome were seen.

Peri-implant Soft Tissue Management: Cairo Opinion Consensus Conference.

Peri-implant soft tissues play a role of paramount importance, not only on the esthetic appearance, but also on the maintenance and long-term stability of implants. The present report presents the conclusions from the Consensus Conference of the South European North African Middle Eastern Implantology & Modern Dentistry Association (SENAME) (4-6 November 2016, Cairo, Egypt). The conference focused on the topic of the soft tissue around dental implants, and in particular, on the influence of implant configurations on the marginal soft tissues, soft tissue alterations after immediate, early or delayed implant placement and immediate loading, the long-term outcomes of soft tissue stability around dental implants, and soft tissue augmentation around dental implants. Thirty world experts in this field were invited to take part in this two-day event; however, only 29 experts were in the final consensus voting process.

Bias Tunable Photocurrent in Metal-Insulator-Semiconductor Heterostructures with Photoresponse Enhanced by Carbon Nanotubes.

Metal-insulator-semiconductor-insulator-metal (MISIM) heterostructures, with rectifying current-voltage characteristics and photosensitivity in the visible and near-infrared spectra, are fabricated and studied. It is shown that the photocurrent can be enhanced by adding a multi-walled carbon nanotube film in the contact region to achieve a responsivity higher than 100   mA   W - 1 under incandescent light of 0.1   mW   cm - 2 . The optoelectrical characteristics of the MISIM heterostructures are investigated at lower and higher biases and are explained by a band model based on two asymmetric back-to-back Schottky barriers. The forward current of the heterojunctions is due to majority-carrier injection over the lower barrier, while the reverse current exhibits two different conduction regimes corresponding to the diffusion of thermal/photo generated carriers and majority-carrier tunneling through the higher Schottky barrier. The two conduction regimes in reverse bias generate two plateaus, over which the photocurrent increases linearly with the light intensity that endows the detector with bias-controlled photocurrent.

Field Emission Characterization of MoS2 Nanoflowers.

Nanostructured materials have wide potential applicability as field emitters due to their high aspect ratio. We hydrothermally synthesized MoS2 nanoflowers on copper foil and characterized their field emission properties, by applying a tip-anode configuration in which a tungsten tip with curvature radius down to 30-100 nm has been used as the anode to measure local properties from small areas down to 1-100 µm2. We demonstrate that MoS2 nanoflowers can be competitive with other well-established field emitters. Indeed, we show that a stable field emission current can be measured with a turn-on field as low as 12 V/µm and a field enhancement factor up to 880 at 0.6 µm cathode-anode separation distance.

Graphene Schottky Junction on Pillar Patterned Silicon Substrate.

A graphene/silicon junction with rectifying behaviour and remarkable photo-response was fabricated by transferring a graphene monolayer on a pillar-patterned Si substrate. The device forms a 0.11 eV Schottky barrier with 2.6 ideality factor at room temperature and exhibits strongly bias- and temperature-dependent reverse current. Below room temperature, the reverse current grows exponentially with the applied voltage because the pillar-enhanced electric field lowers the Schottky barrier. Conversely, at higher temperatures, the charge carrier thermal generation is dominant and the reverse current becomes weakly bias-dependent. A quasi-saturated reverse current is similarly observed at room temperature when the charge carriers are photogenerated under light exposure. The device shows photovoltaic effect with 0.7% power conversion efficiency and achieves 88 A/W photoresponsivity when used as photodetector.

A WSe2 vertical field emission transistor.

We report the first observation of a gate-controlled field emission current from a tungsten diselenide (WSe2) monolayer, synthesized by chemical-vapour deposition on a SiO2/Si substrate. Ni contacted WSe2 monolayer back-gated transistors, under high vacuum, exhibit n-type conduction and drain-bias dependent transfer characteristics, which are attributed to oxygen/water desorption and drain induced Schottky barrier lowering, respectively. The gate-tuned n-type conduction enables field emission, i.e. the extraction of electrons by quantum tunnelling, even from the flat part of the WSe2 monolayers. Electron emission occurs under an electric field ∼100 V µm-1 and exhibits good time stability. Remarkably, the field emission current can be modulated by the back-gate voltage. The first field-emission vertical transistor based on the WSe2 monolayer is thus demonstrated and can pave the way to further optimize new WSe2 based devices for use in vacuum electronics.

Retrospective Analysis of Long-Term (up to 12 years) Clinical and Radiologic Performance of Anodized-Surface Implants.

To accurately assess the long-term performance of anodized-surface implants, more data monitoring is needed outside of clinical evaluations. This retrospective study evaluated long-term implant survival and bone remodeling after up to 12 years of function. Data from 195 implants placed in 60 patients over a follow-up period ranging from 0.6 to 12.1 years were included. The implant-level survival rate was 99.0%. Marginal bone loss remained low across all follow-up cohorts. The data show that anodized-surface implants are a safe, reliable option with high implant survival rates and low levels of bone loss.

Immediate functional loading of single implants: a multicenter study with 4 years of follow-up.

Background. In the current scientific literature there are only few studies on the immediate functional loading of single implants. The aim of the present present study was to evaluate the 4-year survival rate, complication rate and peri-implant marginal bone loss (PIMBL) of immediately loaded single implants inserted in healed ridges and fresh post-extraction sites. Methods. Six centers were involved in this prospective study. The surgical and prosthetic protocol was defined in detail, before the start of recruiting patients. Recruitment of patients and performance of surgeries took place between February 2012 and February 2013. Criteria for inclusion were single-tooth gaps in healed ridges and fresh post-extraction sockets. All the fixtures (Anyridge®, Megagen Corporation, Gyeongbuk, South Korea) were functionally loaded immediately after insertion and followed for a period of 4 years. Outcome measures were implant survival, complications and PIMBL. Results. Forty-six patients (18‒73 years of age) were selected. In total, 57 fixtures were placed (10 in fresh post-extraction sockets). After 4 years of functional loading, only one fixture was lost; therefore, high survival rates (97.6% patient-based; 98.1% implant-based) were reported. In addition, a limited incidence of biologic (4.8% patient-based; 3.8% implant-based) and prosthetic (9.7% patient-based; 7.6% implant-based) complications was reported. The overall 4-year PIMBL amounted to 0.38±0.21 mm (healed ridges: 0.4±0.21 mm; fresh post-extraction sockets: 0.33±0.20 mm). Conclusion. Loading single implants immediately seems to be a highly successful treatment modality. However, long-term data are needed to confirm these positive outcomes.

Conventional Vs Digital Impressions: Acceptability, Treatment Comfort and Stress Among Young Orthodontic Patients.

OBJECTIVE: The objective of the present study was to compare patients' acceptability, comfort and stress with conventional and digital impressions. MATERIALS AND METHODS: Thirty young orthodontic patients (15 males and 15 females) who had no previous experience of impressions were enrolled in this study. Conventional impressions for orthodontic study models of the dental arches were taken using an alginate impression material (Hydrogum®, Zhermack Spa, Badia Polesine, Rovigo, Italy). Fifteen days later, digital impressions of both arches were acquired using an intraoral scanner (CS3600®, Carestream Dental, Rochester, NY, USA). Immediately after impression taking, patients' acceptability, comfort and stress were measured using two questionnaires and the State anxiety scale. RESULTS: Data showed no difference in terms of anxiety and stress; however, patients preferred the use of digital impressions systems instead of conventional impression techniques. Alginate impressions resulted as fast as digital impressions. CONCLUSIONS: Digital impressions resulted the most accepted and comfortable impression technique in young orthodontic patients, when compared to conventional techniques.

The influence of repeated abutment changes on peri-implant tissue stability: 3-year post-loading results from a multicentre randomised controlled trial.

PURPOSE: To evaluate the influence of at least three abutment disconnections in conventional loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft tissue changes. A secondary aim was to evaluate whether the presence of less than 2 mm of keratinised mucosa is associated with increased peri-implant marginal bone loss and soft tissue recessions. MATERIALS AND METHODS: Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments that were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments, which were delayed loaded after 3 months and removed at least three times: 1. At impression taking (3 months after implant placement); 2. When checking the zirconium core on titanium abutments at single crowns or the fitting the metal structure at prostheses supported by multiple implants; 3. At delivery of the definitive prostheses (repeated disconnection or conventional loading group). Patients were treated at four centres and each patient contributed to the study, with only one prosthesis followed for 3 years after initial loading. Outcome measures were: prosthesis failures, implant failures, complications, pink aesthetic score (PES), buccal recessions, patient satisfaction, peri-implant marginal bone level changes and height of the keratinised mucosa. RESULTS: Forty patients were randomly allocated to each group according to a parallel group design. Six patients from the definitive abutment group dropped out or died, and one left from the repeated disconnection group. One implant, from the repeated disconnection group, fractured (difference = 3%; CI 95%: -2%, 8%; P = 1). Four provisional crowns and one definitive single crown had to be remade because of poor fitting, and one definitive crown and one definitive prosthesis because of ceramic and implant fracture, respectively, in the repeated disconnection group vs one provisional prosthesis from the definitive abutment group due to frequent debondings (difference = 15%; CI 95%: 2%, 28%; P = 0.060). Five patients from the definitive abutment group and four patients from the repeated disconnection group were affected by complications (difference = 4%; CI 95%: -11%, 20%; P = 0.725). PES scores assessed at 3 years post-loading were 11.7 (standard deviation = 1.8) mm for the definitive abutment group and 11.3 (1.5) mm for the repeated abutment changes group (difference = 0.4; CI 95%: -0.4, 1.2; P = 0.315). However, there was a difference of 0.26 out of a maximum score of 2 in favour of the definitive abutment group for soft tissue contour only. Buccal recessions at 3 years post-loading amounted to -0.1 (0.8) mm for the definitive abutment group and -0.1 (1.2) mm for the repeated abutment changes group (it was actually a soft tissue gain; difference = 0.01 mm CI 95%: -0.48, 0.50; P = 0.965). All patients declared being very satisfied or satisfied with the function and aesthetics of the prostheses and said they would undergo the same procedure again, with the exception of one patient from the repeated disconnection group who was uncertain regarding function. Mean peri-implant marginal bone loss 3 years after loading was 0.07 (0.18) mm for the definitive abutment group and 0.50 (0.93) mm for the repeated abutment changes group (difference = 0.43 mm; CI 95%: 0.13, 0.74; P = 0.007). The height of keratinised mucosa at 3 years post-loading was 2.8 (1.3) mm for the definitive abutment group and 2.8 (1.6) mm for the repeated abutment changes group (difference = 0.03; CI 95%: -0.67, 0.73; P = .926). Up to 3 years after initial loading there were no statistically significant differences between the two procedures, with the exception of 0.4 mm more marginal bone loss at implants subjected to three abutment disconnections. There were no significantly increased marginal bone loss (difference = 0.1 mm, CI 95%: -0.3, 0.5, P = 0.590) or buccal recessions (difference = 0.1 mm, CI 95%: -0.4, 0.7, P = 0.674) at implants with less than 2 mm of keratinised mucosa at loading. CONCLUSIONS: Three-year post-loading data showed that repeated abutment disconnections significantly increased bone loss of 0.43 mm, but this difference may not be considered clinically relevant; therefore clinicians can use the procedure they find more convenient for each specific patient. Immediately non-occlusally loaded dental implants are a viable alternative to conventional loading and no increased bone loss or buccal recessions were noticed at implants with less than 2 mm of keratinised mucosa. Conflict of interest statement: This trial was partially funded by Dentsply Sirona Implants, the manufacturer of the implants and other products evaluated in this investigation. However, data belonged to the authors and by no means did the manufacturer interfere with the conduct of the trial or the publication of the results, with the exception of rejecting a proposal to change the protocol, after the trial was started, allowing the use of indexed abutments.

Intraoral scanners in dentistry: a review of the current literature.

BACKGROUND: Intraoral scanners (IOS) are devices for capturing direct optical impressions in dentistry. The purpose of this narrative review on the use of IOS was to: (1) identify the advantages/disadvantages of using optical impressions compared to conventional impressions; (2) investigate if optical impressions are as accurate as conventional impressions; (3) evaluate the differences between the IOS currently available commercially; (4) determine the current clinical applications/limitations in the use of IOS. METHODS: Electronic database searches were performed using specific keywords and MeSH terms. The searches were confined to full-text articles written in English and published in peer-reviewed journals between January 2007 and June 2017. RESULTS: One hundred thirty-two studies were included in the present review; among them, 20 were previous literature reviews, 78 were in vivo clinical studies (6 randomized controlled/crossover trials, 31 controlled/comparative studies; 24 cohort studies/case series; 17 case reports) and 34 were in vitro comparative studies. CONCLUSIONS: Optical impressions reduce patient discomfort; IOS are time-efficient and simplify clinical procedures for the dentist, eliminating plaster models and allowing better communication with the dental technician and with patients; however, with IOS, it can be difficult to detect deep margin lines in prepared teeth and/or in case of bleeding, there is a learning curve, and there are purchasing and managing costs. The current IOS are sufficiently accurate for capturing impressions for fabricating a whole series of prosthetic restorations (inlays/onlays, copings and frameworks, single crowns and fixed partial dentures) on both natural teeth and implants; in addition, they can be used for smile design, and to fabricate posts and cores, removable partial prostheses and obturators. The literature to date does not support the use of IOS in long-span restorations with natural teeth or implants. Finally, IOS can be integrated in implant dentistry for guided surgery and in orthodontics for fabricating aligners and custom-made devices.

Field Emission from Self-Catalyzed GaAs Nanowires.

We report observations of field emission from self-catalyzed GaAs nanowires grown on Si (111). The measurements were taken inside a scanning electron microscope chamber with a nano-controlled tungsten tip functioning as anode. Experimental data were analyzed in the framework of the Fowler-Nordheim theory. We demonstrate stable current up to 10-7 A emitted from the tip of single nanowire, with a field enhancement factor ß of up to 112 at anode-cathode distance d = 350 nm. A linear dependence of ß on the anode-cathode distance was found. We also show that the presence of a Ga catalyst droplet suppresses the emission of current from the nanowire tip. This allowed for the detection of field emission from the nanowire sidewalls, which occurred with a reduced field enhancement factor and stability. This study further extends GaAs technology to vacuum electronics applications.

I-V and C-V Characterization of a High-Responsivity Graphene/Silicon Photodiode with Embedded MOS Capacitor.

We study the effect of temperature and light on the I-V and C-V characteristics of a graphene/silicon Schottky diode. The device exhibits a reverse-bias photocurrent exceeding the forward current and achieves a photoresponsivity as high as 2.5 A / W . We show that the enhanced photocurrent is due to photo-generated carriers injected in the graphene/Si junction from the parasitic graphene/SiO2/Si capacitor connected in parallel to the diode. The same mechanism can occur with thermally generated carriers, which contribute to the high leakage current often observed in graphene/Si junctions.

Electrical transport and persistent photoconductivity in monolayer MoS2 phototransistors.

We study electrical transport properties in exfoliated molybdenum disulfide (MoS2) back-gated field effect transistors at low drain bias and under different illumination intensities. It is found that photoconductive and photogating effect as well as space charge limited conduction can simultaneously occur. We point out that the photoconductivity increases logarithmically with the light intensity and can persist with a decay time longer than 104 s, due to photo-charge trapping at the MoS2/SiO2 interface and in MoS2 defects. The transfer characteristics present hysteresis that is enhanced by illumination. At low drain bias, the devices feature low contact resistance of [Formula: see text] ON current as high as [Formula: see text] 105 ON-OFF ratio, mobility of ∼1 cm2 V-1 s-1 and photoresponsivity [Formula: see text].

Early Bone Formation around Immediately Loaded Transitional Implants Inserted in the Human Posterior Maxilla: The Effects of Fixture Design and Surface.

Aim. To evaluate the effects of fixture design and surface on the early bone formation around immediately loaded implants inserted in the human posterior maxilla. Materials and Methods. Ten totally edentulous subjects received two transitional implants: one tapered implant with knife-edge threads/nanostructured calcium-incorporated surface (test: Anyridge®, Megagen, Gyeongbuk, South Korea) and one cylindrical implant with self-tapping threads/sandblasted surface (control: EZPlus®, Megagen). The implants were placed according to a split-mouth design and immediately loaded to support an interim complete denture; after 8 weeks, they were removed for histologic/histomorphometric analysis. The bone-to-implant contact (BIC%) and the bone density (BD%) were calculated. The Wilcoxon test was used to evaluate the differences. Results. With test implants, a mean BIC% and BD% of 35.9 (±9.1) and 31.8 (±7.5) were found. With control implants, a mean BIC% and BD% of 29.9 (±7.6) and 32.5 (±3.9) were found. The mean BIC% was higher with test implants, but this difference was not significant (p = 0.16). Similar BD% were found in the two groups (p = 0.9). Conclusions. In the posterior maxilla, under immediate loading conditions, implants with a knife-edge thread design/nanostructured calcium-incorporated surface seem to increase the peri-implant endosseous healing properties, when compared to implants with self-tapping thread design/sandblasted surface.