Fit analysis of stereolithography-manufactured three-unit resin prosthesis with different 3D-printing build orientations and layer thicknesses.

STATEMENT OF PROBLEM: Printing conditions can affect the fit of a 3-dimensionally (3D) printed prosthesis. Therefore, it is important to determine the optimal printing conditions for stereolithography (SLA)-manufactured prostheses. PURPOSE: The purpose of this study was to analyze the fit according to the build orientations and layer thicknesses in SLA-manufactured 3-unit resin prostheses. MATERIAL AND METHODS: SLA 3D printed prostheses were produced in 5 build orientations (0, 30, 45, 60, and 90 degrees) and 2 layer thicknesses (50 and 100 µm). Milled prostheses were fabricated from the same design. The mounted prostheses on the master model were scanned with microcomputed tomography (µCT). Data were processed with the NRecon software program. For quantitative analysis, marginal and internal fits were measured by using the imageJ software program in terms of the following metrics: absolute marginal discrepancy, marginal gap, cervical area, midaxial wall area, line-angle area, and occlusal area. Internal gap volume was also measured with the CTAn software program. For statistical analysis, ANOVA and Tukey HSD tests were used (α=.05). For qualitative analysis, µCT cross-sections were compared among groups, and intaglio surfaces were imaged with a scanning electron microscope. RESULTS: A layer thickness of 50 µm with build orientations of 45 and 60 degrees exhibited smaller mean gap values (P<.05) than the other conditions for all measurements except line-angle area and occlusal area. The scanning electron microscope images showed voids on the intaglio surfaces for the 0- and 90-degree groups. CONCLUSIONS: For SLA 3D printed resin prostheses, a difference in fit occurred based on the printing conditions, although both 3D printed and milled prostheses showed a clinically acceptable fit. When an SLA 3D printed prosthesis is manufactured under appropriate conditions, a clinically acceptable fit can be obtained.

Mechanical complications of implant-supported restorations with internal conical connection implants: A 14-year retrospective study.

STATEMENT OF PROBLEM: Internal conical connections have become the primary choice for implant-supported restorations. However, studies that identified the risk indicators for mechanical complications and diagnosed the prognosis of the implant-supported restorations are lacking. PURPOSE: The purpose of this retrospective clinical study was to evaluate the incidence and consequences of mechanical complications in components of internal conical connection implants and to analyze the risk indicators. MATERIAL AND METHODS: A total of 428 patients with 898 internal conical connection implants were included in the study, and mechanical complications over the 14-year observation period were evaluated. The Cox proportional hazard regression model was used to analyze significant effects on mechanical complications, which were presented as hazard ratio and 95% confidence interval. RESULTS: Mechanical complications occurred in 430 (47.9%) implants and 248 (57.9%) patients: screw loosening (46.4% of implants, 56.8% of patients); screw fracture (2.6% of implants, 4.4% of patients); abutment fracture (11.4% of implants, 21.3% of patients); and implant fracture (3.5% of implants, 5.4% of patients). Implant restorations replacing molars showed the highest risk for mechanical complication (hazard ratio 12.82; 95% confidence interval 2.73-60.31) and for fracture of all components. Men had a higher risk of mechanical complication than women (hazard ratio 2.00; 95% confidence interval 1.55-2.59), and the risk of fracture was higher in all components. With increased splinted implants, the risk of mechanical complication (hazard ratio 0.67; 95% confidence interval 0.49-0.93) and component fracture (hazard ratio 0.73; 95% confidence interval 0.29-0.89) decreased. Gold screws had a lower risk of screw loosening (hazard ratio 0.74; 95% confidence interval 0.58-0.94) than titanium screws, but a higher risk of fracture (hazard ratio 3.45; 95% confidence interval 1.42-8.36). The smaller the implant diameter, the higher the risk of implant fracture (hazard ratio 0.01; 95% confidence interval 0.00-0.05). CONCLUSIONS: Abutments were most frequently fractured among the components of internal conical connection type implants. Molar implant-supported restorations and male patients had higher risks of mechanical complications, and as the number of splinted implants in a prosthesis increased, the risk decreased. Gold screws showed less risk of screw loosening and higher risk of fracture than titanium screws. Narrow-diameter implants had a higher risk of fracture.

Quality of life in patients in South Korea requiring special care after fixed implants: a retrospective analysis.

BACKGROUND: The study on oral health-related quality of life (OHRQoL) of disabled patients is rare but critical for welfare of patients. The aim of this study was to examine the effect of fixed implants in edentulous areas on OHRQoL in Korean disabled patients. METHODS: The OHRQoL of 63 disabled individuals was evaluated using the Oral Health Impact Profile (OHIP)-14 questionnaires and studied by potential affecting variables such as age, sex, disability severity, and time of disability acquisition. Wilcoxon-signed rank tests were used to examine the OHIP-14 scores for those who had pre/post-fixed implants. Multiple linear regression analysis was used to examine the relationships between factors and OHIP-14 scores before and after implants. A partial correlation analysis was also performed to determine which variables influenced OHIP-14 scores before and after treatment. The Mann-Whitney test was employed for sex and time of disability acquisition analysis (α = 0.05). RESULTS: Significant improvement was found in OHIP-14 post-implant treatment scores (P < .001). After implant treatment, the severity of disability produced significantly different results (P = .009). Pearson's correlation coefficient between severity of disability and pre/post-implant OHIP-14 scores was 0.265 (P = .030). After controlling for severity of disability, the results showed older patients had lower OHIP-14 scores (P = .032). No differences were found for sex or time of disability acquisition (congenital vs. acquired). CONCLUSIONS: Fixed implant treatment improved OHRQoL for disabled patients, and the severity of disability was positively correlated with improvement of OHRQoL. For patients with a similar level of disability, the OHRQoL decreased with age.

Clinical Outcomes of Implant-Assisted Removable Partial Dentures According to Implant Strategic Position.

PURPOSE: To retrospectively analyze the success of implant-assisted removable partial dentures (IARPDs) according to three types of strategic positions in distal extension areas of Kennedy Class I and II arches. MATERIALS AND METHODS: The data included 102 arches in 95 patients with Kennedy Class I/II arches treated with IARPDs with implants in three strategic positions: Type 1a, assisted by P-1a implants on the anterior area adjacent to the abutment tooth; Type 1b, assisted by P-1b implants on the anterior area apart from the abutment tooth with or without P-1a; Type 2, assisted by P-2a implants on the posterior area adjacent to the natural tooth or P-2b implants on the posterior area apart from the abutment tooth to modify from Kennedy Class I /II to Class III. The success was defined as the IARPDs without abutment tooth-related, denture-related, and implant-related complications. Kaplan-Meier curves and the multivariable Cox regression model were used to analyze the success of IARPDs and implants. RESULTS: The overall success rate of IARPD treatment was 66.7%; 77.8% in Type 1a, 60.0% in Type 1b, and 68.0% in Type 2. There was no significant effect of treatment type on success rate of IARPDs. However, there was significant differences at the level of implant supporting IARPDs: 83.3% in Type 1a implants, 62.6% in Type 1b implants, and 73.2% in Type 2 implants. The implants of IARPD's adjacent to the natural tooth abutments (P-1a and P-2a) had higher success rates than those away from the natural tooth abutments. CONCLUSIONS: Within the limitations of this study, there was no significant difference in the prosthodontic complications of IARPDs depending on the treatment type. However, the success of implants of IARPD is associated with the strategic position. Strategic implant abutments adjacent to the natural tooth had higher success rates than those away from the natural teeth abutments.

Alternative approach to salvaging an implant with a fractured screw fragment: A clinical report.

Managing fractures of implant abutment screws is challenging because of the uncertainty associated with the removal of the fractured screw fragments. In case of unsuccessful retrieval of the fractured fragment with known techniques, removal and replacement of the implant becomes traumatic and financially burdensome to the patient. This clinical report describes a conservative solution for the management of nonretrievable fractured screws by reconnecting the prostheses to the existing implants by using cut screws. This alternative, cost-effective method obviates the need for surgery and has proved successful and satisfactory for patients.

Dimensional accuracy and surface characteristics of 3D-printed dental casts.

STATEMENT OF PROBLEM: Although studies have reported the accuracy of 3D-printed dental casts, studies addressing cast distortion throughout the complete-arch range are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the dimensional accuracy of different areas in complete-arch casts made with various 3D printing methods. MATERIAL AND METHODS: A computer-aided design (CAD) reference cast was modified from a mandibular cast by adding 6 cylinders in the canine, second premolar, and second molar locations and 3 spheres to define a coordinate system. A total of 50 casts were printed with 5 group materials, which included fused deposition modeling (FDM), digital light processing (DLP1 and DLP2), photopolymer jetting (Polyjet), and stereolithography (SLA). After scanning the 3D printed casts, the overall consistency was examined by superimposing them on the CAD reference cast and measuring the deviations. For dimensional accuracy, cylinder top coordinates were extracted from each printed cast, and X-, Y-, and Z-deviations and the 3D deviation were calculated by subtracting the coordinates of the CAD reference cast from the cast values. Statistical analyses were conducted by the Kruskal-Wallis test and the Mann-Whitney post hoc test (α=.05). Surface characteristics were examined with photographs and scanning electron micrographs. RESULTS: FDM showed more systemic deviations than DLP, Polyjet, and SLA from superimposing analysis (P<.01). In the X-axis, FDM and DLP showed contraction, while Polyjet and SLA showed expansion (P<.01). In the Y-axis, FDM showed forward deviations on the right side and DLP showed contraction (P<.01). Three-dimensional deviation at each cylinder location was lowest in the left canine region, and deviations increased with distance from this site in all groups. The qualitative features of casts varied among 3D printers in terms of shape, surface smoothness, and edge sharpness. CONCLUSIONS: FDM and DLP casts tended to contract, whereas casts in the Polyjet and SLA groups expanded buccolingually and anterioposteriorly. Vertically, deviations were smaller than those in the other directions.

Accuracy of a digital removable partial denture fabricated by casting a rapid prototyped pattern: A clinical study.

STATEMENT OF PROBLEM: A limited number of clinical studies have evaluated the accuracy of a digitally generated removable partial denture (RPD) intraorally. An analysis of the accuracy of the digital RPD on a larger number of participants was needed. PURPOSE: The purpose of this clinical study was to analyze the accuracy of digital RPDs by using the replica technique. MATERIAL AND METHODS: The fit accuracy of digital RPDs fabricated using electronic surveying was analyzed by fabricating replicas with silicone registration material and measuring with a stereomicroscope and image program. A total of 348 measurements in 10 participants were analyzed. The internal discrepancy of the metal framework was evaluated among participants using different Kennedy classifications. The accuracy of fittings in the cingulum and occlusal rest areas were compared according to the denture support type and the measured position below the rest. A 2-way and 1-way ANOVA and an independent 2-sample t test were used for statistical analysis (α=.05). RESULTS: Statistically significant differences were found in the internal discrepancy of the various framework components (P<.05), but no differences were found among participants with different Kennedy classifications (P>.05). The discrepancy under the periphery of the rest was determined to be smaller than that of the center, especially for the cingulum rest (P<.01). CONCLUSIONS: Digital RPDs fabricated using electronic surveying varied in accuracy of fit. According to the rest contact positions, the accuracy observed at the periphery was better than at the center.

Splinting or Nonsplinting Adjacent Implants? A Retrospective Study Up to 15 Years: Part I-Biologic and Mechanical Complication Analysis.

PURPOSE: To analyze the biologic and mechanical complications of splinted and nonsplinted implant restorations. MATERIALS AND METHODS: A total of 423 patients (n = implants: 888) were included in the study. Biologic and mechanical complications that occurred for 15 years were analyzed using the multivariable Cox regression model, and the significant effect of the splinting of prostheses and other risk factors were evaluated. RESULTS: Biologic complications occurred in 38.7% of implants: 26.4% of nonsplinted implants (NS) and 45.4% of splinted implants (SP). Mechanical complications occurred in 49.2% of implants: 59.3% NS and 43.9% SP. Implants splinted with both mesial and distal adjacent implants (SP-mid) had the highest risk of peri-implant diseases. As the number of implants splinted increased, the risk of mechanical complications decreased. Long crown lengths increased the risk of both biologic and mechanical complications. CONCLUSION: Splinted implants had a higher risk of biologic complications and lower risk of mechanical complications. The implant splinted to both adjacent implants (SP-mid) had the highest risk of biologic complications. The greater the number of implants splinted, the lower the risk of mechanical complications. Long crown lengths increased the risk of both biologic and mechanical complications. Int J Oral Maxillofac Implants 2023;38:435-442. doi: 10.11607/jomi.10053.

Splinting or Nonsplinting Adjacent Implants? A Retrospective Study Up to 15 Years: Part II-Success and Survival Rate Analysis.

PURPOSE: To analyze the success and survival of splinted and nonsplinted implants. MATERIALS AND METHODS: A total of 423 patients (n = implants: 888) were included in the study. The success and survival of implants for 15 years were analyzed using a multivariable Cox regression model, and the significant effect of the splinting of prostheses and other risk factors were evaluated. RESULTS: The cumulative success rate was 34.2%: 33.2% in nonsplinted (NS) and 34.8% in splinted implants (SP). The cumulative survival rate was 92.9% (94.1%, NS; 92.3%, SP). Whether to splint was not related to the success and survival of implants. The smaller the implant diameter, the lower the survival rate. The crown length and implant length were significantly associated only with NS implants: The longer the crown length and the shorter the implant length, the greater the risk of implant failure. The emergence angle (EA) and the emergence profile (EP) had a significant effect on only the SP implants: EA3 showed a higher risk than EA1, and EP2 and EP3 had a higher risk of implant failure. CONCLUSION: Crown length and implant length affected only the nonsplinted implants: The higher the crown length and the shorter the implant length, the greater the risk of implant failure. A significant effect for emergence contour was found only in SP implants: the implants restored with prostheses with EA ≥ 30 degrees on both the mesial and distal sides, and convex EP on at least one side had higher risks of failure. Int J Oral Maxillofac Implants 2023;38:443-450. doi: 10.11607/jomi.10054.

Could Fixed Implants Be a Viable Treatment Option in Disabled Patients? A Clinical Retrospective Study.

PURPOSE: To verify the survival rates and marginal bone loss (MBL) of implants in patients with different disability types. MATERIALS AND METHODS: Clinical and radiographic assessments were performed in a total of 189 implants for fixed implant prostheses in 72 patients. Data were collected on loaded implants at least 1 year in function, and the mean observation time was 37.3 months. Implant survival was examined, and MBL was observed around the implants of two groups (mental disability vs physical disability) based on age, sex, implant location (anterior vs posterior), and prosthetic connection (internal vs external). RESULTS: Of the 189 implants, 4 failed; the total implant survival rate was 97.8% across a mean of 37.3 months. The cumulative survival rate at 85 months in a Kaplan-Meier survival curve analysis was 94.3% ± 3% in patients with mental disability and 50% ± 35.4% in patients with physical disability, which was a statistically significant difference between the disability groups (P = .006). Fisher exact test showed significant differences in MBL only with age (P < .001). The implant MBL by disability type-adjusted for age and observation period-showed significant differences in multiple linear regression analyses (P = .003). CONCLUSION: The implant survival rates in patients with disability were in line with those reported for nondisabled patients. The MBL of the implants was within the physiologic bone loss after implant loading. Implants in patients with mental disability showed higher cumulative survival rates than in patients with physical disability, but also a higher amount of MBL. Within the limitations of this study, dental implants for patients with disability are viable. These results can establish future implant treatment plans for this population. Int J Oral Maxillofac Implants 2023;38:562-568. doi: 10.11607/jomi.9880.

Comparison of Fit and Stability Between 3D-Printed and Milled Implant Abutments with Titanium-6Al-4V and Co-Cr Metal Alloys.

PURPOSE: To compare the fit of 3D-printed titanium (Ti) and cobalt-chromium (Co-Cr) abutments with implants to computer numerical control (CNC)-milled, ready-made abutment-implant assemblies. Their clinical applicability was also evaluated by measuring removal torque values (RTVs) and percentage torque loss of abutment screws. MATERIALS AND METHODS: A total of 138 abutments were included in the study: 92 abutments were fabricated with Ti and Co-Cr alloys using computer-assisted design (CAD) through selective laser melting, and 46 ready-made abutments were prepared. The fit of interfaces between 90 abutments from the three groups (30 ready-made, 30 3D-printed Ti, and 30 3D-printed Co-Cr abutments) and implant assemblies was demonstrated by scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM). After 30-Ncm torque tightening of Ti abutment screws twice within 10 minutes, the RTVs and percentage torque loss of screws of 48 abutments (16 ready-made, 16 3D-printed Ti, and 16 3D-printed Co-Cr) were evaluated after 10 minutes of thermocycling and cyclic loading. RESULTS: The fits of 3D-printed Co-Cr abutments were not statistically different from those of ready-made abutments (P = .383), while the fit of 3D-printed Ti abutments was inadequate (P < .001). The RTVs of 3D-printed abutments after cyclic loading were significantly decreased compared with those of CNC-milled abutments (P < .001). CONCLUSION: The fit of interfaces between 3D-printed Co-Cr abutments and implants was adequate. The RTVs of 3D-printed Co-Cr abutments were not significantly different from those of CNC-milled abutments after 10 minutes of 30-Ncm torque tightening and thermocycling.

Clinical and radiographic evaluations of implants as surveyed crowns for Class I removable partial dentures: A retrospective study.

PURPOSE: The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of implants in IC-RPDs. MATERIALS AND METHODS: Seventy implants were placed and used as surveyed crowns in 30 RPDs. The survival rates and MBL around implants based on multiple variables, e.g., position, sex, age, opposing dentitions, splinting, type of used retainer, and first year bone loss, were analyzed. Patient reported outcome measures (PROMs) regarding functional/esthetic improvement after IC-RPD treatment, and complications were also inspected. RESULTS: The 100% implant survival rates were observed, and 60 of those implants showed MBL levels less than 1.5 mm. No significant differences in MBL of implants were observed between implant positions (maxilla vs. mandible; P = .341) and type of used retainers (P = .630). The implant MBL of greater than 0.5 mm at 1 year showed significantly higher MBL after that (P < .001). Splinted implant surveyed crowns showed lower MBL in the maxilla (splinted vs. non-splinted; P = .037). There were significant esthetic/functional improvements observed after treatment, but there were no significant differences in esthetic results based on implant position (maxilla vs. mandible). Implants in mandible showed significantly greater improvement in function than implants in the maxilla (P = .002). Prosthetic complication of IC-RPD was not observed frequently. However, 2 abutment teeth among 60 were failed. The bone loss of abutment teeth was lower than MBL of implants in IC-RPDs (P = .001). CONCLUSION: Class I RPD connected to residual teeth and strategically positioned implants as surveyed crowns can be a viable treatment modality.

Dimensional Accuracy of Dental Models for Three-Unit Prostheses Fabricated by Various 3D Printing Technologies.

Previous studies on accuracy of three-dimensional (3D) printed model focused on full arch measurements at few points. The aim of this study was to examine the dimensional accuracy of 3D-printed models which were teeth-prepped for three-unit fixed prostheses, especially at margin and proximal contact areas. The prepped dental model was scanned with a desktop scanner. Using this reference file, test models were fabricated by digital light processing (DLP), Multi-Jet printing (MJP), and stereo-lithography apparatus (SLA) techniques. We calculated the accuracy (trueness and precision) of 3D-printed models on 3D planes, and deviations of each measured points at buccolingual and mesiodistal planes. We also analyzed the surface roughness of resin printed models. For overall 3D analysis, MJP showed significantly higher accuracy (trueness) than DLP and SLA techniques; however, there was not any statistically significant difference on precision. For deviations on margins of molar tooth and distance to proximal contact, MJP showed significantly accurate results; however, for a premolar tooth, there was no significant difference between the groups. 3D color maps of printed models showed contraction buccolingually, and surface roughness of the models fabricated by MJP technique was observed as the lowest. The accuracy of the 3D-printed resin models by DLP, MJP, and SLA techniques showed a clinically acceptable range to use as a working model for manufacturing dental prostheses.

Clinical Performance of Implant Crown Retained Removable Partial Dentures for Mandibular Edentulism-A Retrospective Study.

The studies on implant-crown-retained removable partial dentures (IC-RPDs) for edentulism are scarce. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of IC-RPDs compared to implant overdentures (IODs) in mandibular edentulism. Variables that influenced survival and marginal bone loss (MBL) of implants in both treatment modalities were analyzed and the functional/esthetic satisfaction of patients as well as prosthetic complications were also observed. Eighteen IC-RPDs with a total of 60 implant-supported survey crowns and 24 IODs with a total 94 implants retained with magnet attachments were observed. After a median observation period of 46.6 months (up to 149 months), we observed 98.3% implant survival rates for IC-RPDs and 92.5% for IODs. Kaplan-Meier survival curves based on the treatment modality showed that, at 96 months, cumulative survival rates were 98.3% in IC-RPD and 83.1% in IOD. For implant survival rates, no statistical differences were observed according to age, sex, opposing dentition, or implant positions (p = 0.515, 0.666, 0.201, 0.749, respectively). The implant MBL measurements for IC-RPD and IOD groups at the final recall check were 0.93 ± 1.22 mm and 2.12 ± 2.09 mm, respectively. Additionally, there were no significant differences between groups (p = 0.554). The implants with peri-implantitis at year 1 showed significantly higher MBL at final check-up (p < 0.001). The MBL of implants showed significant differences based on age (p = 0.008) and opposing dentition (p = 0.003). No significant differences of implant MBL were observed for the position of placed implants (p = 0.621) or sex (p = 0.666). Patient-reported outcome measures (PROMs) on functional and esthetic satisfaction were significantly improved after IC-RPD or IOD treatment (p < 0.001). The most frequent prosthetic complication of IC-RPD was clasp loosening, while for IOD group, it was attachment dislodgement. Within the limitations of this retrospective study, we concluded that IC-RPDs could be considered as a viable treatment option for edentulous patients who need few fixed abutments for satisfaction.

New Rehabilitation Concept for Maxillary Edentulism: A Clinical Retrospective Study of Implant Crown Retained Removable Partial Dentures.

There have been no studies of implant-crown-retained removable partial dentures (IC-RPD) for the treatment of maxillary edentulism. The purpose of this study was to perform clinical and radiographic evaluations of implants in IC-RPD compared to implant overdentures (IOD) in maxillary edentulous patients. Twenty IC-RPDs with 74 splinted implant crowns and 18 IODs with 71 implants retained with magnet attachments were observed in 38 patients. We statistically analyzed survival rates and marginal bone loss (MBL) of implants based on multiple variables including first year pathologic condition, location of placed implant, age, and sex in both treatments. Patient reported oral measurements (PROMs) regarding functional/esthetic improvement after IC-RPD or IOD treatments and prosthetic complications were also statistically analyzed. After a median observation period of 47.1 months (up to 147 months), we observed 97.3% implant survival rates for IC-RPD and 70.4% for IOD (p < 0.001). Among variables, first year pathologic condition (p < 0.001) and sex (p = 0.027) influenced implant survival rates. The MBL of implants for IC-RPD and IOD groups at the final check-up were 1.12 ± 1.19 mm and 3.31 ± 1.71 mm, respectively (p < 0.001). In both groups, patients with peri-implantitis (p < 0.001) and patients older than 65 years (p = 0.029) showed significantly higher implant MBL regardless of treatment modality. Functional and esthetic satisfaction were significantly improved (p < 0.001) after both treatments. The IOD group showed more frequent prosthetic complications compared to the IC-RPD group. Within the limitations of a retrospective study, we concluded that RPD with few splinted implant crowns is a feasible alternative treatment modality for maxillary edentulous patients with anatomical limitations.

Osseointegration of anodized titanium implants coated with poly(lactide-co-glycolide)/basic fibroblast growth factor by electrospray.

PURPOSE: The purpose of this study was to evaluate the effect of basic fibroblast growth factor (bFGF) in combination with a biodegradable polymer coated onto titanium implants. The implants were inserted in rabbit tibiae, and bone growth was examined by histomorphometric analysis. MATERIALS AND METHODS: Forty-eight threaded anodized implants were inserted into the tibiae of 12 rabbits. After 12 weeks of healing, an evaluation was made by light microscopy and computerized image analysis. A total of 56 anodized titanium implants were prepared as follows: group 1 was anodized under 300 V; group 2 was anodized then coated with 0.02 mL poly(lactide-co-glycolide) (PLGA) nanoparticles; group 3 was anodized then coated with 0.02 mL PLGA/bFGF nanoparticles (10 ng bFGF); and group 4 was anodized then coated with 0.2 mL PLGA/bFGF nanoparticles (100 ng bFGF). RESULTS: Nanosized particles were observed on the coated implant surfaces. The mean diameter of the nanoparticles was 268.6 +/- 93.2 nm. The mean bone-to-implant contact (BIC) percentage in group 4 (44.7%) was significantly greater than that seen in groups 1 (31.4%) and 2 (33.6%) (P < .05). CONCLUSIONS: The results of this preliminary study show that coating a titanium implant with PLGA incorporated with bFGF by electrospray may stimulate bone formation adjacent to the surface of an implant inserted in bone.

Mechanical Properties and Metal-Ceramic Bond Strength of Co-Cr Alloy Manufactured by Selective Laser Melting.

Cobalt-chromium (Co-Cr) metal is one of the widely used biomaterials in the fabrication of dental prosthesis. The purpose of this study was to investigate whether there are differences in the properties of metals and bond strength with ceramics depending on the manufacturing methods of Co-Cr alloy. Co-Cr alloy specimens were prepared in three different ways: casting, milling, and selective laser melting (SLM). The mechanical properties (elastic modulus, yield strength, and flexural strength) of the alloys were investigated by flexure method in three-point bending mode, and microstructures of the specimens were analyzed. After application of the veneering ceramic through the three-point bending test, bond strength of the Metal-Ceramic was investigated. The cracked surfaces were observed by means of energy dispersive X-ray (EDX) spectroscopy and scanning electron microscopy (SEM) with backscattered electron (BSE) images. In mechanical properties, the elastic modulus was highest for the casting group, and the yield strength and flexural strength were lowest for the milling group. The SLM group showed finer homogeneous crystalline-microstructure, and a layered structure was observed at the fractured surface. After the ceramic bond strength test, all groups showed a mixed failure pattern. The casting group showed the highest bond strengths, whereas there was no significant difference between the other two groups. However, all groups have met the standard of bond strength according to international standards organization (ISO) with the appropriate passing rate. The results of this study indicate that the SLM manufacturing method may have the potential to replace traditional techniques for fabricating dental prosthesis.

Survival rate and clinical evaluation of the implants in implant assisted removable partial dentures: surveyed crown and overdenture.

PURPOSE: The purpose of this study was to investigate survival rates of the implants used in implant assisted removable partial dentures (IARPDs). MATERIALS AND METHODS: The study was conducted on 21 patients who were treated with IARPDs. The mean follow-up period for IARPD patients ranged from 12 to 185 months (mean 47.9 months). A total of 58 implants were used for IARPDs in two different modalities: 41 for surveyed crowns and 17 for overdentures. The survival of implants was determined by clinical and radiographic evaluations considering relevant factors: location, RPD classification, opposing dentition, splinting, and implant diameter. RESULTS: The survival rate of total 58 implants was 93.1%: 95.1% for implants supporting surveyed crowns and 88.2% for implants used in overdentures. Considering only the implants supporting surveyed crown, regular diameter implants showed a higher survival rate than narrow or wide diameter implants. CONCLUSION: The survival rate of the implants used in IARPDs was 93.1% (surveyed crown: 95.1%, overdenture: 88.2%).

Flexural Strength of 3D-Printing Resin Materials for Provisional Fixed Dental Prostheses.

The clinical application of 3D-printed provisional restorations is increasing due to expansion of intraoral scanners, easy dental computer-aided design (CAD) software, and improved 3D printing speed. This study compared flexural strength of 3D-printed three-unit fixed dental prostheses with that of conventionally fabricated and milled restorations. A metal jig of two abutments and pontic space and an indenter for flexural strength measurement were fabricated. A three-unit fixed dental prosthesis was designed and manufactured using three additive manufacturing technologies, with subtractive manufacturing and a conventional method as controls. Digital light processing (DLP) group specimens were prepared from a polymethyl methacrylate (PMMA)-based resin and printed with a DLP printer. Stereolithography (SLA) group specimens were prepared from PMMA-based resin and printed with an SLA printer, and fused deposition modeling (FDM) group specimens were from a polylactic acid-based resin and printed with an FDM printer. Flexural strength was investigated using a universal testing machine, and the results were statistically analyzed. DLP and SLA groups had significantly higher flexural strength than the conventional group (p < 0.001). No significant difference was observed in flexural strength between DLP and SLA groups. The FDM group showed only dents but no fracture. The results of this study suggest that provisional restorations fabricated by DLP and SLA technologies provide adequate flexural strength for dental use.

The Influence of a Positioning Hex on Abutment Rotation in Tapered Internal Implants: A 3D Finite Element Model Study.

PURPOSE: The purpose of this study was to investigate the resistance against rotation of a two-piece abutment with or without the presence of a positioning hex in tapered internal connection implant systems. MATERIALS AND METHODS: A tapered internal connection implant with an 11-degree internal oblique angle was placed into a constructed three-dimensional (3D) bone model. Two types of abutments were compared: hex-type abutments with a positioning hex and two-piece round-type nonhex abutments. Vertical compressions equivalent to the screw tightening torque of 30 Ncm and 40 Ncm were applied to the abutment screws. A horizontal load of 150 N was applied to the superstructure to create moments. The contact area between the implant and abutment was compared and analyzed. The rotational displacement of the abutments was investigated as well. RESULTS: When a preload equivalent to 40 Ncm of tightening torque was applied, the round-type abutment exhibited a larger contact area than the hex-type abutment by approximately 2.5% to 3.5% in contrast to the internal surface area of the implant. When the screw tightening torque of 30 Ncm was applied, the rotational displacement of the hex-type abutment was approximately 0.54 degrees and the round-type was approximately 1.16 degrees under clockwise moment loading. CONCLUSION: Within the limitations of this study, it can be assumed that the hexagonal design of the abutment acts as rotational resistance against moments.