3D Master Toothguide Is Adequate to Subjective Shade Selection?

Background and Objectives: To study the validity and the degree of representability of the toothguide 3D Master, with 26 physically shade tabs, on the natural tooth colour on a sample of the Spanish population. Materials and Methods: Natural tooth colour was measured in a sample of 1361 Spanish participants of both genders distributed within an age range of 18 and 89 years of age. The colour coordinates were calculated and the frequency of the 26 physically shade tabs of the toothguide as well as the "intermediate shades" (without physical representation in toothguide) through the Easyshade Compact (Vita-Zahnfabrik) spectrophotometer using the 3D Master System nomenclature. The colour differences between the "intermediate shades" were calculated using the Euclidean formula (ΔEab*). The program used for the present descriptive statistical analysis of the results was SAS 9.1.3. Results: A total of 49 "intermediate shades" were registered in 816 participants (60%). The colour coordinates of the 49 'intermediate shades' cover colour coordinates ranging from 0M1.5 (L* 100.0, C* 7.70, h* 112.2) to 5M2.5 (L* 56.8, C* 35.8, h* 78.5). Not all possible 3D Master System's "intermediate shades" were registered in the population studied. 82.4% of the colour differences among the "intermediate shades" were clinically unacceptable (ΔEab* ≥ 5.5 units). Conclusions: Only 40% of the population studied presented a natural tooth colour belonging to the 3D Master Toothguide's physical shade tabs.

Influence of the type of reciprocating motion on the cyclic fatigue resistance of reciprocating files in a dynamic model.

BACKGROUND: The aim of this study was to compare the influence of two novel reciprocating movements on the cyclic fatigue resistance of endodontic reciprocating files. METHODS: 30 Procodile® (Komet Medical, Lemgo, Germany) files were selected in this study and distributed according to the following study groups depending on the movements to be performed: ReFlex Dynamic (n = 10), ReFlex Smart (n = 10) and Reciproc (n = 10) reciprocating movement. These files were fixed to a specific dynamic cyclic fatigue device designed and manufactured by 3D impression to simulate the pecking motion performed by the operator. The time to failure and the number of cycles of in-and-out of the endodontic files was registered. The results were analyzed by ANOVA and Weibull statistics. RESULTS: Statistically significant differences were found when the number of cycles of in-and-out movement and the time to failure of ReFlex Dynamic and Reciproc reciprocating movement (p < 0.001) and between ReFlex Smart and Reciproc reciprocating movement (p < 0.001) were compared in pairs. However, no statistically significant differences were observed between time to failure and number of cycles of in-and-out movement of ReFlex Dynamic and ReFlex Smart reciprocating movement (p = 0.253). CONCLUSIONS: The ReFlex Smart reciprocating movement increased the cyclic fatigue resistance of endodontic reciprocating files compared with traditional reciprocating movement.

How do the dimensions of peri-implant mucosa affect marginal bone loss in equicrestal and subcrestal position of implants? A 1-year clinical trial.

INTRODUCTION: There is evidence that the apico-coronal implant position and the mucosal phenotype can affect the extent of peri-implant bone loss. This clinical trial analyzes the bone remodeling and marginal bone loss that occur around conical-connection implants placed equicrestally and subcrestally, assessing the effect of the peri-implant soft-tissue phenotype. METHODS: Fifty-one patients received 56 implants of distinct diameters (3.5 mm Ø n = 6; 4.3 mm Ø n = 41; 5 mm Ø n = 9) in the posterior part of the maxilla or mandible. The implants were placed equicrestally, 1 mm subcrestally and >1 mm subcrestally, depending on the initial supracrestal tissue height (STH). After 3 months of non-submerged healing, single metal-ceramic screw-retained implant-supported crowns were placed. Longitudinal measurements of STH, mucosal thickness and keratinized mucosa width (KMW) were made at the time of implant placement (T0), crown placement (T1), and after 3 (T2) and 6 months (T3) of prosthetic loading. At each of these points, a radiographic evaluation of bone remodeling and marginal bone loss was also performed. RESULTS: STH was significantly greater for implants placed >1 mm subcrestally than for those placed 1 mm subcrestally. After 12 months of follow-up, a very significant (p < 0.001) loss of KMW was observed, in addition to a marginal bone loss of 0.08 ± 0.1, 0.15 ± 0.2, and 0.14 ± 0.2 mm in the groups placed equicrestally, 1 mm subcrestally and >1 mm subcrestally, respectively. After the multiple linear regression, marginal bone loss was found to depend primarily on KMW (ß = -0.43), while also being affected by STH (ß = 0.32) and implant diameter (ß = -0.28). CONCLUSIONS: Marginal bone loss may be influenced by the position with respect to the bone crest, as well as the KMW, STH, and implant diameter. However, more well-controlled studies are needed to verify these above-mentioned findings with different implant designs and connections.

Using the Modified Apical Access Technique to Treat Peri-Implant Mucosa Defects: Description of the Technique and Three-Dimensional Quantitative Measurement of Buccal Augmented Tissue.

The importance of augmenting the peri-implant soft- and hard-tissue architecture is now widely accepted. However, while most contemporary research supports this premise, clinicians are encountering peri-implant soft tissue defects with increasing frequency, which they are therefore required to reconstruct. These complications can result from the difficulty of establishing an appropriate diagnosis and treatment plan or from suboptimal clinical situations (implant malposition, insufficient vestibular alveolar bone thickness or inadequate mucosal thickness). In this context, it is the peri-implant soft-tissue phenotype that most influences esthetic and health-related results in the short and long term. This article describes two clinical cases in which a modification of the apical access technique is presented that may be useful in clinical scenarios requiring large gains in mucosal thickness. Use of the modified bilaminar apical access with de-epithelialized free gingival graft technique showed promising results, with a significant increase in mucosal thickness and satisfactory outcomes in esthetics and peri-implant health.

The influence of implant depth, abutment height and mucosal phenotype on peri­implant bone levels: A 2-year clinical trial.

OBJECTIVES: To evaluate the bone changes around equicrestal and subcrestal implants, analyzing the effect of abutment height [short abutments (SA < 2 mm) and long abutments (LA > 2 mm)] and the three components of the peri­implant soft-tissue phenotype. METHODS: Twenty-six patients received 71 implants that were placed according to supracrestal tissue height (STH) in an equicrestal (n = 17), shallow subcrestal ≈1 mm (n = 33), or deep subcrestal ≈2 mm (n = 21) position. After 3 months of healing, rehabilitation was completed using metal-ceramic crowns on multi-unit abutments of 1.5 mm, 2.5 mm, or 3.5 mm in height, depending on the prosthetic space and STH. Longitudinal clinical parameters (STH, mucosal thickness, and keratinized mucosa width) and radiographic data [bone remodelling and marginal bone loss (MBL)] were collected at 3, 6, 12, and 24 months postsurgery. RESULTS: The gain in STH was significantly greater around the implants placed in a subcrestal ≈2 mm position. After 2 years, the mean change in bone remodelling in the SA group was significantly greater than in the LA group. According to the multiple linear regression, bone remodelling depends primarily on abutment height (ß = -0.43), followed by crestal position (ß = 0.34), and keratinized mucosa width (ß = -0.22), while MBL depends on abutment height (ß = -0.37), and the patient's age (ß = -0.36). CONCLUSIONS: Implants placed in an equicrestal or subcrestal ≈1 mm position with LA undergo less bone remodelling, while the lowest level of MBL occurs in subcrestal ≈2 mm implants with LA. Differing soft-tissue thicknesses combined with the use of either SA or LA produced significant intergroup differences in bone remodelling and MBL. CLINICAL SIGNIFICANCE: Abutment height is the most powerful predictor variable affecting bone remodelling and MBL. Depending on the dimensions of the peri­implant soft-tissue phenotype, placing the implants subcrestally may also be a viable option to decrease bone remodelling and, consequently, reduce MBL. CLINICAL TRIAL REGISTRATION: identification number: NCT05670340.

Histological and immunohistochemical soft-tissue response to cylindrical and concave abutments: Multicenter randomized clinical trial.

BACKGROUND: This study aimed to analyze the influence of concave and cylindrical abutments on peri-implant soft tissue. Dimensions, collagen fiber orientation, and immunohistochemical data were assessed. METHODS: A multicenter, split-mouth, double-blind randomized clinical trial was conducted. Two groups were analyzed: cylindrical abutments and concave abutments. After a 12-week healing period, peri-implant soft tissue samples were collected, processed, and evaluated for dimensions, collagen fiber orientation, and immunohistochemical data. Inflammatory infiltration and vascularization were assessed, and the abutment surfaces were analyzed using scanning electron microscopy. The statistical analysis was performed using the SPSS version 20.0 statistical package. RESULTS: A total of 74 samples in 37 patients were evaluated. Histological evaluation of peri-implant soft tissue dimensions revealed significant differences between concave and cylindrical abutments. Concave abutments exhibited greater total height (concave: 3.57 ± 0.28 - cylindrical: 2.95 ± 0.27) and barrier epithelium extension (concave: 2.46 ± 0.17 - cylindrical: 1.89 ± 0.21) (p < 0.05), while the supracrestal connective tissue extension (concave: 1.11 ± 0.17 - cylindrical: 1.03 ± 0.16) was slightly greater (p > 0.05). Collagen fiber orientation favored concave abutments (23.76 ± 5.86), with significantly more transverse/perpendicular fibers than for cylindrical abutments (15.68 ± 4.57). The immunohistochemical analysis evidenced greater inflammatory and vascular intensity in the lower portion for both abutments, though concave abutments showed lower overall intensity (concave: 1.05 ± 0.78 - cylindrical: 1.97 ± 0.68) (p < 0.05). The abutment surface analysis demonstrated a higher percentage of tissue remnants on concave abutments (42.47 ± 1.32; 45.12 ± 3.03) (p < 0.05). CONCLUSIONS: Within the limitations of this study, concave abutments presented significantly greater peri-implant tissue height, linked to an extended barrier epithelium, versus cylindrical abutments in thick tissue phenotype. This enhanced soft tissue sealing, favoring a greater percentage of transversely oriented collagen fibers. The concave design reduced chronic inflammatory exudation with T and B cells, thus minimizing the risk of chronic inflammation. PLAIN LANGUAGE SUMMARY: This study looked at how 2 different shapes of dental implant abutments (the parts that connect the implant to the crown), specifically concave and cylindrical, affect the soft tissue around the implants. We wanted to see how these shapes influenced the tissue's size, structure, and health. We conducted a clinical trial with 37 patients, comparing the 2 types of abutments in the same mouth over 12 weeks. Our findings showed that the concave abutments led to a taller and more extensive layer of protective tissue around the implant compared to the cylindrical ones. This protective tissue had more favorable collagen fiber orientation, which is important for the strength and health of the tissue. Additionally, the concave abutments resulted in less inflammation and better tissue integration. In conclusion, concave abutments may provide better support and health for the soft tissue around dental implants, reducing the risk of chronic inflammation and potentially leading to better long-term outcomes for patients with dental implants.

Preliminary results of customized bone graft made by robocasting hydroxyapatite and tricalcium phosphates for oral surgery.

OBJECTIVE: The objective of this study was to assess the mechanical characteristics and the clinical usefulness of beta-tricalcium phosphate (ß-TCP) and hydroxyapatite (HA) bioblocks grafted in edentulous jaws of 12 patients. METHODS: The scaffolds were produced by robocasting ceramic inks containing 80%/20% ß-TCP and HA, respectively, with an overall porosity of 60%, with a macropore size between 300 and 500 µm. The mechanical performance of cylindrical vs conical specimens was compared using a universal testing machine. The clinical study was performed on 12 edentulous patients who received 4 cylindrical bone bioblocks. After 10 to 16 weeks of osseointegration, the bioblocks were explanted with trephine for histologic analysis by Goldner and Von Kossa staining. RESULTS: Conical shapes were significantly stronger (96.4 ± 8.7 MPa) than cylindrical shapes (87.8 ± 12.2 MPa). The overall degree of porosity ranged from 53.4% to 58.1% in the coronal region to 62.5% to 66.9% at the apex. After the maturation period, 41 valid bioblocks (85.4%) were obtained for histologic study. Bone showing some cellularity was found in 68.4% of the samples, indicating biologically active bone, and adequate calcification was found in 31.7% of the samples. In terms of biomaterial degradation, 73.2% of the samples were completely resorbed or showed significant resorption. CONCLUSIONS: The 80%/20% ß-TCP and HA grafts customized by robocasting appear adequate for regenerating self-contained defects.

Factors Influencing the Accuracy of Guided Surgery: An In Vitro Trial.

Purpose: To examine how the accuracy (linear and angular deviation) of implants placed using computer-guided surgery varies in relation to the type of surgical technique (fully guided, half-guided, vs freehand implant placement), bone density (type D1 to D4 bone), and type of support surface (tooth- vs mucosa-supported). Materials and Methods: A total of 32 mandible models were produced (16 partially edentulous and 16 edentulous) using acrylic resin, each calibrated to a different bone density (D1 to D4). Four implants planned using Mguide software were placed in each acrylic resin mandible. A total of 128 implants were placed, distributed according to bone density (D1 to D4, n = 32), the degree of intervention in the surgery (fully guided [FG] = 80, half-guided [HG] = 32, and freehand surgery [F] = 16), and the type of support surface (tooth-supported: n = 64 and mucosa-supported: n = 64). To determine the linear, vertical, and angular deviations between the planned three-dimensional position and the actual position of the implants, the linear and angular difference between them was calculated, with the analysis performed through preoperative and postoperative CBCT scans. The effect was analyzed using parametric tests and linear regression models. Results: All parameters of linear and angular discrepancy in the various regions analyzed (neck, body, and apex) were primarily influenced by the technique and, to a lesser extent, by the bone type, although both variables were predictive and highly significant. These discrepancies tend to increase in completely edentulous models. The regression models show that linear deviations increase by between 630.2 µm at neck level in the buccolingual direction and 836.7 µm at apex level in the mesiodistal direction when comparing the FG and HG techniques. This increase is accumulative when comparing the HG and F techniques. Regarding the effect of bone density, the regression models found that linear discrepancies increase by between 132.6 µm in the axial direction and 199.0 µm at the apex of the implant in the buccolingual direction with each reduction in bone density (D1 to D4). Conclusion: According to this in vitro study, the highest implant placement predictability is found among dentate models with high bone density and a fully guided surgical technique.

Treatment of Esthetic Complications with Peri-implant Soft Tissue: A Description of the "Apical Approach" Surgical Technique and Presentation of Two Clinical Cases

Peri-implant soft tissue deformities are an increasingly common phenomenon in the esthetic zone. While the most widely studied esthetic complications are peri-implant soft tissue dehiscences, there are other esthetic concerns in routine clinical practice that require investigation and treatment. Thus, this report on two clinical cases describes a surgical approach using the apical access technique to treat peri-implant soft tissue discoloration and fenestration. In both clinical scenarios, the defect was accessed via a single horizontal apical incision without removing the cement-retained crowns. A bilaminar technique using apical access with a simultaneous connective tissue graft seems to offer promising results for the treatment of peri-implant soft tissue deformities. At the 12-month reevaluation, an increase in peri-implant soft tissue thickness was observed, resolving the pathologies presented.

Histologic Outcomes of the Use of Different Biomaterials for Socket Regeneration in Fresh Extraction Sockets: A Split-Mouth Randomized Clinical Trial.

PURPOSE: To analyze the quality of bone regeneration in fresh sockets using four different materials at different time points. MATERIALS AND METHODS: A split-mouth randomized clinical trial was designed to evaluate the histologic and histomorphometric characteristics of 82 fresh sockets from 30 patients. One socket per patient healed spontaneously (control), and at least one fresh socket was grafted with a material chosen randomly from a sealed envelope: plateletrich growth factor (PRGF; n = 20 sites), PRGF + autologous bone (n = 9 sockets), autologous bone (n = 10 sites), or PRGF + demineralized freeze-dried bone allograft (DFDBA; n = 13). Biopsy specimens were taken at different time points divided into three assessment groups: short duration (2 to 4 months), intermediate duration (5 to 6 months), and long duration (7 to 12 months). The histologic findings were assessed to quantify the trabeculae pattern, the degree of mineralization, and the quality of bone regeneration. RESULTS: A total of 26 patients with 73 sockets completed the study. Mineralization after a short duration was found to be significantly higher among sockets treated only with autologous bone (47.3% ± 3.6%) or with PRGF+autologous bone (45.1% ± 13.6%). During the intermediate time point, this difference was not observed; also, the control sites were found to have the highest amount of mineralization (37.7% ± 14.9%). After a long duration of wound healing, the PRGF+DFDBA group had the greatest percentage of mineralized tissue (54.7% ± 28.7%), which was significantly higher than the sites treated only with PRGF (30.0% ± 13.2%). CONCLUSION: From a histologic point of view, the use of autologous graft with or without PRGF seems to be the best strategy for socket regeneration within a short period of time (2 to 4 months). However, the application of PRGF alone inside fresh sockets may interfere with normal bone healing compared with control sites healed spontaneously.

Analysis of the Importance of the Motion Used in the Resistance of Different Mechanical Instrumentation Systems in Endodontics: A Comparative Study.

Aim: The aim of this study was to compare the cyclic fatigue strength of different reciprocating rotary systems depending on the movement used. Methods: Four study groups were analyzed (n = 30): (1) Reciproc®, (2) Reciproc Blue®, (3) Wave One Gold® and (4) Procodile®. Each group was divided into three subgroups according to the motion used: (A) Reflex Dynamic® (n = 10), (B) ReFlex Smart® (n = 10) and (C) conventional reciprocating motion (n = 10). They were used in a dynamic cyclic fatigue prototype until their fracture, and the time was measured in seconds. The results obtained were analyzed with the ANOVA method, and for two-to-two comparisons, the Tukey method and Weibull statistics were used. Results: Procodile ReFlex Smart had the longest time to failure, and statistically significant differences were found between Procodile ReFlex Smart and the other files and motions (p < 0.05). Conclusion: Smart motions increase cyclic fatigue strength. ReFlex Smart® motion increases the cyclic fatigue strength of reciprocating rotary systems, and Procodile® ReFlex Smart was the most resistant system file.

Maxillary reconstruction with subperiosteal implants in a cancer patient: A one-year follow-up.

Introduction: To describe a clinical case on cancer patient with ablative tumor surgery, from treatment planning, surgical resection and subsequent implantological rehabilitation. Case Report: A 61-year-old male, diagnosed with a squamous cell carcinoma in the maxilla, requires the removal of the lesion and corresponding oral rehabilitation. However, two surgeries were necessary to rehabilitate the upper jaw. A custom-made prosthesis was fabricated. It was made from sintered titanium using machined subperiosteal implants with a universal external connection. Finally, a milled cobalt- chrome structure was produced and a feldspar ceramic covering was subsequently applied. Conclusions: Rehabilitation using subperiosteal implants may be an alternative tool for complex surgery involving large atrophies or cancer patients who have undergone highly ablative surgery. Key words:Oral rehabilitation, oral cancer, subperiostal implants.

Effectiveness of biomolecule-based bioactive surfaces, on os-seointegration of titanium dental implants: A systematic review and meta-analysis of in vivo studies.

Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically active substances have been proposed. MEDLINE [via Pubmed], Embase and Web of Science were searched with the terms "titanium dental implants", "surface properties", "bioactive surface modifications", "biomolecules", "BMP", "antibacterial agent", "peptide", "collagen", "grown factor", "osseointegration", "bone apposition", "osteogenic", "osteogenesis", "new bone formation", "bone to implant contact", "bone regeneration" and "in vivo studies", until May 2022. A total of 10,697 references were iden-tified and 26 were included to analyze 1,109 implants, with follow-ups from 2 to 84 weeks. The ARRIVE guidelines and the SYRCLE tool were used to evaluate the methodology and scientific evidence. A meta-analysis was performed (RevMan 2020 software, Cochane Collaboration) with random effects that evaluated BIC at 4 weeks, with subgroups for the different coatings. The heterogeneity of the pooled studies was very high (95% CI, I2 = 99%). The subgroup of BMPs was the most favorable to coating. Surface modification of Ti implants by organic bioactive molecules seems to favor osseointegration in the early stages of healing, but long-term studies are necessary to corroborate the results of the experimental studies.

Double Lateral Sliding Bridge Flap versus Laterally Closed Tunnel for the Treatment of Single Recessions in the Mandibular Anterior Teeth: A Pseudorandomized Clinical Trial.

(1) Background: This study compared the clinical and esthetic results of the double lateral sliding bridge flap (DLSBF) and the laterally closed tunnel (LCT) techniques, with a subepithelial connective tissue graft (SCTG), for the treatment of single Miller class II-III recessions in the mandibular anterior teeth. (2) Methods: This pseudorandomized clinical trial evaluated 14 patients, 7 of whom were part of the DLSBF + SCTG group, with an average follow-up of 58.7 ± 24.0 months, and 7 of whom were in the LCT + SCTG group, with an average follow-up of 16.7 ± 3.3 months. Clinical and esthetic evaluations of the following parameters were performed and the results for the two groups were compared: gingival recession depth, probing depth, keratinized tissue width, gingival thickness, percentage of root coverage and root coverage esthetic score. (3) Results: After the follow-up period, each technique provided evidence of a reduction in recession depth and clinical attachment level, as well as increased keratinized tissue width and gingival thickness, with statistically significant differences (p < 0.05). The analysis showed that gingival recession depth decreased less in the DLSBF group (4.3 ± 1.2 mm to 0.6 ± 1.1 mm) than it did in the LCT group (4.9 ± 1.1 mm to 0.1 ± 0.4 mm), but no significant difference was found between the two groups. Similarly, a greater reduction in the clinical attachment level parameter was observed in the LCT group, while a greater increase in gingival thickness was observed in the DLSBF group. The presence of scars was the only parameter for which statistically significant differences (p < 0.05) between the two study groups were found. (4) Conclusions: Within the limitations of the study, it indicates that the LCT + SCTG technique may be considered an optimal technique in terms of reducing gingival recession depth, complete root coverage and esthetic results for the treatment of single gingival recessions in the mandibular anterior teeth.

Functional and Patient-Centered Treatment Outcomes with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants: A Randomized Clinical Trial.

This study aims to assess the treatment outcomes (functional and subjective) of mandibular overdentures retained on two implants with or without an immediate loading protocol. In this randomized clinical trial, twenty fully edentulous patients were treated with a mandibular two-implant-retained overdenture and a complete new maxillary denture. In half of the sample, the implants were loaded immediately by means of VulkanLoc® abutments after emplacement of the implant, but in the counterparts, these VulkanLoc® abutments were connected to implants two months after the surgery (conventional protocol), and until that time the dentures were retained by healing abutments. Treatment outcomes were assessed at two, six, and twelve months after surgery. Functional outcomes were calculated according to masticatory performance, estimated by the mixed fraction of a two-coloured chewing gum after five, ten, and fifteen chewing strokes, by the occlusal force recorded by pressure-sensitive sheets, and by the bioelectrical muscular activity. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analogue scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study show that new complete dentures resulted in significant improvements in chewing ability, patient satisfaction, and oral health-related quality of life and that subsequent implant-retained overdentures produced further and faster significant improvements. The loading protocol may influence those positive self-reported outcomes rather than the objective functional evaluations.

Patient-Centered Treatment Outcomes with Full-Arch PEEK Rehabilitation Supported on Four Immediate or Conventionally Loaded Implants. A Randomized Clinical Trial.

This study aims to assess the treatment outcomes (functional and subjective) of full-arch fixed hybrid rehabilitations made of PEEK (poly-ether-ether-ketone) with milled crowns of nano-filled composite (NFC) supported on four to six implants. In this randomized clinical trial, 34 edentate patients in the upper and/or the lower jaws were treated with the fixed hybrid dentures. In 16 patients (47.1% of the sample), the implants were loaded immediately (IL) by means of a provisional fixed rehabilitation made of PMMA (polymethylmethacrylate) screwed on Multi-Unit (MU) abutments connected after emplacement of the implant; however, in the counterparts (n = 18) these MU abutments were covered by healing caps and were left unloaded during two months (conventional loading protocol-CL), when all patients received a fixed hybrid PEEK-NFC rehabilitation on the upper and/or the lower jaw. Treatment outcomes were assessed 12 months after prostheses delivery. Functional outcomes were calculated according to masticatory performance, estimated by mixing ability tests of two colored chewing gums after ten chewing strokes, by the occlusal force/area recorded by pressure-sensitive sheets, and by electromyography of masseters and temporal muscles at maximum biteforce. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analog scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study showed that treatment with fixed PEEK-NFC hybrid prostheses significantly improved the masticatory performance, bite force, occlusal pattern, quality of life, and satisfaction, with the IL group being those with significantly higher occlusal bite forces and greater satisfaction in comparison with CL group. It should be concluded that PEEK-NFC hybrid prostheses can improve several patient-centered outcomes and that loading protocol significantly affects the patient's self-rated satisfaction.