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.

Comparative analysis of flexural strength of 3D printed and milled 4Y-TZP and 3Y-TZP zirconia.

STATEMENT OF PROBLEM: The mechanical properties of 3 dimensionally (3D) printed zirconia have been reported to be comparable with those of milled zirconia, except for the flexural strength. However, most previous studies tested 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP), making it necessary to study 3D printed zirconia with 4 mol% yttria content (4Y-TZP). PURPOSE: The purpose of this in vitro study was to compare the flexural strength of 3D printed 4Y-TZP with 3Y-TZP materials and milled 4Y-TZP. MATERIAL AND METHODS: A total of 80 disk specimens (Ø15×1.5 mm) were fabricated and divided into 4 groups (n=20) using the fabrication method and yttria content: milled 3Y-TZP (Katana HT; Kuraray Noritake), 3D printed 3Y-TZP (TZ-3Y-E; Tosoh), milled 4Y-TZP (Katana STML; Kuraray Noritake), and 3D printed 4Y-TZP (3DMAT; Genoss). The biaxial flexural strength was determined with a piston-on-3-ball test (n=15). The flexural strength of each specimen was measured, and the Weibull modulus (m) and characteristic strength (σ0) were estimated from the fracture load distribution. Two intact and fractured specimens were examined with scanning electron microscopy (SEM). The crystalline phase of the specimens in each group was identified through X-ray diffraction (XRD) analysis (n=5). A 1-way ANOVA was used to compare the flexural strength among different groups. Subsequently, pairwise comparisons were conducted with the Tukey post hoc method (α=.05). RESULTS: The flexural strength of 3D printed 4Y-TZP was significantly higher than that of milled 4Y-TZP (P<.001). In contrast, the flexural strength of 3D printed 3Y-TZP was significantly lower than that of milled 3Y-TZP (P<.001). X-ray diffraction (XRD) analysis revealed that the tetragonal phase was the dominant phase in all groups, with the identification of some cubic phase peaks. CONCLUSIONS: Three dimensionally printed 4Y-TZP showed significantly higher flexural strength than milled 4Y-TZP and exhibited a clinically acceptable flexural strength exceeding 800 MPa.

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.

High-Temperature Skin Softening Materials Overcoming the Trade-Off between Thermal Conductivity and Thermal Contact Resistance.

The trade-off between thermal conductivity (κ) and thermal contact resistance (Rc ) is regarded as a hurdle to develop superior interface materials for thermal management. Here a high-temperature skin softening material to overcome the trade-off relationship, realizing a record-high total thermal conductance (254.92 mW mm-2 K-1 ) for isotropic pad-type interface materials is introduced. A highly conductive hard core is constructed by incorporating Ag flakes and silver nanoparticle-decorated multiwalled carbon nanotubes in thermosetting epoxy (EP). The thin soft skin is composed of filler-embedded thermoplastic poly(ethylene-co-vinyl acetate) (PEVA). The κ (82.8 W m-1 K-1 ) of the PEVA-EP-PEVA interface material is only slightly compromised, compared with that (106.5 W m-1 K-1 ) of the EP core (386 µm). However, the elastic modulus (E = 2.10 GPa) at the skin is significantly smaller than the EP (26.28 GPa), enhancing conformality and decreasing Rc from 108.41 to 78.73 mm2 K W-1 . The thermoplastic skin is further softened at an elevated temperature (100 °C), dramatically decreasing E (0.19 GPa) and Rc (0.17 mm2 K W-1 ) with little change in κ, overcoming the trade-off relationship and enhancing the total thermal conductance by 2030%. The successful heat dissipation and applicability to the continuous manufacturing process demonstrate excellent feasibility as future thermal management materials.

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.

Towards chip-scale optical frequency synthesis based on optical heterodyne phase-locked loop.

An integrated heterodyne optical phase-locked loop was designed and demonstrated with an indium phosphide based photonic integrated circuit and commercial off-the-shelf electronic components. As an input reference, a stable microresonator-based optical frequency comb with a 50-dB span of 25 nm (~3 THz) around 1550 nm, having a spacing of ~26 GHz, was used. A widely-tunable on-chip sampled-grating distributed-Bragg-reflector laser is offset locked across multiple comb lines. An arbitrary frequency synthesis between the comb lines is demonstrated by tuning the RF offset source, and better than 100Hz tuning resolution with ± 5 Hz accuracy is obtained. Frequency switching of the on-chip laser to a point more than two dozen comb lines away (~5.6 nm) and simultaneous locking to the corresponding nearest comb line is also achieved in a time ~200 ns. A low residual phase noise of the optical phase-locking system is successfully achieved, as experimentally verified by the value of -80 dBc/Hz at an offset of as low as 200 Hz.

Vulnerability-Based Critical Neurons, Synapses, and Pathways in the Caenorhabditis elegans Connectome.

Determining the fundamental architectural design of complex nervous systems will lead to significant medical and technological advances. Yet it remains unclear how nervous systems evolved highly efficient networks with near optimal sharing of pathways that yet produce multiple distinct behaviors to reach the organism's goals. To determine this, the nematode roundworm Caenorhabditis elegans is an attractive model system. Progress has been made in delineating the behavioral circuits of the C. elegans, however, many details are unclear, including the specific functions of every neuron and synapse, as well as the extent the behavioral circuits are separate and parallel versus integrative and serial. Network analysis provides a normative approach to help specify the network design. We investigated the vulnerability of the Caenorhabditis elegans connectome by performing computational experiments that (a) "attacked" 279 individual neurons and 2,990 weighted synaptic connections (composed of 6,393 chemical synapses and 890 electrical junctions) and (b) quantified the effects of each removal on global network properties that influence information processing. The analysis identified 12 critical neurons and 29 critical synapses for establishing fundamental network properties. These critical constituents were found to be control elements-i.e., those with the most influence over multiple underlying pathways. Additionally, the critical synapses formed into circuit-level pathways. These emergent pathways provide evidence for (a) the importance of backward locomotion, avoidance behavior, and social feeding behavior to the organism; (b) the potential roles of specific neurons whose functions have been unclear; and

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.

Comparison of fixed implant-supported prostheses, removable implant-supported prostheses, and complete dentures: patient satisfaction and oral health-related quality of life.

OBJECTIVES: The purpose of this study was to compare patient satisfaction and oral health-related quality of life (OHRQoL) among fully edentulous patients treated with either fixed implant-supported prostheses (FP), removable implant-supported prostheses (RP), or complete dentures (CD). MATERIAL AND METHODS: Eighty-six patients - 29 FP, 27 RP, and 30 CD patients - participated in this study. The survey was conducted using face-to-face interviews with a questionnaire that included a patient satisfaction scale and Oral Health Impact Profile (OHIP-14). We measured patient satisfaction after prosthetic treatments and OHRQoL before and after the treatments. RESULTS: After prosthetic treatments, OHRQoL increased in all three groups (P < 0.05). The FP and RP groups showed no significant difference in patient satisfaction and OHRQoL, and both groups showed greater improvement compared with the CD group. Specifically, the OHRQoL dimensions of functional limitation, physical pain, psychological discomfort, and psychological disability in the FP group, and functional limitation in the RP group, improved greatly in comparison with the CD group (P < 0.05). CONCLUSIONS: Although further research is still needed, prosthetic treatments may provide superior OHRQoL for fully edentulous patients. In particular, both the FP and RP treatments provided significantly greater improvement of OHRQoL and patient satisfaction than the CD treatment. Reliable information of OHRQoL and patient satisfaction helps experts and patients choose the best prosthetic treatment option.

Groundwater pumping effects on contaminant loading management in agricultural regions.

Groundwater pumping changes the behavior of subsurface water, including the location of the water table and characteristics of the flow system, and eventually affects the fate of contaminants, such as nitrate from agricultural fertilizers. The objectives of this study were to demonstrate the importance of considering the existing pumping conditions for contaminant loading management and to develop a management model to obtain a contaminant loading design more appropriate and practical for agricultural regions where groundwater pumping is common. Results from this study found that optimal designs for contaminant loading could be determined differently when the existing pumping conditions were considered. This study also showed that prediction of contamination and contaminant loading management without considering pumping activities might be unrealistic. Motivated by these results, a management model optimizing the permissible on-ground contaminant loading mass together with pumping rates was developed and applied to field investigation and monitoring data from Icheon, Korea. The analytical solution for 1-D unsaturated solute transport was integrated with the 3-D saturated solute transport model in order to approximate the fate of contaminants loaded periodically from on-ground sources. This model was further expanded to manage agricultural contaminant loading in regions where groundwater extraction tends to be concentrated in a specific period of time, such as during the rice-growing season, using a method that approximates contaminant leaching to a fluctuating water table. The results illustrated that the simultaneous management of groundwater quantity and quality was effective and appropriate to the agricultural contaminant loading management and the model developed in this study, which can consider time-variant pumping, could be used to accurately estimate and to reasonably manage contaminant loading in agricultural areas.

Giant thermal rectification efficiency by geometrically enhanced asymmetric non-linear radiation.

Thermal rectification is an asymmetric heat transport phenomenon where thermal conductance changes depending on the temperature gradient direction. The experimentally reported efficiency of thermal rectification materials and devices, which are applicable for a wide range of temperatures, is relatively low. Here we report a giant thermal rectification efficiency of 218% by maximizing asymmetry in parameters of the Stefan-Boltzmann law for highly non-linear thermal radiation. The asymmetry in emissivity is realized by sputter-depositing manganese (ε = ∼0.38) on the top right half surface of a polyurethane specimen (ε = ∼0.98). The surface area of the polyurethane side is also dramatically increased (1302%) by 3D printing to realize asymmetry in geometry. There is an excellent agreement between the experimentally measured temperature profiles and finite element simulation results, demonstrating the reliability of the analysis. Machine learning analysis reveals that the surface area is a dominant factor for thermal rectification and suggests novel light-weight designs with high efficiencies. This work may find applications in energy efficient thermal rectification management of electronic devices and housings.

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.

Effect of hemispherical dimples at titanium implant abutments for the retention of cemented crowns.

PURPOSE: The aim of this study was to assess the effect of hemispherical dimple structures on the retention of cobalt-chromium (Co-Cr) crowns cemented to titanium abutments, with different heights and numbers of dimples on the axial walls. MATERIALS AND METHODS: 3.0-mm and 6.0-mm abutments (N = 180) and Co-Cr crowns were prepared. The experimental groups were divided into two and four dimple groups. The crowns were cemented by TempBond and PANAVIA F 2.0 cements. The retention forces were measured after thermal treatments. A two-way Analysis of Variance (ANOVA) and post-hoc Tukey HSD test were conducted to analyze change in retention forces by use of dimples between groups, as well as t test for the effect of abutment height change (α = .05). RESULTS: Results of the two-way ANOVA showed a statistically significant difference in retention force due to the use of dimples, regardless of the types of cements used (P < .001). A significantly higher mean retention forces were observed in the groups with dimples than in the control group, using the post hoc Tukey HSD test (P < .001). Results of t test displayed a statistically significant increase in the retention force with 6.0-mm abutments compared with 3.0-mm abutments (P < .001). The groups without dimples revealed adhesive failure of cements, while the groups with dimples showed mixed failure of cements. CONCLUSION: Use of hemispherical dimples was effective for increasing retention forces of cemented crowns.

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.

A retrospective comparison of clinical outcomes of implant restorations for posterior edentulous area: 3-unit bridge supported by 2 implants vs 3 splinted implant-supported crowns.

PURPOSE: To compare the clinical outcomes of two types of implant restoration for posterior edentulous area, 3-unit bridge supported by 2 implants and 3 implant-supported splinted crowns. MATERIALS AND METHODS: The data included 127 implant-supported fixed restorations in 85 patients: 37 restorations of 3-unit bridge supported by 2 implants (2-IB), 37 restorations of 3 implant-supported splinted crowns (3-IC), and 53 single restorations (S) as controls. Peri-implantitis and mechanical complications that occurred for 14 years were analyzed by multivariable Cox regression model. Kaplan-Meier curves and the multivariable Cox regression model were used to analyze the success and survival of implants. RESULTS: Peri-implantitis occurred in 28.4% of 2-IB group, 37.8% of 3-IC group, and 28.3% of S control group with no significant difference. According to the implant position, middle implants (P2) of the 3-IC group had the highest risk of peri-implantitis. The 3-IC group showed a lower mechanical complication rate (7.2%) than the 2-IB (16.2%) and S control group (20.8%). The cumulative success rate was 52.8% in S (control) group, 62.2% in 2-IB group, and 60.4% in 3-IC group. The cumulative survival rate was 98.1% in S (control) group, 98.6% in 2-IB group, and 95.5% in 3-IC group. There was no significant difference in the success and survival rate according to the restoration type. CONCLUSION: The restoration type was not associated with the success and survival of implants. The risk of mechanical complications was reduced in 3 implant-supported splinted crowns. However, the middle implants of the 3 implant-supported splinted crowns had a higher risk of peri-implantitis.