Resonance Frequency Analysis to Assess the Stability of Immediate Implants: A Retrospective Clinical Trial.

Adequate implant primary stability is a key factor to obtain osseointegration and can be measured at insertion by insertion torque (IT) and at different timepoints with resonance frequency analysis (RFA), expressed as an implant stability quotient (ISQ). This retrospective study investigated the correlation between ISQ and IT at implant insertion. All patients who were eligible for this single-cohort retrospective clinical trial were treated with an immediate implant. IT parameters were recorded at implant insertion, and ISQ values were recorded at insertion and at 2-, 4-, and 12-month follow-ups. The study comprised 23 patients who received 32 implants. The mean IT value was 46.87 ± 9.66 Ncm (range: 25 to 65 Ncm), and the mean ISQ value at implant insertion was 71.45 ± 4.24 (range: 63 to 78); these values showed a statistically significant correlation (P < .0001). According to the present data and considering the implant design used in this trial, there is a statistically significant and positive correlation between IT and ISQ values. Thus, ISQ can be used as a reliable method to measure implant stability over time.

The Use of Zirconia for Implant-Supported Fixed Complete Dental Prostheses: A Narrative Review.

The success of implant-supported fixed complete dental prostheses (ISFCDPs) depends on multiple factors: some are related to the fixtures, such as fixture material, surface characteristics, positioning, and type of connection to prosthetic components; others are related to the prostheses, such as design and materials used. Zirconia is a material widely used in fixed prosthodontics, whether on natural teeth or on implants, with excellent results over time. Regarding the use of zirconia for ISFCDPs, the 2018 ITI Consensus Report stated that "implant-supported monolithic zirconia prostheses may be a future option with more supporting evidence". Since CAD/CAM technology and zirconia are being continuously innovated to achieve better results and performances over time, a narrative review of the literature seems necessary to focus research efforts towards effective and durable solutions for implant-supported, full-arch rehabilitations. The objective of the present narrative review was to search the literature for studies regarding the clinical performance of zirconia-based ISFCDPs. According to the results of this review, the use of zirconia for ISFCDPs showed good clinical outcomes, with high survival rates ranging from 88% to 100% and prosthetic complications that were restorable by the clinicians in most cases.

Histologic Evaluation of Soft Tissues around Dental Implant Abutments: A Narrative Review.

The basis for dental implant success comes not only with the titanium implant osseointegration but also depends on other factors such as the development of a soft tissue barrier, which protects the peri-implant bone from the oral environment. The characteristics of surfaces in contact with peri-implant soft tissues may affect the capacity of peri-implant mucosal cells to create a tight seal around the implant, thus influencing long-term implant success. Many histological studies on animals have been conducted on different materials to better understand their influence on peri-implant soft tissues, with the limitation that results from animal studies cannot be fully translated in humans. The aim of this review paper was to analyze the literature focusing on histological clinical studies in humans which have examined different materials or different surface treatments and their effects on peri-implant soft tissues. The research was conducted according to the following PICO question: "Do different implant/abutment materials affect peri-implant soft tissues adhesion and health?". Nine articles were analyzed in this review. The results of this review show the influence of different abutment materials on the peri-implant soft tissues, and the need of further research regarding the effect that abutment materials, surface treatments, and surface properties have on soft tissues.

Narrow-diameter versus standard-diameter implants placed in horizontally regenerated bone in the rehabilitation of partially and completely edentulous patients: A systematic review.

PURPOSE: The present systematic review and meta-analysis aimed to investigate the available evidence in the literature to answer the following focused question: In partially edentulous arches with reduced bone width, do implants placed after horizontal bone augmentation exhibit differences in survival and success rate compared to narrow-diameter implants placed in native bone? MATERIALS AND METHODS: A population, intervention, comparison and outcome question was defined and an electronic search was conducted using the MEDLINE (via PubMed) and Cochrane Oral Health Group databases to identify all studies analysing the use of standard-diameter implants inserted in regenerated bone or narrow-diameter implants for the rehabilitation of partially or completely edentulous atrophic maxillae and mandibles. Inclusion criteria and quality assessments were established, and studies were selected on this basis. RESULTS: Twenty-four studies met the inclusion criteria and were analysed cumulatively. A comparative meta-analysis was not possible due to the lack of studies directly comparing the two rehabilitation methods in question. A cumulative implant survival rate of 97.80% (1246/1274; pooled proportion 0.984, 95% confidence interval 0.977-0.991) was reported for the narrow implants placed in atrophic ridges, while similar results were obtained for the standard-diameter implants placed in regenerated bone, with a cumulative implant survival rate of 97.94% (1332/1360; pooled proportion 0.983, 95% confidence interval 0.976-0.990). CONCLUSIONS: The present systematic review found high and comparable survival rates between narrow- and standard-diameter implants placed in regenerated bone; however, well-designed randomised controlled trials are required to support the hypothesis that both treatment strategies are successful in comparable circumstances.

One-Year Clinical Performance of Activa™ Bioactive-Restorative Composite in Primary Molars.

Restorative procedures for caries affecting primary molars are a daily challenge for pediatric dentistry, and one of the main factors influencing the results of these restorative procedures is the choice of dental material used: bioactive materials were recently introduced, combining the strength of composites and the benefits of glass ionomers. The present study's objective is to clinically evaluate the aesthetic, functional and biological properties of Activa™ Bioactive composite in approximal and occlusal carious lesions for 1 year using the FDI criteria for evaluating direct dental restorations. Forty-five children with occlusal or approximal caries in first or second primary molars were included in the study: the cavities were then randomized to be restored with either Activa BioActive or SDR Bulk-fill and evaluated over time according to Federation Dentaire Internationale (FDI) criteria. Results showed that Activa BioActive composite has similar performance over time compared to Bulk-fill composite, for both functional and aesthetic properties. Thus, within the limitations of this study, including the short follow-up period, it can be concluded that bioactive materials might be the material of choice to restore primary molars. A longer follow-up period is desirable to confirm these findings.

Application of IBM Watson to Support Literature Reviews: A Preliminary Experience in Restorative Dentistry.

Literature reviews are crucial in the choice of the best personalized material type and restauration type in restorative dentistry. We developed an IBM-Watson based system to support literature search for restorative dentistry, and compared its results to a literature search performed by a trained professional. We found that our system could assist the researcher in performing a literature review, but the grounding semantic model needs to be refined in order to provide more extensive results.

Tissue level implants in healthy versus medically compromised patients: a cohort comparative study.

BACKGROUND: Dental implants placed in medically compromised patients have predictable outcomes and a high rate of survival, compared to those placed in healthy patients. The aims of this study were to observe and compare implant survival/success rates and soft tissue response to tissue-level implants placed in healthy and medically compromised patients with a 1-year follow-up. METHODS: Seventy-two patients, 36 healthy patients (20 females and 16 males) and 36 medically compromised patients (18 females and 18 males) affected by cardiovascular diseases (arrythmia, hypertension, atrial fibrillation, bypass and pacemaker surgery), depression, endocrine metabolic diseases (hypercholesterolemia, type II diabetes, Hashimoto's thyroiditis), gastrointestinal diseases (gastritis, hiatal hernia, gastric ulcers), asthma, osteoporosis or glaucoma received one tissue-level implant. Measurements for primary and secondary outcomes were collected immediately after implant placement and at 1 year from implant insertion. RESULTS: Three were failed and two were survived out of a total of 72 implants. Among healthy patients, two implants failed while one was classified as survived; among Medically compromised patients one implant failed and another one was classified as survived. No statistically significant difference was found between the two groups in terms of success rate or survival rate. No statistically significant differences between the two groups' marginal bone level was observed. In healthy patients a mean loss of keratinized tissue (-0.1±0.6 mm) was reported, while in medically compromised patients a mean gain was reported (+0.5±0.8 mm). CONCLUSIONS: In terms of success, failure and survival rates, tissue level implants placed in healthy and in medically compromised individuals showed no short-term (1 year) differences.

Twelve-year longitudinal clinical evaluation of bonded indirect composite resin inlays.

OBJECTIVE: This prospective clinical study evaluated the clinical performance of one-, two- and multi-surface composite resin inlays over a 12-year period on premolars and molars. METHOD AND MATERIALS: One clinician placed 113 indirect composite resin inlays (Signum, Heraeus Kulzer) in 30 patients that were bonded using a three-step bonding system and composite resin luting cement. Evaluations were made at 3 and 12 years by another clinician who was not involved in the placement of the restorations, using the modified US Public Health Service (USPHS) criteria. Data were analyzed using a nonparametric statistical test (Mann-Whitney U test) followed by Bonferroni correction (alpha = .05). RESULTS: Fourteen patients could not be followed, yielding to the follow-up of 99 restorations. After 12 years, compared to the 3-year follow-up, tooth integrity, secondary caries, and sensitivity criteria showed significant change, while other parameters did not show significant difference (P > .05). Parameters such as loss of marginal integrity, loss of restoration integrity, loss of surface polish, and secondary caries received more frequently delta scores. At the 3-year follow-up, the clinical performance of one- or two-surface inlays did not show significant difference from multi-surface ones (P = .6317), but at the 12-year follow-up, the results were more favorable for multi-surface inlays. Overall, the failure rate at 12 years was 12%. CONCLUSIONS: Adhesively bonded indirect composite resin inlays showed acceptable long-term clinical results in terms of function, but surface and margin characteristics changed over time.