Interdisciplinary rehabilitation of a patient with ectodermal dysplasia utilizing digital tools: A clinical report.

The present clinical report describes the rehabilitation of a patient diagnosed with ectodermal dysplasia performed by an interdisciplinary team in a comprehensive approach aided by digital technology. The complexity of the treatment was related to predictability regarding timing and the type of approach. The patient was referred for treatment because of congenitally missing and abnormally shaped permanent teeth. The need for an interdisciplinary team involving orthodontic, periodontic, and prosthodontic specialists was identified. A virtual treatment plan was developed to guide tooth movement, placement of dental implants, and tooth preparation for indirect restorations. Therefore, each treatment phase could be communicated to the patient and treatment team in a predictable way.

Clinical and radiologic outcomes after submerged and transmucosal implant placement with two-piece implants in the anterior maxilla and mandible: 3-year results of a randomized controlled clinical trial.

PURPOSE: The aim of this investigation was to evaluate the 3-year outcomes regarding crestal bone level, clinical parameters, and patient satisfaction, following submerged and transmucosal implant placement for two-piece implants in the anterior maxilla and mandible. MATERIALS AND METHODS: Patients requiring dental implants for single-tooth replacement in the anterior maxilla or mandible were enrolled in a randomized, controlled, multicenter clinical trial. The implants were randomized at placement to either submerged or transmucosal healing, with final restorations placed after 6 months. Radiographic and clinical parameters were recorded after 1, 2, and 3 years; a questionnaire was also used to assess patient satisfaction. A two-sided, unpaired T-test (significance level p ≤ .05) was used to statistically evaluate the differences between the two groups. RESULTS: A total of 106 patients were included in the 3-year analysis. The mean change in crestal bone level from implant placement to 3 years was 0.68 ± 0.98 mm (p < .001) and 0.58 ± 0.77 mm (p < .001) in the submerged and transmucosal groups, respectively; the differences between the groups were not significant. Clinical parameters remained stable throughout the study, with no significant differences between the groups, and patient satisfaction was good or excellent for over 90% of subjects in both groups. CONCLUSIONS: The results demonstrate excellent clinical and radiographic conditions after 3 years for implants supporting single-tooth restorations, regardless of whether a submerged or transmucosal surgical technique was used.

The influence of restorative procedures on esthetic outcomes in implant dentistry: a systematic review.

PURPOSE: The objectives of this review were to (1) identify if prosthodontic parameters influence the esthetic outcome of implant-supported restorations and (2) make clinically relevant recommendations based upon the findings. MATERIALS AND METHODS: Electronic and manual searches of dental literature were performed to collect information on esthetic outcomes based on objective criteria. The prosthodontic parameters included optimal three-dimensional implant position, the utilization of provisional restorations, the timing of provisional restoration with regard to implant placement, the choice of prosthodontic platform size and form, the abutment and definitive restoration material, and the mode of prosthesis retention. Regions including maxillary and mandibular anterior teeth and premolars were considered. All levels of evidence, including case studies, were accepted. RESULTS: From 472 titles, 152 full-text articles were evaluated and 58 records included for data extraction (15 randomized controlled trials, 6 cohort studies, and 37 case series studies). Considerable heterogeneity in study design was found. A meta-analysis of controlled studies was not possible. It was consistently reported that facial malpositioning of implants increases the likelihood of mucosal recession. No studies directly compared esthetic outcomes associated with the use or non-use of provisional restorations. The literature contains a greater number of case series studies evaluating esthetic outcomes for protocols including, rather than excluding, provisional restorations. It is not possible to identify any significant variation in esthetic outcomes based on the character of the abutment platform from the current literature. Based on the findings, no significant difference can be established between all-ceramic and metal-ceramic prostheses with regard to esthetic indices over short observation periods. No firm conclusions relating esthetic benefits for cement in comparison to screw retention can be identified. CONCLUSIONS: There is a need for RCTs comparing accepted procedures in routine practice. The utilization of provisional restorations remains strongly recommended in order to trial the planned definitive restoration, to facilitate maturation of healing tissues and for patient convenience. Implant positioning according to the planned prosthesis remains a requirement to achieve a long-lasting esthetic outcome. The majority of studies reported on single-tooth replacement, and many of the outcomes may not be relevant or applicable to the large number of esthetic indications involving more than one tooth.

Use of prefabricated titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone.

This report describes the fabrication of customized abutments consisting of prefabricated 2-piece titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone. The heat-pressed lithium disilicate provides esthetic customized anatomic structures and crowns independently of the computer-aided design and computer-aided manufacturing process.

Submerged and transmucosal healing yield the same clinical outcomes with two-piece implants in the anterior maxilla and mandible: interim 1-year results of a randomized, controlled clinical trial.

OBJECTIVES: To test whether or not transmucosal healing at two-piece implants is as successful as submerged placement regarding crestal bone levels and patient satisfaction. MATERIAL AND METHODS: Adults requiring implants in the anterior maxilla or mandible in regions 21-25, 11-15, 31-35 or 41-45 (WHO) were recruited for this randomized, controlled multi-center clinical trial of a 5-year duration. Randomization was performed at implantation allowing for either submerged or transmucosal healing. Final reconstructions were seated 6 months after implantation. Radiographic interproximal crestal bone levels and peri-implant soft tissue parameters were measured at implant placement (IP) (baseline), 6 and 12 months. Patient satisfaction was assessed by a questionnaire. A two-sided t-test (80% power, significance level α=0.05) was performed on bone-level changes at 6 and 12 months. RESULTS: One hundred and twenty-seven subjects were included in the 12-month analysis (submerged [S]: 52.5%, transmucosal [TM]: 47.2%). From IP to 6 months, the change in the crestal bone level was -0.32 mm (P<0.001) for the S group and -0.29 mm (P<0.001) for the TM group. From IP to 12 months, bone-level changes were statistically significant in both groups (S -0.47 mm, P<0.001; TM -0.48 mm, P<0.001). The mean differences of change in the bone levels between the two groups were not statistically significant at either time point, indicating the equivalence of both procedures. For both groups, very good results were obtained for soft tissue parameters and for patient satisfaction. CONCLUSIONS: Transmucosal healing of two-piece implants is as successful as the submerged healing mode with respect to tissue integration and patient satisfaction within the first 12 months after IP.

Early loading after 21 days of healing of nonsubmerged titanium implants with a chemically modified sandblasted and acid-etched surface: two-year results of a prospective two-center study.

PURPOSE: The aim of this two-center study was to evaluate screw-type titanium implants with a chemically modified, sandblasted and acid-etched surface when placed in the posterior maxilla or mandible, and loaded 21 days after placement. MATERIAL AND METHODS: All 56 patients met strict inclusion criteria and provided informed consent. Each patient displayed either a single-tooth gap, an extended edentulous space, or a distal extension situation in the posterior mandible or maxilla. Eighty-nine dental implants (SLActive, Institut Straumann AG, Basel, Switzerland) were inserted according to an established nonsubmerged protocol and underwent undisturbed healing for a period of 21 days. Where appropriate, the implants were loaded after 21 days of healing with provisional restorations in full occlusion. Definitive metal ceramic restorations were fabricated and positioned on each implant after 6 months of healing. Clinical measurements regarding soft tissue parameters and radiographs were obtained at different time points up to 24 months after implant placement. RESULTS: Of the 89 inserted implants, two (2.2%) implants failed to integrate and were removed during healing, and two (2.2%) additional implants required a prolonged healing time. A total of 85 (95.6%) implants were therefore loaded without incident after 21 days of healing. No additional implant was lost throughout the study period, whereas one implant was lost to follow-up and therefore left unaccounted for further analysis. The remaining 86 implants all exhibited favorable radiographic and clinical findings. Based on strict success criteria, these implants were considered successfully integrated 2 years after insertion, resulting in a 2-year success rate of 97.7%. CONCLUSION: The results of this prospective two-center study demonstrate that titanium implants with a modified SLA surface can predictably achieve successful tissue integration when loaded in full occlusion 21 days after placement. Integration could be maintained without incident for at least 2 years of follow-up.

Single-stage Straumann dental implants in the aesthetic zone: considerations and treatment procedures.

The aim of this paper was to identify factors significant to the use of single-stage dental implants in the aesthetic zone and discuss treatment considerations related to them. In view of available literature and clinical experiences, treatment outcomes associated with the use of single-stage Straumann implants (Institut Straumann AG, Waldenburg, Switzerland) in the aesethetic zone can be considered positive and predictable.

Calculations of Znii 3d94s5s and Agi 4d95s6s, and Some New Levels in these Spectra.

Results of intermediate-coupling calculations are given for Zn ii 3d 94s5s and Ag i 4d 95s6s. A [(4d 9)J i, (5s6s)J ii]J coupling scheme is appropriate for the latter. New 3d 94s(3D)5s 2D2½ and 3d 94s(1D)5s 2D2½ levels were found in Zn ii, and a few other additions and revisions are given for the analysis. The combinations of the new levels 3d 9(2D)4s4p(3P°) 4 F 4 1 / 2 ° in Zn ii and 4d 9(2D)5s5p(3P°) 2 F 2 1 / 2 ° in Ag i are also listed.

New Vacuum Ultraviolet Wavelengths and Revised Energy Levels in the Second Spectrum of Zinc (Zn ii).

Spectra from sliding spark discharges between zinc electrodes and from a hollow-cathode source were photographed in the range 2105-1400 Å with the NBS 10.7 m vacuum spectrograph. New measurements of 130 Zn ii lines in this region, combined in some cases with previous measurements in the air region, were used to derive revised positions for the known levels. Wavelengths calculated from these levels are given for 267 lines in the region 2570-730 Å. The line list also includes unclassified Zn ii lines below 2570 Å, based on the most complete description of this spectrum [A. M. Crooker and K. A. Dick, Can. J. Phys. 46, 1241 (1968)]. A few additions to the line list of Crooker and Dick above 2700 Å are given. The line and level lists take into account recent work at the National Bureau of Standards on the Zn ii analysis.

Energies of 1snl (l≥3) Configurations in He4i as Calculated from Polarization Theory.

The calculated singlet-triplet mean energies are given for all He4 i configurations having 3 ≤ l ≤ n - 1 from 4f to 8k. Since only Stark-shifted transitions have been observed for such configurations with l ≥ 4, the calculated positions are the most accurate available. The polarization energy (to the quadrupole approximation) for two-electron ions may be evaluated for higher nl or Z from the simple formulas. The calculated and observed positions of the Isnf configurations in He4 I and Li7 II agree within the experimental uncertainties.