Occlusal changes on implant-supported single crowns with one year follow-up after loading: A systematic review and meta-analysis.

OBJECTIVE: This systematic review evaluated the occlusal changes after loading with implant-supported single crowns. SOURCES: An electronic literature search was conducted in PubMed, Embase and Cochrane library for randomized (RCTs) or non-randomized controlled clinical trials (CCTs), with a minimum of 10 patients. STUDY SELECTION: Studies reporting the occlusal force changes on implant-supported single crowns - with natural teeth as antagonist - measured at baseline and after loading periods were included. 4 CCTs including 133 ISCs in posterior sites were included for meta-analysis. All analyzed ISCs had no contact at a light bite and a light contact at a heavy bite in MIP at loading (baseline). DATA: The relative occlusal forces (ROFs) of each implant-supported single crown (ISC) or control tooth (CT) were extracted. ROFs were defined as percentage of the total occlusal force of the entire dentition at maximum intercuspal position (MIP). A meta-analysis was conducted to compare the ROF changes at different follow-up periods and the weighted mean differences in ROF between ISCs and CTs were pooled and analyzed. The amount of change in ROF was significantly lower in 6 to 12 months after loading comparing the follow-up period between baseline and 6 month (p < 0.05). At baseline and 3-month follow-up, CTs presented significant higher ROF than ISCs (p < 0.05), while no significant difference was found after half year following. CONCLUSIONS: This study showed that the ROF changes significantly over time after loading of ISCs. It might prove that the occlusal concept defined at the time of prosthetic delivery changes or adapts naturally over time. CLINICAL SIGNIFICANCE: The function of specific implant occlusal concept (no contact at a light bite and a light contact at a heavy bite in MIP) is limited over time and careful monitoring and occlusal adjustments should be recommendable during the first-year follow-up.

Occurrence, associated factors and soft tissue reconstructive therapy for buccal soft tissue dehiscence at dental implants: Consensus report of group 3 of the DGI/SEPA/Osteology Workshop.

OBJECTIVES: To systematically assess the literature and report on (1) the frequency of occurrence of buccal soft tissue dehiscence (BSTD) at implants, (2) factors associated with the occurrence of BSTD and (3) treatment outcomes of reconstructive therapy for the coverage of BSTD. MATERIALS AND METHODS: Two systematic reviews addressing focused questions related to implant BSTD occurrence, associated factors and the treatment outcomes of BSTD coverage served as the basis for group discussions and the consensus statements. The main findings of the systematic reviews, consensus statements and implications for clinical practice and for future research were formulated within group 3 and were further discussed and reached final approval within the plenary session. RESULTS: Buccally positioned implants were the factor most strongly associated with the risk of occurrence of BSTD, followed by thin tissue phenotype. At immediate implants, it was identified that the use of a connective tissue graft (CTG) may act as a protective factor for BSTD. Coverage of BSTD may be achieved with a combination of a coronally advanced flap (CAF) and a connective tissue graft, with or without prosthesis modification/removal, although feasibility of the procedure depends upon multiple local and patient-related factors. Soft tissue substitutes showed limited BSTD coverage. CONCLUSION: Correct three-dimensional (3D) positioning of the implant is of utmost relevance to prevent the occurrence of BSTD. If present, BSTD may be covered by CAF +CTG, however the evidence comes from a low number of observational studies. Therefore, future research is needed for the development of further evidence-based clinical recommendations.

Effectiveness of soft tissue augmentation procedures for coverage of buccal soft tissue dehiscence around dental implants: A systematic review.

OBJECTIVE: This systematic review evaluated the effectiveness of soft tissue augmentation procedures for complete coverage and mean coverage of buccal soft tissue dehiscence (BSTD) in patients with implant-supported restorations. METHODS: Three databases were surveyed for randomized (RCTs), non-randomized controlled clinical trials (CCTs), cohort studies, case-control studies, and case series with a minimum of five patients per control or test group. Studies dealing with soft tissue augmentation procedures to cover BSTD-occurring during implant function and not due to the result of peri-implantitis-were included. Risk of bias was evaluated with RoB 2 or the National Institutes of Health's Quality Assessment. Whenever possible, exploratory meta-analyses were performed to evaluate weighted mean effects (WME) for the different outcomes. The primary outcomes were the percentage of complete coverage and mean coverage of BSTD. RESULTS: Seven articles were included. Only one study was a RCT, with a high risk of bias. Meta-analyses showed that after 1 year (2 studies, n = 36 patients; WME = 70; 95% confidence interval [CI] = 50; 90; p = .23) as well as after 5 years (3 studies, n = 54 patients; WME = 70; 95%; CI = 60; 80; p = .44), complete coverage of BSTD could be achieved in 70% of the cases. CONCLUSION: Based on limited evidence, it can be concluded that BSTD can be substantially reduced with the use of soft tissue augmentation procedures. Further research with comparative trials using larger samples and longer follow-up periods is needed to study the stability of soft tissues in the long term.

In vivo full-arch accuracy of intraoral scanners: a narrative review.

AIM: The present narrative review aims to provide an overview of the in vivo accuracy of full-arch scans performed with currently used intraoral devices and to compare different methods for the determination of in vivo accuracy. Materials and methods: An electronic search was performed with the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases, including articles from 2015 to 2020. Specific search strategies were developed for each platform. RESULTS: The final search resulted in five published articles. The mean values of trueness and precision of the examined scanners ranged from 12.9 to 80.01 µm for trueness and from 42.9 to 86.0 µm for precision in full-arch dentition. Not all studies evaluated both trueness and precision. Furthermore, the methods and references for determining the in vivo accuracy proved to be very different. CONCLUSION: To date, no scientific consensus on the required accuracy of in vivo full-arch scans has been reached and published. Due to the small number of studies on the in vivo accuracy of full-arch scans, further studies should be conducted in this area. In addition, a concept for a valid reference that can be scanned both extraorally and intraorally should be developed.