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1.
J Prosthet Dent ; 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33618859

RESUMEN

STATEMENT OF PROBLEM: Limited information is available on the association between prosthesis-associated risk factors and biologic complications for patients with implant fixed complete dental prostheses (IFCDPs). PURPOSE: The purpose of this retrospective study was to assess the implant survival and biologic complications of IFCDPs up to 5 years of follow-up. MATERIAL AND METHODS: Patients who had received IFCDPs between August 1, 2009 and August 1, 2014 were identified through an electronic health record review. Those who consented to participate in the study attended a single-visit study appointment. Clinical and radiographic examinations, intraoral photographs, and peri-implant hard and soft tissues parameters were assessed. Only prostheses which could be removed during the study visit were included. Associations between biologic complications and prosthetic factors, such as time with prosthesis in place, prosthesis material, number of implants, cantilever length, and type of prosthesis retention, were assessed. RESULTS: A total of 37 participants (mean ±standard deviation age 62.35 ±10.39 years) with 43 IFCDPs were included. None of the implants had failed, leading to an implant survival of 100% at 5.1 ±2.21 years. Ten of the prostheses were metal-ceramic (Group MC) and 33 were metal-acrylic resin (Group MR). Minor complications were more frequent than major ones. Considering minor complications, peri-implant mucositis was found in 53% of the implant sites, more often in the maxilla (P=.001). The most common major biologic complication was peri-implantitis, which affected 4.0% of the implants, more often in the mandible (P=.025). Peri-implant soft tissue hypertrophy was present 2.79 times more often (95% CI: 1.35 - 5.76, P<.003) around implants supporting metal-acrylic resin prostheses than metal-ceramic ones, with the former type also showing significantly more plaque accumulation (P<.003). CONCLUSIONS: Biologic complications such as soft tissue hypertrophy and plaque accumulation were more often associated with metal-acrylic resin prostheses. Peri-implant mucositis occurred more often under maxillary IFCDPs, while peri-implantitis appeared more common around mandibular implants.

2.
J Prosthodont ; 2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33474754

RESUMEN

PURPOSE: To conduct an in vitro comparison of the amount of three-dimensional (3D) deviation of 3D printed casts generated from digital implant impressions with an intraoral scanner (IOS) to stone casts made of conventional impressions. MATERIAL AND METHODS: A maxillary master cast with partially edentulous anterior area was fabricated with two internal connection implants (Regular CrossFit, Straumann). Stone casts (n = 10) that served as a control were fabricated with the splinted open-tray impression technique. Twenty digital impressions were made using a white light IOS (TRIOS, 3shape) and the Standard Tesselation Language (STL) files obtained were saved. Based on the STL files, a digital light processing (DLP) and a stereolithographic (SLA) 3D printer (Varseo S and Form 2) were used to print casts (n = 10 from each 3D printer). The master cast and all casts generated from each group were digitized using the same IOS. The STL files obtained were superimposed on the master cast STL file (reference) to evaluate the amount of 3D deviation with inspection software using the root mean square value (RMS). The independent-samples Kruskal-Wallis test and Dunn's test with Bonferroni correction (for post hoc comparisons) were used for statistical analyses. RESULTS: The Varseo S group had the lowest median RMS value [77.5 µm (IQR = 91.4-135.4)], followed closely by the Conventional group [77.7 µm (IQR = 61.5-93.4)]. The Form 2 had the highest mean value [98.8 µm (IQR = 57.6-87.9)]. The independent-samples Kruskal-Wallis test revealed a significant difference between the groups (p = 0.018). Post hoc testing revealed a significant difference between Varseo S and Form 2 (p = 0.009). CONCLUSION: The casts generated from the Varseo S 3D printer had better 3D accuracy than did those from the Form 2 3D printer. Both the Varseo S group and the conventional stone casts groups had similar 3D accuracy.

3.
Compend Contin Educ Dent ; 41(9): e5-e9, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33001661

RESUMEN

This article describes the case of a partially edentulous patient who had undergone template-guided implant placement and was treated using a triple digital scanning protocol that allowed for CAD/CAM prosthodontic rehabilitation in a complete digital workflow. At the impression appointment, the provisional implant-supported screw-retained prosthesis was digitally scanned both intraorally (first scan) and, after removal, extraorally (second scan). After the second scan, scan bodies were placed intraorally and an implant-level digital impression was taken (third scan). The three standard tessellation language (STL) files derived from the three digital scans were imported in a CAD software and superimposed into one file that contained all of the information from the implant 3D position, prosthesis contours, and transmucosal part of the peri-implant soft tissues. The superimposition of the three STL files led to one master file to serve as a blueprint for the definitive prosthesis. The definitive monolithic zirconia prosthesis was CAM copy-milled, externally stained, and inserted. The patient was satisfied with both the esthetic and functional outcome and the minimally invasive, time-efficient, two-visit restorative protocol. In summary, this case report illustrates a technique for a complete digital workflow in an implant rehabilitation for the replacement of multiple missing teeth in the esthetic zone in two visits.


Asunto(s)
Implantes Dentales , Flujo de Trabajo , Diseño Asistido por Computadora , Prótesis Dental de Soporte Implantado , Estética Dental , Humanos
4.
J Prosthodont ; 29(8): 718-724, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32648318

RESUMEN

PURPOSE: To assess the accuracy of template-guided implant surgery for edentulous arches. MATERIALS AND METHODS: The stone master casts of 25 edentulous arches treated with either 4 or 6 implants with CBCT generated template-guided surgery were included in this observational cohort study. The stone casts generated from the surgical templates (group one) prior to implant placement were digitized into Standard Tesselation (STL) files with a reference scanner. For comparison, the stone master casts derived from intraoral complete-arch impressions after implant placement (group two) were also digitized. The resultant STL files were superimposed and best-fit-alignment algorithm was used to quantify the 3D deviations present between the two groups. Descriptive statistics were computed for all categorical variables. Due to the presence of nonindependent samples between maxillary and mandibular casts, a mixed-effects model was used. RESULTS: Deviations between the implant analogs of the stone casts representing digitally planned versus actually placed implants were found. The mean root-mean-square error (RMSE) between all 25 arches was found to be 0.2 mm (SD ± 0.15). The mean RMSE between presurgical and postsurgical maxillary stone casts were 0.19 ± 0.15 mm, while between mandibular stone casts were 0.21 ± 0.16 mm and were not significant (p = 0.67). The mean RMSE between presurgical and postsurgical stone casts arches with 4 versus 6 implants were found to be significant (p = 0.01). CONCLUSIONS: According to the results of the study and based on the amount of 3D deviations between the digitally planned implant positions and the actually placed implants, template-guided surgery is a safe treatment modality for implant placement in edentulous arches.


Asunto(s)
Implantes Dentales , Boca Edéntula , Cirugía Asistida por Computador , Diseño Asistido por Computadora , Técnica de Impresión Dental , Humanos , Maxilar/cirugía , Boca Edéntula/cirugía
5.
J Prosthodont ; 29(8): 660-678, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32613641

RESUMEN

PURPOSE: To systematically review in vitro and clinical studies comparing quantitatively the 3D accuracy (global implant deviations) of digital vs conventional implant impressions for partially and completely edentulous patients. MATERIALS AND METHODS: Electronic and manual searches were conducted to identify in vitro and clinical studies, reporting on the 3D accuracy between digital and conventional implant impressions. Secondary outcomes were the effect of implant angulation, type of conventional impression technique, and type of intraoral scanner on the accuracy of implant impressions. RESULTS: The inclusion criteria were met by 9 in vitro studies and 1 clinical study reporting on completely edentulous impressions, while 6 in vitro and 2 clinical studies reported on partially edentulous impressions. Quantitative meta-analysis was performed for 5 completely edentulous and 6 partially edentulous studies. The studies exhibited high values for heterogeneity. A random effects model was conducted to estimate the effect size. Based on 5 in vitro studies on completely edentulous impressions, the mean 3D implant deviation between conventional and digital impressions was 8.20 µm (95% CI: -53.56, 37.15) and the digital impressions had nominally less deviation (p = 0.72). Based on 1 clinical and 5 in vitro studies on partially edentulous impressions, the mean 3D implant deviation between conventional and digital impressions was 52.31 µm (95% CI: 6.30, 98.33) and the conventional impressions had nominally less deviation (p = 0.03). Five in vitro and 2 clinical studies were not included in the quantitative analysis due to heterogeneity in the methodology. Implant angulation affected the accuracy in favor of the partially edentulous conventional impressions whereas the effect of different scanners was not statistically significant on the completely edentulous impressions (p = 0.82). CONCLUSIONS: Digital scans appear to have comparable 3D accuracy with conventional implant impressions based mainly on in vitro studies. However, clinical trials are recommended to investigate the clinical accuracy of digital scans and digitally fabricated interim or prototype prostheses, before digital implant scans can be recommended for routine clinical use.


Asunto(s)
Implantes Dentales , Boca Edéntula , Diseño Asistido por Computadora , Materiales de Impresión Dental , Técnica de Impresión Dental , Modelos Dentales , Humanos
6.
J Clin Periodontol ; 47(11): 1326-1343, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32691437

RESUMEN

AIM: To systematically review buccal bone thickness (BBT) in the anterior maxilla in different teeth, age groups and genders. MATERIALS AND METHODS: PubMed, EMBASE and Cochrane databases were searched up to April 2020. Clinical and radiographic studies reporting on BBT of maxillary anterior teeth, with at least 10 patients, were included. A meta-analysis was performed using random effect models to report differences of BBT. RESULTS: 50 studies were included. Using bone crest (BC) as a reference point, no significant differences were found in BBT between different tooth types, except for 0.16 mm (95%-CI: 0.02-0.30) increased mid-root thickness of premolars compared to canines. Using the CEJ as a reference point, canines presented with a significantly increased thickness of 0.32 mm (95%-CI: 0.11-0.54) coronally compared to laterals. When BC was used as reference, males demonstrated a significantly increased thickness of 0.21 mm (95%-CI: 0.15-0.27) apically, while middle-aged adults showed a 0.06 mm (95%-CI: -0.12, -0.01) statistically significant increase in the coronal level compared to older adults. CONCLUSIONS: Few maxillary anterior teeth have BBT greater than 1 mm. Buccal bone tends to get thicker from a coronal to apical position along the root surface and from an anterior to posterior position in the arch.

7.
J Prosthodont ; 29(6): 479-488, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32364656

RESUMEN

PURPOSE: To determine the prevalence and distribution of prosthetic complications affecting implant-supported fixed dental prostheses (ISFDPs). MATERIALS AND METHODS: Subjects previously treated with one or more ISFDP(s) were identified from an electronic health record search and recalled for comprehensive clinical examination. Past prosthesis failures and complications were identified from the patient records while any existing complications, not previously recorded, were assessed during examination. ISFDP survival and failure rates were calculated with Kaplan-Meier curves and life table analysis, while regression Poisson analysis was used to identify associations between outcomes and possible patient- and prosthesis-based risk factors. RESULTS: Seventy-four subjects with 107 ISFDPs were enrolled in the study with a mean time between prosthesis delivery and exam of 3.14 years (range: 1.00-9.00 years). Four prostheses failed, resulting in a cumulative prosthesis survival rate of 96.26%. Prosthetic complications affected 48.59% of ISFDPs, the majority (94.87%) of them minor complications. Only the use of a nightguard was associated with a lower prevalence of prosthetic screw loosening (HR 0.11, 95% CI 0.02-0.59, p = 0.007) while no outcome differences were noted for other variables. Patient satisfaction was high regardless of presence or number of complications. CONCLUSIONS: ISFDPs demonstrated a high survival rate and overall high, patient-reported satisfaction. Minor prosthetic complications were common but were only significantly associated with nightguard use.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Falla de Prótesis , Estudios Retrospectivos , Tasa de Supervivencia
8.
J Prosthet Dent ; 2020 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-32456790

RESUMEN

A clinical and laboratory workflow for fabricating and retrofitting a monolithic ceramic crown to an existing removable partial denture (RPD) is described. A conventional polyvinyl siloxane impression was made of the prepared tooth with the RPD in place. A stone cast was poured and, after die sectioning, scanned with a tabletop scanner. The ceramic crown was designed and fabricated by using a digital workflow to fit the RPD clasp assembly, providing an adequate undercut for the clasp. The crown was then delivered and the RPD evaluated for adequate fit.

9.
J Prosthodont ; 29(6): 460-465, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32185825

RESUMEN

The purpose of the present report is to illustrate a proof-of-concept protocol with the double digital scanning (DDS) technique for complete digital workflow in double full-arch implant rehabilitation. Two patients (4 restored arches) presented with hopeless dentitions and they were treated with a 4-appointment prosthodontic protocol and monolithic zirconia prostheses implementing a complete digital workflow. The outcomes are presented after clinical and radiographic observation for 2 years.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Diseño Asistido por Computadora , Diseño de Prótesis Dental , Humanos , Flujo de Trabajo , Circonio
10.
J Prosthodont ; 29(4): 281-286, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32166793

RESUMEN

PURPOSE: A prospective clinical study to compare for the first time the accuracy of digital and conventional maxillary implant impressions for completely edentulous patients. MATERIALS AND METHODS: Sixteen patients received maxillary implant supported fixed complete dentures. After the verification of the conventional final casts, the casts were scanned with a desktop (extraoral) scanner. Intraoral full-arch digital scans were also obtained with scan bodies and STL files. Extraoral and intraoral scans were superimposed and analyzed with reverse engineering software. The primary outcome measure was the assessment of accuracy between scans of the verified conventional casts and digital full-arch impressions. The secondary outcome was the effect of the implant number on the 3D accuracy of impressions with Spearman's rank correlation coefficient. RESULTS: The 3D deviations between virtual casts from intraoral full-arch digital scans and digitized final stone casts generated from conventional implant impressions were found to be 162 ± 77 µm. In the 4-implant group, 5-implant group, and 6-implant group the 3D deviations were found to be 139 ± 56 µm, 146 ± 90 µm, and 185 ± 81 µm, respectively. There was a positive correlation between increased implant number and 3D-deviations, but there was no statistically significant difference (p = 0.191). CONCLUSIONS: The 3D accuracy of full-arch digital implant scans lies within previously reported clinically acceptable threshold. Full-arch digital scans and a complete digital workflow in the fabrication of maxillary fixed complete dentures may be clinically feasible.


Asunto(s)
Implantes Dentales , Técnica de Impresión Dental , Diseño Asistido por Computadora , Materiales de Impresión Dental , Modelos Dentales , Humanos , Imagenología Tridimensional , Maxilar , Estudios Prospectivos
11.
J Prosthodont ; 29(5): 429-435, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32180293

RESUMEN

PURPOSE: This is a single center, retrospective study to assess the prevalence of peri-implant disease and biologic complications in a cohort of partially edentulous subjects in relation to selected prosthetic factors. MATERIALS AND METHODS: Subjects previously treated with one or more implant-supported fixed dental prosthesis (ISFDPs) were recalled for a comprehensive examination. Clinical and radiographic records were taken and questionnaires were administered. The prevalence of implant failure, peri-implant disease and other biologic complications were correlated with selected prosthetic, clinical and patient-related factors using chi-square and multiple regression analyses. RESULTS: A convenience sample of 71 subjects with 100 prostheses supported by 222 dental implants were enrolled in the study. The mean follow-up time after prosthesis delivery was 3.3 ± 1.5 years (range of 1-9 years). The cumulative implant survival rate was 99.1%. Peri-implantitis was the most frequent major biologic complication (5% of implants), while the most frequent minor biologic complication was peri-implant mucositis (84.10% of implants). A diagnosis of peri-implant mucositis was more likely associated with cement-retained prostheses compared to screw-retained prostheses (OR 6.8, 95% CI 1.1-78.6, p = 0.045) and for short-span prostheses (≤3 prosthetic units) (OR 2.3, 95% CI 1.1-5.0, p = 0.034). Subject-reported quality of life measures were high regardless of the existence of major and/or minor complications, but decreased with increasing number of minor and total biologic complications. CONCLUSIONS: Peri-implant mucositis and other minor biologic complications were highly prevalent. The distribution of the observed complications differed based on the method of prosthesis retention and the number of prosthetic units replaced.


Asunto(s)
Productos Biológicos , Implantes Dentales , Periimplantitis , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Calidad de Vida , Estudios Retrospectivos
12.
J Prosthet Dent ; 2020 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-32057487

RESUMEN

STATEMENT OF PROBLEM: Limited information is available regarding the fabrication of tooth-supported interim single crowns (SCs) with either a digital or a conventional workflow. PURPOSE: The purpose of this randomized clinical trial was to compare the time efficiency and fit of interim crowns fabricated by using either a digital or a conventional workflow. MATERIAL AND METHODS: Forty participants in need of posterior tooth-supported SCs were enrolled and randomly allocated to either the digital or conventional group. In the digital group, the interim SCs were fabricated by using digital sextant scans and computer-aided design and computer-aided manufacturing (CAD-CAM) technology without definitive casts. The conventional group included conventional impressions and direct fabrication of the interim restorations intraorally. Five experienced and 5 less experienced clinicians were randomly assigned to fabricate the interim SCs. The total fabrication time (laboratory and clinical) was recorded for time efficiency. The fit assessment included marginal fit, proximal contact, occlusal contact, and crown morphology. The evaluated parameters were analyzed with the Mann-Whitney U Test (α=.05). RESULTS: The digital workflow required significantly less total fabrication time (laboratory and clinical) than the conventional workflow (P<.001). The less-experienced clinicians needed longer clinical time with the conventional workflow than the experienced ones (P=.023). In contrast, the laboratory time and total fabrication time were shorter for less-experienced clinicians using the digital workflow (P=.005 and P=.015). The interim SCs fabricated with the digital workflow had significantly better fit and occlusal contacts than those fabricated with the conventional workflow (P=.005 and P<.001). With the digital workflow, the interim SCs made by less-experienced clinicians were of the same quality as those made by experienced clinicians. When using the conventional workflow, the fit of the experienced clinicians was significantly better than that of the less-experienced clinicians. CONCLUSIONS: The interim SCs fabricated with a digital workflow required a shorter fabrication time and resulted in better fit than those fabricated with a conventional workflow, especially for less-experienced clinicians.

13.
J Prosthet Dent ; 124(5): 589-593, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31959396

RESUMEN

STATEMENT OF PROBLEM: Data on the accuracy of printed casts from complete-arch digital implant scans are lacking. PURPOSE: The purpose of this in vitro study was to compare the 3D accuracy of printed casts from a complete-arch digital implant intraoral scan with stone casts from conventional impressions. MATERIAL AND METHODS: An edentulous mandibular cast with 4 multiunit abutments with adequate anteroposterior spread was used as the master cast. Digital scans (n=25) were made by using a white light intraoral scanner (IOS). The generated standard tessellation language (STL) data sets were imported into a computer-assisted design (CAD) software program to generate complete-arch implant casts through 3D printing technology. The 25 printed casts and the mandibular master cast were further digitized by using a laboratory reference scanner (Activity 880; Smart Optics). These STL data sets were superimposed on the digitized master cast in a metrology software program (Geomagic Control X) for virtual analysis. The root mean square (RMS) error and the average offset were measured. RESULTS: When compared with the master cast, the printed casts had a mean ±standard deviation RMS error of 59 ±16 µm (95% CI: 53, 66). The maximum RMS error reached 98 µm. The average offsets were all negative, with a significant difference compared with zero (P<.001). CONCLUSIONS: The implant 3D deviations of the printed casts from complete-arch digital scans had statistically significant differences compared with those of the master cast but may still be within the acceptable range for clinical application.


Asunto(s)
Implantes Dentales , Técnica de Impresión Dental , Diseño Asistido por Computadora , Modelos Dentales , Imagenología Tridimensional , Impresión Tridimensional , Flujo de Trabajo
14.
J Prosthet Dent ; 124(5): 539-546, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31982146

RESUMEN

STATEMENT OF PROBLEM: Implant fixed complete dental prostheses (IFCDPs) are widely used in the rehabilitation of completely edentulous patients, yet limited information is available on the relationship between prosthetic complications and patient-associated and prosthesis-associated risk factors. PURPOSE: The purpose of this retrospective study was to assess the prosthetic complication and survival rates of IFCDPs after a mean observational period of 3.5 years. MATERIAL AND METHODS: Eligible participants were identified by an electronic health record review. The study consisted of a review of the dental record and a single-visit study appointment when a comprehensive examination was performed, including a review of the medical and dental history, clinical and radiographic examination, intraoral photographs, patient satisfaction questionnaire, and occlusal analysis. Prosthodontic parameters and risk factors were assessed, including time with the prosthesis in place, bruxism, occlusal device use, prosthesis material, number of implants, cantilever length, and mode of prosthesis retention. Association between these prosthodontic parameters and risk factors and the observed prosthetic complications was assessed. RESULTS: A total of 37 participants (mean age 62.35 ±10.39 years) with 48 IFCDPs were included. Thirty-eight prostheses were metal-acrylic resin (MR group), whereas 10 were metal-ceramic (MC group). Five of the 48 prostheses failed during the follow-up period, a cumulative prosthesis survival rate of 88%. Minor complications were more frequent than major complications. The most frequent minor complication was loss of screw access hole material (5.18%/year), whereas the most frequently observed major complication was major wear of the prosthetic material (5.85%/year). A significant association was found between not wearing an occlusal device and minor chipping, loss of access hole material, and framework fracture. Minor chipping was significantly associated with bruxism, whereas the opposing dentition significantly affected the total number of prosthetic complications. CONCLUSIONS: High survival rates were observed with both MR and MC IFCDPs. No significant difference was found between MR and MC groups in terms of patient satisfaction, as well as total number of prosthetic complications.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Anciano , Implantes Dentales/efectos adversos , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Tasa de Supervivencia
15.
J Prosthodont ; 29(1): 3-11, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31650669

RESUMEN

PURPOSE: To report the rate of technical complications and prosthesis survival in a cohort of edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of at least 1 year. MATERIALS AND METHODS: The single-visit examination included clinical and radiographic assessment, occlusal analysis, photographs and questionnaire assessing patient satisfaction in a cohort of 52 patients rehabilitated with 71 IFCDPs (supported by 457 implants). The IFCDPs were assessed for technical complications, number of implants and cantilever extension, retention type and prosthetic material type. Comparison was made between ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). Kaplan-Meier survival curve analysis was carried out for assessment of prosthesis survival and was done for both Groups 1 and 2 separately. The Cox proportional hazard model was used for survival analysis, adjusting for a number of potential confounders, to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. Responses to patient satisfaction questions were compared with Fisher's exact test. RESULTS: Out of 71 edentulous arches (52 patients) restored with IFCDPs, 6 IFCDPs had failed, yielding a cumulative prosthesis survival rate of 91.6 % after a mean observation period of 5.2 years (range: 1-12 years) after definitive prosthesis insertion. Three IFCDPs were lost due to implant failures after 5.8 to 11 years of functional loading. Additionally, 3 metal-resin IFCDPs failed due to technical complications. Minor complications were the most frequent complications observed, namely wear of the prosthetic material (9.8% annual rate) being the most common, followed by decementation of cement-retained IFCDPs (2.9%), and loss of the screw access filing material of the screw-retained IFCDPs (2.7%). The most frequently observed major complication was fracture of the prosthetic material (1.9% annual rate), followed by fracture of occlusal screw (0.3%), and fracture of framework (0.3%). The annual rate of wear of prosthetic material was 7.3% for porcelain IFCDPs (n = 19/55) and 19.4% for metal-resin IFCDPs (n = 13/16), yielding a statistically significant difference between the 2 groups (p = 0.01). CONCLUSIONS: After a mean exposure time of 5.2 years, 91.6% prosthesis survival rates were achieved (65 out of 71 IFCDPs). The most frequent minor technical complication was wear of the prosthetic material with estimated 5-year rate of 49.0%, while the most frequent major complication was fracture of the prosthetic material with estimated 5-year dental unit-based rate of 9.5%. The cumulative rates for "prosthesis free of minor complications" at 5- and 10-years were 60.5% (95% CI: 47.2-71.3%) and 8.9% (95% CI: 2.9-18.0%), respectively. The cumulative rates for "prosthesis free of major technical complications" at 5- and 10-years were 85.5% (95% CI: 73.0-92.5%) and 30.1% (95% CI: 12.0-50.6%), respectively. Presence of bruxism, and absence of a nightguard were associated with increased risk for chipping of the prosthetic material of the IFCDPs.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Falla de Prótesis , Estudios Retrospectivos
16.
J Oral Rehabil ; 47(3): 403-415, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31846097

RESUMEN

PURPOSE: To analyse randomised controlled clinical trials (RCTs) and prospective cohort studies reporting on the survival and failure rates of functionally loaded short implants (SI) based on the actual length of time in function. MATERIALS AND METHODS: This meta-analysis was conducted according to PRISMA guidelines for systematic reviews. Electronic and manual searches were conducted to identify RCTs and prospective cohort studies reporting survival and complication rates of short dental implants (≤6 mm) based on the time in function. Secondary outcomes included the location (maxilla or mandible), type of restoration (single crown [SC] versus fixed dental prosthesis [FDP]) and marginal bone loss (MBL). RESULTS: A total of 20 studies (11 RCTs and 9 prospective) fulfilled the inclusion criteria and featured a total of 1238 SI placed in 747 patients. The overall (early and late) mean percentage of short implant failure was 4%. SI with up to 1-year follow-up presented failure rate of 2%, while SI followed up for >3 years showed a failure rate of 10%. SI restored with SC presented a late failure rate of 4% while SI restored with FPD 2%. The late failure rate did not differ in terms of location (maxilla or mandible) both with 3%. CONCLUSION: Short implants in function for more than 3 years presented higher failure rates compared to SI in function for <3 years. Splinting crowns supported by SIs in the posterior area should be considered. However, SI is a valid option for selected cases given their relatively high long-term survival rates.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Coronas , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto
17.
Int J Esthet Dent ; 14(4): 394-404, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31549105

RESUMEN

With the advancement of computer-aided design/computer-aided manufacturing (CAD/CAM) in dentistry, the use of digital technologies is being increasingly adopted by clinicians and laboratory technicians. Clinicians are using intraoral scanners (IOSs) more and more to perform computer-aided impressions. While these are mainly used to digitize dentate or partially edentulous jaws, it is feasible with a few of the available systems to scan edentulous jaws, with or without implants. To scan edentulous jaws, the registration and articulation of patient-relevant references and planes is difficult without the use of physical casts. The present article introduces simple yet effective methods to integrate individual interocclusal information during the intraoral scan procedure. The techniques described aim to simplify the digital registration procedure of edentulous jaws, with or without implants, and integrate patient-relevant information in the virtual articulator without the need to manufacture and articulate casts after the intraoral scan.


Asunto(s)
Arcada Edéntula , Diseño Asistido por Computadora , Técnica de Impresión Dental , Humanos
18.
J Prosthet Dent ; 122(3): 189-192, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30948298

RESUMEN

During complete-arch digital implant scanning, one of the most technique-sensitive steps is the data registration and superimposition or matching of different surface geometry data sets because of the absence of fixed landmarks. This article describes a straightforward technique for facilitating the accurate superimposition or matching of surface scan files from digital scans for the fabrication of the prosthesis prototype with a complete digital workflow.


Asunto(s)
Prótesis Dental de Soporte Implantado , Flujo de Trabajo , Diseño Asistido por Computadora , Diseño de Prótesis Dental
19.
J Prosthet Dent ; 122(5): 441-449, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30982622

RESUMEN

STATEMENT OF PROBLEM: Long-term outcomes with metal-ceramic (MC) implant-supported fixed complete dental prostheses (IFCDPs) are scarce. PURPOSE: The purpose of this retrospective study was to assess the rate of biologic and technical complications in a cohort of edentulous patients treated with MC IFCDPs by residents after a mean clinical follow-up of 5 years (range: 1 to 12 years). MATERIAL AND METHODS: Forty-one participants with 55 MC IFCDPs underwent a single-visit comprehensive examination that included a medical and dental history review and clinical and radiographic examinations. All supporting implants and prostheses were examined for biologic and technical complications. Life table analysis and Kaplan-Meier survival curves were calculated. RESULTS: Of 359 moderately rough surface dental implants, 2 had failed in 1 patient after 11 years of functional loading, yielding a cumulative implant survival rate of 99.4%. Owing to the implant failure, 1 of 55 edentulous arches restored with IFCDPs failed, yielding a cumulative prosthesis survival rate of 98.2% after mean observation period of 5.0 years. Soft tissue recession was the most frequent minor biologic complication (annual rate 7.8% at the prosthesis level) for both cement and screw-retained IFCDPs (group C and S), and peri-implantitis (annual rate 1.6% at the implant level) the most frequent major biologic complication. Wear of porcelain (annual rate 8.0% at the prosthesis level) was the most frequent minor technical complication for both groups, and fracture of porcelain (annual rate 0.8% at the dental-unit level) was the most frequent major technical complication. Minor complications were the most frequent in both the groups (cement and screw retained). CONCLUSIONS: High implant and prosthesis survival rates (above 98%) were achieved, yet substantial complication rates were encountered. The most frequent major biologic complication was peri-implantitis, with a 5-year implant-based rate of 8% (95% confidence interval [CI]: 5.8-11.1), whereas the most frequent major complication was fracture of porcelain with a 5-year dental unit-based rate of 4%. The estimated cumulative rates for "prosthesis free of biologic complications" were 50.4% (95% CI: 36.4% to 63.0%) at 5 years and 10.1% (95% CI: 3.5% to 20.8%) at 10 years, whereas for "prosthesis free of technical complications," they were 56.4% (95% CI: 41.7% to 68.8%) at 5 years and 9.8% (95% CI: 3.2% to 21.0%) at 10 years.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Estudios de Cohortes , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Metales , Estudios Retrospectivos , Tasa de Supervivencia
20.
J Prosthodont ; 28(4): 387-397, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30806990

RESUMEN

PURPOSE: To retrospectively assess complications and clinical and radiographic outcomes of edentulous patients treated with double full-arch implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.1 years. MATERIALS AND METHODS: The single-visit clinical and radiographic examination included medical and dental history review and clinical assessment of biologic and technical complications encountered with all implants and IFCDPs. Life table analysis and Kaplan-Meier survival curves were calculated. Analysis was conducted to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. RESULTS: Nineteen edentulous patients restored with 38 IFCDPs were included. A total of 249 implants were placed and 2 implants failed after a mean observation period of 5.1 years (range: 1-12 years), yielding an overall implant survival rate of 99.2% and prosthesis survival rate of 92.1%. Three out of 38 IFCDPs were lost, 1 after implant losses and 2 due to technical complications. The most frequent minor biologic complication was soft tissue recession with an estimated 5-year rate of 45.5% (95% CI: 39.4-57.5), while the most frequent major complication was peri-implantitis with an estimated 5-year implant-based rate of 9.5% (95% CI: 6.7-11.3). The most frequent minor technical complication was wear of the prosthetic material with an estimated 5-year rate of 49.0% (95% CI: 37.4-76.4), while the most frequent major technical complication was fracture of the prosthetic material with an estimated 5-year dental unit-based rate of 8.0% (95% CI: 6.6-10.1). CONCLUSIONS: After a mean use time of 5.1 years, high implant and prosthesis survival rates were observed. The most frequent major biologic complication was peri-implantitis, and the most frequent major technical complication was fracture of the prosthetic material. The 5-year estimated cumulative rates for "prosthesis free of biologic complications" was 50.7% (95% CI: 33.7-65.4) and for "prosthesis free of technical complications" was 57.1% (95% CI: 39.3-71.5).


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Estudios Retrospectivos
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