Behavior of polyether-ether-ketone (PEEK) in prostheses on dental implants. A review.

BACKGROUND: The development of new and innovative materials such as high performance polymers (PEEK) opens a wide therapeutic range in implant prostheses. They are presented as alternative materials to metal and zirconium alloys in the manufacture of structures and attachments for implant prostheses and fixed and removable dental substitutes. The objective of this review is to know the characteristics of this material and thus assess its advantages and disadvantages in its possible applications in prostheses on dental implants. MATERIAL AND METHODS: A bibliographic search was carried out through the PubMed and Scopus search engines, of articles published from 2007 to 2020, excluding all articles in which PEEK was used for tooth prostheses. The data on the sufficiency of the PEEK material were organized according to its chemical, physical and mechanical properties. RESULTS: 148 articles were found in the databases using as keywords; Polyetheretherketone; PEEK; BioHPP; healing abutments; dental prostheses; dental prosthodontics; Full-arch rehabilitation; fixed implant prosthodontics; implant-retained prostheses; implant prostheses. CONCLUSIONS: It is concluded that PEEK offers greater lightness, good aesthetics, biocompatibility, and an elastic modulus more similar to bone than other materials commonly used in implant prostheses; however, it presents a higher risk of fracture and abrasion. More long-term clinical studies will be necessary to advise its use in implant prostheses. Key words:Polyetheretherketone, PEEK, BioHPP, healing abutments, dental prostheses, dental prosthodontics,Full-arch rehabilitation, fixed implant prosthodontics, implant-retained prostheses, implant prostheses.

Analysis of fit on implants of chrome cobalt versus titanium frameworks made by cad / cam milling.

BACKGROUND: This study analyzed the degree of passive and vertical fit achieved in frameworks using either cobalt-chromium (Co-Cr) or titanium (Ti) implant-supported fixed partial dentures ( FPDs) fabricated with a CAD/CAM milling technique. MATERIAL AND METHODS: 33 3-unit FDPs, 17 of Co-Cr metal alloy (test group) and 16 of Ti (control group), were manufactured with two implants by copy milled technology. Optical microscopy was used to measure passive fit (PF) and vertical fit (VF) in all frameworks. The PF was evaluated by using the Single Screw test and the VF with the screws tightened at 20 Ncm. Descriptive and inferential analysis were performed to evaluate statistically significant differences in the tested groups for each fit. Brunner-Langer models were applied to assess potential material and implant area effects on the measurements. An ANOVA test was performed to estimate both main effects and interactions. RESULTS: The average PF values in the screwed implant were 4.43 ± 0.52 µm for Ti and 5.50 ± 1.61 µm for Co-Cr and in the non-screwed implant 5.59 ± 1.32 µm in the group Ti and 6.25 ± 1.55 µm the Co-Cr group. In this last implant, it was not observed statistically significant differences between both types of alloy (p = 0.178) nor between zones. Ti control group exhibited a significantly better VF than Co-Cr (p = 0.046) in the screwed implant but there were no differences in the implant not screwed. The VF in the non-screwed implant was better in lingual than in buccal zone. CONCLUSIONS: The PF and VF measurements observed in Co-Cr frameworks are clinically acceptable. 3-unit implant supported FPDs made with Co-Cr alloy using milling technique showed similar dimensional accuracy than those obtained with Ti. Key words:Cobalt- chromium alloy, misfit, passive fit, vertical fit, milling.

Predictability of short implants (< 10 mm) as a treatment option for the rehabilitation of atrophic maxillae. A systematic review

BACKGROUND: Short implants (< 10 mm) are one of the treatment options available in cases of limited vertical bone. Although such implants are now widely used, there is controversy regarding their clinical reliability. The purpose of this paper is to evaluate the predictability of short implants as an alternative to technically more complex treatments in patients with atrophic maxillae, based on a systematic review of the literature and the analysis of the implant survival rates, changes in periimplant bone level, and associated complications. It is postulated that short implants offer clinical results similar to those of longer implants. MATERIAL AND METHODS: A Medline-PubMed search was made covering the period between January 2004 and December 2014 (both included). Studies in English published in indexed journals, involving at least 20 implants and with a follow-up period of at least 12 months were considered. A manual search in four high impact journals was also conducted. RESULTS: A total of 37 studies meeting the inclusion criteria were included in this review. 9792 implants placed in over 5000 patients were analyzed. CONCLUSIONS: Based on the results of this review, short implants are seen to offer clinical results in terms of survival, bone loss and complications similar to those of longer implants

Effect of platform switching on the peri-implant bone: A finite element study.

BACKGROUND: There exists a relation between the presence and location of the micro-gap and the loss of peri implant bone. Several authors have shown that the treatments based on the use of platform switching result in less peri-implant bone loss and an increased tissue stability. The purpose of this study was to analyse the effect of the platform switching on the distribution of stresses on the peri-implant bone using the finite element method. MATERIAL AND METHODS: A realistic 3D full-mandible finite element model representing cortical bone and trabecular bone was used to study the distribution of the stress on the bone induced by an implant of diameter 4.1 mm. Two abutments were modelled. The first one, of diameter 4.1 mm, was used in the reference model to represent a conventional implant. The second one, of diameter 3.2 mm, was used to represent the implant with platform switching. Both models were subjected to axial and oblique masticatory loads. RESULTS: The analyses showed that, although no relevant differences can be found for the trabecular bone, the use of platform switching reduces the maximum stress level in the cortical bone by almost 36% with axial loads and by 40% with oblique loads. CONCLUSIONS: The full 3D Finite Element model, that can be used to investigate the influence of other parameters (implant diameter, connexion type, …) on the biomechanical behaviour of the implant, showed that this stress reduction can be a biomechanical reasons to explain why the platform switching seems to reduce or eliminate crestal bone resorption after the prosthetic restoration. KEY WORDS: Dental implant, platform switching, finite element method.

Fractographic Study of the Interface Between Zirconia Y-TZP and Its Veneering Ceramic After Shear Strength Testing.

This study analyzed the shear strength and fracture characteristics of the interface between zirconia samples and their veneering ceramic compared with a metal-ceramic and a lithium disilicate glass-ceramic control group together with an assessment of the possible relationship between the fracture characteristics and the recorded shear strength. The greatest shear strengths corresponded to the lithium disilicate glass-ceramic control group followed by the metal-ceramic control group, with lesser strengths in the zirconia groups. Since the fractographic study showed cohesive-type failure to predominate in the zirconia samples, it is concluded that improvements are needed in the veneering ceramic and liner used in zirconia restorations.

Narrow-diameter implants: Are they a predictable treatment option? A literature review

OBJECTIVE: To evaluate the predictability of narrow-diameter implants as a treatment option in routine clinical practice. A literature review was performed of studies reporting clinical results obtained with these implants. Survival rates, peri-implant bone loss and related complications were evaluated. The working hypothesis was that narrow-diameter implants offer clinical results similar to those obtained with implants of greater diameter. MATERIAL AND METHODS: A Medline-PubMed search covering the period between 2002 and 2012 was carried out. Studies published in English and with a follow-up period of at least 12 months were considered for inclusion. A manual search was also conducted in different journals with an important impact factor. RESULTS: Twenty-one studies meeting the screening criteria were included in the literature review. A total of 2980 narrow-diameter implants placed in 1607 patients were analyzed. CONCLUSIONS: The results obtained from the literature indicate that narrow-diameter implants are a predictable treatment option, since they afford clinical results comparable to those obtained with implants of greater diameter

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Narrow-diameter implants: are they a predictable treatment option? A literature review.

OBJECTIVE: To evaluate the predictability of narrow-diameter implants as a treatment option in routine clinical practice. A literature review was performed of studies reporting clinical results obtained with these implants. Survival rates, peri-implant bone loss and related complications were evaluated. The working hypothesis was that narrow-diameter implants offer clinical results similar to those obtained with implants of greater diameter. MATERIAL AND METHODS: A Medline-PubMed search covering the period between 2002 and 2012 was carried out. Studies published in English and with a follow-up period of at least 12 months were considered for inclusion. A manual search was also conducted in different journals with an important impact factor. results: Twenty-one studies meeting the screening criteria were included in the literature review. A total of 2980 narrow-diameter implants placed in 1607 patients were analyzed. CONCLUSIONS: The results obtained from the literature indicate that narrow-diameter implants are a predictable treatment option, since they afford clinical results comparable to those obtained with implants of greater diameter.

Telescopic crowns in adult case with lip and palate cleft. Update on the etiology and management.

Lip and palatal clefts are among the most important congenital craniofacial malformations to be taken into account in general dental practice, due to their high incidence and important repercussions upon the oral cavity. The underlying causes are genetic and fundamentally environmental, and the disorders manifest as early as in the embryonic period. Males are predominantly affected, with a 7:3 ratio versus females. Our patient, a 20-year-old male, presented the most common association, i.e., total unilateral hare lip with palatal cleft. A description is provided of the treatment for his dental problem, together with an update on the etiology and management of adults with malformations of this kind.

Uso de las coronas telescópicas en el tratamiento de un paciente adulto con fisura labiopalatina. Puesta al día de la etiología y el tratamiento / Telescopic crowns in adult case with lip and palate cleft. Update on the etiology and management

La fisura labiopalatina es una de las malformaciones congénitas craneofaciales más importantes a tener en cuenta por el odontólogo general debido a su alta incidencia y a su elevada repercusión en la cavidad oral. Sus causas se deben a factores genéticos y predominantemente a factores ambientales, haciendo su aparición ya en el período embrionario. El sexo masculino se encuentra más afectado, en una relación de 7:3. La asociación más frecuente es el labio leporino unilateral total con fisura palatina, que es el caso que nos atañe. Presentamos el caso de un varón de 20 años que acude a nuestra consulta demandando una solución estética a su situación dental. El tratamiento efectuado al paciente, así como una puesta al día en cuanto a la etiología y tratamiento en adultos de esta malformación es el motivo del presente artículo

Lip and palatal clefts are among the most important congenital craniofacial malformations to be taken into account in general dental practice, due to their high incidence and important repercussions upon the oral cavity. The underlyingcauses are genetic and fundamentally environmental, and the disorders manifest as early as in the embryonic period. Males are predominantly affected, with a 7:3 ratio versus females. Our patient, a 20-year-old male, presented the most common association, i.e., total unilateral hare lip with palatal cleft. A description is provided of the treatmentfor his dental problem, together with an update on the etiology and management of adults with malformations of this kind

Choice of ceramic for use in treatments with porcelain laminate veneers.

Porcelain laminate veneers (PLVs) have been used for over two decades to treat esthetic and/or functional problems, particularly in the anterior sector. A range of dental ceramic materials are presently available on the market for these treatments, though with very different characteristics in terms of the composition, optic properties and manufacturing processes involved. As a result, selection of the material best suited for the management of each individual patient may prove complicated. The present study proposes a simple system for selecting the most appropriate ceramic material, based on the two variables that most influence the esthetic outcome: the intrinsic characteristics of the substrate tooth, and the characteristics of the ceramic material in terms of resistance and optic properties.

Selección de la ceramica a utilizar en tratamientos mediante frentes laminados de porcelana / Choice of ceramic for use in treatments with porcelain laminate veneers

El tratamiento mediante Frentes Laminados de Porcelana (FLP) se utiliza desde hace más de dos décadas para el tratamiento de problemas estéticos y/o funcionales, particularmente en el grupo anterior de las arcadas dentarias (1,2,3). La actual oferta en el mercado de cerámicas dentales aptas para este tipo de tratamiento, pero muy distintas en cuanto a composición, características ópticas y sistema de elaboración, hace complicada la selección del material más adecuado a cada paciente en particular. Proponemos un sistema sencillo de elección de la cerámica teniendo en cuenta las dos variables que más influirán en el resultado estético final: de un lado las características propias del diente (sustrato en el que nos apoyamos), y de otro las características propias del material cerámico en cuanto a resistencia y propiedades ópticas

Porcelain laminate veneers (PLVs) have been used for over two decades to treat esthetic and/or functional problems, particularly in the anterior sector (1-3). A range of dental ceramic materials are presently available on the market for these treatments, though with very different characteristics in terms of the composition, optic properties and manufacturing processes involved. As a result, selection of the material best suited for the management of each individual patient may prove complicated. The present study proposes a simple system for selecting the most appropriate ceramic material, based on the two variables that most influence the esthetic outcome: the intrinsic characteristics of the substrate tooth, and the characteristics of the ceramic material in terms of resistance and optic properties

Clasificación actual de las cerámicas dentales / Updated classification of dental ceramics

Cuando hablamos de porcelana, hablamos de la física y química del silicio y de los tres elementos derivados de él que más importancia tienen dentro de la porcelana: el cuarzo o sílice, los feldespatos y el caolín. Las porcelanas dentales están formadas básicamente por un vidrio en el que se encuentran partículas más o menos grandes de minerales cristalizados; es decir, una fase vítrea (feldespatos) de estructura atómica no periódica y por lo tanto amorfa que contiene una fase ordenada periódica y por lo tanto cristalina (sílice). El intento de clasificar las porcelanas tiene como utilidad facilitar la comunicación entre los distintos profesionales, así como el poder situar cada porcelana o nuevo producto presentado en un compartimiento donde las características tales como temperatura de sinterización, composición y manejo sean com-partidas por aquéllas que compongan el mismo grupo (AU)