[Understanding chair-side digital technology for stomatology from an engineering viewpoint].

In recent years with the rapid development of digital technology for stomatology, the application field, application model, technical features and technical connotation of the chair-side digital technology has got development and change. The open modular system has gradually replaced the traditional closed system, and the application field of digital technology is no longer limited to chair-side dental restoration, it also has been extend to various kinds of chair-side digital treatment-assisted technology. In this paper, from the engineering point of view, the up to date general connotation of chair-side digital technology was explained, the characteristics and the development of each unit in chair-side digital technology were analyzed, and the application pattern and the localization status were also discussed in this paper. The aim of this paper was to introduce the trend of chair-side digital technological to readers and to better guide clinical application.

Dental ceramics: a review of new materials and processing methods.

The evolution of computerized systems for the production of dental restorations associated to the development of novel microstructures for ceramic materials has caused an important change in the clinical workflow for dentists and technicians, as well as in the treatment options offered to patients. New microstructures have also been developed by the industry in order to offer ceramic and composite materials with optimized properties, i.e., good mechanical properties, appropriate wear behavior and acceptable aesthetic characteristics. The objective of this literature review is to discuss the main advantages and disadvantages of the new ceramic systems and processing methods. The manuscript is divided in five parts: I) monolithic zirconia restorations; II) multilayered dental prostheses; III) new glass-ceramics; IV) polymer infiltrated ceramics; and V) novel processing technologies. Dental ceramics and processing technologies have evolved significantly in the past ten years, with most of the evolution being related to new microstructures and CAD-CAM methods. In addition, a trend towards the use of monolithic restorations has changed the way clinicians produce all-ceramic dental prostheses, since the more aesthetic multilayered restorations unfortunately are more prone to chipping or delamination. Composite materials processed via CAD-CAM have become an interesting option, as they have intermediate properties between ceramics and polymers and are more easily milled and polished.

Dental ceramics: a review of new materials and processing methods

Abstract The evolution of computerized systems for the production of dental restorations associated to the development of novel microstructures for ceramic materials has caused an important change in the clinical workflow for dentists and technicians, as well as in the treatment options offered to patients. New microstructures have also been developed by the industry in order to offer ceramic and composite materials with optimized properties, i.e., good mechanical properties, appropriate wear behavior and acceptable aesthetic characteristics. The objective of this literature review is to discuss the main advantages and disadvantages of the new ceramic systems and processing methods. The manuscript is divided in five parts: I) monolithic zirconia restorations; II) multilayered dental prostheses; III) new glass-ceramics; IV) polymer infiltrated ceramics; and V) novel processing technologies. Dental ceramics and processing technologies have evolved significantly in the past ten years, with most of the evolution being related to new microstructures and CAD-CAM methods. In addition, a trend towards the use of monolithic restorations has changed the way clinicians produce all-ceramic dental prostheses, since the more aesthetic multilayered restorations unfortunately are more prone to chipping or delamination. Composite materials processed via CAD-CAM have become an interesting option, as they have intermediate properties between ceramics and polymers and are more easily milled and polished.

[Three-dimensional printing and oral medicine].

After 30 years of development, three-dimensional printing technology has made great progress, and the model and surgical guide have been clinically applied. The three-dimensional printing of titanium and other metal prosthesis and dental crown after adequate research will be applied clinically, and three-dimensional bioprinting and related biological materials need further study. Three-dimensional printing provides opportunities for the development of oral medicine, which will change the way of clinical work, teaching and research. The dentists should integrate multi-disciplinary knowledge and understand the essence of new technology to meet the challenges of the era of digital medicine.

Silicon Nitride (Si3N4) Implants: The Future of Dental Implantology?

For decades titanium has been the preferred material for dental implant fabrication, with mechanical and biological performance resulting in high clinical success rates. These have been further enhanced by incremental development of surface modifications aimed at improving speed and degree of osseointegration and resulting in enhanced clinical treatment options and outcomes. However, increasing demand for metal-free dental restorations has also led to the development of ceramic-based dental implants, such as zirconia. In orthopedics, alternative biomaterials, such as polyetheretherketone or silicon nitride, have been used for implant applications. The latter is potentially of particular interest for oral use as it has been shown to have antibacterial properties. In this article we aim to shed light on this particular biomaterial as a future promising candidate for dental implantology applications, addressing basic specifications required for any dental implant material. In view of available preclinical data, silicon nitride seems to have the essential characteristics to be a candidate for dental implants material. This novel ceramic has a surface with potentially antimicrobial properties, and if this is confirmed in future research, it could be of great interest for oral use.

Zirconia dental implants: where are we now, and where are we heading?

Despite decades of titanium as the gold standard in oral implantology, the search for alternatives has been growing. High esthetic standards and increasing incidence of titanium allergies, along with a rising demand for metal-free reconstructions, have led to the proposal of ceramics as potential surrogates. Following numerous experimental studies, zirconium dioxide (zirconia) has earned its place as a potential substitute for titanium in implantology. Yet, despite zirconia's excellent biocompatibility and tissue integration, low affinity to plaque and favorable biomechanical properties, early failures were significantly higher for zirconia implants than for titanium implants. Technical failure as a result of fracture of the material is also a major concern. So far, zirconia implants have been mainly manufactured as one-piece implant systems because of the material's limitations. Nevertheless, various two-piece systems have been progressively emerging with promising results. Screw-retained abutments are desirable but present a major technical challenge. Innovation and technical advances will undoubtedly lead to further improvement in the reliability and strength of zirconia implants, allowing for novel designs, connections and reconstructions. Additional clinical studies are required to identify all relevant technical and biological factors affecting implant success and patients' satisfaction. However, the evidence for a final verdict is, at present, still incomplete.

Digital technology in fixed implant prosthodontics.

Digital protocols are increasingly influencing prosthodontic treatment concepts. Implant-supported single-unit and short-span reconstructions will benefit mostly from the present digital trends. In these protocols, monolithic implant crowns connected to prefabricated titanium abutments, which are created based on data obtained from an intraoral scan followed by virtual design and production, without the need of a physical master cast, have to be considered in lieu of conventional manufacturing techniques for posterior implant restorations. No space for storage is needed in the complete digital workflow, and if a remake is required a replica of the original reconstruction can be produced quickly and inexpensively using rapid prototyping. The technological process is split into subtractive methods, such as milling or laser ablation, and additive processing, such as three-dimensional printing and selective laser melting. The dimensions of the supra-implant soft-tissue architecture can be calculated in advance of implant placement, according to the morphologic copy, and consequently are individualized for each patient. All these technologies have to be considered before implementing new digital dental workflows in daily routine. The correct indication and application are prerequisite and crucial for the success of the overall therapy, and, finally, for a satisfied patient. This includes a teamwork approach and equally affects the clinician, the dental assistant and the technician as well. The digitization process has the potential to change the entire dental profession. The major benefits will be reduced production costs, improvement in time efficiency and fulfilment of patients' perceptions of a modernized treatment concept.

Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions.

In the 1960s and 1970s, implant-supported prostheses based on subperiosteal or blade implants had a poor reputation because of questionable clinical outcomes and lack of scientific documentation. The change to a scientifically sound discipline was initiated by the two scientific pioneers of modern implant dentistry, Professor P. I. Brånemark from the University of Gothenburg in Sweden and Professor André Schroeder from the University of Bern in Switzerland. Together with their teams, and independently of each other, they laid the foundation for the most significant development and paradigm shift in dental medicine. The present volume of Periodontology 2000 celebrates 50 years of osseointegration. It reviews the progress of implant therapy over the past 50 years, including the basics of implant surgery required to achieve osseointegration on a predictable basis and evolving innovations. The development of bone-augmentation techniques, such as guided bone regeneration and sinus floor elevation, to correct local bone defects at potential implant sites has increased the indications for implant therapy. The paradigm shift to moderately rough implant surfaces resulted in faster and enhanced bone integration and led to improvements in various treatment protocols, such as immediate and early implant placement in postextraction sites, and made various loading protocols possible, including immediate and early implant loading. In the past 15 years, preoperative analysis and presurgical planning improved as a result of the introduction of three-dimensional imaging techniques. Hereby, cone-beam computed tomography offers better image quality with reduced radiation exposure, when compared with dental computed tomography. This opened the door for digital planning and surgical modifications. Over the last 50 years this evolution has facilitated tremendous progress in esthetic outcomes with implant-supported prostheses and improved patient-centered outcomes. This volume of Periodontology 2000 also discusses the current trends and open questions of implant dentistry, such as the potential of digital implant dentistry in the surgical and prosthetic field, the trend for an increasing average age of implant patients and the related adaptations of treatment protocols, and the second attempt to establish ceramic implants using, this time, zirconia as the implant material. Finally, some of the hottest controversies are discussed, such as recent suggestions on bone integration being a potential foreign-body reaction and the evidence-based appraisal of the peri-implantitis debate.

Aspectos fundamentais para o resultado estético em implantes imediatos: uma revisão de literatura / Fundamental aspects for the aesthetic result in immediate implants: a literature review

O objetivo dessa revisão foi buscar na literatura o que há de mais atual no que envolve a implantação imediata (I.I.), abordando aspectos de seleção do paciente, de planejamento, cirúrgicos e protéticos e determinando o tipo de tratamento mais previsível. Para isso, foi realizada uma pesquisa bibliográfica no PUBMED com as palavras-chave esthetic, immediate dental implant e review, totalizando 40 trabalhos. Foram selecionados 23 trabalhos pertinentes ao tema. Posteriormente foram realizadas novas buscas com as palavras-chave atraumatic extraction, connective tissue, bone graft, guided surgery, flapless immediate implant vs flap, socket shield, immediate provisionalization, platform switching, associadas com a palavra-chave immediate implant. Além disso, foram realizadas pesquisa e seleção manual na lista de referências dos trabalhos em questão e também acrescentados uma revisão de literatura na língua portuguesa e trabalhos de 2017 relevantes ao tema, totalizando 72 trabalhos para confecção desta monografia. Com base nesta revisão de literatura, as conclusões foram de que não há consenso sobre o tratamento cirúrgico/protético mais previsível em I.I.; o planejamento digital parece favorecer os resultados da I.I.; o momento de instalação tipo 2 do implante é o tratamento mais previsível; a determinação do remanescente ósseo é fundamental para o planejamento em I.I.; deve-se preferencialmente realizar I.I. em pacientes com fenótipo periodontal espesso; a abordagem cirúrgica sem retalho, o uso de enxerto de tecido conjuntivo subepitelial e o implante imediato com plataforma trocada parecem ter resultados estéticos mais favoráveis; a técnica de preservação radicular associada ao I.I. parece favorecer o resultado estético; o uso de enxerto ósseo no alvéolo durante a colocação de implante imediato permite menor alteração dos volumes teciduais; a provisionalização imediata parece favorecer o resultado estético a curto prazo quando é associada a enxerto ósseo e garante uma manutenção dos volumes de tecido mole

The objective of this review is to search the literature for the most current in what involves immediate implantation (I.I.), addressing aspects of patient selection, planning, surgical and prosthetic and determinants of the type of more predictable treatment...

History and current state of metal adhesion systems used in prosthesis fabrication and placement.

The adhesion techniques used in prosthetic dentistry have substantially improved with respect to retention of veneering resin to the metal framework of resin-veneered restorations and the bonding of resin-bonded fixed partial dentures (RBFPDs) to abutment teeth. In the early 1970s, prostheses relied on macromechanical retention for veneering surfaces and the retention holes of retainers. Later, retention was achieved by using small spherical particles. In addition, the use of small pits created by electrochemical corrosion was tested in resin-veneered restorations and RBFPDs. Thus, micromechanical retention gradually supplanted macromechanical retention. First-generation adhesive monomers were introduced at the end of the 1970s and were succeeded in the early 1980s by the marketing of adhesive resin cements, which were effective for use with non-noble alloys when surface oxidation procedures were used. In 1994, a second-generation adhesive primer for noble alloys was introduced, which prompted development of other adhesive primers. These primers were applied mainly to silver-palladium-copper-gold and type IV gold alloys and improved the reliability of RBFPDs. Recent studies have confirmed the effectiveness of such primers when used with high-gold-content metal ceramic alloys. Due to these developments, RBFPDs now have excellent esthetic characteristics.

Implantes curtos: parâmetros a serem observados no planejamento / Short implants: parameters to be observed in planning

Este trabalho consiste em uma revisão de literatura acerca do uso de implantes curtos como altrenativa para reabilitação oral, principalmente nas regiões posteriores de mandívula e maxila. Muitos pacientes que apresentam reabsorção óssea severa dos maxilares desejam usar próteses fixas suportadas por implantes...

Avaliação da adaptação das infraestruturas metálicas em próteses fixas: monobloco versus solda ( revisão de literatura) / Adaptation assessment of infra structures in fixed prosthesis: monobloco versus welding

A adaptação das infraestruturas metálicas representa um passo fundamental na longevidade das próteses fixas dentossuportadas e, principalmente, implantossuportadas. A comparação dos diferentes métodos de obtenção das infraestruturas se faz necessário para compreendermos as limitações inerentes a cada um desses processos. A literatura atual enfatiza os menores índices de desadaptação das infraestruturas soldadas, em comparação com as infraestruturas em monobloco, apesar de encontrarmos autores que apresentam dados que contestam essa superioridade dos sistemas de solda

Adaptation of metallic infrastruture is a key step in the longevity of dentossuportadas ans mainly implant-fixed prostheses. The comparison between the different methods of obtaining infrastructure is needed to understand the limitations inherent in each of these processes. Current literature emphasizes the smaller indices mismatch welded infrastructure compared with infrastructure one-piece cast, although we found that authors who challenge the superiority of welding systems

Prótese do tipo protocolo de carga imediata

A prótese total sobre implantes, chamada de Protocolo de Branemark, tem sido amplamente utilizada há vários anos e com grande índice de sucesso como alternativa para reabilitação de pacientes com perda total de dentes...