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Background: Angulated screw channel (ASC) abutment allows off-axis dental implants to be used in dental restorations without the need for cementation. As this is a relatively new system, research on its clinical performance is limited. Objectives: To summarize the available in-vitro and in-vivo studies on the mechanical and technical issues associated with the ASC system and compare its clinical performance with that of conventional implant-supported abutments. Methods: A comprehensive literature search in PubMed, Web of Science, and ScienceDirect databases was performed, focusing on articles about angulated (angled) screw channel (ASC) systems published in English between January 2015 and November 2023. Only in-vitro and in-vivo studies were included. Results: After analyzing the recorded articles, 26 studies (11 in vivo and 15 in vitro) were included in the final discussion and review. Conclusion: Although the ASC system is still relatively new, and is presently outperformed by conventional abutment systems in terms of technical and mechanical properties, in short- and medium-term in-vivo studies, it was shown reliable for retaining single or multiple-unit implant restorations in both posterior and anterior zones. Still, further long-term clinical research is needed to fully elucidate the risk factors associated with ASC failures.

This study aimed to investigate the effect of four retention systems for implant-supported posterior crowns under compressive loading using three-dimensional finite element analysis. A morse-taper dental implant (4.1 × 10 mm) was designed with Computer Aided Design software based on non-uniform rational B-spline surfaces. According to International Organization for Standardization 14,801:2016, the implant was positioned at 3 mm above the crestal level. Then four models were designed with different crown retention systems: screw-retained (A), cement-retained (B), lateral-screw-retained (C), and modified lateral-screw-retained (D). The models were imported to the analysis software and mesh was generated based on the coincident nodes between the juxtaposed lines. For the boundary conditions, two loads (600 N) were applied (axial to the implant fixture and oblique at 30°) totaling 8 conditions according to retention design and loading. The von-Mises stress analysis showed that different retention systems modify the stress magnitude in the implant-supported posterior crown. There is a similar stress pattern in the implant threads. However, models C and D presented higher stress concentrations in the crown margin in comparison with A and B. The oblique loading highly increased the stress magnitude for all models. In the simulated conditions, part of the stress was concentrated at the lateral screw under axial loading for model C and oblique loading for model D. The results indicate a possible new failure origin for crown retained using lateral screws in comparison to conventional cement-retained or screw-retained systems.

Statement of problem: The relation between cement color and abutment substrate material and the corresponding effect on the color accuracy of high-transparency pre-colored zirconia (HT-Zr) remains unclear. Purpose: This in-vitro study aimed to investigate the difference in color accuracy when the HT-Zr is bonded to different materials-based substrates with differently colored resin cement. Materials and methods: Vita A1 shade HT-Zr with 1 mm thickness was used as the testing sample. The samples were first placed on zirconia (ZR), tooth color resin (CR), and metallic (MT) abutment substrates. Subsequently, four differently colored cements (translucent (TR), bleach, opaque, and A2 shade (A2)) were used for bonding HT-Zr onto the substrate, and the non-bonded group was used as the control group (CG). There were 15 groups in total (n = 10 per group). A digital colorimeter was used to obtain Commission Internationale de l’Eclairage (CIELab) color parameters. The translucency parameter (TP00) of the substrate and sample, as well as color difference (ΔE00) and chroma (C) between the different groups were calculated. Additionally, the ΔE00 and TP00 were compared with the moderately unacceptable match of ΔE00 = 3.6. The statistical analysis was conducted using ANOVA and Tukey HSD post-hoc test (α = 0.05). Results: HT-Zr exhibited high translucency (TP00 = 11.02 ± 0.18), and the mean ΔE00 of the testing samples ranged between 2.18 ± 0.20 and 13.14 ± 0.31. The ZR-CG and MT-A2 groups showed the highest and lowest lightness separately. The CR-CG group exhibited the highest C, and the ΔE00 was lower than that of 3.6. The MT-TR group showed the lowest C and the highest ΔE00. The inter-group comparison revealed that the ΔE00 for different cement is mostly lower than the acceptable color match of 1.0; moreover, the ΔE00 for all the substrates, excluding the CG group, is higher than 3.6. Conclusions: The abutment substrate materials and the cement color should be considered with caution when using HT-Zr, with the effect of abutment substrate materials being more apparent in color accuracy. HT-Zr restorations are not recommended for discolored or bleached abutments but only for natural-colored abutments to achieve the optimal color appearance.

Objectives: To present the clinical results obtained using a novel coded healing abutment (CHA)., Methods: We evaluated 103 patients with fixed implant-supported zirconia restorations (90 single crowns, 26 partial dentures, and 6 full arches) manufactured via computer-aided-design/computer-assisted-manufacturing and starting from the point of intraoral scans of novel CHAs (i-Physio®, LYRA-ETK, Sallanches, France). Patients were followed for one year. We assessed the clinical precision of the final restorations at delivery (quality, fit, and occlusal and interproximal contacts), as well as hard and soft tissues stability and patient satisfaction at the one-year follow-up. All complications were recorded., Results: The quality of the restorations was high, with satisfactory marginal fits (96.8% of the cases), occlusal contacts (95.1%), and interproximal contacts (94.3%). Excellent hard and soft tissues stability were found at the one-year follow-up assessment, with few complications (0.9% biological, 4.9% mechanical, and 1.6% technical) for an overall restoration success rate of 92.3% at the patient level and 91.9% at the restoration level. Patient satisfaction was high., Conclusions: Within the limits of this study (retrospective design, short follow-up time) this novel CHA, with high prosthetic precision and esthetics, was clinically reliable and promoted hard and soft tissue stability. Further studies on a larger sample of patients and a longer follow-up period are needed to confirm these preliminary clinical outcomes., Clinical Relevance: High prosthetic precision can be achieved when scanning CHAs. CHAs simplify digital impressions, reduce the manipulation of soft tissues, and prepare them for scanning, thereby promoting tissue healing and stability over time. Additionally, CHAs can serve as temporary abutments for immediate, nonfunctional loading., Competing Interests: Declaration of competing interest The authors report no conflict of interest for the preparation of this study., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: To investigate the accuracy (trueness and precision) of wireless and wired intraoral scanners (IOSs) when scanning an implant with the combined healing abutment-scan body (CHA-SB) system., Methods: A partially edentulous mandibular model with a CHA-SB at the right first molar site was digitized with 2 wireless (NeoScan 2000 (NW) and TRIOS 4 wireless (T4 W)) and 2 wired (NeoScan 1000 (N) and TRIOS 4 wired (T4)) IOSs 44 times in total (n = 11). The reference scan file was generated by digitizing the same master model and CHA-SB with an industrial-grade optical scanner. All files were imported into a metrology-grade analysis software program to evaluate the surface (root mean square, RMS), linear, and angular deviations of the top part of the SB. The average deviation values defined the precision of the scans. The data were statistically analyzed (α = 0.05)., Results: IOS type affected the surface and angular deviations and the precision (linear deviations on the x-axis) of the scans (p ≤ 0.043). T4 W had lower RMS than N and T4 (p ≤ 0.031). T4 had higher angular deviations than N on the XZ plane and had the lowest angular deviations on the YZ plane (p ≤ 0.011). T4 W scans had higher precision than N scans (p = 0.024)., Conclusion: Despite some differences in the trueness or precision of scans, tested IOSs mostly enabled similar scan accuracy. Regardless of the IOS, the implant scans had a tendency to tilt mesiobuccally, which can be considered clinically small., Clinical Significance: Tested wireless intraoral scanners may be suitable alternatives to their wired counterparts while digitizing an implant with a combined healing abutment-scan body system in the posterior region. However, the crowns fabricated from tested scans might require buccal, mesial, and occlusal surface veneering and distal surface adjustments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: To digitally evaluate the trueness and fit of additively and subtractively manufactured fixed complete dentures in materials intended for definitive use., Methods: An edentulous maxillary model with implants at the left first molar, left canine, right canine, and right first molar site was digitized and a fixed complete denture was designed. This design was used to fabricate fixed dentures in an additively manufactured resin for definitive use (AM), a high-impact polymer composite (SM-CR), and a strength gradient zirconia (SM-ZR) (n = 10). Each fixed denture was digitized and the surface (overall, occlusal, except occlusal, and abutments), linear, and interimplant distance deviations were analyzed. The fit was assessed with the triple-scan protocol. Data were analyzed with Welch analysis of variance and Games-Howell tests (α = 0.05)., Results: SM-ZR led to lower overall deviations than AM, which had the highest occlusal and the lowest abutments deviations (P ≤ 0.007). SM-ZR had the lowest occlusal and SM-CR had the highest except occlusal deviations (P ≤ 0.002). AM mostly had higher linear and SM-CR mostly had higher interimplant distance deviations (P ≤ 0.043). AM led to the highest marginal gap at the left canine site, while SM-CR had the highest and SM-ZR had the lowest gaps at the right canine site (P ≤ 0.022)., Conclusions: SM-ZR dentures mostly had trueness and marginal fit similar to or better than the other groups. Tested fixed complete dentures were mostly smaller than the design file in terms of interimplant distances., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study aimed to evaluate the accuracy of computer-aided design and computer-aided manufacturing (CAD-CAM)-assisted templates (CCAT), guiding rod templates (GRT), and freehand (FH) preparation of guide planes., Methods: Forty-five identical maxillary resin casts were divided into three groups, in which the guide planes of the two abutment teeth were prepared using a CCAT (n=15), GRT (n=15), and FH (n=15). The CCAT and GRT were digitally designed on a digital cast of virtually prepared guide planes and fabricated using three-dimensional printing (3DP) technology. To assess the 3D trueness, the prepared guide planes were digitally scanned and compared to the virtually designed guide planes. The angle deviation was measured to assess the trueness of the direction of the guide plane preparation. Shapiro-Wilk and Levene's tests were used to check the normality and equivalence of the variance of the data. The data were compared by using the Kruskal‒Wallis H test (α=0.05)., Results: The CCAT group exhibited significantly better 3D trueness (78.5±19.8 μm) than the GRT group (211.3±42.4 μm, p<0.05) and the FH group (198.9±44.3 μm, p<0.05). Additionally, the CCAT group (1.31±0.50°) showed significantly smaller direction trueness compared to the GRT (4.65±0.72°, p<0.05) and FH (5.64±0.70°, p<0.05) groups., Conclusions: The novel CAD-CAM-assisted template significantly improved the quality of the guide planes compared with the GRT and FH procedures. This enhancement suggests that removable partial dentures can be predictably inserted immediately after guide plane preparation., Clinical Significance: CAD-CAM-assisted templates improve the quality of guide plane preparation., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: To evaluate the fracture resistance (FR) of polyetheretherketone (PEEK) abutments produced by additive and subtractive methods compared to milled zirconia abutments., Methods: Custom abutments were designed on Ti-base abutments and produced from three different materials, namely additively manufactured PEEK (PEEK-AM), subtractively manufactured PEEK (PEEK-SM), and zirconia (N = 60). PEEK-AM abutments were printed using PEEK filaments (VESTAKEEP®i4 3DF-T, Evonik Industries AG) on a M150 Medical 3D Printer (ORION AM) by fused filament fabrication (FFF). All surface treatments were carried out according to the manufacturer's instructions. All abutments were cemented on Ti-bases with hybrid abutment cement and then restored with milled zirconia crowns. Each subgroup was divided into non-aged and aged subgroups (n = 10). The aged groups were subjected to thermomechanical aging (49 N, 5-55 °C, 1.2 million cycles). FR tests were performed by using an universal testing machine. Data were statistically analyzed with one-way and two-way ANOVA and t-test., Results: The survival rate of the specimens after aging was determined as 100%. It was found that both the material and aging had a significant effect on the FR (p<.001). There was a statistical difference among the fracture values of the groups (p<.001). In both the aged and non-aged groups, PEEK-AM showed the statistically lowest FR, while the highest FR was seen in the zirconia group, which was significantly higher than the PEEK-SM (p<.001)., Conclusion: Hybrid abutments were successfully manufactured, and extrusion-based processed PEEK seems to be a good alternative to subtractive processed PEEK. However, since subtractive manufacturing still appears to be superior, further developments in additive manufacturing are needed to further improve the quality of 3D-printed PEEK parts, especially in terms of accuracy and bonding between adjacent layers., Clinical Significance: Additively manufactured PEEK abutments have the potential to be an alternative for implant-supported restorations in the posterior region., Competing Interests: Declaration of competing interest All other authors have no conflicts of interest to declare. The authors do not have any financial interest in the companies whose materials are included in this article., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To assess radiographic, clinical and patient-reported outcomes of single zirconia implant-supported crowns on titanium base abutments (TBA) over a 7.5-year period., Methods: Twenty-four patients received bone-level titanium implants and screw-retained zirconia implant crowns utilising TBA. Marginal bone level (MBL), clinical parameters (probing depth-PD, bleeding on probing-BoP, plaque control record-PCR), technical complications (USPHS criteria) and patient satisfaction were assessed at crown delivery (baseline), 1 year (FU-1) and at 7.5 years (FU-7.5) of follow-up., Results: Eighteen patients were available for re-examination at 7.5 years. The mean MBL at FU-7.5 (0.35 ± 0.20mm) did not significantly change compared to baseline (0.54 ± 0.39, p=.352) and to FU-1 (0.54 ± 0.45mm, p=0.524). From baseline to 7.5 years, the mean PD increased significantly, from 3.0 ± 0.6mm to 3.7 ± 0.8mm (p=0.005). However, BoP and PCR did not significantly change; (BOP: from 27.1 ± 20.7% to 25.0 ± 20.0%, p=0.498; PCR: from 11.1 ± 21.2% to 25.0 ± 25.1%, p=0.100). Nine patients presented with more than one bleeding site. This denoted a peri-implant mucositis prevalence of 50%, whilst none of the implants presented peri-implantitis. One incidence of minor and major ceramic chipping were reported on 2 out of the 18 crowns, resulting in a prosthetic survival rate of 94.4%. Seventeen patients were highly satisfied with their result., Conclusion: Single implant-supported zirconia crowns on TBA displayed: (i) minor number of technical complications, (ii) high prosthetic survival rate, (iii) stable marginal bone level and (iv) high patient satisfaction at 7.5 years., Clinical Implications: Titanium base abutments despite their high use in clinical practice, lacked medium- and long-term studies. The presented findings highlight their clinical performance at 7.5 years as they display satisfying radiographic, clinical and patient-related outcomes. TBA appear to be a suitable abutment choice for medium-term implant-supported restorations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study compared the accuracy of seven intraoral scanners (IOS) by the virtual-fit method., Methods: Four maxillary arches with tooth abutments were scanned with an industrial reference scanner (n=1) and by Aoralscan3, EmeraldS, Helios600, Lumina, Mediti700, Primescan, and Trios5 IOSs (each n=12). Two complete-arch fixed frameworks were designed on each IOS scan with a 70 µm (group 70) and a 90 µm internal cement space (group 70+20, additional 20 µm at the margin). The virtual-fit method was comprised of superimposing the framework designs onto the reference scan using a non-penetrating algorithm simulating the clinical try-in. Internal and marginal gaps were measured. Precision was estimated by the mean absolute errors (MAE)., Results: In group 70, Mediti700 (43 µm), Primescan (42 µm), and EmeraldS were in the best homogenous subset for the marginal gap, followed by the Lumina (67 µm), Aoralscan3 (70 µm), and Trios5 (70 µm), whereas Helios600 (118 µm) was in the third subset. Based on the MAE at the margin, Mediti700, Trios5, and EmeraldS were in the first-best homogenous subset, followed by Primescan. Lumina and Helios600 were in the third subset, and Aoralscan3 was in the fourth subset. In group 70+20, the marginal gap was significantly decreased for Lumina and Aoralscan3, whereas MAE significantly decreased for EmeraldS and Aoralscan3. The rank of IOSs was similar for the internal gap., Conclusion: EmeraldS, Mediti700, Primescan, and Trios5 meet the marginal and internal fit criteria for fixed tooth-borne complete arch restorations. Increasing the cement space during design could enhance restoration fit., Clinical Significance: The virtual-fit alignment method can effectively evaluate the accuracy of different intraoral scanners, offering valuable clinical guidance for distinguishing among them. Recent software and hardware versions of long-standing IOS manufacturers are suitable for fabricating complete arch restoration., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: Tooth preparation is complicated because it requires the preparation of an abutment while simultaneously predicting the ideal shape of the tooth. This study aimed to develop and evaluate a system using augmented reality (AR) head-mounted displays (HMDs) that provide dynamic navigation capabilities for tooth preparation., Methods: The proposed system utilizes optical see-through HMDs to overlay digital information onto the real world and enrich the user's environment. By integrating tracking algorithms and three-dimensional modeling, the system provides real-time visualization and navigation capabilities during tooth preparation by using two different visualization techniques. The experimental setup involved a comprehensive analysis of the distance to the surface and cross-sectional angles between the ideal and prepared teeth using three scenarios: traditional (without AR), overlay (AR-assisted visualization of the ideal prepared tooth), and cross-sectional (AR-assisted visualization with cross-sectional views and angular displays)., Results: A user study (N = 24) revealed that the cross-sectional approach was more effective for angle adjustment and reduced the occurrence of over-reduction. Additional questionnaires revealed that the AR-assisted approaches were perceived as less difficult, with the cross-sectional approach excelling in terms of performance., Conclusions: Visualization and navigation using cross-sectional approaches have the potential to support safer tooth preparation with less overreduction than traditional and overlay approaches do. The angular displays provided by the cross-sectional approach are considered helpful for tooth preparation., Clinical Significance: The AR navigation system can assist dentists during tooth preparation and has the potential to enhance the accuracy and safety of prosthodontic treatment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: To evaluate the bone changes around equicrestal and subcrestal implants, analyzing the effect of abutment height [short abutments (SA < 2 mm) and long abutments (LA > 2 mm)] and the three components of the peri‑implant soft-tissue phenotype., Methods: Twenty-six patients received 71 implants that were placed according to supracrestal tissue height (STH) in an equicrestal (n = 17), shallow subcrestal ≈1 mm (n = 33), or deep subcrestal ≈2 mm (n = 21) position. After 3 months of healing, rehabilitation was completed using metal-ceramic crowns on multi-unit abutments of 1.5 mm, 2.5 mm, or 3.5 mm in height, depending on the prosthetic space and STH. Longitudinal clinical parameters (STH, mucosal thickness, and keratinized mucosa width) and radiographic data [bone remodelling and marginal bone loss (MBL)] were collected at 3, 6, 12, and 24 months postsurgery., Results: The gain in STH was significantly greater around the implants placed in a subcrestal ≈2 mm position. After 2 years, the mean change in bone remodelling in the SA group was significantly greater than in the LA group. According to the multiple linear regression, bone remodelling depends primarily on abutment height (β = -0.43), followed by crestal position (β = 0.34), and keratinized mucosa width (β = -0.22), while MBL depends on abutment height (β = -0.37), and the patient's age (β = -0.36)., Conclusions: Implants placed in an equicrestal or subcrestal ≈1 mm position with LA undergo less bone remodelling, while the lowest level of MBL occurs in subcrestal ≈2 mm implants with LA. Differing soft-tissue thicknesses combined with the use of either SA or LA produced significant intergroup differences in bone remodelling and MBL., Clinical Significance: Abutment height is the most powerful predictor variable affecting bone remodelling and MBL. Depending on the dimensions of the peri‑implant soft-tissue phenotype, placing the implants subcrestally may also be a viable option to decrease bone remodelling and, consequently, reduce MBL., Clinical Trial Registration: identification number: NCT05670340., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: To evaluate the clinical conditions of single-unit posterior restorations on teeth prepared without finishing line, after 5.6 years of clinical service., Materials and Methods: 50 crowns (25 zirconia-based (Zr) and 25 porcelain-fused-to-metal (PFM)) were selected from 34 patients. The restorations were evaluated according to the California Dental Association (CDA) Quality Criteria, and periodontal variables were studied in the abutment teeth compared with the unrestored contralateral teeth. Variables were examined using Mann-Whitney and Pearson´s Chi-Square tests (α = 0.05). The success of the prosthesis was calculated using Kaplan-Meier test., Results: CDA Quality Criteria was considered satisfactory-excellent in all restorations except for one of them, due to chipping on a PFM crown. At, 66 months, the success rates for PFM and Zr crowns were 85.7 % and 100 %, respectively. The plaque index (PI) showed that the restored abutment teeth accumulated significantly less plaque than the control teeth, but the gingival index (GI) was statistically higher in the abutment teeth. In 80 % of cases the probing depth (PB) was ≤3 mm. In addition, in 21 % of the cases, gingival recession was less than 2 mm. The restoration material had a statistically significant effect on GI and PB, with Zr crowns showing less inflammation and less deep pockets than PFM restorations. On the contrary, greater gingival recession was found at the margins of the Zr crowns when compared to the PFM. No statistical differences were found between the two materials in the GI., Conclusions: Cemented crowns on vertical preparations show good clinical behavior after 5 years. The periodontal parameters (PI, GI, PD) of the Zr restorations are significantly better than those of PFM, with the exception of gingival recession., Clinical Relevance: The use of restorations on vertically prepared teeth is a suitable alternative to classical horizontal preparations., Competing Interests: Declaration of competing interest Mario Gonzalez-Bonilla declares that he has no conflict of interest. Santiago Berrendero declares that he has no conflict of interest. Belen Moron-Conejo declares that she has no conflict of interest. Francisco Martinez-Rus declares that he has no conflict of interest. Maria Paz Salido declares that she has no conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study aimed to enhance gingival fibroblast function and to achieve antibacterial activity around the implant abutment by using a zinc (Zn)-containing bioactive glass (BG) coating., Methods: 45S5 BG containing 0, 5, and 10 wt.% Zn were coated on zirconia disks. The release of silica and Zn ions in physiological saline and their antibacterial effects were measured. The effects of BG coatings on human gingival fibroblasts (hGFs) were assessed using cytotoxicity assays and by analyzing the gene expression of various genes related to antioxidant enzymes, wound healing, and fibrosis., Results: BG coatings are capable of continuous degradation and simultaneous ion release. The antibacterial effect of BG coatings increased with the addition of Zn, while the cytotoxicity remained unchanged compared to the group without coatings. BG coating enhances the expression of angiogenesis genes, while the Zn-containing BG enhances the expression of antioxidant genes at an early time point. BG coating enhances the expression of collagen genes at later time points., Conclusions: The antibacterial effect of BG improved with the increase in Zn concentration, without inducing cytotoxicity. BG coating enhances the expression of angiogenesis genes, and Zn-containing BG enhances the expression of antioxidant genes at an early time point. BG coating enhances the expression of collagen genes at later time points., Clinical Significance: Adding 10 wt% Zn to BG could enhance the environment around implant abutments by providing antibacterial, antioxidant, and anti-fibrotic effects, having potential for clinical use., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: Multilayer monolithic zirconia (M-Zr) crowns can be engineered to achieve gradational translucency and color intensity. However, this modification may compromise the mechanical strength, raising concerns regarding the ability of M-Zr crowns to withstand occlusal stresses. The effects of M-Zr crown thickness on translucency and ability to endure occlusal forces were investigated at different tooth positions (incisors, premolars, and molars). The objective was to determine the minimal thickness of M-Zr crowns used in tooth preparation to meet aesthetic and functional demands., Methods: M-Zr samples (Vita A1) with four thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were prepared and subjected to translucency testing using a digital colorimeter by 3-third and 9-square division methods. Crown-shaped M-Zr samples with three thicknesses (1.0, 1.5, and 2.0 mm) and three tooth positions (incisor, premolar, and molar) were digitally designed, and 2.0 mm metal abutments were fabricated. The samples were bonded to the abutments; their fracture characteristics were evaluated using a universal testing machine, and their fracture surfaces examined using an optical microscope. Statistical analyses included the Shapiro-Wilk test, Pearson correlation, and one-way and two-way ANOVA with a post hoc Tukey HSD test (α = 0.05)., Results: Color analysis results revealed a significant negative correlation between thickness and translucency (r < -0.96, P < 0.01), with the highest values in the incisal region. Cross-sectional profiles confirmed the uniform thickness and morphology of the digitally designed M-Zr crowns. The results of fracture strength analysis showed position-dependent variability, a strong positive correlation with thickness (r > 0.96, P < 0.01), and fracture strengths consistently exceeding 1200 N across all tooth positions. Fracture patterns indicated that thinner crowns at the incisors and molars were more prone to cracking, whereas those at the premolars demonstrated significantly higher strength (4872.51 N, P < 0.05), only with crack or even no fracture occurring at 2.0 mm., Conclusions: Thickness significantly influenced both the translucency and fracture strength of M-Zr, with the tooth position playing an additional role, albeit to a lesser extent. Although thinner crowns exhibited lower strength at each tooth position, even at a thickness of 1.0 mm, fracture strength exceeding 1200 N was maintained, surpassing the typical occlusal forces. Thus, it can be asserted that M-Zr crowns with a minimum thickness of 1.0 mm can meet both aesthetic and functional requirements., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: To evaluate whether post-milling firing and material type affect the fabrication trueness and internal fit of lithium disilicate crowns., Methods: A prefabricated cobalt chromium abutment was digitized to design a mandibular right first molar crown. This design file was used to fabricate crowns from different lithium disilicate ceramics (nano-lithium disilicate (AM), fully crystallized lithium disilicate (IN), advanced lithium disilicate (TS), and lithium disilicate (EX)) (n = 10). Crowns, the abutment, and the crowns when seated on the abutment were digitized by using an intraoral scanner. Fabrication trueness was assessed by using the root mean square method, while the internal fit was evaluated according to the triple scan method. These processes were repeated after the post-milling firing of AM, TS, and EX. Paired samples t-tests were used to analyze the effect of post-milling firing within AM, TS, and EX, while all materials were compared with 1-way analysis of variance and Tukey HSD tests (α = 0.05)., Results: Post-milling firing reduced the surface deviations and internal gap of AM and EX (P ≤ 0.014). AM mostly had higher deviations and internal gaps than other materials (P ≤ 0.030)., Conclusions: Post-milling firing increased the trueness and internal fit of tested nano-lithium disilicate and lithium disilicate ceramics. Nano-lithium disilicate mostly had lower trueness and higher internal gap; however, the maximum meaningful differences among tested materials were small. Therefore, the adjustment duration and clinical fit of tested crowns may be similar., Clinical Significance: Tested lithium disilicate ceramics may be suitable alternatives to one another in terms of fabrication trueness and internal fit, considering the small differences in measured deviations and internal gaps., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study aimed to evaluate the accuracy of an intraoral scanner (IOS - Medit i700) on tooth abutments with vertical preparations at 2 depths below the free gingival margin, and to determine if the IOS can reproduce the area beyond the finish surface of the tested preparation geometry., Methods: Two abutments for a maxillary first molar were designed by means of CAD software, with vertical preparations set at 1 and 2 mm below the gingiva. These abutments were subsequently printed in resin and placed on a reference model. The reference files consisted of scans made using a metrological machine on these abutments. Ten scans were made with the tested IOS on each sample, resulting in two study groups. The scans from the experimental groups were labeled "V-1″ for vertical preparation at 1 mm below the gingival margin and "V-2″ for 2 mm below. The analysis of these scans was performed using Geomagic Control X (3D SYSTEMS) to assess their trueness and precision in µm. Descriptive statistics with a 95 % confidence interval were employed, alongside independent sample tests, to ascertain any differences between the groups (α=0.05)., Results: Statistically significant differences were not found both for trueness (p=.104) and precision (p=.409), between the tested geometries. The mean values for trueness were V-1 = 37.5[31.4-43.6]; V-2 = 32.6[30.6-34.6]. About the precision, the mean values were V-1 = 20.5[8.4-32.5]; V-2 = 18.4[8.2-28.5]. In both the study groups, it was possible to detect the surface beyond the finish area., Conclusions: Within the limitations of this study, vertical preparation design allows for registration of the tooth anatomy beyond the finish area with IOS. Moreover, the mean accuracy values were clinically acceptable at both 1 and 2 mm below the gingival margin., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: To evaluate the repositioning accuracy of the implant- and abutment-level impression components (impression abutments and implant scan bodies) and implant abutments (with and without anti-rotational hex index); also, to estimate the tightening torque influence on the positional stability of abutments., Methods: Seven types of prosthetic components (n = 7) [impression pick-up copings (PC), implant scan bodies (ISB), non‑hex and hex titanium base implant abutments (TB H and TB NH), multi-unit impression copings (MU PC), multi-unit implant scan bodies (MU ISB), and multi-unit caps (MU C) (Medentika GmbH)] were tested. For repositioning accuracy tests a coordinate measuring machine (CMM) was used. During assembly 15 Ncm torque for all components was applied. After measurement, only hex and non‑hex abutments were torqued to 25 Ncm and their coordinates were again recorded to assess torque influence. The procedure was repeated 7 times for each component. Linear and 3D deviations, angulation to the vertical axis, and axial rotation were calculated. The Kruskal-Wallis test was used to compare the measurements between the groups. A post-hoc test (Mann-Whitney U test) was used for pairwise comparison to determine the influence of the torque (α=0.05)., Results: Implant- and abutment-level components used for digital scans showed different positional discrepancies compared to ones used for conventional impressions and ranged from 10 to 37 µm. Hex abutments demonstrated statistically significantly lower 3D deviations (4.4 ± 7.1 µm) compared to non‑hex abutments (8.7 ± 6.1 µm). Torque influence was significantly lower for hex abutments than for non‑hex abutments., Conclusions: Repositioning inaccuracies were found in all implant- and abutment-level impression components (impression abutments and implant scan bodies) and all abutments (with and without anti-rotational hex index) tested. Final tightening of the components could cause further positional discrepancies., Clinical Significance: The misfit of the prosthetic components used in conventional and digital workflows stays in the clinically acceptable range. Even when multiple connections and disconnections on the track of the laboratory preparation is needed, it should not have a negative influence for single teeth reconstructions. However, in the complex cases with multiple implants, repetitive repositioning of the prosthetic components may lead to the accumulation of vertical, horizontal and rotational errors leading to the clinical problems with the passive fit of the final framework., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Purpose: The objective of this study was to compare patient-reported outcomes (PROs) of peri‑implant soft tissue inflammation and aesthetics around single-tooth implants in the anterior maxillary region with three different implant-abutment interface designs., Methods: Participants were randomized to one of three different types of implant-abutment interface designs [Conical (CI), flat-to-flat (FI), and Platform Switched (PS)]. Implants and provisional crowns with prefabricated titanium abutments were placed 5 months following extraction and/or ridge augmentation. Permanent ceramic crowns with zirconia abutments were placed after 12 weeks. To assess PROs, appearance and inflammation questionnaires were completed from provisional crown placement to the 3-year follow-up., Results: Tooth appearance at the 3-year follow-up revealed a difference amongst CI, FI and PS implants (p=0.049; Kruskal-Wallis test). PS was rated better than FI (p=0.047) at 1 year for appearance of soft-tissue and satisfaction with colour. There were no differences for self-consciousness, smile and pain/discomfort while eating/hard food items., Conclusions: Although participants tended to rate the health of mucosa around PS implants as slighty better than the other two implant systems, the differences were minimal and inconsistent. Thus, patient satisfaction in terms self-perceived gingival health and esthetics was high for all 3 systems tested, suggesting that patients are unable to detect mucosal inflammation., Clinical Significance: Patients find it difficult to perceive mucosal inflammation; hence, it is recommended that patients attend implant follow-up visits, even if they do not perceive inflammation. The study suggests that there is a relationship between the PROs and the clinical outcomes of tested implants., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Ltd.)

Objectives: This study aimed to evaluate implants from different manufacturers and determine whether implant-healing abutment interface has a significant impact on implant seal., Methods: An air-injection pressure measurement test was performed on implants with either line-contact (modified TSIII [TSM] and Bone Level Tapered [BLT]) or partial face-contact (BlueDiamond [BD], SuperLine [SL], ISII, and UFII) interface design from 6 different manufacturers. Forty implants per implant type were analysed. Pressure data were evaluated with Kruskal-Wallis test and Dunn's post hoc analysis (statistical significance was set at P < .05)., Results: BLT implants leaked when the mean pressure was increased to 199.9 kPa. The following implants showed mean leakage pressures of 182.9 (TSM), 157.4 (BD), 112.9 (SL), 101.8 (ISII), and 30.6 (UFII). There was a significant difference between line-contact and partial face-contact implants (P < .001)., Conclusions: The implant interface design has a significant impact on implant microbial leakage. Implants with a line-contact interface exhibited a higher resistance to leakage than those with partial face-contact., Competing Interests: Conflict of interest None disclosed., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: Numerous studies investigating the survival time of post and cores have found that loss of retention is the most common cause of failure Nevertheless, investigations focusing on decementation, survival after recementation, and the influencing parameters in a large number of patients with long follow-up periods are lacking. Therefore, the aim of this short communication article is the survival analysis of post and cores after recementation and repeated loss of retention., Materials and Methods: During the observation period (2004-2020), 653 patients received 953 post and cores. From these, 112 post and cores which suffered loss of retention were selected. The patient files were analysed for the following parameters: Type of covering prosthetic restoration, location, type of tooth, luting material, post and core material, bone attachment and therapist. The survival time until loss of retention or repeated decementations after recementation was documented. Survival probability was assessed using Kaplan-Meier and Cox regression analyses., Results: The average time until decementation was 13.33 years. The cumulative decementation rate was 11.8%, while in 42.0% of the cases, post and cores showed multiple losses of retention. A significant influence (Kaplan-Meier analysis) was recorded for the type of covering prosthetic restoration, type of tooth, luting material, post and core material and bone attachment. The multifactorial survival analysis (Cox regression) showed a significant influence of patient's age and the type of covering prosthetic restoration., Conclusions: Once decementation occurs, recementation neither guarantees definitive fit nor necessarily predetermines repeated decementations., Clinical Significance: Post and cores should be avoided under primary crown-retained removable partial dentures (RPD). If this treatment is inevitable, a continuous follow-up is necessary to check the denture for proper fit to the tissues to prevent overloading on the post and core., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: To test the failure load and failure mode of a novel implant-crown interface specifically designed for the fabrication of fully personalized, abutment-free monolithic zirconia CAD-CAM crowns compared to conventional implant-abutment interfaces involving prefabricated or centrally manufactured abutments for zirconia CAD-CAM crowns., Methods: Implants (N=48) were divided into groups (n=12) according to different implant-abutment interface designs: (1) internal implant connection with personalized, abutment-free CAD-CAM crowns (Abut-Free-Zr), (2) internal conical connection with customized, centrally manufactured zirconia CAD-CAM abutments (Cen-Abut-Zr), (3) prefabricated titanium base abutments from manufacturer 1 (Ti-Base-1), (4) additional prefabricated titanium base abutments from manufacturer 2 (Ti-Base-2). All specimens were restored with a screw-retained monolithic zirconia CAD-CAM molar crown and subjected to thermomechanical aging (1.200.000 cycles, 49 N, 1.67 Hz, 30° angulation, thermocycling 5-50°C). Static load until failure was applied in a universal testing machine. Failure modes were analyzed descriptively under digital microscope. Mean failure load values were statistically analyzed at a significance level of p<0.05., Results: All specimens survived thermomechanical aging. The mean failure loads varied between 1332 N (Abut-Free-Zr) and 1601 N (Ti-Base-2), difference being significant between these groups (p<0.05). No differences between the other groups were seen. The predominant failure mode per group was crown fracture above implant connection (Abut-Free-Zr, 75%), abutment fracture below implant neck (Cen-Abut-Zr, 83%), crown fracture leaving an intact abutment (Ti-Base-1/Ti-Base-2 100%)., Conclusions: Implant-crown interface with fully personalized, abutment-free monolithic CAD-CAM zirconia crowns exhibited similar failure loads as conventional implant-abutment interfaces (except group Ti-Base-2) involving CAD-CAM crowns with prefabricated or centrally manufactured abutment., Clinical Significance: The new implant connection simplifies the digital workflow for all-ceramic implant reconstructions. The specific design of the implant-crown interface allows the fabrication of fully personalized, abutment-free zirconia implant crowns both in-house and in-laboratory without the need of a prefabricated abutment or central manufacturing., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Evaluate the effect of aging using two different methods on the three-dimensional fit of zirconia abutments at the implant-abutment connection and estimate the probability of survival of anterior crowns supported by straight and 17-degree angled abutments., Materials and Methods: Two different zirconia abutment designs, straight and 17-degree angled abutments (n = 63/group), were evaluated in the current study. The abutments were randomly allocated into three experimental groups according to laboratory aging condition (134°C, 2.2 bar, 20 h): (i) control, (ii) autoclave aging, and (iii) hydrothermal reactor aging. Crystalline content was determined by X-Ray diffraction (XRD) and Raman spectroscopy, and microstructure was analyzed using field-emission gun scanning electron microscope (FEG-SEM). Implant-abutment volume misfit was determined in the straight abutments by micro-computed tomography using the silicone replica technique. For fatigue testing, abutments were torqued to the implants and connected to standardized maxillary incisor zirconia crowns. The assemblies were subjected to step-stress accelerated life testing (SSALT) in water until fracture or suspension. The use level probability Weibull curves and probability of survival for a mission of 50,000 cycles at 50, 100, 150 and 200 N were calculated and plotted. Fractured samples were analyzed using a stereomicroscope and scanning electron microscope., Results: The crystalline spectra depicted a zirconia system primarily composed of the tetragonal phase. Laboratory aging yielded a 20%- and 37%-increase in the monoclinic content for abutments aged in autoclave and hydrothermal reactor relative to control, respectively. A fully crystalline matrix with a regular grain size was observed in the FEG-SEM for control abutments, with a considerable presence of intergranular defects. While autoclave aging triggered no significant alteration to the microstructure, defect population was reduced after hydrothermal reactor aging. Control abutments presented a significantly higher volume misfit (2.128 ± 0.54 mm 3 ) relative to aged abutments using autoclave (1.244 ± 0.48 mm 3 ) or hydrothermal reactor (1.441 ± 0.41 mm 3 ). The beta (β) values indicated that failures were predominantly controlled by material strength rather than fatigue damage accumulation for all groups, except for straight control abutments. Irrespective of aging, the probability of survival of straight and angled zirconia abutments was up to 95% (95-100%) at 50 and 100 N. A 50N-increase in the load resulted in wider range of survival estimate, with straight autoclave abutments percentage significantly lower probability of survival (77%) than angled hydrothermal reactor abutments (99%). At 200N, angled hydrothermal reactor (97%) or autoclave (82%) aged abutments demonstrated the highest probability of survival, angled control (71%) and straight hydrothermal reactor (69%) abutments intermediate values, and straight autoclave (23%) and control (7%) abutments the lowest estimate. The failure mode predominantly involved abutment and/or abutment screw fracture for both straight and angled abutments., Conclusions: Hydrothermal aging significantly influenced volume misfit, as well as the probability of survival of zirconia abutments at higher loads for both angled and straight abutments., (Copyright © 2021. Published by Elsevier Ltd.)

Osseointegration at the bone-implant interface and soft tissue integration (STI) at the trans-mucosal region are crucial for the long-term success of dental implants, especially in compromised patient conditions. The STI quality of conventional smooth and bio-inert titanium-based implants is inferior to that of natural tissue (i.e. teeth), and hence various surface modifications have been suggested. This review article compares and contrasts the various modification strategies (physical, chemical and biological) utilized to enhance STI of Ti implants. It also details the STI challenges associated with conventional Ti-based implants, current surface modification strategies and cutting-edge nano-engineering solutions. The topographical, biological and therapeutic advances achievable via electrochemically anodized Ti implants with TiO 2 nanotubes/nanopores are highlighted. Finally, the status and future directions of such nano-engineered implants is discussed, with emphasis on bridging the gap between research and clinical translation., Competing Interests: Declaration of Competing Interest None., (Copyright © 2021 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Objectives: This retrospective, single-center, practice-based cohort study aimed to analyze the longevity of direct fiber reinforced composite fixed partial dentures (DFRC-FPD) and to analyze factors influencing their survival and success., Methods: Within one private practice 100 DFRC-FPD were directly applied. The preparation of a proximal cavity was limited to abutment teeth with an existing filling (minimal-invasive approach). All intact enamel surfaces were preserved (micro-invasive approach). DFRC-FPD were reinforced by fiber-splints with semi polymer network matrices (Everstick C + B©). At the last follow-up DFRC-FPD were considered successful if they were still in function without any need of therapy. DFRC-FPD were considered as survived if they were repaired or replaced. Multi-level Cox proportional hazard models were used to evaluate the association between clinical factors and time., Results: Within a mean follow-up period (range) of 53 (2-109) months 7 bridges did not survive (cumulative survival rate: 93%) and further 24 bridges had received a restorative follow-up treatment (cumulative success rate: 69%). The annual failure rate was 1.6% for survival and 8.3% for success. The main failure type was fracture of the composite material (n = 30). In multivariate analysis no significant predictor could be found for success and survival., Conclusions: For directly prepared fiber reinforced composite bridges high survival and moderate success times were observed after up to nine years. Based on the present results DFRC-FPD might be an immediate, short- to medium-term solution for replacing 1 to 2 missing teeth with no or minimal tooth preparation., Clinical Significance: Within the limitations of the present study DFRC-FPD offered an immediate, micro-/minimal-invasive, inexpensive short- and medium-term solution to replace missing teeth, even if no box-shaped proximal cavity was prepared., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Purpose: The aim of this study was to describe the surgical technique of immediate dental implant placement in calvarial grafts for augmentation of the severely resorbed maxilla and to assess the treatment results., Methods: In 13 patients the maxilla was augmented with calvarial bone followed by simultaneous dental implant placement (total: 68 implants). In the frontal "knife edge" region, implants were inserted in the buccal plated area. In the maxillary sinus area, implants were inserted into alveolar bone that was plated buccally or palatally through the sinus window. After 4 months, the implants were retrieved and subsequently loaded. Per-operative and post-operative variables were scored. One bone biopsy sample was taken for histological analysis., Results: The surgical procedure and wound healing was uneventful. During abutment connection after 4 months, all implants were fully osseointegrated with no signs of graft resorption. Radiographically, the mean (±SD) peri-implant bone loss after 1 year of functional loading was 0.23 ± 0.44 mm. No implants were lost. Histological examination revealed vital calvarial and maxillary bone with active remodeling., Conclusion: Immediate dental implant placement in calvarial bone grafts to rehabilitate severely resorbed maxilla is technically feasible and seems to have a high success rate., (Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

This in vitro study evaluated the effects of different abutment axial heights on the retentiveness of adhesively and self-adhesively luted zirconia copings. Ankylos implants were embedded in resin blocks. Two groups of titanium abutments ("long", height: 6.79 mm, taper: 4.8°; "short", height: 4.31 mm, taper: 4.8°; Compartis-ISUS, DeguDent) were used for the luting of CAD/CAM-fabricated zirconia copings (Compartis, DeguDent) with an adhesive (Multilink Automix; Ivoclar Vivadent) and a self-adhesive (RelyX Unicem; 3M ESPE) composite. After water storage and 5000 thermocycles (5 °C/55 °C), retention forces were evaluated using a universal testing machine (Zwick). Significant differences were determined via two-way ANOVA and t-tests with Bonferroni-Holm correction. Significant interactions between abutment geometry and luting agents were observed. RelyX Unicem showed the highest levels of retentiveness, irrespective of the varying abutment geometries (mean values long/short: 487.7 N/447.9 N). When Multilink Automix was used, removal forces were significantly lower (311.7 N/101.1 N) and negatively affected by the use of the shorter abutments. Customized long abutments supported better retention forces than customized short abutments for both luting agents., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: This study aims to evaluate the fracture load of differently fabricated 3-unit posterior fixed dental prostheses (FDPs) with an intermediate pontic., Methods: Fifty sets of two stainless-steel abutments were randomly assigned to five groups (n = 10 each) depending on the material and technique used for manufacturing the FDPs: (1) Metal-ceramic (MC, control); (2) Lava Zirconia (LZ, bi-layered); (3) Lava Plus (LM, monolithic); (4) VITA In-Ceram YZ (YZ, bi-layered); and (5) IPS e-max ZirCAD (ZZ, bi-layered). After being luted to the dies, all FDPs were submitted to thermo-mechanical cycling (120,000 masticatory cycles, 50 N; plus 774 thermal cycles of 5 °C/55 °C, dwell time: 30 s). Samples were then subjected to a three-point bending test until fracture in a universal testing machine (cross-head speed: 1 mm/min). Fracture load of the veneering ceramic (VF) and total fracture load (TF) were recorded. Microstructure and failure patterns were assessed. Data was analysed using one-way ANOVA and Tukey HSD post-hoc tests (α = 0.05)., Results: MC restorations recorded higher VF and TF values than did zirconia FDPs (p = 0.0001), which showed no between-group differences. Within the bi-layered groups, TF was significantly higher than VF. LM pieces registered lower average grain size than did LZ specimens (p = 0.001). Overall, the connector was the weakest part., Conclusions: All of the groups tested could withstand clinical chewing forces in terms of average fracture load. Zirconia-based samples performed similarly to each other, but showed lower mean fracture load values than did metal-ceramic ones., Clinical Significance: Monolithic zirconia may be recommendable for solving the chipping problem., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: Evaluate the peri-implant status on the long-term (1-9years) of patients treated with immediately-loaded full-arch prostheses in a private practice., Methods: A retrospective cohort study was carried out in patients consecutively treated with immediately loaded full-arch restorations supported with a minimum of 4 implants (Replace ® Tapered, Nobel Biocare AB) and Multi-Unit conical abutments (MUA ® , Nobel Biocare AB) with a follow-up of over 12months after placement of the final prosthesis., Results: A total of 378 implants were placed in 56 patients. Forty upper and 32 lower arches were restored, and 16 patients received bimaxillary rehabilitation. The mean duration of follow-up was 50 months, and the implant and patient peri-implantitis prevalences were 14.3% and 50%, respectively. Mucositis affected 56.9% of the implants and 50% of the patients. The survival rate was 96.4% by patient, but reached 99.5% in the implant-based analysis, and the success rate was 95.5% for implants and 80.4% for patients., Conclusions: Immediately-loaded full-arch restorations have an acceptable outcome after 1-9years of follow-up. However, the incidence of peri-implant diseases is high, and further research is needed to confirm whether these may compromise the predictability of the prostheses over the long-term., Clinical Significance: After a mean follow-up of 50months, the incidence of mucositis and peri-implantitis affected the 96.4% and 50% of patients, respectively. However, these results were reduced almost by half when the threshold of bleeding on probing and peri-implant bone loss applied was less strict., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objectives: The etiology of the reduced marginal bone loss observed around platform-switched implant-abutment connections is not clear but could be related to the release of variable amounts of corrosion products. The present study evaluated the effect of different concentrations of metal ions released from different implant abutment couples on osteoblastic cell viability, apoptosis and expression of genes related to bone resorption., Methods: Osteoblastic cells were exposed to five conditions of culture media prepared containing metal ions (titanium, aluminum, vanadium, cobalt, chromium and molybdenum) in different concentrations representing the amounts released from platform-matched and platform-switched implant-abutment couples as a result of an earlier accelerated corrosion experiment. Cell viability was evaluated over 21days using the Alamar Blue assay. Induction of apoptosis was measured after 24h of exposure using flow cytometry. Expression of interleukin-6, interleukin-8, cyclooxygenase-2, caspase-8, osteoprotegerin and receptor activator of nuclear factor kappa-B ligand (RANKL) by osteoblastic cells were analysed after exposure for 1, 3 and 21days using real-time quantitative polymerase chain reaction assay RESULTS: Metal ions in concentrations representing the platform-matched groups led to a reduction in cell viability (P<0.01) up to 7days of exposure. Stimulated cells showed higher rates of early apoptosis (P<0.01) compared to non-treated cells. Metal ions up-regulated the expression of interleukin-6, interleukin-8, cyclooxygenase-2 and RANKL in a dose dependent manner after 1day of exposure (P<0.05). The up-regulation was more pronounced in the groups containing the corrosion products of platform-matched implant-abutment couples., Conclusion: Osteoblastic cell viability, apoptosis, and regulation of bone resorbing mediators were significantly altered in the presence of metal ions. The change in cytokine levels expressed was directly proportional to the metal ion concentration., Clinical Significance: The observed biological responses to decreased amounts of metal ions released from platform-switched implant-abutment couples compared to platform-matched couples may partly explain the positive radiographic findings in respect to crestal bone level when utilising the "platform-switching" concept, which highlights the possible role of corrosion products in the mediation of crestal bone loss around dental implants., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: To evaluate bone reconstruction and soft tissue reactions at immediate implants placed into intact sockets and those with buccal bone dehiscence defects., Methods: Fifty-nine internal connection implants from four different manufacturers were immediately placed in intact sockets(non-dehiscence group, n=40), and in alveoli with buccal bone dehiscence defects: 1) Group 1(n= N10), the defect depth measured 3-5 mm from the gingival margin. 2) Group 2(n=9), the depth ranged from 5mm to 7mm. The surrounding bony voids were grafted with deproteinized bovine bone mineral (DBBM) particles. Cone beam computed tomography(CBCT) was performed immediately after surgery (T1), and at 6 months later(T2). Radiographs were taken at prosthesis placement and one year postloading(T3). Soft tissue parameters were measured at baseline (T0), prosthesis placement and T3., Results: No implants were lost during the observation period. For the dehiscence groups, the buccal bone plates were radiographically reconstructed to comparable horizontal and vertical bone volumes compared with the non-dehiscence group. Marginal bone loss occurred between the time of final restoration and 1-year postloading was not statistically different(P=0.732) between groups. Soft tissue parameters did not reveal inferior results for the dehiscence groups., Conclusions: Within the limitations of this study, flapless implant placement into compromised sockets in combination with DBBM grafting may be a viable technique to reconstitute the defected buccal bone plates due to space maintenance and primary socket closure provided by healing abutments and bone grafts., Clinical Significance: Immediate implants and DBBM grafting without using membranes may be indicated for sockets with buccal bone defects., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

This in vitro study investigated the role of welding techniques of implant-supported prostheses in the 2D and 3D marginal misfits of prosthetic frameworks, strain induced on the mini abutment, and detorque of prosthetic screws. The correlations between the analyzed variables were also investigated. Frameworks were cast in commercially pure titanium (cp-Ti). A marginal misfit of 200μm was simulated in the working models (control group) (n=20). The 2D marginal misfit was analyzed according to the single-screw test protocol using a precision optical microscope. The 3D marginal misfit was performed by X-ray microtomography. Strain gauge analysis was performed to investigate the strain induced on the mini abutment. A digital torque meter was used for analysis of the detorque and the mean value was calculated for each framework. Afterwards, the frameworks were divided into two experimental groups (n=10): Laser (L) and TIG (T). The welding techniques were performed according to the following parameters: L (390V/9ms); T (36A/60ms). The L and T groups were reevaluated according to the marginal misfit, strain, and detorque. The results were submitted to one-way ANOVA followed by Tukey's HSD test and Person correlation analysis (α=0.05). Welding techniques statistically reduced the 2D and 3D marginal misfits of prosthetic frameworks (p<0.001), the strain induced on the mini abutment replicas (p=0.006), and improved the screw torque maintenance (p<0.001). Similar behavior was noted between L and T groups for all dependent variables (p>0.05). Positive correlations were observed between 2D and 3D marginal misfit reading methods (r=0.943, p<0.0001) and between misfit and strain (2D r=0.844, p<0.0001 and 3D r=0.864, p<0.0001). Negative correlation was observed between misfit and detorque (2D r=-0.823, p=0.003 and 3D r=-0.811, p=0.005). In conclusion, the welding techniques improved the biomechanical behavior of the implant-supported system. TIG can be an acceptable and affordable technique to reduce the misfit of 3-unit Ti frameworks., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objectives: The purpose was to assess the early effects of removable partial denture (RPD) placement on abutment teeth in patients with periodontal disease., Methods: Fifteen distal-extension RPDs and 19 abutment teeth were evaluated in 13 patients with moderate-to-severe periodontal diseases. Clinical periodontal records and grey level (GL) score based on digital subtraction radiography were measured on the day of denture placement (baseline) and at 1day, 1 week, 1 month, 3 months, and 6 months after the placement. Occlusal force on total dentition (Ft) and abutment tooth (Fa) were recorded with (baseline) and without denture on the day of the placement, and with denture in the follow-up examinations., Results: No statistically significant difference between a follow-up period and the baseline was found in the clinical periodontal and occlusal force records, except for Ft with denture on the day of the placement, which was significantly lower than the baseline (p<0.05). The GL at distal crestal of the abutment was significantly higher at 1 week after the placement than at the baseline (p<0.05), while the scores of following examinations returned to the baseline level., Conclusions: The distal crestal bone of the abutment tooth transitorily reacts to mechanical stress due to the denture placement, while this does not suggest a detrimental effect within the limitation of the study design with a short-term observation period., Clinical Significance: The RPDs can be safely used for patients with periodontal diseases for at least 6 months if they are properly placed and maintained by professional care., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objectives: This study aimed to assess the impact of different abutment materials on peri-implant tissue regeneration after surgical treatment of peri-implantitis in a large animal model., Material and Methods: Titanium implants (n = 51) were inserted in the upper and lower jaw of eight beagle dogs and a peri-implant infection was induced. After two months the peri-implant infection was surgically treated and abutments with different surfaces (Ti-2: n = 14; CoCrMb: n = 13; Ag-modified Ti-4: n = 14; Ti-4 control: n = 10) were applied. Clinical attachment level (CAL), modified sulcus bleeding index (mBI), bleeding on probing (BoP), and the sulcus fluid flow rate (SFFR) were determined 4, 8, and 12 weeks after surgical treatment to document the peri-implant tissue reaction., Results: Superior levels for CAL and mBI were found with the Ti-4 control and the Ag-modified abutments, with the Ag-modified abutments showing the best values after 12 weeks. Lowest SFFR values compared with the other treatment groups underlined the superior soft tissue reaction adjacent to Ag-modified abutments. After 12 weeks inferior CAL, SFFR, BOP and mBI values were documented for the Ti-2 surface., Conclusion: Within limitations of the study, Ag-modified abutments lead to superior tissue reactions. Further studies are needed to investigate the properties of abutment materials., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Objectives: To evaluate the two-year survival rate (SR) and marginal bone loss (MBL) of fixed dental prostheses (FDPs) supported by straight (S) and tilted (T) implants under the influence of diverse study variables., Methods: A prospective investigation comprising 21 patients provided with a total of 27 maxillary screw-retained restorations fixed to 70 dental implants was developed. Two groups of implants were considered depending on their inclination with respect to the occlusal plane: Group 1 (S, n=37): straight/axial implants and Group 2 (T, n=33): tilted/angled fixations. Each FDP was supported by a combination of S and T implants. SR and MBL were assessed at the time of loading and two years after surgery. Patient-, surgical- and/or rehabilitation-related information was gathered. Data were statistically analysed at the α=0.05 significance level., Results: After 24 months, a 100% SR was achieved and the MBL of S and T implants were statistically similar. T implants located in the molar region showed lower MBL than did those replacing premolars (p=0.031)., Conclusions: Upright and angled fixations inserted at posterior maxillary areas resulted in comparable survival rates and peri-implant MBL after two years. The marginal bone resorption around tilted implants depended on their location., Clinical Significance: Screw-retained restorations fixed to straight and tilted implants seem to be a safe treatment option in posterior atrophic maxillae., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objectives: to assess FRC FPDs longevity through systematically reviewing contemporary clinical evidence. Population investigated comprised patients requiring replacement of a single missing anterior/posterior tooth. Intervention was FRC FPDs. No control/comparison selected. Outcome was longevity of FRC FPDs. The focus question was: 'What is the longevity of FRC FPDs used to replace one anterior or posterior tooth in patients?', Data: Randomised, non-randomised, controlled, prospective and retrospective clinical studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were applied. The Overall Strength of Clinical Recommendation (OSCR) was assessed using the Strength of Recommendation Taxonomy system. Survival of FPDs was assessed using the Kaplan-Meier method. Analysis of FPD-survival according to location and occurrence of different failures was performed using Logrank and Chi-square testing., Sources: PubMed, MEDLINE, and Web of Science databases were searched between January 2007 and December 2015., Study Selection: Nine studies were included, involving placement of 592 FRC FPDs in 463 patients. Follow-up periods ranged between 2 months and 8 years. Kaplan-Meier overall survival probability was 94.5% (95%C.I: 92.5%-96.5%) at 4.8 years. There was no significant difference in survival probability of anterior versus posterior FRC FPDs (P=0.278). Veneering material fracture/delamination occurred significantly more than other types of failures (Ps<0.05). A meta-analysis could not be performed. OSCR was moderate., Conclusions: FRC FPDs demonstrated high overall survival with predictable performance outcomes. However, long-term performance remains unclear., Clinical Significance: FRC FPDs are viable medium-term management alternatives for replacing single anterior or posterior teeth in patients., (Copyright © 2016 Elsevier Ltd. All rights reserved.)