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Objectives: This in vitro study compared the accuracy of conventional impressions (CNVs), photogrammetry (PG), and intraoral scanning (IOS) for recording implant impressions of edentulous segments, ranging from part to complete arches by different evaluation methods., Methods: The master model for an edentulous maxillary arch was created with six implants (a-f). CNVs, PG, and IOS were used for impressions. Three impression ranges (bcde, bcdef, and abcdef) were chosen for analysis. The best-fit algorithm, absolute linear deviation, and angular deviation were used for evaluation. Trueness and precision were analyzed by two-way ANOVA and the Kruskal-Wallis test, respectively., Results: The accuracy of multiple implant impressions was significantly influenced by the impression method and impression range (p < 0.05) regardless of the evaluation methods used. At smaller ranges (bcde and bcdef), there was no difference in the trueness of the three impression methods, whereas at a larger range (abcdef), both PG and CNV exhibited similar trueness, which was significantly higher than that of IOS(p < 0.05). The precision of PG was significantly better than that of CNV and IOS in most of cases (p < 0.05). As the range expanded, the trueness and precision of PG and IOS decreased (p < 0.05), whereas the accuracy of CNV remained stable., Conclusions: In the case of large-range impressions, PG demonstrated a similar degree of trueness and better precision compared with CNVs, whereas the trueness and precision of the intraoral scanning were worse. This indicated that PG might be a promising method for multiple implant impressions., (© 2024 Wiley Periodicals LLC.)

ABSTRACT Background: Loss of teeth has been associated with neurological and sleep disorders. It is considered to be a predictor of stroke and leads to modifications of airway patency and predisposition to obstructive sleep apnea. Objective: To investigate sleep quality, risk of obstructive sleep apnea and excessive sleepiness among post-stroke patients with tooth loss attending the Neurovascular Clinic of the Federal University of São Paulo. Methods: The prevalence rates of different types of stroke were assessed among 130 patients with different degrees of tooth loss, along with the presence of sleep disturbances, risk of obstructive sleep apnea and excessive daytime sleepiness. Results: The prevalence of ischemic stroke was 94.6%, with either no significant disability or slight disability. Our sample had poor sleep quality, and a high risk of obstructive sleep apnea, but without excessive daytime sleepiness. Half of our sample had lost between 9 and 31 teeth, and more than 25% had edentulism. The majority used full removable dental prostheses, and more than half of these individuals slept without removing the prosthesis. Conclusions: We found high prevalence of poor sleep quality and high risk of obstructive sleep apnea among post-stroke patients with tooth loss. This indicates the need for further studies on treating and preventing sleep disturbances in stroke patients with tooth loss.

Background: The use of biologics may be indicated for alveolar ridge preservation (ARP) and reconstruction (ARR), and implant site development (ISD). The present systematic review aimed to analyze the effect of autologous blood‐derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet‐derived growth factor‐BB (rhPDGF‐BB), and recombinant human bone morphogenetic protein‐2 (rhBMP‐2), on the outcomes of ARP/ARR and ISD therapy (i.e., alveolar ridge augmentation [ARA] and maxillary sinus floor augmentation [MSFA]). Methods: An electronic search for eligible articles published from January 2000 to October 2021 was conducted. Randomized clinical trials evaluating the efficacy of ABPs, EMD, rhBMP‐2, and rhPDGF‐BB for ARP/ARR and ISD were included according to pre‐established eligibility criteria. Data on linear and volumetric dimensional changes, histomorphometric findings, and a variety of secondary outcomes (i.e., clinical, implant‐related, digital imaging, safety, and patient‐reported outcome measures [PROMs]) were extracted and critically analyzed. Risk of bias assessment of the selected investigations was also conducted. Results: A total of 39 articles were included and analyzed qualitatively. Due to the high level of heterogeneity across studies, quantitative analyses were not feasible. Most studies in the topic of ARP/ARR revealed that the use of biologics rendered similar results compared with conventional protocols. However, when juxtaposed to unassisted healing or socket filling using collagen sponges, the application of biologics did contribute to attenuate post‐extraction alveolar ridge atrophy in most investigations. Additionally, histomorphometric outcomes were positively influenced by the application of biologics. The use of biologics in ARA interventions did not yield superior clinical or radiographic outcomes compared with control therapies. Nevertheless, ABPs enhanced new bone formation and reduced the likelihood of early wound dehiscence. The use of biologics in MSFA interventions did not translate into superior clinical or radiographic outcomes. It was observed, though, that the use of some biologics may promote bone formation during earlier stages of healing. Only four clinical investigations evaluated PROMs and reported a modest beneficial impact of the use of biologics on pain and swelling. No severe adverse events in association with the use of the biologics evaluated in this systematic review were noted. Conclusions: Outcomes of therapy after post‐extraction ARP/ARR and ARA in edentulous ridges were comparable among different therapeutic modalities evaluated in this systematic review. Nevertheless, the use of biologics (i.e., PRF, EMD, rhPDGF‐BB, and rhBMP‐2) in combination with a bone graft material generally results into superior histomorphometric outcomes and faster wound healing compared with control groups. [ABSTRACT FROM AUTHOR]

Objectives: To assess the accuracy of a real‐time dynamic navigation system applied in zygomatic implant (ZI) surgery and summarize device‐related negative events and their management. Material and methods: Patients who presented with severely maxillary atrophy or maxillary defects and received dynamic navigation‐supported ZI surgery were included. The deviations of entry, exit, and angle were measured after image data fusion. A linear mixed‐effects model was used. Statistical significance was defined as p <.05. Device‐related negative events and their management were also recorded and analyzed. Results: Two hundred and thirty‐one zygomatic implants (ZIs) with navigation‐guided placement were planned in 74 consecutive patients between Jan 2015 and Aug 2020. Among them, 71 patients with 221 ZIs received navigation‐guided surgery finally. The deviations in entry, exit, and angle were 1.57 ± 0.71 mm, 2.1 ± 0.94 mm and 2.68 ± 1.25 degrees, respectively. Significant differences were found in entry and exit deviation according to the number of ZIs in the zygomata (p =.03 and.00, respectively). Patients with atrophic maxillary or maxillary defects showed a significant difference in exit deviation (p =.01). A total of 28 device‐related negative events occurred, and one resulted in 2 ZI failures due to implant malposition. The overall survival rate of ZIs was 98.64%, and the mean follow‐up time was 24.11 months (Standard Deviation [SD]: 12.62). Conclusions: The navigation‐supported ZI implantation is an accurate and reliable surgical approach. However, relevant technical negative events in the navigation process are worthy of attention. [ABSTRACT FROM AUTHOR]

Background: Bone readiness for implant placement is typically evaluated by bone quality/density on 2-dimensional radiographs and cone beam computed tomography at an arbitrary time between 3 and 6 months after tooth extraction and alveolar ridge preservation (ARP). The aim of this study is to investigate if high-frequency ultrasound (US) can classify bone readiness in humans, using micro-CT as a reference standard to obtain bone mineral density (BMD) and bone volume fraction (BVTV) of healed sockets receiving ARP in humans., Methods: A total of 27 bone cores were harvested during the implant surgery from 24 patients who received prior extraction with ARP. US images were taken immediately before the implant surgery at a site co-registered with the tissue biopsy collection location, made possible with a specially designed guide, and then classified into 3 tiers using B-mode image criteria (1) favorable, (2) questionable, and (3) unfavorable. Bone mineral density (hydroxyapatite) and BVTV were obtained from micro-CT as the gold standard., Results: Hydroxyapatite and BVTV were evaluated within the projected US slice plane and thresholded to favorable (>2200 mg/cm 3 ; >0.45 mm 3 /mm 3 ), questionable (1500-2200 mg/cm 3 ; 0.4-0.45 mm 3 /mm 3 ), and unfavorable (<1500 mg/cm 3 ; <0.4 mm 3 /mm 3 ). The present US B-mode classification inversely scales with BMD. Regression analysis showed a significant relation between US classification and BMD as well as BVTV. T-test analysis demonstrated a significant correlation between US reader scores and the gold standard. When comparing Tier 1 with the combination of Tier 2 and 3, US achieved a significant group differentiation relative to mean BMD (p = 0.004, true positive 66.7%, false positive 0%, true negative 100%, false negative 33.3%, specificity 100%, sensitivity 66.7%, receiver operating characteristics area under the curve 0.86). Similar results were found between US-derived tiers and BVTV., Conclusion: Preliminary data suggest US could classify jawbone surface quality that correlates with BMD/BVTV and serve as the basis for future development of US-based socket healing evaluation after ARP., (© 2024 The Authors. Journal of Periodontology published by Wiley Periodicals LLC on behalf of American Academy of Periodontology.)

Objectives: This study aimed to evaluate the impact of prefabricated auxiliary devices (PADs) in different optical properties and shapes on the accuracy of digital implant impressions., Methods: An edentulous maxillary all-on-4 master model was fabricated. PADs were 3D-printed in different resin materials (Grey, Translucent, White, Yellow) and shapes (Cuboid, Cylinder, Sphere) using a 3D printer (AccuFab-C1s, 3DShining, Hangzhou, China). The master model was digitalized using a dental laboratory scanner (D2000, 3Shape, Copenhagen, Denmark) 4 times as the reference models. Test models were obtained without (control group) or with PADs by an intraoral scanner (Aoralscan 3, Shining3D, Hangzhou, China) for ten repetitions of each group using the scanning pattern recommended by the manufacturer. The related files were imported into inspection software to assess Root Mean Square (RMS), linear and angular accuracy. Aligned Ranks Transformation ANOVA, Kruskal-Wallis and Mann-Whitney tests were used to evaluate the differences in these values. The level of significance was set at α=0.05., Results: PADs in different optical properties and shapes demonstrated accuracy enhancement to different extents depending on their combinations. The PADs in combinations of white-cuboid, grey-sphere and yellow-sphere demonstrated the optimal trueness enhancement. The Aligned Ranks Transformation ANOVA indicated that the optical properties of the PADs significantly influenced the RMS, linear and angular accuracy. The main effect of optical properties indicated that translucent PADs generally generated more deviations than the others. The shapes of the PADs significantly influenced the angular accuracy. The main effect of shapes indicated that cylinder resulted in lower angular trueness on YZ plane than cuboid (p = 0.006) and sphere (p < 0.001)., Conclusion: The optical properties and shapes of the PADs significantly influenced the scanning accuracy. Translucent PADs demonstrated more deviations than the others. Lower angular trueness on the YZ plane was seen in cylinder design compared to the others., Clinical Significance: The optical properties and shapes of prefabricated auxiliary devices should be critically considered to optimize the scanning accuracy. Prefabricated auxiliary devices in translucent optical properties and cylinder shape should be avoided., 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.)

Purpose: To present an addendum to existing fixed dental prostheses (FDPs) classification system for maxillary prostheses. The new classification identifies the relationships between FP-1 (fixed prostheses) designs and newly developed clinical interdental gingival contours., Materials and Methods: Clinical and laboratory descriptions of the various types of full-arch fixed prostheses are described with photographic illustrations. Benefits and limitations of the various prosthetic designs are explained. Surgical differences in the amount of alveolectomy are illustrated. One clinical case is demonstrated., Results: A new classification system for maxillary implant fixed complete dentures is presented. The new system will serve as an improved communication aid for clinicians, patients, and laboratory technicians. Treatment of patients with edentulous maxillae and/or terminal dentitions and implant fixed complete dentures include several options relative to design and materials. Restorative space can have a major impact on prosthesis design and longevity. Early on in dental implant therapy, prostheses were generally made with cast metal frameworks, denture bases and denture teeth. Prosthetic complications were widely reported. With increased clinical experience and improved materials, computer-aided design and computer-aided manufacturing (CAD-CAM) protocols were developed that allowed stronger prostheses to be constructed in reduced or small restorative volumes. FP-1 ceramic implant-supported fixed prostheses (CISFPs) are designed to replace only the dental hard tissues and to promote preservation and rehabilitation of gingival soft tissues. The physical properties and minimum thickness requirements in full arch prostheses are influenced by several factors including distances between implants and rigid connector sizes., Conclusion: FP-1 CISFPs may be the closest prostheses the profession can offer edentulous patients that mimic the look, feel, and function of missing dentitions. Aesthetic outcomes of FP-1 CISFPs are variable and depend on a multitude of factors. This article presented a classification system that builds on existing classification by identifying the level of papilla heights achieved with FP-1 CISFPs., (© 2024 by the American College of Prosthodontists.)

Background: The expectations for the clinical and laboratory phases of tissue-supported complete dentures (TSCDs) are changing. Currently, there is a trend towards fast, comfortable, reliable, and low-cost methods. In TSCD impressions, simplified impression and digital impression methods involving the use of an intraoral scanner (IOS) are becoming preferable. Given this situation, this study aims to compare different conventional and digital impression methods used in TSCDs., Methods: Patients with maxillary complete edentulism and healthy oral mucosa were included in this study. In the digital group, two different impressions were made using an IOS (Trios4) without (D1) and with (D2) artificial intelligence scanning (AI-Scan). In addition, a modified impression (D3) was made using the IOS in two steps, including the occlusal rim. In the conventional group, a two-step impression (C1) using an individual tray with zinc oxide eugenol and a one-step simplified impression (C2) using a stock tray with irreversible hydrocolloid were made. The comparison groups were determined to be C1-C2, C1-D1, D1-D2, and D1-D3. The best-fit algorithm was used to superimpose the impressions to be compared. The right and left vestibular areas, postdam area, palatal area, right and left matching area, entire surface, and borders were evaluated separately., Results: Fifteen patients were included in this study. In the C1-C2 group, the mean deviation at the borders was statistically significant (p = 0.01). No regions in the C1-D1 and D1-D3 groups exhibited significant differences in the mean amount of deviation (p > 0,05). In the D1-D2 group, the mean deviation in the palatal area was significant (p = 0,03)., Conclusion: In maxillary edentulism, digital impressions have shown comparable results to conventional impressions, suggesting promising implications for clinical applications., Trial Registration: The clinical trial has been registered (ClinicalTrials.gov ID NCT06400277, registration date 06/05/2024, 'retrospectively registered')., Competing Interests: Declarations Ethics approval and consent to participate The clinical protocol for this study was approved by the Hacettepe University Clinical Trials Ethics Committee (ID:22026) and the Ministry of Health’s Medicines and Medical Devices Agency (ID: E-68869993-511.06-821974). Informed consent was obtained from all of the participants in the study. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

With the rapid development of implant techniques and digital technology, intraoral digital impressions have become a commonly used impression method in implant restoration. At present, the accuracy of intraoral digital impressions directly applied to implant-supported prostheses in edentulous jaw remains inadequate. This is due to the high accuracy requirement of full-arch implant impressions, while there are still technical challenges in intraoral digital impressions about recognition and stitching. In this regard, scholars have proposed a variety of scanning strategies to improve the accuracy of intraoral scans, including mucosal modifications, auxiliary devices and novel scan bodies. At the same time, as a new digital impression technique, stereo photogrammetry has been developing steadily and exhibits promising accuracy. This article reviews the research progress on the accuracy of edentulous full-arch implant impressions and techniques which can improve the accuracy of intraoral digital impressions thus providing a reference for clinical application.

Commonly used materials for fixed restorations in edentulous jaws include acrylic resins, polymerized ceramics, ceramics and zirconia, which have distinct physicochemical properties and clinical application features. The selection of these materials in clinical practice is related to the prosthodontic space, oral soft and hard tissue conditions, occlusal force, lifestyle habits, oral parafunctions, opposing dentition materials, and expectations of patients. Common mechanical complications associated with fixed restorations in edentulous jaws are cracking/chipping and abrasion of the facing materials, which can be avoided through occlusal adjustment, restoration design and processing, and the selection of appropriate restorative materials. This article reviews the characteristics, selection, and design considerations of commonly used materials for fixed restorations in edentulous jaws, as well as the causes and management of common clinical complications related to restorative materials, aiming to provide references for the selection of appropriate materials in fixed restorations for edentulous jaws in clinical practice.

Objectives: The present study aimed to systematically review the studies comparing the accuracy of intraoral scan (IOS) and conventional implant impressions (CI) in completely edentulous patients., Materials and Methods: Electronic searches were performed in PubMed, Embase and Cochrane CENTRAL up to December 1, 2023. Clinical studies and in vitro studies reporting the accuracy of digital full arch impressions were included. The primary outcome is the 3-dimensional deviations between the study reference models. A risk of bias assessment was performed for clinical studies. A stratified meta-analysis and a single-armed meta-analysis were conducted., Results: A total of 49 studies were included, with 8 clinical studies and 41 in vitro studies. For comparison between IOS and conventional impressions, studies were categorized into two groups based on the different measurement methods employed: RMS and CMM. In studies using RMS, the result favored the IOS in the unparalleled situation with the mean difference of -99.29 μm (95% CI: [-141.38, -57.19], I 2  = 81%), while the result was opposite with the mean difference of 13.62 μm (95% CI: [10.97, 16.28], I 2  = 26%) when implants were paralleled. For different brands of IOS, the accuracy ranged from 76.11 μm (95% CI: [42.36, 109.86]) to 158.63 μm (95% CI: [-14.68, 331.93])., Conclusions: Accuracy of intraoral scan is clinically acceptable in edentulous arches, especially for unparalleled implants. More clinical studies are needed to verify the present finding., (© 2024 Wiley Periodicals LLC.)

Statement of Problem: The 2-implant mandibular overdenture (2IMO) is a popular treatment for patients with an edentulous mandible, but information on the effect of the optimum implant position on the peri-implant crestal bone level with immediate loading protocols is lacking., Purpose: The purpose of this prospective clinical study was to evaluate correlations between different implant positions and crestal bone loss and between interimplant distance and the crestal bone loss in patients with 2IMOs with immediate loading protocols at 1-year follow-up., Material and Methods: A total of 24 participants (13 men, 11 women, mean ±standard deviation age 63.25 ±10.76 years) were treated with 2IMOs (48 Ti-Zr implants) by a single operator between August 2015 and October 2020. The implant diameters (3.3 mm or 4.1 mm) and lengths (10 mm or 12 mm) were selected based on the crestal bone width, and the implants were placed, if possible, in the canine regions. Implant positions and interimplant distance (mm) were measured intraorally with dividers. Prefabricated mandibular dentures were immediately loaded with the LOCATOR-attachments by using a direct intraoral pickup procedure. Crestal bone-level changes were measured with a software program on the mesial and distal sides of each implant from periapical radiographs made with a paralleling technique (at baseline and 1-year follow-up). The measurement values were normalized. The Spearman rho correlation test and paired samples t tests were used for data analysis (α=.05)., Results: The mean ±standard deviation position of the implants from the midline was 8.78 ±2.25 mm (9.00 ±2.22 mm right side, 8.56 ±2.31 mm left side), and the mean interimplant distance was 16.94 ±4.03 mm. At 1-year follow-up, the mean ±standard deviation crestal bone loss was 0.50 ±0.47 mm (n=48) (0.57 ±0.65 mm mesial, 0.43 ±0.53 mm distal). The mean ±standard deviation crestal bone loss was 0.46 ±0.4 mm with Ø3.3-mm implants (n=42) and 0.9 ±0.8 mm with Ø4.1-mm implants (n=6) (P=.005). Implant positions were negatively correlated (rs=-0.37) with the crestal bone loss, and the correlation was significant (P=.009). Interimplant distances were also negatively correlated with crestal bone loss (rs=-0.60; P=.002). Bone loss on the mesial side was positively correlated with that on the distal side rs=0.20; however, the correlation was not significant (P=.16)., Conclusions: A weak and negative correlation was found between the implant position from the midline and the crestal bone loss and also between the interimplant distance and crestal bone loss in patients provided with 2IMOs with immediate loading protocols., (Copyright © 2022 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to evaluate the effect of the All-on-4 design and 4 alternative implant-supported fixed prosthesis designs on stress distribution in implants, peri-implant bone, and prosthetic framework in the edentulous mandible under different loading conditions using three-dimensional finite element analysis (3D-FEA).Five different experimental finite element models (Model A (unsplinted 6), Model B (splinted 6), Model C (All-on-4), Model D (axial; 2 anterior, 2 posterior), and Model E (4 interforaminal)) were created. Three different loading conditions were applied (canine loading, unilateral I-loading, and unilateral II-loading). The highest minimum (Pmin) and the maximum (Pmax) principal stress values were acquired for cortical and trabecular bones; the highest von Mises (mvM) stress values were obtained for implants and metal frameworks. Model B and Model D showed the most favorable stress distribution. The All-on-4 design (Model C) also showed acceptable stress values close to those of Model B and Model D in the cortical and trabecular bones. In accordance with the stress values in the bone structure, the lowest stress values were measured in the implants and Co-Cr framework in Model B and Model D. The highest stress values in all structures were measured for unilateral loading- II, while the lowest values were found for canine loading. It was concluded that Model B and Model D experimental models showed better biomechanical performance in all structures. Furthermore, the use of a splinted framework, avoiding cantilevers, results in lower stress transmission. On the other hand, canine loading and unilateral loading-I exhibited the best loading conditions., (© 2024. The Author(s).)

Centric relation (CR) was used in the complete dentures for edentulous jaws firstly. Then, CR was gradually applied in the clinical diagnosis and treatment of dentate jaws. Regarding the application of CR in dentate jaws, there are many doubts about its rationality. For instance, should CR be the core of diagnosis and treatment of temporomandibular disorders? Should CR be used as the jaw position of establishing occlusion in occlusal reconstruction? Should CR serve as the target jaw position in orthodontic treatment? Meanwhile, varieties of CR clinical applications are objective. According to the existing evidence, this paper summarizes the applicable conditions of several main clinical situations with little controversy. We preliminarily put forward the decision tree for the clinical application of CR, which can be used as a reference in clinical practice.

Objective: To investigate the relationships among tooth loss, denture wearing, nutrition intake, and nutritional status. Material and Methods: This observational cohort study was conducted on 26 patients (≥ 45 years old) at the Faculty of Dentistry, Universitas Indonesia. Tooth loss was classified according to the Eichner Index. The Semi-quantitative Food Frequency Questionnaire was used to measure nutritional intake (kcal). Mini Nutritional Assessment Short Form (MNA-SF) and Handgrip Strength (HGS) assessments were employed to measure the nutritional status at baseline (before denture insertion), 1, 2, 3, 6, 9, and 12 months after denture use. Results: Significant differences in nutritional intake (p

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Objective: To evaluate the intra-examiner and inter-examiner reliability of linear and curvilinear measurements for the complete assessment of implant sites and jaw pathologies using Cone-Beam Computed Tomography (CBCT). Material and Methods: Fifty cone-beam computed tomographic images of patients were retrieved from the archives of Dentomaxillofacial Radiology. CBCT images taken for implant planning and evaluation of intrabony jaw pathologies (benign cyst/tumor) were included. Two expert oral and maxillofacial radiologists analyzed the images independently and made the measurements. The images for implant planning were analyzed for width, the height of the edentulous site, and the qualitative analysis of bone in the region. Jaw pathologies were assessed for linear dimensions and curvilinear measurements. Results: The inter-observer measurement error for implant site analysis ranged from 0.12 to 0.42 mm with almost perfect agreement (ICC: 0.94 to 1). The inter-observer measurement error for jaw pathology was 0.09 to 0.25 mm (ICC: 0.98-1). Curvilinear measurements showed perfect agreement between the observers. The intraobserver reliability for the various parameters used for the assessment of the implant site and jaw pathologies indicated almost perfect agreement. Conclusion: Reliability between the radiologists is high for various measurements on CBCT images taken for implant planning and jaw pathologies.