Optimizing Anterior Implant Outcome Immediately After Implant Placement and Grafting by Using Patient’s Extracted Teeth: A Case Report

Optimizing anterior implant outcome using patient’s extracted teeth. Successful implant treatment in the anterior maxilla is predicated on providing a functional and esthetically acceptable outcome. As well, achieving a predictable ideal emergence profile and soft tissue contour is expected. Placing immediate provisional restorations utilizing the patient’s modified extracted teeth can facilitate initiate facial soft tissue contouring while precluding undue pressure on the surgical site during the early healing phase. This allows for a one stage surgical procedure, fixed provisionalization and ideal tissue contouring. This clinical report presents the use of a patient’s modified extracted permanent teeth as bonded fixed provisional restorations placed immediately after implant placement and bone grafting. The gingival-lingual and cingulum tooth structure was recontoured to allow no contact with the implant or bone graft material. A combination of cement and screw-retained definitive restorations were fabricated with contours reflecting the tissue contours established by the interim restoration

Computerâ Guided Immediate Implant Placement and Predigitally Designed Immediate Provisionalization

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142440/1/cap10007_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142440/2/cap10007.pd

Optical Impression in Restorative Dentistry

Intraoral scanners are responsible for data acquisition in digital workflow, which represents the first step in restorative dentistry. The present chapter aimed to investigate the various methods for acquiring oral information, diverse clinical applications based on optical impression technique, use of intraoral scan data according to the need for model, and the various considerations regarding the selection of intraoral scanners suitable for clinical goals. The acquired optical impression data can be sent anywhere in the world, which offers the advantage of overcoming any temporal or spatial constraints. The purpose of this chapter is to understand digital workflow using optical impression and to learn how to use it effectively in clinical practice

Retention Of Long-Term Interim Restorations With Sodium Fluoride Enriched Interim Cement

Purpose: Interim fixed dental prostheses, or provisional restorations , are fabricated to restore teeth when definitive prostheses are made indirectly. Patients undergoing extensive prosthodontic treatment frequently require provisionalization for several months or years. The ideal interim cement would retain the restoration for as long as needed and still allow for ease of removal. It would also avoid recurrent caries by preventing demineralization of tooth structure. This study aims to determine if adding sodium fluoride varnish to interim cement may assist in the retention of interim restorations. Materials and methods: stainless steel dies representing a crown preparation were fabricated. Provisional crowns were milled for the dies using CAD/CAM technology. Crowns were provisionally cemented onto the dies using TempBond NE and NexTemp provisional cements as well as a mixture of TempBond NE and Duraphat fluoride varnish. Samples were stored for 24h then tested or thermocycled for 2500 or 5000 cycles before being tested. Retentive strength of each cement was recorded using a universal testing machine. Results: TempBond NE and NexTemp cements performed similarly when tested after 24h. The addition of Duraphat significantly decreased the retention when added to TempBond NE. NexTemp cement had high variability in retention over all tested time periods. Thermocycling for 2500 and 5000 cycles significantly decreased the retention of all cements. Conclusions: The addition of Duraphat fluoride varnish significantly decreased the retention of TempBond NE and is therefore not recommended for clinical use. Thermocycling significantly reduced the retention of TempBond NE and NexTemp. This may suggest that use of these cements for three months, as simulated in this study, is not recommended

Custom abutments for dental implants, their evolution and uses: a narrative review

Introdução: Recentemente no mundo da dentística o uso de Computer Imaging and Computer Manufacturing (CAD/CAM) para criar pilares de implantes personalizados de Titânio ou Zircônia para atender às demandas funcionais e estéticas de nossos pacientes, está se tornando cada vez mais proeminente com vários métodos, cada um adequado para uma melhor localização e tipo de dente que deve substituir. Objetivo: Este estudo tem como objetivo a discussão dos pilares personalizados em implantes dentários, seus desenvolvimentos, vantagens e desvantagens, técnicas de fabrico, indicações e contraindicações e por fim sua viabilidade clínica. Metodologia: Pubmed, B-on (1990-2022) com as palavras-chave: : (“dental implant” OR” dental abutment” OR “custom dental abutment”) AND (“3D Printing” OR “zirconia” OR” titanium” OR “milled abutment” OR “sintering” OR “emergence profile” OR “peri-implant tissue” OR “replacement” OR “materials” OR “ CAD/CAM” OR “Clinical Trial” OR “Esthetic”). Resultado: Os Abutments Personalizados que atualmente apresentam melhor desempenho são os de Titânio, sendo que os copings de Zircônia sobre Titânio conseguem obter os melhores resultados estéticos e funcionais.Introduction: Recently in the world of dentistry the use of Computer Imaging and Computer Manufacturing (CAD/CAM) in order to create Titanium or Zirconia custom implant abutments to meet the functional and esthetic demands of our patients is becoming more and more prominent with several methods each suited to a better locale and type of tooth it’s supposed to replace. Objective: This study has as its objective the discussion of custom-made abutments in dental implants, their development, advantages and disadvantages, manufacturing techniques, indications and contraindications and finally their clinical viability. Methodology: Pubmed, B-on (1990-2022) with the following keywords: (“dental implant” OR” dental abutment” OR “custom dental abutment”) AND (“3D Printing” OR “zirconia” OR” titanium” OR “milled abutment” OR “sintering” OR “emergence profile” OR “peri-implant tissue” OR “replacement” OR “materials” OR “CAD/CAM” OR “Clinical Trial” OR “Esthetic”). Result: The Custom Abutments that currently perform the best are Titanium ones, with Zirconia copings on Titanium being able to achieve the best results both esthetically and functionally

In-Vitro Comparative Evaluation of the Physical Properties of Three Dimensional-Printed and Milled High Performance Ceramics

Aim: to investigate the potential role of 3D printing to produce zirconia restorations and to assess the mechanical properties of the 3D printed zirconia. Hypotheses: 1) The flexural strength of 3D printed yttria-stabilized zirconia is comparable or superior to milled yttria-stabilized, isostatic pressed zirconia, and 2) thermocycling and chewing simulation does not affect the flexural strength of 3D printed yttria-stabilized zirconia. Material and methods: 30 bars of printed yttria-stabilized zirconia and 10 bars of milled yttria-stabilized, isostatic pressed zirconia were utilized in this study. Printed zirconia bars were divided in 3 groups (10 bars per group): untreated, thermocycling and chewing simulation. Flexural strength test was performed on all the samples using a three-point bend test. One-way ANOVA analysis compared the 3 groups of printed zirconia samples, and Mann-Whitney test was used to compare the non-treated printed zirconia group to the milled zirconia group. Results: No statistically significant difference between the three groups of printed zirconia samples was found (P = 0.119). No statistically significant difference between the non-treated printed zirconia group and non-treated samples of milled yttria- stabilized, isostatic pressed zirconia was found (P = 0.178). Conclusion: No statistically significant differences in flexural strength were detected between yttria-stabilized printed zirconia and milled yttria-stabilized, isostatic pressed zirconia, and non-treated, thermocycling and chewing simulation tested printed zirconia samples. These results indicate the promising role of 3D printing in the fabrication of zirconia. Additional studies are needed to explore the full potential of this technology

Immediate implant placement using customized healing abutments as a method of hard and soft tissue preservation. A review article

INTRODUCTION: Dental implant placement with its excellent and predictable results is becoming the treatment of choice after tooth removal. A key step in creating a proper environment and conditions for it is the process of tissue preservation after the extraction. Various ridge preservation procedures have been suggested and performed, one of which is the application of immediate implant protocol using customized healing abutments. AIM: This review observes immediate implants not only as a definitive treatment after tooth extraction but also as a method for ridge preservation, especially in conjunction with customized healing abutments. We compared and evaluated the reports on their application and summarized their features, advantages, and limitations. MATERIALS AND METHODS: The present article is based on 61 articles. A manual and electronic search using PubMed and Google Scholar databases was conducted until June 2022. RESULTS: The majority of studies support the concept of immediate implant placement with customized healing abutments as a successful and reliable strategy for tissue preservation. It has numerous advantages, some of which are reduced healing time and post-operative discomfort, and excellent aesthetic results without the need for additional surgical stages. CONCLUSION: Further investigation is still necessary to clarify the exact protocols and indications for this treatment, and to point out the conditions, which demand greater caution

Vertical misfit of laser-sintered and vacuum-cast implant-supported crown copings luted with definitive and temporary luting agents

Objectives. This study aimed to evaluate the vertical discrepancy of implant-supported crown structures constructed with vacuum-casting and Direct Metal Laser Sintering (DMLS) technologies, and luted with different cement types. Study D esign. Crown copings were fabricated using: (1) direct metal laser sintered Co-Cr (LS); (2) vacuum-cast Co-Cr (CC); and (3) vacuum-cast Ti (CT). Frameworks were luted onto machined implant abutments under constant seating pressure. Each alloy group was randomly divided into 5 subgroups (n = 10 each) according to the cement system utilized: Subgroup 1 (KC) used resin-modified glass-ionomer Ketac Cem Plus; Subgroup 2 (PF) used Panavia F 2.0 dual-cure resin cement; Subgroup 3 (RXU) used RelyX Unicem 2 Automix self-adhesive dual-cure resin cement; Subgroup 4 (PIC) used acrylic/urethane-based temporary Premier Implant Cement; and Subgroup 5 (DT) used acrylic/urethane-based temporary DentoTemp cement. Vertical misfit was measured by scanning electron microscopy (SEM). Two-way ANOVA and Student-Newman-Keuls tests were run to investigate the effect of alloy/fabrication technique, and cement type on vertical misfit. The statistical significance was set at ? = 0.05. Results. The alloy/manufacturing technique and the luting cement affected the vertical discrepancy (p < 0.001). For each cement type, LS samples exhibited the best fit (p < 0.01) whereas CC and CT frames were statistically similar. Within each alloy group, PF and RXU provided comparably greater discrepancies than KC, PIC, and DT, which showed no differences. Conclusions. Laser sintering may be an alternative to vacuum-casting of base metals to obtain passive-fitting implant-supported crown copings. The best marginal adaptation corresponded to laser sintered structures luted with glass-ionomer KC, or temporary PIC or DT cements. The highest discrepancies were recorded for Co-Cr and Ti cast frameworks bonded with PF or RXU resinous agents. All groups were within the clinically acceptable misfit range

A Simplified Technique for Implant-Abutment Level Impression After Soft Tissue Adaptation Around Provisional Restoration

Impression techniques for implant restorations can be implant level or abutment level impressions with open tray or closed tray techniques. Conventional implant-abutment level impression techniques are predictable for maximizing esthetic outcomes. Restoration of the implant traditionally requires the use of the metal or plastic impression copings, analogs, and laboratory components. Simplifying the dental implant restoration by reducing armamentarium through incorporating conventional techniques used daily for crowns and bridges will allow more general dentists to restore implants in their practices. The demonstrated technique is useful when modifications to implant abutments are required to correct the angulation of malpositioned implants. This technique utilizes conventional crown and bridge impression techniques. As an added benefit, it reduces costs by utilizing techniques used daily for crowns and bridges. The aim of this report is to describe a simplified conventional impression technique for custom abutments and modified prefabricated solid abutments for definitive restorations

Recent advances in additive manufacturing of patient-specific devices for dental and maxillofacial rehabilitation

ObjectivesCustomization and the production of patient-specific devices, tailoring the unique anatomy of each patient's jaw and facial structures, are the new frontiers in dentistry and maxillofacial surgery. As a technological advancement, additive manufacturing has been applied to produce customized objects based on 3D computerized models. Therefore, this paper presents advances in additive manufacturing strategies for patient-specific devices in diverse dental specialties.MethodsThis paper overviews current 3D printing techniques to fabricate dental and maxillofacial devices. Then, the most recent literature (2018–2023) available in scientific databases reporting advances in 3D-printed patient-specific devices for dental and maxillofacial applications is critically discussed, focusing on the major outcomes, material-related details, and potential clinical advantages.ResultsThe recent application of 3D-printed customized devices in oral prosthodontics, implantology and maxillofacial surgery, periodontics, orthodontics, and endodontics are presented. Moreover, the potential application of 4D printing as an advanced manufacturing technology and the challenges and future perspectives for additive manufacturing in the dental and maxillofacial area are reported.SignificanceAdditive manufacturing techniques have been designed to benefit several areas of dentistry, and the technologies, materials, and devices continue to be optimized. Image-based and accurately printed patient-specific devices to replace, repair, and regenerate dental and maxillofacial structures hold significant potential to maximize the standard of care in dentistry