Biegefestigkeit von Verblendkeramiken für Zirkoniumdioxid : hat die Prüfmethode einen Einfluss auf die Werte?

Die klinische Zuverlässigkeit von Zirkoniumdioxid-Restaurationen wird diskutiert. Das Hauptproblem scheint die erhöhte Frakturrate der Verblendungen zu sein. Die Festigkeit der Verblendkeramiken ist dabei einer der Faktoren, die die Stabilität der gesamten Restauration bestimmen. Deshalb war es das Ziel der vorliegenden Untersuchung, die Biegefestigkeit von Verblendkeramiken für Zirkoniumdioxid vergleichend zu untersuchen. Die Festigkeitswerte wurden mit drei verschiedenen Messmethoden ermittelt und denjenigen von Verblendmassen für die Metallkeramik gegenübergestellt

How do professional development programs on comparing solution methods and classroom discourse affect students' achievement in mathematics? The mediating role of students’ subject matter justifications

Comparing solution methods fosters strategy flexibility in equation solving. Productive classroom discourse such as Accountable Talk (AT) orchestrated by teachers can improve students' justifications during classroom discussions and achievement. Do students' subject matter justifications during classroom discourse mediate the effect of teachers' professional development (PD) programs focused on comparing and AT on students’ mathematics achievement? We investigated whether two PD programs (comparing or comparing+AT) compared to a control group increased the number of students justifications, and whether this affected mathematics achievement (strategy flexibility, procedural knowledge, and conceptual knowledge). The study (739 9th and 10th grade students in 39 classes) had an experimental pre-post control group design. Both PD programs significantly increased students justifications compared to the control group. The results of our multilevel path models showed significant small mediation effects in the comparing+AT group on procedural and conceptual knowledge. No mediation effects were found in the comparing group

Time efficiency and efficacy of a centralized computer-aided-design/computer-aided-manufacturing workflow for implant crown fabrication: A prospective controlled clinical study

OBJECTIVE To assess time efficiency and the efficacy of the prosthetic manufacturing for implant crown fabrication in a centralized workflow applying computer aided design and computer aided manufacturing (CAD-CAM). MATERIAL AND METHODS Fifty-nine patients with one posterior implant each, were randomly allocated to either a centralized digital workflow (c-DW, test) or a laboratory digital workflow (l-DW, control). Patients were excluded from efficiency and efficacy analyses, if any additional restoration than this single implant crown had to be fabricated. A customized titanium abutment and a monolithic zirconia crown were fabricated in the c-DW. In the l-DW, models were digitalized for CAD-CAM fabrication of a monolithic zirconia crown using a standardized titanium base abutment. Time for impression, laboratory operating and delivery time were recorded. The efficacy of the prosthetic manufacturing was evaluated at try-in and at delivery. Data was analyzed descriptively. Statistical analyses using student's unpaired t- and paired Wilcoxon were performed (p < 0.05). RESULTS At impression taking, 12 patients (c-DW) and 19 patients (l-DW) were included. The impression time was 9.4±3.5 min (c-DW) and 15.1 ± 4.6 min (l-DW) (p < 0.05). The laboratory operating time was 130 ± 31 min (c-DW) and 218.0±8 min (l-DW) (p < 0.05). The delivery time was significantly longer in the c-DW (5.9 ± 3.5 1 days) as compared to the l-DW (0.5±0.05 days). At try-in and at delivery, efficacy of prosthetic manufacturing was similar high in both workflows. CLINICAL RELEVANCE The c-DW was more time efficient compared to the lab-DW and rendered a similar efficacy of prosthetic manufacturing

Computer‐assisted bone augmentation, implant planning and placement: An in vitro investigation

Aim To assess in vitro the workflow for alveolar ridge augmentation with customised 3D printed block grafts and simultaneous computer-assisted implant planning and placement. Methods Twenty resin mandible models with an edentulous area and horizontal ridge defect in the region 34–36 were scanned with cone beam computed tomography (CBCT). A block graft for horizontal ridge augmentation in the region 34–36 and an implant in the position 35 were digitally planned. Twenty block grafts were 3D printed out of resin and one template for guided implant placement were stereolithographically produced. The resin block grafts were positioned onto the ridge defects and stabilised with two fixation screws each. Subsequently, one implant was inserted in the position 35 through the corresponding template for guided implant placement. Optical scans of the study models together with the fixated block graft were performed prior to and after implant placement. The scans taken after block grafting were superimposed with the virtual block grafting plan through a best-fit algorithm, and the linear deviation between the planned and the achieved block positions was calculated. The precision of the block fixation was obtained by superimposing the 20 scans taken after grafting and calculating the deviation between the corresponding resin blocks. The superimposition between the scans taken after and prior to implant placement was performed to measure a possible displacement in the block position induced by guided implant placement. The (98–2%)/2 percentile value was determined as a parameter for surface deviation. Results The mean deviation in the position of the block graft compared to the virtual plan amounted to 0.79 ± 0.13 mm. The mean deviation between the positions of the 20 block grafts measured 0.47 ± 0.2 mm, indicating a clinically acceptable precision. Guided implant placement induced a mean shift of 0.16 ± 0.06 mm in the position of the block graft. Conclusions Within the limitations of this in vitro study, it can be concluded that customised block grafts fabricated through CBCT, computer-assisted design and 3D printing allow alveolar ridge augmentation with clinically acceptable predictability and reproducibility. Computer-assisted implant planning and placement can be performed simultaneously with computer-assisted block grafting leading to clinically non-relevant dislocation of block grafts

Exploring the Microbiome of Healthy and Diseased Peri-Implant Sites Using Illumina Sequencing

Aim To compare the microbiome of healthy (H) and diseased (P) peri-implant sites and determine the core peri-implant microbiome. Materials and Methods Submucosal biofilms from 32 H and 35 P sites were analyzed using 16S rRNA sequencing (MiSeq, Illumina), QIIME and HOMINGS. Differences between groups were determined using Principal Coordinate Analysis (PCoA), t-tests and Wilcoxon rank sum test and FDR-adjusted. The peri-implant core microbiome was determined. Results PCoA showed partitioning between H and P at all taxonomic levels. Bacteroidetes, Spirochetes and Synergistetes were higher in P, while Actinobacteria prevailed in H (p\u3c0.05). Porphyromonas and Treponema were more abundant in P and while Rothia and Neisseria were higher in H (p\u3c0.05). The core peri-implant microbiome contained Fusobacterium, Parvimonas and Campylobacter sp. T. denticola and P. gingivalis levels were higher in P, as well as F. alocis, F fastidiosum and T. maltophilum (p\u3c0.05). Conclusion The peri-implantitis microbiome is commensal-depleted and pathogen-enriched, harboring traditional and new pathogens. The core peri-implant microbiome harbors taxa from genera often associated with periodontal inflammation

A prospective, controlled clinical trial evaluating the clinical radiological and aesthetic outcome after 5 years of immediately placed implants in sockets exhibiting periapical pathology

OBJECTIVE: The aim was to compare the clinical, aesthetic and radiological outcome of immediately placed implants in sockets with or without periapical pathology 5 years after placement. MATERIALS AND METHODS: Twenty-seven patients were followed 5 years after immediate implant placement (test-group: 12 patients with periapical pathologies; control-group: 15 patients without periapical pathology). Clinical (FMBS, FMPS, CAL, keratinized mucosa), aesthetical (length of clinical crown, Papilla index), and radiological (vertical distance implant shoulder to first bone to implant contact (IS-BIC)) parameters were assessed. Both 95% confidence intervals, as well as results of statistical tests (one-sample, two-sample, paired t-test) were provided. RESULTS: After 5 years the implant survival rate was 100% for all 27 implants. In the test group the width of the keratinized mucosa increased significantly over the observation period (0.8 ± 1.0 mm). Concerning aesthetic parameters at the 3-month as well as at the 5-year examination no statistically significant difference could be found between the two groups. In the control-group the papilla mesial and distal to the implant increased statistically significant during the observation period by 0.5 ± 0.5 and 0.4 ± 0.6 index score points, respectively. The position of the gingival margin at the implant site and the two neighboring teeth remained stable. At the 5-year visit IS-BIC measured between 1.4 ± 0.5 mm (mesial, control) and 1.7 ± 0.7 mm (distal, test), no significant difference could be found between the two groups. Over the observation period no statistically significant change of IS-BIC could be found in the test- as well as in the control-group. None of the examined radiographs revealed any signs of retrograde peri-implantitis. CONCLUSION: The replacement of teeth exhibiting periapical pathologies by implants placed immediately after tooth extraction can be a successful treatment modality with no disadvantages in clinical, aesthetical and radiological parameters to immediately placed implants into healthy sockets

Success of 6-mm Implants with Single-Tooth Restorations: A 3-year Randomized Controlled Clinical Trial

The aim of the study was to test whether implants of 6 mm in length perform equally well as 10-mm implants in terms of survival and marginal bone-level changes when supporting single crowns. Patients with a posterior single-tooth gap were randomly allocated to either the placement of a 6-mm (test) or 10-mm implant (control). The treatment protocol allowed for internal sinus lift but not for lateral bone augmentation. After a healing period of 10 wk, implants were loaded with screw-retained single crowns. Survival rates, number of pockets ≥5 mm, and bleeding-on-probing were assessed clinically. The change of marginal bone level and crown-to-implant ratios were analyzed by 2 examiners. Longitudinal intragroup analyses for marginal bone levels were performed applying the Wilcoxon signed rank test. Intergroup differences at baseline and at 3 y were compared using the Mann-Whitney U test. The effect of implant length and crown-to-implant ratio on changes of marginal bone level also was determined. Of 94 implants placed (47 test and 47 control), 78 implants (40 test and 38 control) were available for follow-up examination at 3 y of loading. One test implant was lost during the second year. Hence, implant survival was not significantly different between the 2 groups after 3 y (98% test; 100% control). We found no significant change in the crestal bone level from baseline to 3 y for test and control implants with -0.19 ± 0.62 mm and -0.33 ± 0.71 mm, respectively. The intergroup difference was not significant. Crown-to-implant ratios were not associated with a statistically significant difference in marginal bone loss. However, the number of sites with pockets ≥5 mm was significantly higher in the test group. Based on the 3-y assessment, the use of 6-mm implants can be considered a viable option when reconstructing posterior single tooth gaps (German Clinical Trials Registry: DRKS00006290)