Accuracy of complete-arch digital implant impression with intraoral optical scanning and stereophotogrammetry: An in vivo prospective comparative study

Objectives: To assess accuracy of intraoral optical scanning (IOS) and stereophotogrammetry (SPG), complete-arch digital implant impressions in vivo. Materials and Methods: Consecutive patients needing implant-supported screw-retained zirconia complete-arch fixed-dental prostheses (ISZ-FDP) were recruited. For each patient, three impressions were taken: IOS, SPG (tests), and open-tray plaster (reference). Linear (ΔX, ΔY, and ΔZ), three-dimensional (ΔEUC), and angular deviations (ΔANGLE) were evaluated and stratified according to scanning technology for each implant. Potential effects of impression device (IOS and SPG), arch (maxilla and mandible), and implant number (4 and 6) were evaluated through multivariable analysis. Significance level was set at.05. Results: A total of 11 complete arches (5 maxillae, 6 mandibles) in 11 patients were rehabilitated with ISZ-FDPs supported by 4 (n = 8) and 6 implants (n = 3). A total of 50 implants and 100 implant positions were captured by two investigated devices and compared to respective reference (mean ΔEUC IOS 137.2, SPG 87.6 μm; mean ΔANGLE 0.79, 0.38°). Differences between measurements (SPG-IOS) were computed for each implant, with negative values indicating better SPG accuracy. Significant mean ΔEUC difference of −49.60 μm (p =.0143; SD 138.15) and mean ΔANGLE difference of −0.40° (p <.0001; SD 0.65) were observed in favor of SPG. Multivariable analysis showed significant effect on ΔEUC (p =.0162) and ΔANGLE (p =.0001) only for impression devices, with SPG performing better. Conclusions: SPG experienced significantly higher linear and angular accuracy. No effect of type of arch or implant number was detected. Higher extreme deviations were experienced for IOS. SPG can be feasible for complete-arch digital impressions with caution, and rigid prototype try-in is recommended before screw-retained prosthesis manufacturing. © 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Clinical performance of immediately placed and immediately loaded single implants in the esthetic zone: A systematic review and meta-analysis.

OBJECTIVES The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone (15-25), what is the influence of an immediate implant placement and immediate loading protocol on the clinical performance (primary aim) and esthetic outcomes (secondary aim) focusing on investigations published after 2010. MATERIAL AND METHODS An electronic search in Medline (PubMed), the Cochrane Central Register of Controlled Trials, and EMBASE databases up to April 2022 was performed to identify clinical studies investigating the outcome of single implants subjected to immediate placement with immediate restoration/loading (Type 1A). RESULTS Sixty-three studies (10 randomized controlled trials, 28 prospective and 25 retrospective cohort studies) were included with a follow-up ranging from 12 to 96 months. One thousand nine hundred sixty-one implants reported survival rates of 99.2 (98.6-99.5) % at 1 year, 97.5 (95.9-98.4) % after 3 years, and 95.8 (93.3-97.4) % after 5 years; 1064 immediately loaded restorations presented survival rates of 98.9 (97.8-99.5) % after 1 year, 96.8 (93.6-98.4) % after 2 years, and 94.8 (89.6-97.4) % after 5 years. Comparing baseline to 12-month data using the Hedges' g effect size (95% CI), papilla height presented an overall effect size of -0.71 (-1.25, -0.1) mm, midfacial recession change of -0.15 (-0.66, 0.36) mm, and a 0.82 (0.37, 1.28) gain in PES. CONCLUSIONS Immediate implant placement and immediate loading can be considered a predictable and safe treatment option for single maxillary anterior restorations with adequate survival rates and favorable esthetics outcomes for up to 5 years

Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis.

OBJECTIVES The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. MATERIALS AND METHODS An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. RESULTS A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). CONCLUSIONS Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments

Guided bone regeneration and abutment connection augment the buccal soft tissue contour: 3-year results of a prospective comparative clinical study

AIM: To test whether implant placement with simultaneous guided bone regeneration (GBR) differs from implant placement without GBR regarding the change in marginal mucosal contour. MATERIALS AND METHODS: In 28 patients, single implants were placed >4 months after tooth extraction. Eighteen implants were completely surrounded by native bone, and no bone augmentation was performed. At 10 implant sites, bone defects and thin bone plates were grafted with deproteinized bovine-derived bone mineral and covered with collagen membrane. Impressions were taken prior to implant placement (baseline), at 3 months before abutment connection, at 6 months immediately after crown insertion, at 1 year, and at 3 years. Models were optically scanned and 3D images were superimposed for the evaluation of mucosal contour changes at the mid-buccal aspect. The nonparametric Mann-Whitney U-test was applied to detect differences. RESULTS: From baseline to 6 months, horizontal contour change at the level 1 and 2 mm apical to the mucosal margin measured 0.65 ± 0.74 mm and 0.55 ± 0.56 mm at sites without GBR, and 1.92 ± 0.87 mm and 1.76 ± 0.70 mm at sites with GBR (P < 0.05). In the period from baseline to 1 year, the corresponding values amounted to 0.81 ± 0.67 mm and 0.60 ± 0.55 mm in the group without GBR, and to 1.81 ± 0.86 mm and 1.37 ± 0.62 mm in the group with GBR (P < 0.05). From baseline to 6 months, mucosal margin moved 0.16 ± 0.49 mm in the coronal direction in the group without GBR and 0.82 ± 0.65 mm in the group with GBR (P < 0.05). In the period from baseline to 1 year, vertical change of mucosal margin amounted to 0.64 ± 0.54 mm in the group without GBR and to 1.17 ± 0.53 mm in the GBR group (P < 0.05). From 1 to 3 years, the mucosal contours remained stable. CONCLUSIONS: Implant placement with simultaneous GBR resulted in more gain of buccal soft tissue contour in comparison with implant placement without GBR. Abutment connection increased the contour of the marginal mucosa at the augmented and the nonaugmented sites. GBR procedure contributed more to the contour gain than did the abutment connection. The augmented and the nonaugmented ridges exhibited stable peri-implant mucosal contour over a 3-year period

Titanium-zirconium narrow-diameter versus titanium regular-diameter implants for anterior and premolar single crowns: 3-year results of a randomized controlled clinical study.

AIM To test whether titanium-zirconium (Ti-Zr) 3.3 mm diameter implants perform differently from titanium (Ti) 4.1 mm diameter implants with respect to marginal bone level (MBL) and clinical parameters. MATERIAL AND METHODS Forty patients in need of a single-implant crown in the anterior or premolar regions were enrolled in two centres. Following random allocation, either a Ti-Zr or a Ti implant was inserted. Porcelain-fused-to-metal crowns were inserted 6 months after implantation. Implant survival, change in MBL, clinical parameters, change in mid-facial mucosa and papilla levels, and the occurrence of biological and technical complications were assessed at the 3-year follow-up. RESULTS At 3 years, 32 of the 40 included patients were examined (15 Ti, 17 Ti-Zr). There were no implant failures. From the implant placement to 3 years, the median change in mean MBL amounted to 0.21 mm (mean: -0.31) in the Ti group and 0.10 mm (mean: -0.40) in the Ti-Zr group. There were no significant differences between the groups with respect to the change in MBL, the change in mucosa levels, and the occurrence of complications. CONCLUSIONS Ti-Zr implants with 3.3 mm diameter used for the support of single crowns in the anterior and the premolar regions did not differ from Ti implants with 4.1 mm diameter regarding the clinical performance over a 3-year period. This article is protected by copyright. All rights reserved

Group 2 ITI Consensus Report: Prosthodontics and implant dentistry

ObjectivesWorking Group 2 was convened to address topics relevant to prosthodontics and dental implants. Systematic reviews were developed according to focused questions addressing (a) the number of implants required to support fixed full‐arch restorations, (b) the influence of intentionally tilted implants compared to axial positioned implants when supporting fixed dental prostheses (FDPs), (c) implant placement and loading protocols, (d) zirconia dental implants, (e) zirconia and metal ceramic implant supported single crowns and (f) zirconia and metal ceramic implant supported FDPs.Materials and methodsGroup 2 considered and discussed information gathered in six systematic reviews. Group participants discussed statements developed by the authors and developed consensus. The group developed and found consensus for clinical recommendations based on both the statements and the experience of the group. The consensus statements and clinical recommendations were presented to the plenary (gathering of all conference attendees) and discussed. Final versions were developed after consensus was reached.ResultsA total of 27 consensus statements were developed from the systematic reviews. Additionally, the group developed 24 clinical recommendations based on the combined expertise of the participants and the developed consensus statements.ConclusionsThe literature supports the use of various implant numbers to support full‐arch fixed prostheses. The use of intentionally tilted dental implants is indicated when appropriate conditions exist. Implant placement and loading protocols should be considered together when planning and treating patients. One‐piece zirconia dental implants can be recommended when appropriate clinical conditions exist although two‐piece zirconia implants should be used with caution as a result of insufficient data. Clinical performance of zirconia and metal ceramic single implant supported crowns is similar and each demonstrates significant, though different, complications. Zirconia ceramic FDPs are less reliable than metal ceramic. Implant supported monolithic zirconia prostheses may be a future option with more supporting evidence.</p

Caractérisation et modélisation de la jonction émail-cément pour l'optimisation du design des implants dentaires destinés aux régions esthétiquement sensibles

Cette recherche consistait à créer un modèle de la jonction émail-cément (JEC) des incisives et canines maxillaires chez les humains. Celui-ci a été comparé avec des implants dentaires courants, et ensuite utilisé pour proposer une optimisation des implants destinés aux régions esthétiquement sensibles. Grâce à 548 images digitales de 137 dents humaines, la dimension cervicale, la courbure de la JUC, la distance JEC-point de contact interdentaire ainsi que le contour de la JEC ont été mesurés puis comparés aux dimensions implantaires. En fonction des différences dans le sens transversal et vertical, ainsi que de l'espace biologique autour des implants dentaires, il est important de modifier leur épaulement en adoptant une forme festonnée, visant à reproduire la morphologie de la zone cervicale de la racine. Cette étude révèle des données précises concernant la forme et les caractéristiques d'un implant esthétiquement idéal, en considérant comme "modèle" la JEC

Systematic literature review of digital three-dimensional superimposition techniques to create virtual dental patients

PURPOSE Digital developments have led to the opportunity to compose simulated patient models based on three-dimensional (3D) skeletal, facial, and dental imaging. The aim of this systematic review is to provide an update on the current knowledge, to report on the technical progress in the field of 3D virtual patient science, and to identify further research needs to accomplish clinical translation. MATERIALS AND METHODS Searches were performed electronically (MEDLINE and OVID) and manually up to March 2014 for studies of 3D fusion imaging to create a virtual dental patient. Inclusion criteria were limited to human studies reporting on the technical protocol for superimposition of at least two different 3D data sets and medical field of interest. RESULTS Of the 403 titles originally retrieved, 51 abstracts and, subsequently, 21 full texts were selected for review. Of the 21 full texts, 18 studies were included in the systematic review. Most of the investigations were designed as feasibility studies. Three different types of 3D data were identified for simulation: facial skeleton, extraoral soft tissue, and dentition. A total of 112 patients were investigated in the development of 3D virtual models. CONCLUSION Superimposition of data on the facial skeleton, soft tissue, and/or dentition is a feasible technique to create a virtual patient under static conditions. Three-dimensional image fusion is of interest and importance in all fields of dental medicine. Future research should focus on the real-time replication of a human head, including dynamic movements, capturing data in a single step

Digital tools to optimize implant therapy

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