• The Journal of Advanced Prosthodontics
• /
• v.12 no.1
• /
• pp.15-21
• /
• 2020

PURPOSE. The aim of the current study was to analyze treatment concepts of a cohort of German dentists for planning, fabrication, and maintenance of implant-supported fixed and removable restorations. MATERIALS AND METHODS. A questionnaire including queries about experiences with implant-supported restorations as well as prosthetic and maintenance treatment concepts for supplying patients with fixed and removable implant-supported prosthetic restorations was developed and sent to 350 dental offices registered in the municipal area of Leipzig, Germany. RESULTS. An overall total of 62 returned questionnaires were included in the analyses, which relates to a response rate of 17.7%. Participating dentists were more involved in the prosthetic aspects of implant dentistry rather than surgery, while prosthetic concepts such as backward planning, digital processing, and application of all-ceramic materials were not commonly performed. Simple attachments were preferred over complex retention systems in removable implant-supported restorations. Tooth/implant-supported fixed denture prostheses as well as removable denture prostheses with supporting posterior implants were not regarded as a favorable treatment option. CONCLUSION. Within the limitations of the study, the data indicate that dentists favor simple and conventional treatment approaches in implant prosthetics. Prosthetic aspects in the planning of implant-supported restorations are often neglected. Prosthetic treatment guidelines and aspects should commonly be considered in the planning phase of implant-supported prosthetic restorations, and awareness should be increased in postgraduate education.

• The Journal of Advanced Prosthodontics
• /
• v.14 no.4
• /
• pp.223-235
• /
• 2022

PURPOSE. To compare the clinical outcomes of two types of implant restoration for posterior edentulous area, 3-unit bridge supported by 2 implants and 3 implant-supported splinted crowns. MATERIALS AND METHODS. The data included 127 implant-supported fixed restorations in 85 patients: 37 restorations of 3-unit bridge supported by 2 implants (2-IB), 37 restorations of 3 implant-supported splinted crowns (3-IC), and 53 single restorations (S) as controls. Peri-implantitis and mechanical complications that occurred for 14 years were analyzed by multivariable Cox regression model. Kaplan-Meier curves and the multivariable Cox regression model were used to analyze the success and survival of implants. RESULTS. Peri-implantitis occurred in 28.4% of 2-IB group, 37.8% of 3-IC group, and 28.3% of S control group with no significant difference. According to the implant position, middle implants (P2) of the 3-IC group had the highest risk of peri-implantitis. The 3-IC group showed a lower mechanical complication rate (7.2%) than the 2-IB (16.2%) and S control group (20.8%). The cumulative success rate was 52.8% in S (control) group, 62.2% in 2-IB group, and 60.4% in 3-IC group. The cumulative survival rate was 98.1% in S (control) group, 98.6% in 2-IB group, and 95.5% in 3-IC group. There was no significant difference in the success and survival rate according to the restoration type. CONCLUSION. The restoration type was not associated with the success and survival of implants. The risk of mechanical complications was reduced in 3 implant-supported splinted crowns. However, the middle implants of the 3 implant-supported splinted crowns had a higher risk of peri-implantitis.

• Journal of Korean Dental Science
• /
• v.10 no.2
• /
• pp.74-81
• /
• 2017

This report describes two cases of complete arch implant-supported restorations. The first patient had seven dental implants in each arch with monolithic zirconia frameworks. At four weeks' follow-up, the one-piece maxillary framework was fractured, which was re-designed and re-fabricated using laser-sintered cobalt-chrome alloy. The second patient had four implants in the mandible only. A mandibular monolithic zirconia framework and a maxillary conventional complete denture were fabricated and delivered. At five years' follow-up, the patient reported no significant discomfort. Careful consideration and monitoring of the status of antagonistic arches and stress distribution on zirconia frameworks were suggested for complete arch implant-supported fixed restorations.

• The Journal of Advanced Prosthodontics
• /
• v.1 no.3
• /
• pp.140-144
• /
• 2009

STATEMENT OF PROBLEM. Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE. This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS. Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS. The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION. To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.

• The Journal of the Korean dental association
• /
• v.54 no.3
• /
• pp.198-205
• /
• 2016

The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

• Journal of Periodontal and Implant Science
• /
• v.36 no.4
• /
• pp.925-938
• /
• 2006

The aim of this study was to systematically investigate the complications of single implant-supported restorations followed more than 5-year. Thirty-five studies were selected for the systematic review. A total of 3932 single implants were included at the beginning of studies. Thirty-one implants were removed before loading and 91 implants after loading. The overall implant loss rate was 3.1 %. Implant losses were concentrated on the period between loading and 2-year follow-up, and, after a stable period, increased after 5-year follow-up. The mean marginal bone loss at single-tooth implants was well within 0.2 mm/year, i.e., acceptable annual bone loss by the implant success criteria. However, considerable amounts of single implants suffered a marginal bone loss at implant more than 0.2 mm/year. Fistula was a frequent biological complication in the early studies. The most frequent technical problem was a screw loosening, but its frequency was reduced after the use of a gold screw and torque controller. Within the limits of this study, the complications of single implants might be underestimated due to the lack of information about the biological and technical complications available in the relevant literature.

• The Journal of Advanced Prosthodontics
• /
• v.11 no.5
• /
• pp.271-279
• /
• 2019

PURPOSE. The newest technologies for digital implant impression (DII) taking are developing rapidly and showing acceptable clinical results. However, scientific literature is lacking data from clinical studies about the accuracy of DII. The aim of this study was to compare digital and conventional dental implant impressions (CII) in a clinical environment. MATERIALS AND METHODS. Twenty-four fixed zirconia restorations supported by 2 implants were fabricated using conventional open-tray impression technique with splinted transfers (CII group) and scan with Trios 3 IOS (3Shape) (DII group). After multiple verification procedures, master models were scanned using laboratory scanner D800 (3Shape). 3D models from conventional and digital workflow were imported to reverse engineering software and superimposed with high resolution 3D CAD models of scan bodies. Distance between center points, angulation, rotation, vertical shift, and surface mismatch of the scan bodies were measured and compared between conventional and digital impressions. RESULTS. Statistically significant differences were found for: a) inter-implant distance, b) rotation, c) vertical shift, and d) surface mismatch differences, comparing DII and CII groups for mesial and distal implant scan bodies ($P{\leq}.05$). CONCLUSION. Recorded linear differences between digital and conventional impressions were of limited clinical significance with two implant-supported restorations.

• The Journal of the Korean dental association
• /
• v.51 no.4
• /
• pp.204-209
• /
• 2013

Implant-supported restorations were connected to commercially pure titanium endosteal implants 3 months in mandible and 6 months in maxilla after the implants were inserted into patient jaws. Modifications of titanium implant surfaces have reduced the waiting time for osseointegration, resulting in the development of the early loading concept, which is defined at present as a restoration in contact with the opposing dentition and placed at least 1 week after implant placement, but no later than 2 months afterward. Nowadays, immediate loading protocols have also been introduced, using the implants that are designed to enhance initial stability. Immediate loading eliminates the edentulous period of a patient. Although dentists widely accept these concepts of early and immediate loading, they agree the conventional loading concept is still necessary, which describes loading protocols later than 2 months after implant insertion. The timing of loading is determined mainly by the factors of a patient. This paper considers for what dental clinicians should be careful in implant-supported restoration procedures, considering the implant late failure.

• The Journal of Advanced Prosthodontics
• /
• v.11 no.4
• /
• pp.232-238
• /
• 2019

PURPOSE. The aim of this study was to investigate simulated localized and generalized wear of indirect composite resins used for implant supported provisional restorations. MATERIALS AND METHODS. The study investigated ten indirect composite resins. Two kinds of wear were simulated by 400,000 cycles in a Leinfelder-Suzuki (Alabama) machine. Localized wear was simulated with a stainless-steel ball bearing antagonist and generalized with a flat-ended stainless-steel cylinder antagonist. The tests were carried out in water slurry of polymethyl methacrylate beads. Wear was measured using a Proscan 2100 noncontact profilometer in conjunction with Proscan and AnSur 3D software. RESULTS. Both localized and generalized wear were significantly different (P<.05) among the indirect composite resins. SR Nexco and Gradia Plus showed significantly less wear than the other indirect composite resins. The rank order of wear was same in both types of wear simulation. CONCLUSION. Indirect composite resins are recommended when a provisional implant-supported restoration is required to function in place over a long period. Although only some indirect composite resins showed similar wear resistance to CAD/CAM composite resins, the wear resistance of all the indirect composite resins was higher than that of bis-acryl base provisional and polymethyl methacrylate resins.

• The Journal of the Korean dental association
• /
• v.39 no.9 s.388
• /
• pp.732-744
• /
• 2001