Attitude and treatment options in implant-supported prosthetics: A survey among a cohort of German dentists

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.

In vitro performance and fracture resistance of novel CAD/CAM ceramic molar crowns loaded on implants and human teeth

PURPOSE: To investigate the fatigue and fracture resistance of computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic molar crowns on dental implants and human teeth. MATERIALS AND METHODS: Molar crowns (n=48; n=8/group) were fabricated of a lithium-disilicate-strengthened lithium aluminosilicate glass ceramic (N). Surfaces were polished (P) or glazed (G). Crowns were tested on human teeth (T) and implant-abutment analogues (I) simulating a chairside (C, crown bonded to abutment) or labside (L, screw channel) procedure for implant groups. Polished/glazed lithium disilicate (E) crowns (n=16) served as reference. Combined thermal cycling and mechanical loading (TC: 3000×5℃/3000×55℃; ML: 1.2×106 cycles, 50 N) with antagonistic human molars (groups T) and steatite spheres (groups I) was performed under a chewing simulator. TCML crowns were then analyzed for failures (optical microscopy, SEM) and fracture force was determined. Data were statistically analyzed (Kolmogorow-Smirnov, one-way-ANOVA, post-hoc Bonferroni, α=.05). RESULTS: All crowns survived TCML and showed small traces of wear. In human teeth groups, fracture forces of N crowns varied between 1214±293 N (NPT) and 1324±498 N (NGT), differing significantly (P≤.003) from the polished reference EPT (2044±302 N). Fracture forces in implant groups varied between 934±154 N (NGI_L) and 1782±153 N (NPI_C), providing higher values for the respective chairside crowns. Differences between polishing and glazing were not significant (P≥.066) between crowns of identical materials and abutment support. CONCLUSION: Fracture resistance was influenced by the ceramic material, and partly by the tooth or implant situation and the clinical procedure (chairside/labside). Type of surface finish (polishing/glazing) had no significant influence. Clinical survival of the new glass ceramic may be comparable to lithium disilicate.

Biofilm formation on denture base resin including ZnO, CaO, and TiO₂ nanoparticles

PURPOSE: This laboratory study aimed to investigate the effect of doping an acrylic denture base resin material with nanoparticles of ZnO, CaO, and TiO₂ on biofilm formation. MATERIALS AND METHODS: Standardized specimens of a commercially available cold-curing acrylic denture base resin material were doped with 0.1, 0.2, 0.4, or 0.8 wt% commercially available ZnO, CaO, and TiO₂ nanopowder. Energy dispersive X-ray spectroscopy (EDX) was used to identify the availability of the nanoparticles on the surface of the modified specimens. Surface roughness was determined by employing a profilometric approach; biofilm formation was simulated using a monospecies Candida albicans biofilm model and a multispecies biofilm model including C. albicans, Actinomyces naeslundii, and Streptococcus gordonii. Relative viable biomass was determined after 20 hours and 44 hours using a MTT-based approach. RESULTS: No statistically significant disparities were identified among the various materials regarding surface roughness and relative viable biomass. CONCLUSION: The results indicate that doping denture base resin materials with commercially available ZnO, CaO, or TiO₂ nanopowders do not inhibit biofilm formation on their surface. Further studies might address the impact of varying particle sizes as well as increasing the fraction of nanoparticles mixed into the acrylic resin matrix.