Risk Factors with Porcelain Laminate Veneers Experienced during Cementation: A Review.

The clinical success of porcelain laminate veneers (PLVs) depends on many clinical and technical factors, from planning to execution, among which adhesive cementation is of significant importance. This procedure carries many risk factors if not optimally executed. The objective of this study was to document the clinical parameters affecting successful cementation procedures with a focus on the adhesive strength, integrity, and esthetics of the PLVs. A literature search was conducted through MEDLINE, complemented by a hand search using predefined keywords. Articles published in English between 1995 and 2023 were selected. According to this review, the success and longevity of PLVs rely in great part on the implementation of a precise cementation technique, starting from field isolation, adequate materials selection for adhesion, proper manipulation of the materials, the seating of the veneers, polymerization, and elimination of the excess cement. Several clinical steps performed before cementation, including treatment planning, preparation, impression, and adequate choice of the restorative material, could affect the quality of cementation. Scientific evidence suggests careful implementation of this process to achieve predictable outcomes with PLVs. The short- and long-term clinical success of adhesively luted PLVs is tributary to a deep understanding of the materials used and the implementation of clinical protocols. It is also contingent upon all the previous steps from case selection, treatment planning, and execution until and after the cementation.

Use of narrow-diameter implants in the posterior segments of the jaws: A retrospective observational study of 2 to 11 years.

STATEMENT OF PROBLEM: The placement of narrow-diameter implants (NDIs) in the posterior region is still debated in view of the high biomechanical risks in these areas. PURPOSE: The purpose of this retrospective observational study was to evaluate the success and survival rates of NDIs restored with fixed prostheses in the posterior region (primary outcome) and analyze whether splinting multiple units (prosthesis design) affects the biological and mechanical complications (secondary outcome). MATERIAL AND METHODS: Dental records from 2 private clinics were reviewed for NDIs in the posterior region installed between 2009 and 2018. Ninety study participants (58 women and 32 men) aged between 21 and 84 years (mean age 49.9 years) were recalled for the assessment of implant survival and success of 160 NDIs previously provided for partial posterior edentulism associated with moderate horizontal bone loss or reduced interradicular space (105 premolars and 55 molars). The implants were restored with metal-ceramic single crowns or splinted multiple-unit prostheses, either screw-retained or cemented on custom (n=100) or stock titanium abutments (n=60). Peri-implant probing depth (PPD), bleeding on probing (BOP), bone quality, type of edentulism, and patient satisfaction were scored. The chi-squared test for independence and 2-sample Welch t test were performed for statistical analysis (α=.05). RESULTS: The overall success rate was 89.37%. One implant had been removed 4 years after loading, another after 9 years, yielding a cumulative survival rate of 98.75%. Fourteen implants exhibited PPD > 5 mm. One implant and 1 abutment screw fractured, and 16 restorations demonstrated porcelain chipping. The chi-squared test showed no significant relationship between prosthetic design and complications whether biological (P=.087) or mechanical (P=.805). Eighty-two percent of patients were satisfied with esthetics, 76% with function, 85% with total duration of treatment, and 90% with overall treatment cost. CONCLUSIONS: Within the limitations of this retrospective study, NDIs may be considered a reliable option to replace posterior teeth. The prosthetic design had no significant impact on biological or mechanical complications.

Prosthetic maintenance of different mandibular implant overdentures: A systematic review.

STATEMENT OF PROBLEM: Different factors can affect prosthetic maintenance requirements for mandibular implant overdentures (IODs). However, the literature shows a high level of disagreement concerning the effect of each factor on maintenance needs. PURPOSE: The purpose of this systematic review was to address the focus question: "In the clinical studies published since 2004 of adult patients with totally edentulous mandibles treated by IODs with a variable number of implants and different designs, what were the maintenance types, frequencies, and complications?" MATERIAL AND METHODS: A search of MEDLINE and PubMed databases was performed targeting papers in English on prosthetic maintenance of mandibular IODs published between 2004 and June 2015, aiming at recognizing the needs for adjustment, repair, and renewal. The recorded data were divided into 6 categories, and a percentage value was attributed to each. RESULTS: From a total of 130 articles, 33 studies met the specified inclusion criteria for the review (14 randomized controlled trials, 8 prospective clinical trials, 3 retrospective studies, and 4 systematic reviews). These articles provided evidence that a mean complication rate was impossible to determine because of the multiplicity of contributing factors. No clear identification of the causes of mechanical complications was found, nor was there any clear evidence of superiority of one implant and/or attachment design over another. CONCLUSIONS: Prosthetic complications with IODs are unavoidable. However, they can be reduced to an expected level if a close follow-up protocol is implemented aiming at anticipating risks of unexpected complications. Further clinical studies are needed to achieve a constructive meta-analysis that accounts for different parameters such as opposite arch, attachment functional variety, connection method, and prosthesis quality.

Use of narrow-diameter implants in the posterior jaw: a systematic review.

STATEMENT OF PROBLEM: Evidence is limited on the efficacy of narrow-diameter implants (NDIs) in the posterior jaw. PURPOSE: The purpose of this systematic review was to assess the survival of NDIs and provide guidelines for their safe use. MATERIALS AND METHODS: Electronic search of the English-language literature enriched by hand search to identify suitable publications was made. Only peer-reviewed clinical studies published from January 1990 through March 2014 were included. RESULTS: Seventeen studies with a total of 1644 implants met the inclusion criteria, with an observation period from 1 up to 12 years. The mean survival rate of 98.6% was reported. Technical and other complications were observed. CONCLUSION: Short-term clinical data suggest that NDIs may serve in the posterior jaw as an alternative to standard-diameter implants. However, certain clinical conditions must be observed to assure long-term success.

Revisiting implant-retained mandibular overdentures: planning according to treatment needs.

Increasingly popular, implant-retained mandibular overdentures have a highly predictable success rate and provide many options in terms of design and attachment systems. General dentists may have some difficulties in choosing the appropriate system. This paper provides a general overview of the various options that are available, taking into consideration the specifications and challenges of each.