Clinical outcomes of dental implants placed in fresh sockets: A five-year retrospective study.

Purpose: This retrospective clinical study aimed to evaluate the implants placed in fresh sockets and investigate the effect of varied oral health conditions and treatment plan details on the clinical and radiographic outcomes. Materials and methods: Fifty-nine participants (102 implants) were included in this study. Four variables, including mean probing depth (PD), mean marginal bone loss (MBL), pink esthetic score (PES), and patient satisfaction, were significant dependent variables, and the effects of independent variables on these four items were studied. The data were analyzed by the analysis of covariance (ANCOVA) using a statistical software. Results: The mean follow-up period was 4.75 ± 1.74 years, and the mean MBL was 1.21 ± 0.81 mm. The survival rate was 97 %. There were significant effects of the finish line site, keratinized gingival width, and attached gingival width on PD after adjusting the factors. Also, the implant brand, plaque index, and uncemented prosthesis affected MBL significantly. In addition, significant effects of the surgeon, implant brand, and proximal contact on PES were found. Conclusion: More PD was found around restorations with a finish line site > 1.5 mm subgingival. Sufficient attached gingiva was a more effective factor on PD than keratinized gingiva. Implants with more plaque scores showed more MBL.

Clinical Marginal and Internal Adaptation of Single Metal-Ceramic Crowns Fabricated with Casting, Milling, and Milling/Sintering Methods.

PURPOSE: To compare the adaptation of single metal-ceramic crowns (MCCs) fabricated with three different methods: lost-wax metal casting (LMC), milling of hard cobalt-chromium (HCC) blanks, and milling of soft presintered cobalt-chromium (SCC) blanks. MATERIALS AND METHODS: In this double-blind parallel randomized clinical trial, 60 single MCCs were fabricated using three different methods. Adaptation of the copings was evaluated radiographically, visually, and microscopically. Data were compared among the three groups using the Kruskal-Wallis test, followed by the Dunn post hoc test, one-way ANOVA, and paired t test (α = .05). RESULTS: Radiographic data showed that the frequency of crowns with no marginal discrepancy was significantly higher in the SCC group than the LMC group. Evaluation of marginal adaptation with an explorer revealed that crowns with excellent marginal adaptation had lower frequency in the LMC group than the HCC and SCC groups. In the silicone replica technique, the recorded data revealed no significant difference. Application of porcelain veneering did not affect the adaptation of the copings. CONCLUSIONS: The SCC and HCC groups showed better clinical outcomes compared to the LMC group. However, all MCCs fabricated with the LMC method, milling of HCC blanks, and milling of SCC blanks had acceptable clinical adaptation. Int J Prosthodont 2023;36:581-587.

Comparing the color match of monolithic CAD-CAM dental ceramics with the VITA Classical shade guide.

STATEMENT OF PROBLEM: Matching the shade selected and the final color of a ceramic restoration is challenging, and studies on matching monolithic ceramics to the shade selected are lacking. PURPOSE: The purpose of this in vitro study was to compare the color match of monolithic lithium disilicate (LDS), zirconia-reinforced lithium silicate (ZLS), presintered zirconia-reinforced lithium silicate (PS-ZLS), polymer-infiltrated ceramic network (PICN), and multilayer zirconia with the 3 modes of the VITA Classical shade guide. MATERIAL AND METHODS: This study was performed on 50 rectangular plates (14×12×1 mm) of 5 types of ceramics with A2 shade (n=10). Zirconia specimens were evaluated in 3 locations: incisal, medial, and cervical thirds. The color coordinates of the specimens of all 7 groups were measured on #3 and #8 Ivoclar Natural Die Color material by using a reflective spectrophotometer. The color coordinates of A2 VITA shade were measured in 5 modes: without backing placed in specimen holder, shade tab on the backgrounds #3 and #8, and 1-mm-thick shade tab on the backgrounds #3 and #8. The color difference of each specimen with 3 modes of A2 shade (without backing and on similar backgrounds) was calculated by using the ΔE00 formula, and comparison among groups was performed by using 2-way ANOVA and Tamhane post hoc tests. The comparison of ΔE00 between the values obtained from backgrounds #3 and #8 was performed by using the independent t test (α=.05). RESULTS: In both backgrounds, statistically significant differences were found between the studied groups and VITA shade (P<.001). In most situations, the amount of color difference was lowest for the "shade tab on the backgrounds" mode. On background #3, the highest color difference was related to ZLS (6.48 ±0.23), and the lowest values were observed in the PICN group (1.02 ±0.31). On background #8, the highest color difference was related to ZLS compared with the "without backing" mode (8.62 ±0.27), and the lowest values were reported for ZLS compared with the "shade tab on the backgrounds" mode (1.27 ±0.44). The independent t test showed a statistically significant color difference on the 2 different backgrounds for all situations (P<.001). CONCLUSIONS: Color selection of monolithic ceramics with the VITA Classical shade guide is improved by placing the VITA tabs on a similar background. Background color has a significant effect on the final shade of the monolithic ceramics. Choosing the correct color for LDS, ZLS, and PS-ZLS requires more care than for PICN and zirconia.

Comparison of translucency and opalescence among different dental monolithic ceramics.

STATEMENT OF PROBLEM: Monolithic ceramic restorations designed by computer-aided design and computer-aided manufacturing are increasingly being used by clinicians. With the introduction of new materials, their optical characteristics also need to be investigated. PURPOSE: The purpose of this in vitro study was to compare the translucency and opalescence of lithium disilicate, zirconia-reinforced lithium silicate, presintered zirconia-reinforced lithium silicate, polymer-infiltrated ceramic-network material, and multilayer zirconia. MATERIAL AND METHODS: A total of 50 rectangular plates (14×12×1 mm) of 5 monolithic ceramics were prepared in this in vitro study (n=10). Each zirconia specimen was divided into 3 groups of incisal, middle, and gingival thirds. Each group was then evaluated separately. The color parameters of specimens were measured on 3 backgrounds, white, black, and #3 Ivoclar Natural Die Color material, by using a spectrophotometer. The translucency and opalescence of the specimens were determined by the relevant equations, and between-group comparisons were made. One-way ANOVA and Tamhane post hoc tests were used to compare groups (α=.05). RESULTS: The difference among the groups was significant in translucency (F=137.346, df=6, P<.001), contrast ratio (F=134.148, df=6, P<.001), and opalescence parameters (F=128.028, df=6, P<.001). The 3 zirconia groups (10.87 ±0.54 to 11.88 ±0.26) had a significantly lower translucency than the other groups, and the zirconia-reinforced lithium silicate group (18.14 ±0.74) showed the highest translucency. Zirconia-reinforced lithium silicate (12.36 ±0.42) had the highest opalescence, and the lowest opalescence was found for polymer-infiltrated ceramic-network (5.43 ±0.28) and the incisal third of zirconia (5.45 ±1.06). CONCLUSIONS: The zirconia-reinforced lithium silicate and presintered zirconia-reinforced lithium silicate specimens had the highest translucency and opalescence. The studied multilayer zirconia, which had different cubic phase values from incisal to gingival blank, showed similar translucency over the entire range, and differences among different regions were related to chromatic variables.

The Correlation of Clinical Outcomes (Marginal Bone Loss, Probing Depth, and Patient Satisfaction) With Different Prosthetic Aspects of Implant Overdentures: A Five-Year Retrospective Cohort Study.

Implant overdentures increase retention, stability, support, and subsequently comfort and patient satisfaction with removable dentures. This study aimed to investigate the correlation of clinical outcomes (marginal bone loss, probing depth, and patient satisfaction) with different prosthetic aspects of mandibular implant overdentures. Seventy-four implant overdenture wearers who had received their overdentures between 1 to 5 years ago were selected using simple cluster sampling. The data investigated included mucosal health of the mouth, condition of peri-implant tissues, marginal bone loss (MBL), and patient satisfaction. The relationship of MBL and probing depth (PD) with independent variables was assessed by Pearson and Spearman's rho correlation coefficients. The comparisons of MBL, PD, patient satisfaction, and tissue irritation among different states of independent variables were done by analysis of covariance, Tukey and Tamhane post-tests, and chi-square tests (α = 0.05). A total of 186 implants were evaluated. The mean ages of participants and overdentures were 61.62 ± 9.28 (year) and 38.45 ± 16.64 (month), respectively. The survival rate and success rate were calculated to be 100% and 97.8%, respectively. Higher width of attached gingiva was correlated with less PD significantly (P = .006). Gingival index (P < .001) and plaque index (P = .006) were correlated with PD positively. Mean MBL for those who needed matrix/patrix adjustment was significantly higher than that of those who did not need it (P = .025). Taking into account our small sample size, the results of this study suggest that healthy peri-implant mucosa is significantly correlated with the presence of attached gingiva and appropriate oral health care. Furthermore, patients receiving implant overdentures should be informed about the importance of regular recalls.

Effect of repeated firing on the translucency of CAD-CAM monolithic glass-ceramics.

STATEMENT OF PROBLEM: The effects of multiple firings on the translucency of newly introduced computer-aided design and computer-aided manufacturing (CAD-CAM) glass-ceramics have not been well evaluated. PURPOSE: The purpose of this in vitro study was to assess the changes in the translucency of high-translucency (HT) and low-translucency (LT) lithium disilicate (LDS) and zirconia-reinforced lithium silicate (ZLS) glass-ceramics of 0.6 and 1 mm thickness during crystallization, correction, and glaze firing cycles. MATERIAL AND METHODS: Eighty specimens in 8 groups (n=10) were sectioned and polished to obtain thicknesses of 0.6 and 1 mm. The specimens were then fired in 3 cycles, and the color coordinates were measured by using a spectrophotometer after each cycle. The translucency parameter (TP) and the contrast ratio (CR) were calculated to determine the translucency level. The data were analyzed by using a statistical software program. The TP and CR data after each firing cycle were compared within each group by using repeated-measures ANOVA. Pair-wise comparisons were made by using a multiple paired t test. Comparisons between the 2 thicknesses of different materials were made by using the independent t test (α=.05). RESULTS: Repeated firings significantly increased the translucency of 0.6-mm LT-LDS and decreased the translucency of 0.6-mm HT-ZLS (P<.017). No significant changes were noted in the translucency of specimens of 1-mm thickness after repeated firings. Also, 0.6-mm-thick specimens of all materials had significantly higher translucency than 1-mm-thick specimens (P≤.001). The highest translucency was noted in HT-LDS, followed by HT-ZLS. CONCLUSIONS: Repeated firings significantly affected the translucency of LDS and ZLS CAD-CAM glass-ceramics. The translucency increased with decreasing thickness.

Patient satisfaction with occlusal scheme of conventional complete dentures.

Occlusal scheme is a controversial topic that has been linked to patient satisfaction with conventional complete dentures (CCDs). This study aimed to compare the patient satisfaction with CCDs with four different occlusal schemes namely the lingualised occlusion (LO), buccalised occlusion (BO), fully bilateral balanced occlusion (FBBO) and partially group function occlusion (PGFO). In this clinical study, new CCDs were made for 121 patients; out of which, 97 patients (mean age of 57.87 ± 9.5 years) completed the 1-year follow-up. The CCD wearers were followed up at 1 month, 3 months and 1 year after CCD delivery. Data were collected via an interview and recorded in a checklist by a blinded examiner. The checklist included the demographic variables, the 19-item version of Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT), and seven 100-mm line visual analogue scales (VASs) to assess the items related to patient satisfaction. The Kruskal-Wallis and Friedman tests followed by post hoc tests were used to compare the variables among the 4 groups and between the 3 follow-ups. P-value ≤ .05 was considered statistically significant for all tests. The patients with BO presented higher satisfaction scores for comfort, stability and retention at the 1-year follow-up compared with PGFO. Both PGFO and FBBO groups had higher physical pain scores compared with BO and LO. The psychological discomfort scores of FBBO group were significantly higher than those in LO group. Pairwise comparisons revealed no significant differences in the general patient satisfaction and total OHIP-EDENT scores between the 4 groups. For most items, within-group analysis showed significant improvement of the satisfaction scores and reduction of domain scores over time.

In Vivo and In Vitro Comparison of Internal and Marginal Fit of Digital and Conventional Impressions for Full-Coverage Fixed Restorations: A Systematic Review and Meta-analysis.

PURPOSE: This study aims to evaluate digital and conventional impressions for full-coverage restorations in terms of marginal and internal discrepancies. STUDY SELECTION: The analysis included in vivo and in vitro studies reporting the marginal or internal gap of full-coverage restorations that provide both the conventional and digital impression. The PubMed, Cochrane Trials, and Scopus databases were searched. The quality of clinical trials was rated using Cochrane Collaboration's tool, and the quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation tool. Heterogeneity among the studies was evaluated, and a meta-analysis with subgroup analysis was conducted whenever it was possible. RESULTS: Thirty-three articles (8 prospective clinical trials and 26 in vitro studies) were selected to extract data after applying the predefined selection criteria. The standard mean difference (SMD) of the meta-analysis for marginal adaptation was -0.76 (95% confidence interval: -1.23 to -0.29) and -0.59 (95% confidence interval: -0.93 to -0.24) for in vitro and in vivo studies, respectively, indicating digital impressions provided significantly less marginal gap than conventional impressions in in vitro studies (P = .002). The impression technique did not significantly influence the internal adaptation. CONCLUSIONS: Differences in marginal adaptation between the digital and conventional groups are not significant for in vivo studies, but for in vitro studies, the digital impression resulted in better marginal adaptation. Based on the Grading of Recommendations, Assessment, Development, and Evaluation approach for marginal adaptation, clinical studies were classified as high confidence and in vitro studies were graded moderate because of the inconsistency. Furthermore, high-quality studies are needed to confirm our results (the International Prospective Register of Systematic Reviews; CRD42017077925).

Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis.

Purpose: The resin infiltration technique, used as a microinvasive treatment for initial caries, seals white spot lesions on the tooth surface. The purpose of this systematic review was to perform a review on the effectiveness of resin infiltration in preventing initial caries progression. Methods: This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRIMSA) guidelines. The searched databases included Embase, Scopus, Cochrane, and PubMed, and no filters were applied other than the English language. The heterogeneity level among the included studies was measured by I2, Tau2, and Q indices using CMA (version 2) software. A forest plot was applied to show the results and to estimate the effectiveness of resin infiltration technique. Results: Eight articles were selected forthe quantitative analysis of data and preparation of evidence table. Results of the meta-analysis of all studies showed a risk ratio of 0.374 (95 percent confidence interval equals 0.291 to 0.480) which revealed that resin infiltration significantly reduced the risk of caries progression compared with the control groups (P<0.001). Conclusions: Within the limitations of this review, it can be asserted that the resin infiltration technique is effective in preventing initial caries progression in primary and permanent teeth.