Maxillary implant overdenture retained by four unsplinted attachments and opposed by a natural or fixed dentition: One-year clinical outcomes.

OBJECTIVES: The aim of this prospective study was to evaluate the implant, prosthesis, and patient-reported outcomes of maxillary removable prostheses retained by 4 implant-supported study abutments after a follow-up period of 1 year in patients with natural teeth or a fixed rehabilitation in the mandible. MATERIALS AND METHODS: A total of 30 patients were included, and all received 4 implants in the upper maxilla. After 12 weeks, the prostheses were connected to the implant with unsplinted attachments. The implant and prosthodontics outcomes were assessed over a follow-up period of 1 year. Patient-reported outcome measures (PROMs) were evaluated with the Oral Health Impact Profile (OHIP-20) questionnaire and an adaptation of the McGill Denture Satisfaction Instrument using a visual analogue scale (VAS). RESULTS: A single patient dropped out. At the post-operative 12-week follow-up, 79.3% (95% CI: 64.6%-94.1%) of the patients displayed peri-implant mucosa hyperplasia and 69.0% (95% CI: 52.1%-85.8%) showed pain. After 1 year, 16 implants failed in 10 patients, leading to an implant survival rate of 86.2% (95% CI: 79.0%-92.5%), and the mean peri-implant bone loss was 1.01 ± 0.77 mm (95% CI: 0.85-1.16 mm). The prosthesis survival rate was 96.6% (95% CI: 82.2%-99.9%). The OHIP-20 and VAS scores both improved significantly from baseline to 1 year (p < .001). CONCLUSION: The implant survival rate was lower compared to the literature for the upper maxilla. Despite the encountered problems, PROMs showed significant improvement with the implant overdenture retained by 4 unsplinted implants compared to conventional dentures.

[Ceramic posts]. / Les piliers en céramique.

As a result of ceramics and all-ceram technologies development esthetic inlay core and abutments flooded the market. Their tooth-colored appearance enhances restoration biomimetism principally on the marginal gingiva area. This article reviews indications and types of cores designed for natural teeth and implants.

[All-ceramic peripheral restorations: crowns and bridges]. / Restaurations périphériques de type all-céram: couronnes et bridges.

Over the last years, current technologies in dental ceramics are strongly improved, constantly producing new materials for the restoration of the single or plural teeth. Feldspathic porcelains fused to a cast metal substructure, the so-called "metal-ceramic crown," has been long time the gold standard; this is primarily due to their predictable long-term strength characteristics. All-ceramic systems are a focus of interest, because they offer aesthetic results that may be difficult to achieve with metal-ceramic systems. Nowadays, the new ceramics associate aesthetic and good mechanical qualities, biocompatibility, accurate marginal fit and low invasive preparations. Thanks to the diversification of all-ceram processes, materials properties and clinical situations are now the prime criteria which determine the practitioner's choice. In this article, we try to summarize different clinical concepts for peripheric all-ceram restoration, such as crowns and bridges used in a daily dental practice.