Ceramic Implant Rehabilitation: Consensus Statements from Joint Congress for Ceramic Implantology.

The objectives of the study group focused on the following main topics related to the performance of one- and two-piece ceramic implants: defining bone-implant-contact percentages and its measurement methods, evaluating the pink esthetic score as an esthetic outcome parameter after immediate implantation, recognizing the different results of ceramic implant designs, as redefined by the German Association of Oral Implantology, incorporating the patient report outcome measure to include satisfaction and improvement in oral health-related quality of life, and conducting preclinical studies to address existing gaps in ceramic implants. During the Joint Congress for Ceramic Implantology (2022), the study group evaluated 17 clinical trials published between 2015 and 2021. After extensive discussions and multiple closed sessions, consensus statements and recommendations were developed, incorporating all approved modifications. A one-piece implant design features a coronal part that is fused to the implant body or interfaces with the post-abutment restoration platform, undergoing transmucosal healing. Long-term evaluations of this implant design have been supported by established favorable clinical evidence. Inaccuracies in the pink esthetic score and bone-implant-contact percentages were managed by establishing control groups for preclinical studies and randomizing clinical trials. The patient-reported outcome measures were adjusted to include an individual visual analog scale, collected from each clinical study, that quantified improved oral health and quality of life. Preclinical investigations should focus on examining the spread of ceramic debris and the impact of heat generation on tissue and cellular levels during drilling. Further technical advancements should prioritize wound management and developing safe drilling protocols.

Esthetic dental perception comparisons between 2D- and 3D-simulated dental discrepancies.

STATEMENT OF PROBLEM: Intraoral scanners (IOSs), facial scanners (FSs), and computer-aided design (CAD) software programs have become powerful tools for treatment planning. However, discrepancies in perception regarding 2-dimensional (2D) or 3-dimensional (3D) simulations by dentists, dental students, and laypeople have not been analyzed. PURPOSE: The purpose of this observational study was to analyze the perceptions of laypersons, dental students, and dentists regarding disparities of the maxillary dental midline and the occlusal plane when analyzing the dental discrepancies on 2D- and 3D-clinical simulations. MATERIAL AND METHODS: A female model was digitized by using an FS, IOS, and a full-face smile photograph. Dental discrepancies were simulated by using a 2D photograph (2D group) and 3D scan (3D group) of the model. In both simulation groups, 2 subgroups were produced. The occlusal plane of the first subgroup was modified in 1-degree increments without changing the dental midline or the position of the maxillary dental incisors. In the second subgroup, the occlusal plane was modified by using the same increments, but the maxillary central incisors and dental midline were altered to match the inclination of the occlusal plane. A total of 300 participants (N=300) were asked to rate the 2D images (N=12) and 3D videos (N=12) on a 1-to-6 scale and answer a questionnaire. Ordinal logistic regression was used to analyze the ratings. RESULTS: The ratings decreased with the increased tilt of the occlusal plane, and the layperson group gave consistently higher ratings than the other 2 groups. For dentists, the odds of giving a higher versus lower rating decreased by almost a half for each degree of tilt. However, for students, that effect was diminished by a positive interaction term, and for laypersons, the effect was even less. Students gave similar ratings to dentists, but laypersons gave higher ratings. As the age of the participants increased, however, the ratings also increased. The use of 3D versus 2D images had a positive effect on the ratings, but the effect decreased for the student observers and decreased even further for laypersons. Furthermore, midline alteration led to higher ratings but also resulted in worsening of the odds ratio for the tilt. Seventy percent of the dentists, 57% of the dental students, and 52% of the laypersons preferred 2D simulations to 3D simulations. CONCLUSIONS: Dentists, dental students, and laypersons decreased their ratings with increased inclination of the occlusal plane; however, laypersons still graded all the 2D and 3D images as esthetically pleasant, giving consistently higher ratings than the dentists and dental students. Overall, 3D simulations obtained higher ratings than 2D images, but the positive effect decreased for the student observers and decreased even further for laypersons.

Perception of occlusal plane that is nonparallel to interpupillary and commissural lines but with the maxillary dental midline ideally positioned.

STATEMENT OF PROBLEM: How disparities in parallelism between the occlusal plane and the interpupillary (IP) or commissural facial front lines are perceived is unclear. PURPOSE: The purpose of this observational study was to examine the perceptions of laypersons, dental students, and dentists regarding disparities of the anterior occlusal plane (AOP) and posterior occlusal plane (POP) with respect to the IP and commissural line (CL) with the maxillary dental midline ideally positioned. MATERIAL AND METHODS: A model of a symmetric female face was digitally created with the IP and CL parallel and the facial midline coincident with the maxillary dental midline. Two groups of images were created, one with the POP modified in 1-degree increments, in which both the maxillary dental midline and the position of the maxillary central incisors were not manipulated, and the other with the POP modified in the same increments but with the position of both maxillary central incisors lengthened to follow the inclination of the occlusal plane. Participants (N=312) were asked to rate the images on a 1-to-6 scale. The Kruskal-Wallis medians test and ordinal logistic regression were used to analyze the ratings. RESULTS: Group median ratings for different occupations gradually decreased with increased inclination of the occlusal plane. Significant differences were found for inclinations from 2 to 5 degrees. Significant odd ratios were found for age and sex. CONCLUSIONS: Dental professionals detected smaller POP disparities. The dentist and dental student groups gave lower ratings in proportion to the amount of POP inclination. Laypersons gave lower ratings only after 3 degrees of POP inclination but still graded all the images as esthetically pleasant. Older people and men tended to give higher ratings to the same image.