Clinical performance of single implant prostheses restored using titanium base abutments: A systematic review and meta-analysis.

PURPOSE: The aim of this review was to evaluate the survival rates of restorations utilizing titanium base abutments (TBA) for restoring single-unit implant prostheses. MATERIALS AND METHODS: This review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The focus question was: In patients who require the restoration of a single dental implant utilizing a titanium base abutment, what are the determining factors and outcomes relating to implant prosthesis prognosis and survival? A comprehensive search of databases (PubMed, EMBASE, and Cochrane Library) was conducted on 16 April 2023 and updated on 5 May 2023. Randomized clinical trials (RCT), retrospective studies and prospective studies, reporting on the use of TBA for single implant prostheses, were reviewed. A Cochrane collaboration risk of bias assessment analysis was performed for randomized clinical studies, and the Newcastle-Ottawa Scale tool was applied for non-randomized studies. A meta-analysis was performed on clinical trials reporting on survival rates of both TBA and other abutments. Other clinical studies, reporting on TBA only, were included for descriptive statistics. RESULTS: The search provided 1159 titles after duplicates were removed. Six RCTs were included to perform a meta-analysis and compare the survival of the TBA to other abutments [OR 0.74; 95% CI: 0.21-2.63, heterogeneity; I2 0%; p = .99]. Twenty-three prospective and retrospective studies fulfilled the criteria and were included in the meta-analysis after 12 months of function. A total of 857 single implant-supported prostheses fabricated with a TBA were included. TBA abutments have an estimate 98.6% survival rate after 1 year in function (95% CI: 97.9%-99.4%). The mean follow-up period was 31.2 ± 16.9 months. CONCLUSIONS: Single implant prosthesis restored with titanium base abutments showed favourable short-term survival rates.

Influência de diferentes intermediários protéticos na satisfação e qualidade de vida de pacientes reabilitados com próteses unitárias livres de metal sobre implantes: um ensaio clínico / Influence of different prosthetic intermediates on the satisfaction and quality of life of patients rehabilitated with metal-free single prostheses on implants: a clinical trial

Introdução: Intermediários protéticos de diferentes formas, materiais ou métodos de confecção utilizados em tratamento com coroas sobre implante podem gerar impacto sobre o resultado final da reabilitação. Objetivo: Avaliar a interferência de dois intermediáros protéticos: (1) pré-fabricados em titânio (GT) ou (2) personalizados em zircônia (GZ) sobre a satisfação e qualidade de vida dos pacientes reabilitados por meio de coroas livres de metal sobre implantes unitários instalados na região do sorriso. Material e métodos: Um ensaio clínico não randomizado-controlado e cego foi realizado. Todos os pacientes passaram por uma etapa de coroa provisória antes da instalação da coroa final. A satisfação foi avaliada por meio da escala visual analógica ­ EVA e a qualidade de vida por meio do Oral Impacts on Daily Performances (OIDP) e do Oral Health Impact Profile (OHIP-14). As avaliações aconteceram em três tempos, baseline (T0), sete dias após a instalação da coroa provisória (T1) e sete dias após a instalação da coroa final (T2). Os dados foram avaliados por meio do teste de Mann-Whitney, para as análises intergrupos, e do teste de Wilcoxon para as avaliações intragrupos. O teste de correlação de Spearman foi realizada para avaliação dos fatores que interferiram na estética final. Resultados: Vinte e quatro pacientes foram incluídos, a média de idade foi de 41,88 anos. Foram instalados 26 implantes, 14 no GT e 12 no GZ, a região anterior teve 20 implantes instalados e a região posterior teve 06 implantes. Houve uma melhora significativa da satisfação, independentemente do grupo, entre T0 e T1 (p=0,013) e entre T1 e T2 (p<0,001). Considerando a amostra como um todo, as dimensões do OHIP-14 foram influenciadas positivamente entre T0 e T1 (p<0,001) e T0 e T2 (p<0,001). E as performances do OIDP também melhoraram entre T0 e T1 (p=0,007), T1 e T2 (p=0,007) e T0 e T2 (p<0,001). Conclusão: Os diferentes intermediários protéticos testados nesta pesquisa parecem não interferir nas variáveis estudadas e a instalação de coroa livre de metal sobre implante parece desempenhar um papel importante na melhoria dos níveis de satisfação e qualidade de vida dos pacientes (AU).

Introduction: Prosthetic abutment of different shapes, materials or fabrication methods used in oral rehabilitation can play a role in the success of the rehabilitation. Objective: To evaluate the influence of two different abtments: (1) prefabricated titanium (GT) or (2) customized zirconia (GZ) in the quality of life, and patients' satisfaction wearing metal-free crowns on single implants placed in the smile region. Material and methods: A non-randomized-controlled-blinded clinical trial was performed. All patients received a temporary restoration before the final metal-free crown. The patient's satisfaction was assessed by a Visual Analog Scale (VAS), and quality of life by the Oral Impacts on Daily Performances (OIDP) and the Oral Health Impact Profile (OHIP-14). The follow-up was performed at baseline (T0), seven days after provisional crown placement (T1) and seven days after the final crown (T2). Data were assessed using the MannWhitney test for intergroup analyses, and the Wilcoxon test for intragroup assessments. The Spearman correlation test was performed to evaluate the factors that can influence the final esthetics. Results: Twenty-four patients were included; the mean age was 41.88 years. Twenty-six implants were placed, fourteen in GT and twelve in GZ. Twenty implants were placed in the anterior region and 06 in the posterior. A significant improvement was noticed in the patient's satisfaction, regardless of the group, between T0 and T1 (p=0.013) and T1 and T2 (p<0.001). Considering the whole sample, the dimensions of the OHIP14 were positively influenced between T0 and T1 (p<0.001) and T0 and T2 (p<0.001). The performances of the OIDP also improved between T0 and T1 (p=0.007) as well as between T1 and T2 (p=0.007) and between T0 and T2 (p<0.001). Conclusion: The prosthetic abutments tested in this study do not seem to play a role in the variables studied and the metal-free crown placement seems to play an important role in improving the levels of patient's satisfaction and quality of life (AU).

Single implant restoration with esthetic prosthodontic treatment in maxillary anterior tooth: A case report / 대한치과보철학회지

In a single implant restoration of maxillary anterior teeth, it is difficult to accomplish an aesthetic restoration of the implant prosthesis in the case of gingival recession and bone defect problems. To maintain aesthetic stability in the long term, it is important to place the implant in the ideal position as well as the recovery of the soft tissue and harmony with the prosthesis. Not only ideal implant position but also the harmony with surrounding soft tissues are important to fabricate aesthetic implant prosthesis for these cases. for these cases, a 47- years -old male with lowered level of osseous crest and gingival recession on maxillary anterior tooth was treated with guided bone regeneration and gingival recontouring.

Pain and discomfort following immediate and delayed loading by overdentures in the single mandibular implant study (SMIS).

OBJECTIVES: This randomized clinical trial compares immediate and delayed loading of single implants to support mandibular overdentures. The aim of this preliminary analysis is to test the hypothesis whether patients with immediate loading will experience less pain and discomfort through the intervention than patients with delayed loading. MATERIALS AND METHODS: Edentulous patients in nine German dental schools received a midline implant with a length of 11 mm. Implants with a minimum insertion torque of 30 Ncm and an implant stability quotient of ≥60 were randomly allocated to group A for immediate loading using ball attachments or to group B for delayed loading after 3 months. Patients completed questionnaires with 100-mm visual analogue scales about the items pain, pain during chewing, swelling, bleeding, and perception of the intervention at the day of surgery and 1, 2, 3, and 7 days, thereafter. Groups were compared by Wilcoxon-Mann-Whitney tests (P ≤ 0.05). RESULTS: The questionnaires of 81 patients in group A and 74 patients in group B were completed. The medians for pain and discomfort were moderate (<30). Participants of group A felt significantly more pain from the first day and more swelling from the third day after implantation than participants of group B. The individual perception of interventions showed no significant differences between groups. CONCLUSIONS: Immediate loading evoked more postoperative pain and swelling than the two stages of delayed loading. CLINICAL RELEVANCE: Immediate loading of a single mandibular midline implant supporting overdentures should be carefully considered.

Oral health-related quality of life and esthetic outcome in single anterior maxillary implants.

OBJECTIVES: The aim of this study is twofold: to assess the esthetic outcome of single dental implant restorations in the anterior maxillary area after up to 3 years of function, and to evaluate the relationship between the esthetic outcome and oral health-related quality of life. MATERIALS AND METHODS: Twenty patients who were treated with an anterior maxillary single implant restoration were recalled for esthetic outcome evaluation using pink and white esthetic scores (PES/WES). All patients completed a questionnaire regarding satisfaction of treatment outcome and quality of life related to the implant restorations. Patient satisfaction was assessed by visual analog scales (VAS) analysis, whereas oral impact on daily life performances (OIDP) was used to evaluate the quality of life of patients. RESULTS: The esthetic outcome assessed by PES/WES showed favorable results. The median PES/WES scores were 16.00 (maximum possible score = 20). The median PES scores and WES scores were 7.50 and 8.00, respectively. Patient satisfaction rated in VAS scale ranged from 8 to 10. OIDP assessment showed an impact on daily life performance in 45% of patients. The most common impacts were eating (n = 5) and cleaning teeth (n = 4). No significant difference in PES/WES scores was found between the patients who perceived and did not perceive oral impacts. CONCLUSIONS: There was some discrepancy between the dentist's evaluation and patient's perception but a strong positive satisfaction was reported from all patients which let suppose that the psychosocial factors that involve patient's perspective should be further investigated.

Screw-retained crown restorations of single implants: A step-by-step clinical guide.

This paper shows the clinical steps for preparing a screw-retained crown for the restoration of a single implant. Impression-taking using open-tray technique and delivery of the crown is presented in a step-by-step manner elucidated by detailed photographs. Furthermore, the advantages and disadvantages of screw-retained crowns are discussed in comparison with the cemented restorations.