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Purpose: To evaluate the clinical performance of implant-prosthetic rehabilitations carried out using ceramic-coated CAD/CAM titanium abutments. Materials and Methods: Thirty implants were placed in 30 patients and rehabilitated with 30 single crowns attached to CAD/CAM titanium abutments. A conventional procedure was applied, implants were placed after postextraction socket healing, and prosthetic restorations were placed after implant healing. Implant lengths ranged from 6 to 15 mm, and widths were 3.6, 4.2, and 4.8 mm. At the time of prosthesis delivery (T0), after 2 years (T1), and after 5 years (T2), the Plaque Index (PI), bleeding on probing (BoP), pocket probing depth (PPD), marginal bone level (MBL), and pink/white esthetic scores (PES/WES) were evaluated for each implant. Results: No patient dropped out of the study during the follow-up period. All 30 implants were clinically successful 5 years after prosthesis delivery (survival rate: 100%) and showed no signs of peri-implant infection. Peri-implant soft tissues were in good health (BoP at T2: 0% in 73% of patients; 25% in 13% of patients; 50% in 10% of patients; and 75% in 3% of patients). The mean PPD was 2.05 ± 0.56 mm at T0, 1.992 ± 0.6 mm at T1, and 1.867 ± 0.439 mm at T2. The mean MBL was 0.413 ± 0.440 mm at T0, 0.306 ± 0.388 mm at T1, and 0.263 ± 0.368 mm at T2. The mean PES, WES, and PES/WES indices (7.43 ± 1.04, 7.57 ± 0.82, and 15.00 ± 1.17, respectively) indicate good integration of soft tissues, satisfactory esthetics, and overall positive outcomes. Conclusions: The success rates, maintenance of MBLs, and periodontal and esthetic indices suggest the validity of implant-prosthetic rehabilitations with CAD/CAM abutments in cases of single crowns. Keywords: Implant-prosthetic rehabilitation; CAD/CAM abutments; Single crowns; Clinical performance; Peri-implant soft tissues

Purpose: To describe a fully digital workflow for an implant-supported fixed hybrid restoration that involves a double CAD/CAM structure and to highlight the benefits of this type of restoration. Materials and methods: Using a fully digital workflow, starting from intraoral scans, the necessary steps for producing the final hybrid prosthesis are described. The prosthesis consists of a titanium primary structure and a zirconia secondary structure that is cemented onto the primary structure in the laboratory. A clinical case is presented to illustrate the steps required for prosthetic rehabilitation. Results: This technique enables the fabrication of clinically valid and passive prostheses using a fully digital workflow. Conclusion: In just three clinical sessions, a fully digital workflow makes it possible to produce robust implant-supported fixed hybrid prostheses, comprising a titanium primary structure and an outer secondary structure made of zirconia. This procedure can be applied to a wide range of cases from simple to extended, including full-arch restorations. Keywords: CAD/CAM, dental prosthesis, digital workflow, titanium, zirconia Drs Parpaiola, Toia and Norton report a relationship with Dentsply Sirona (Charlotte, NC, USA) that includes speaking and lecture fees. The other authors declare no commercial associations or conflicts of interest relating to this study.

Purpose: Evaluations of multicenter clinical trials are needed to determine the effectiveness of care in routine implant therapy in clinical practice. Materials and Methods: Ninety-two clinicians in 75 clinics in 13 countries recruited five subjects per clinic who were in need of a minimum of two dental implants to restore a partially edentulous quadrant and were followed for a minimum of 1 year after loading. A centralized Internet-based case report form was developed to coordinate data recording. Data entry was done by each clinic, with follow-up source verification. Results: The study recruited 549 subjects in 101 clinics with 1,893 implants placed. Three hundred forty subjects completed the 1-year recall (gender distribution of 56% female, 44% male; mean age of 57 years with a range of 18 to 84 years). In all, 1,246 dental implants were followed; a majority of subjects had two to four implants. Twenty-eight percent of subjects received osseous grafting prior to or coincident with implant placement. In the maxilla, 779 (63%) implants were placed, 256 in the anterior and 523 in the posterior; in the mandible, 467 implants were placed, 85 in the anterior and 382 in the posterior arch. The median edentulous period prior to implant placement was 24 months (range, 0 to 480 months); 46% of all patients received implants within 12 months of tooth loss. At 1 year after prosthesis insertion, 15 subjects had lost a total of 17 implants, for a cumulative implant survival rate of 98.6%. Chi-square and Fisher exact tests indicated a higher risk of implant loss at sites with advanced resorption and for wider-diameter implants (5-mm tapered body). There was no statistical relationship with implant loss relative to implant length or anatomic location within the oral cavity. Conclusions: The outcomes support the need for ongoing involvement of clinicians in routine practice assessments of patient-based outcomes of implant therapy. Keywords: clinical trial, effectiveness trial, outcomes, risk factors, trial design