Abstract: Objective To assess the survival and technical complication rate of partial and full-arch all-ceramic implant-supported fixed dental prostheses (P-FDP/FA-FDP) and supporting implants. Materials and methods An electronic search through three databases (MEDLINE/Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients. Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5-year survival and complication estimates. Results A total of five studies for the P-FDP group and seven studies for the FA-FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P-FDP group, reconstructions were located in posterior regions. Meta-analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for P- and FA-FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5-year complication rates of 22.8% (P-FDPs) and 34.8% (FA-FDPs). Five-year survival estimates of implants supporting P-FDPs and FA-FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, one screw-loosening and 11 de-cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates. Conclusions All-ceramic implant-supported P- and FA-FDPs comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long-term outcome needs to be further evaluated

Abstract: Purpose Based on the excellent long-term data, dental implants made of titanium are considered the international implantological standard for replacing missing teeth. However, ceramic implants made of zirconia (ZrO2) have experienced a renaissance in the last 15 years due to constant innovations in materials and products, with material properties and soft tissue- and osseointegration behavior comparable to those of titanium. However, one limitation concerning ceramic implants is the lack of reliable long-term data, especially in the case of two-piece implant systems. As there is an increasing demand for ceramic implants from practitioners and patients, the German Society for Implantology (DGI) has decided to develop a guideline on the use of dental ceramic implants at the highest available evidence level with the involvement of experts in this field. Methods Statements and recommendations were prepared after conducting a systematic literature search and an independent assessment process involving the relevant clinical literature from 2008 to 2021. The adopted recommendations and statements are summarized in this guideline. Results and conclusions It confirms the feasible use of one-piece zirconia implants as an addendum/alternative to titanium implants. No final conclusion regarding the application of two-piece ceramic implant systems could be drawn on the basis of the existing data, thus its use can only be recommended after the patient has been informed in detail about the lack of long-term clinical data

Abstract: Objective This review aimed at evaluating the survival and technical complication rates of all-ceramic implant-supported single crowns (SC). Material and Methods Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant-supported all-ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5- and 10-year survival and complication estimates. Results Forty-one included studies reported on implant-supported SCs made of veneered and monolithic high-strength oxide ceramics, monolithic, and veneered glass-based ceramics and of a monolithic resin-nano-ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%-96.4%) after 5 years and 94.4% (95% CI: 91.1%-96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%-97.7%) and 96.2% (95% CI: 95.1%-97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%-14.8%)/2.7% (95% CI: 2.1%-3.5%), framework fractures 1.9% (95% CI: 0.7%-4.9%)/1.2% (95% CI: 1%-1.5%), screw loosening 3.6% (95% CI: 1.6%-8.4%)/5.2% (95% CI: 3.6%-7.5%), and decementations with 1.1% (95% CI: 0.4%-2.8%) after 5 years. Some confounding variables influenced the above-mentioned estimates significantly. Conclusions All-ceramic implant-supported SCs showed--with the exception of a RNC material--high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant-supported all-ceramic SCs

Abstract: Objectives To assess clinical, radiological and esthetic outcomes of restorations supported by root-analogue implants (RAIs) or roots of severely damaged teeth after forced orthodontic extrusion (FOE). Materials and methods Clinical data regarding milled one-piece (titanium/zirconia roots and zirconia abutments) RAIs (REPLICATETM System) and FOE were recorded and retrospectively evaluated for 40 patients by two investigators. Strict inclusion and exclusion criteria were applied. Functional and esthetic outcomes were assessed for n = 20 pre-molars and n = 20 anterior teeth via comparison of radiographic and digital images applying the novel Functional Implant Prosthodontic Score (FIPS). Krippendorff's alpha coefficient was calculated to assess inter-rater reliability. Mann-Whitney-U-Test was used to compare the assessed parameters. Level of significance was set to p 0.05.brbrResultsbrAfter a mean observation period of 18.4 ± 5.7 months for restorations supported by RAIs and 43.9 ± 16.4 months for restorations after FOE, mean FIPS scores were 9.2/8.8 ± 1.1/1.2 (RAIs) and 7.4/7.7 ± 1.3/1.5 (FOE), respectively. Krippendorff's alpha coefficients did not reveal unacceptable inter-rater reliabilities regarding the investigators and applicability of FIPS. Significant differences were documented when comparing restorations after FOE or supported by RAIs regarding bone loss (p 0.01), presence of papillae (p 0.05) and quality and quantity of mucosa (p 0.02) in favor of FOE.brbrConclusions

Abstract: Computer-aided design and computer-aided manufacturing (CAD-CAM) enable subtractive or additive fabrication of temporary fixed dental prostheses (FDPs). The present in-vitro study aimed to compare the fracture resistance of both milled and additive manufactured three-unit FDPs and bar-shaped, ISO-conform specimens. Polymethylmethacrylate was used for subtractive manufacturing and a light-curing resin for additive manufacturing. Three (bars) and four (FDPs) different printing orientations were evaluated. All bars (n = 32) were subjected to a three-point bending test after 24 h of water storage. Half of the 80 FDPs were dynamically loaded (250,000 cycles, 98 N) with simultaneous hydrothermal cycling. Non-aged (n = 40) and surviving FDPs (n = 11) were subjected to static loading until fracture. Regarding the bar-shaped specimens, the milled group showed the highest flexural strength (114 ± 10 MPa, p = 0.001), followed by the vertically printed group (97 ± 10 MPa, p