New technology coupled with a better understanding of tissue biology has played a key role in restoring the somewhat tarnished image of implant dentistry, Thanks to carefully conducted longitudinal studies, it has now become clear that the replacement of missing teeth by artificial implants integrated into the living tissues of the jaws is a predictable procedure, as long as certain guidelines are followed in the manufacture of the implant, its placement, its eventual functional loading, and its maintenance. Yet, functional success for a natural tooth is dependent on a number of anatomic, physiologic, and environmental considerations which differ in some important respects from those that insure the functional success of an implant. In this paper, we review the anatomic features of the natural dentition with emphasis on the periodontal tissues, and contrast these characteristics with those that exist around well‐integrated endosseous implants.

Objectives: To assess the influence of metallic posts in the detection of simulated vertical root fractures (VRFs) using the following imaging examinations: 2 cone beam CT (CBCT) systems [CBCT1: NewTom ® 3G (QR Srl, Verona, Italy) and CBCT2: i-CAT Next Generation ® (Imaging Sciences International, Hatfield, PA)] and film and digital radiographs. Additionally, the influence of the orientation of the fracture line in the detection of VRFs was evaluated. Methods: 100, human, single-rooted endodontically treated premolars were divided into 5 groups (Group 1: with posts and buccolingual VRFs, Group 2: with posts and mesiodistal VRFs, Group 3: without posts and with buccolingual VRFs, Group 4: without posts and with mesiodistal VRFs, and Group 5: with posts and without VRFs). The premolars were placed in human mandibles and imaged using the four examination modalities. The sensitivity and the specificity of each examination in the experimental groups were calculated. The data were analysed using Student's t-test.Results: The presence of metallic posts reduced the sensitivity of the CBCT1 system (p 5 0.0244). Digital radiographs and the CBCT1 and CBCT2 systems had a higher sensitivity in detecting buccolingual fractures in teeth with posts, whereas film and digital radiographs had a higher sensitivity in detecting buccolingual fractures in teeth without posts (p , 0.05). The CBCT1 examination demonstrated the lowest specificity (p , 0.05). Conclusions:The presence of metallic posts did not influence the sensitivity of most of the examinations, excluding the CBCT1 system. The fracture line orientation may influence VRF detection.

No abstract