To provide a long-term comparison of metal-acrylic and zirconia implant-supported fixed complete dental prostheses. Materials and Methods: Patients treated with a metal-acrylic or zirconia fixed implant prosthesis with a minimum 5-year follow-up were included. All complications were registered, along with events such as peri-implantitis and implant failure. Survival and all costs associated with the prostheses were assessed to provide an overall evaluation of each type of fixed implant prosthesis protocol. Results: Seventy-four rehabilitated arches (43 metal-acrylic, 31 zirconia, mean follow-up: 8.7 ± 3.37 years) were included. Delayed complications accompanied the metal-acrylic prostheses more frequently. In both groups, single tooth chipping/fracture was the most prominent minor complication, and incidence of multiple teeth and framework fracture was the most frequent major complication. Zirconia fixed implant prostheses demonstrated higher prosthetic survival rates than the metal-acrylic prostheses (93.7% ± 5.5% at 5 years vs 83.0% ± 11.1%). No difference was observed for peri-implantitis or implant failure. The initial cost for zirconia prosthesis fabrication was significantly higher than metal-acrylic hybrids (an estimated difference of $7,829 [P < .001]); however, due to reduced complication rates for the zirconia fixed implant prosthesis, maintenance and treatment for complications did not greatly differ between groups. Conclusion: Within the limitations, zirconia fixed implant prostheses presented higher initial costs than metal-acrylic hybrids, however, with satisfactory outcomes, reduction of overall complications, and superior survival rates.

Background Clinical data on the restorative designs affecting the early progression of peri‐implantitis are scarce. The aim of this retrospective study was to evaluate the influence of several restorative factors (e.g., restoration emergence angle, and internal screw length/diameter) on the marginal bone loss around implants with peri‐implantitis. Methods Implants diagnosed with peri‐implantitis having 1‐ (T1) and 2‐year (T2) follow‐ups were included. In addition, within 6 months pre‐diagnosis (Tb), all cases required to have full documentation in which no evidence of peri‐implantitis was not indicated. Changes in marginal bone levels (MBLs) from Tb to T1 and from T1 to T2 were evaluated. The effect of several variables on MBLs changes was assessed via univariate and multivariate generalized estimating equations. Results Eighty‐three bone‐level implants from 65 patients were selected. The mean follow‐up before peri‐implantitis diagnosis was 99.47 ± 47.93 months. The radiographic mean marginal bone loss was 1.52 ± 1.33 mm (Tb to T1) and 0.58 ± 0.52 mm (T1 to T2). Restoration emergence angle and frequency of maintenance visits significantly affected MBLs from Tb to T1. Besides, 66.3% of the included implants’ bone levels were in a zone within 1 mm of the apical end of the internal screw at T1 and remained in this zone during the second follow‐up year. Conclusions Significant marginal bone loss occurred in the early post‐diagnosis period of peri‐implantitis, which could be affected by the restoration emergence angle. Peri‐implant MBLs were frequently located in a zone within 1 mm of the apical end of the internal screw.

Aim To compare the clinical outcomes of ≤6 mm extra‐short implants (test group) versus ≥10 mm long implants (control group), with and without bone augmentation procedures. Materials and Methods A systemic literature search of randomized clinical trials was performed using the PubMed (MEDLINE) and EMBASE databases. A quantitative meta‐analysis was conducted to compare all the outcome variables. Meta‐regression analysis determined the effect of bone augmentation procedures and the influence of other clinical covariates on the results. Results Eighteen studies comprising 1,612 implants (793 extra‐short and 820 long implants) were selected for the meta‐analysis. No statistically significant difference in the survival rate was observed at 1 and 3 years (p > 0.05). Extra‐short implants displayed less marginal bone loss (MBL) from both implant placement time points (1 and 3 years) and prosthetic placement (1 year), as well as less biological complications, surgical time and treatment cost (p < 0.05). Contrarily, a statistically significant small number of prosthetic complications were reported with long implants (p < 0.05). Conclusions Placement of extra‐short implants (≤6 mm) presented as an equivalent option in the treatment of patients with an atrophic posterior arch up to 3‐year follow‐up. However, the long‐term effectiveness of extra‐short dental implants remains to be further studied.

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Background: Incidence and severity of postoperative complications are key elements in determining the risk‐benefit relationship of any surgical procedure. The aim of this retrospective study was to assess and categorize the postoperative complications that occur following, and are associated with, oral, periodontal, and implant surgeries. Methods: A total of 3,900 patients who underwent surgical procedures including, but not limited to, sinus floor elevation, guided tissue regeneration, crown lengthening, implant placement, soft tissue graft, open flap debridement or surgical removal of impacted teeth were included. Postoperative complications were recorded and graded based on impedance to routine daily activity and favorable surgical outcomes. Regression models were generated to evaluate correlations between complication types, as well as between patient/surgical characteristics and the incidence of complications. Results: Surgical removal of impacted teeth and lateral sinus floor elevation had the highest incidence and severity of complications. Postoperative dentinal hypersensitivity (5.7%) was the most frequent complication, followed by excessive pain (4.1%), and moderate postoperative bleeding (3.5%). Based on the devised grading system described in this paper, the complications were 11.1% of Grade I, 3.3% of Grade II, 8.3% of Grade III, 0.1% of Grade IV, and no complications recorded under Grades V or VI. Conclusions: Surgical removal of impacted teeth and lateral sinus floor elevation are more prone to more severe complications compared with other procedures. Additionally, complications that do not impede favorable surgical outcomes and/or routine daily activity are the most likely to occur. Smoking and diabetes are generally associated with postoperative complications.