Objective
To assess the clinical and esthetic outcomes and patient satisfaction of screw‐retained one‐piece implant crowns fabricated with zirconia abutments after a 4.5‐ to 8.8‐year follow‐up.
Material and methods
Thirty‐two patients (12 women and 20 men), who received 40 implant single crowns in anterior and premolar sites, were included in this prospective study. All restorations were based on ceramic hand‐veneered customized CAD/CAM zirconia abutments. The follow‐up consisted of clinical and radiological examinations. The pink esthetic score–white esthetic score (PES‐WES) was used to evaluate the esthetic outcome. Patients’ satisfaction was assessed via visual analog scale (VAS).
Results
Implant and prosthetic survival rates were 100% and 97.5%, respectively. Mean marginal bone loss was −0.17 mm (SD 1.16 mm). Probing depth was ≤4 mm in 98.7% and 5 mm in 1.3% of the sites; 8.3% of them were bleeding on probing positive. No technical or biological complications were observed except for one abutment fracture. The mean PES‐WES scores were 7.0 and 7.1, respectively. VAS scores (10‐point) of 9.41 for function and 9.26 for esthetics showed high patient satisfaction.
Conclusion
After a mean observation period of 6 years and 7 months, screw‐retained implant crowns based on veneered customized CAD/CAM zirconia abutments with conical connection showed very good clinical performance and may be recommended for the replacement of missing anterior and premolar teeth.
(ClinicalTrials.gov # NCT04370314).
Heat-polymerized polymethyl methacrylate (PMMA) has been the material of choice for removable prostheses because of its good mechanical and physical properties. [1][2][3][4][5] However, monomer leaching is a drawback, which is responsible for water sorption and affects dimensional stability and surface properties. [1][2][3][4][5][6][7][8] Advances in digital dentistry and computer-aided design and computer-aided manufacturing (CAD-CAM) technologies have led to the introduction of prepolymerized PMMA blocks. [8][9][10][11][12][13][14][15] Previous studies have reported improved surface properties, less porosity, and microbial adherence to CAD-CAM PMMAs, which may be attributed to the polymerization of blocks under high pressure and temperature. 9,10,12,[16][17][18][19][20] The porous surface of PMMA allows the accumulation of denture biofilm, predominantly composed of the Candida species and bacterial pathogens responsible for chronic atrophic candidiasis and halitosis.
Many studies have evaluated short implants (SIs); however, it is still unclear whether SIs are reliable and can be used to simplify surgical and prosthetic protocols with successful clinical outcomes. The aim of this non-random, conveniently sampled, prospective, split-mouth study was to compare the clinical outcomes when short (SI) (≤8 mm) or regular-length implants (RIs) (>10 mm) were used in the posterior mandible two years after the delivery of splinted reconstructions. Each participant (N=10) received four implants in the posterior mandible; two SIs were placed on one side, and two RIs were placed contra-laterally. Implants were restored with splinted, screw-retained, porcelain-fused-to-metal reconstructions. Survival and success rates, peri-implant marginal bone level (MBL), and soft tissue parameters were evaluated. No participant drop-outs were recorded. Both types of implants showed 100% success and survival rates. From prosthetic delivery to 24 months post-loading, bone remineralization of +0.40 mm for the SIs and +0.36 mm for the RIs was observed without statistically significant differences in MBL between the implant types (p=0.993). SIs showed significantly higher (p=0.001) clinical attachment level (CAL) and probing depth (PD) values. Chipping occurred in one situation in the RI group resulting in a 97.5% prosthetic success rate, which was 100% for the SIs. After 2 years, SIs with splinted reconstructions showed comparable clinical outcomes to those of RIs. Further long-term controlled clinical studies with balanced experimental designs evaluating random and larger populations are required to corroborate these findings.
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