The International journal of prosthodontics最新文献

Purpose: To review and critically discuss current and controversial topics in full-arch rehabilitation, particularly the combination of immediate implant placement and immediate loading.

Materials and methods: A literature review was conducted using a PubMed search of recent relevant publications regarding immediate placement and immediate loading for full-arch rehabilitation. Subtopics identified for review included the following: (1) defining a hopeless dentition and implications for full-mouth extraction; (2) the role of bone removal; and (3) the number of implants required for a full-arch fixed prosthesis.

Results: The number of implants required to support a full-arch fixed restoration is supported by strong scientific evidence. The definition of hopeless dentition and the role of bone removal are still areas of clinical debate with no established consensus.

Conclusions: The classification of hopeless dentition, prosthetic design, bone reduction, and implant number require individualized treatment planning and adherence to evidence-based practices. Evidence-based clinical guidelines remain limited, leaving clinicians without clear protocols for planning and executing complex implant-supported full-arch rehabilitations. Integrating clinical expertise with ethical decision-making is essential to ensure optimal outcomes and long-term success.

Purpose: To evaluate current surgical and prosthetic concepts in adult patients requiring complete tooth extraction for immediate implant placement and restoration in full-arch situations.

Materials and methods: A narrative review was conducted using a comprehensive search strategy on MEDLINE via PubMed based on the PIO question to identify studies published up to October 2024. Data on treatment strategies, survival and success rates, marginal bone loss (MBL), peri-implant health, patient satisfaction, and quality of life (QoL) were extracted and synthesized.

Results: The review highlighted consistently high implant survival rates exceeding 97% and success rates surpassing 95%, with variability observed based on anatomical factors and patient selection. MBL ranged from 0.29 to 1.48 mm over 1 to 5 years, indicating promising long-term outcomes for immediate approaches. Prosthesis survival rates often exceeded 98% despite mechanical complications, such as veneer fractures and screw loosening. Patient satisfaction and QoL improved significantly. Notable differences were identified in preoperative planning, bone augmentation, and primary stability thresholds.

Conclusions: Immediate implant placement and restoration in full-arch rehabilitation is are reliable and predictable when applied to well-selected patients with appropriate planning. High survival rates and enhanced QoL underscore the potential benefits of this approach. However, challenges such as mechanical complications and MBL necessitate further research to optimize protocols and expand applicability to higher-risk populations.

The Oral Reconstruction Foundation organized the International Expert Meeting (IEM) on January 24 to 25, 2025, in Malaga, Spain, inviting expert academicians and clinicians with the aim of establishing clinical recommendations for practitioners on two current topics of interest: (1) immediate implant placement and restorations in single-unit and multiunit FDPs-current evidence, indications, clinical protocols, and (2) immediate implant placement and restorations in full-arch situations-indications and limitations.

Purpose: This scoping review describes the current evidence on immediate implant placement (IIP) and immediate restoration (IR) in single-unit and multiple-unit fixed dental prostheses regarding anatomical, surgical, and prosthetic factors.

Materials and methods: Electronic searches were conducted in PubMed, Embase, and Cochrane databases for systematic reviews on IIP and IR in the anterior and posterior regions of the jaws. Bibliometric data and study details were extracted.

Results: A total of 28 systematic reviews were included. Most reviews addressed anatomical, surgical, and prosthetic factors for improving single-unit IIP and IR in the esthetic zone, with limited evidence for molars or multiunit prostheses. Key anatomical factors included buccal wall integrity, alveolar process dimensions, buccal gap width, and gingival phenotype. Surgical factors commonly addressed were flapless or flapped procedures, implant positioning, and the use of bone or soft tissue grafts. Prosthetic factors emphasized immediate loading protocols, provisional occlusal contacts, and screw-retained restorations.

Conclusions: IIP and IR demonstrate survival rates comparable to delayed protocols when supported by careful patient selection, precise surgical technique, and effective tissue management. The width of the gap, correct implant positioning, and adjunctive soft tissue and bone grafting are critical in the esthetic zone to preserve contours and prevent resorption. Future research should address the evidence gaps in posterior regions and multiunit prostheses to enhance the clinical applicability of immediate implant placement and restoration.

Purpose: To evaluate first and second molar bite raising effect on anterior incisal overbite using steel bearing balls of predefined dimensions.

Materials and methods: The study involved twenty-three young adults (mean age 25, range 22-34) and was composed of two parts, pre-clinical and clinical. a) Pre-clinical: initial evaluations were conducted on dental casts of the participants mounted on a fully adjustable articulator. Stainless-steel bearing balls (2mm and 3mm diameter respectively) were temporarily positioned in the occlusal central groove of the lower first or second molars. Photographs assessed changes in anterior overbite. b) Clinical: subsequent evaluations used intraoral scans on the same participants, excluding those with molar restorations, before and after applying 2mm-diameter stainless-steel bearing balls on lower first molars. Overbite measurements were performed digitally. Reliability was defined through repeated measurements using intraclass correlation coefficients (ICC).

Results: Pre-clinical measurements showed a 2.8±0.5mm overbite decrease with 2mm-diameter bearing balls on the lower first molars and 3.6±0.5mm on the lower second molars. For 3mm-diameter bearing balls, the decrease was 3.7±0.5mm on the first molars and 4.5±0.5mm on second molars. ICC showed excellent reliability. Clinical intraoral scans revealed a mean overbite decrease of 2.7±0.4mm with 2mm-diameter bearing balls on the lower first molars. No significant difference was found between clinical and pre-clinical results for the same participants.

Conclusions: Larger bite raisers and more posterior placement result in greater overbite reduction. The ratio of bite raising to anterior overbite decrease was 1.6 for 2mm-diameter and 1.4 for 3mm-diameter raisers. Considerable inter-individual variability was noted.

Purpose: This clinical report describes, in detail, a step-by-step protocol for the fabrication and adhesive luting of a posterior cantilevered single-retainer all-ceramic resin-bonded fixed dental prosthesis (PC-RBFDP) on the basis of current clinical knowledge and scientific data.

Materials and methods: A 32-year-old patient presented with a missing mandibular molar previously extracted due to endodontic-periodontal complications. After rejecting implant therapy, a PC-RBFDP was proposed and accepted. The restoration was designed as a partial occlusal veneer retainer in 3Y-TZP zirconia, with a feldspathic buccal veneer and a compressive pontic. Tooth preparation was limited to enamel, and the intaglio surface was sandblasted with 50 µm aluminum oxide and treated with a universal primer. Adhesive luting cementation was performed using preheated resin composite under rubber dam isolation and a strictly light-cured protocol following the 'no-finishing concept.' Clinical adjustments were completed, and postoperative occlusion was verified.

Results: The restoration exhibited proper occlusal integration and aesthetic blending. Postoperative control confirmed accurate seating and the absence of excess luting material. Maintenance was facilitated by the compressive pontic design. A three-month follow-up revealed excellent functional integration.

Conclusions: This report outlines the first complete clinical workflow for PC-RBFDPs in posterior regions, providing clinicians with a detailed guide for implementing this minimally invasive treatment in selected cases where implant placement is not indicated.

Purpose: To present a clinical case demonstrating the fabrication of a two-stage telescopic posterior cantilever resin-bonded fixed dental prostheses (PC-RBFDP) on severely mesially tipped mandibular molars to replace a missing premolar and molar with a one-year follow-up.

Materials and methods: To address clinical challenges, premolars and molars were replaced using a telescopic two-stage design. Half-occlusal veneer preparations were performed on mesially tipped molars. Two frameworks were fabricated with a 3Y-TZP/5Y-PSZ multilayer zirconia framework, onto which two glass-ceramic crowns were secondarily bonded. This approach enabled prosthetic axis adjustment, thus avoiding the contraindications of a monobloc PC-RBFDP and the biological challenges induced by an implant-supported crown. Digital impressions and CAD-CAM technology were utilized to manufacture PC-RBFDPs, and bonding was achieved with a universal resin luting cement containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP). Haut du formulaire Results: After one year, the clinical case demonstrated functional and aesthetic success. The telescopic design facilitated the fabrication of a PC-RBFDP for a patient who refused implant therapy, thus overcoming the limitations of a monobloc design.

Conclusions: Despite the limited clinical follow-up and the need for further evidence to support this therapy, the telescopic design shows potential as a viable solution for fabricating PC-RBFDPs in cases where the abutment tooth is severely tipped. This innovative approach may expand the indications for PC-RBFDPs.

Purpose: This review compared the incidence of caries and periodontal parameters of disease activity in abutment versus non-abutment teeth in removable partial dental prosthesis (RPDP) wearers.

Materials and methods: Two reviewers independently searched five electronic databases (PubMed, EBSCO-CINAHL Complete, EBSCO-Dentistry and Oral Sciences, Wiley Cochrane Library, and Scopus) to retrieve studies published until September 9, 2023, and selected randomized controlled trials (RCTs) and longitudinal studies (LSs) reporting at least three months of recall post-delivery. Frequency of new and recurrent caries, probing depths (PPD) in millimeters, and sites with bleeding on probing (BoP) were recorded.

Results: Among the 11,260 records identified, 21 reports from 20 studies (two RCTs and 18 LSs) were included. Four reports described PPD with BoP, 16 reported caries incidence, and one reported both. Synthesis without meta-analysis guidelines were followed for data analysis. Relatively stable periodontal health with 3-month to 10-year follow-up was observed. Caries incidence ranged from 11.9%-46.96% over 2-5 years. Six of the eight reports showed higher caries incidence in abutments than in controls. Cochrane risk of bias (RoB-2.0) assessment indicated high risk in one RCT and moderate risk in another. Four LSs were rated 'good' per the Newcastle-Ottawa Scale with Agency for Healthcare Research and Quality standards. Certainty of evidence was evaluated with Grading of Recommendations Assessment, Development, and Evaluation.

Conclusions: Increased BoP at recalls of 3 months to 7 years was observed. Weak evidence supported stable PPD in RPDP patients. Increased caries risk in abutments compared to non-abutments suggested a need for regular follow-ups.

This case report describes a novel technique enabling the simultaneous placement of dental implants and delivery of a definitive fixed implant-supported prosthesis in a single treatment encounter. This protocol employs a precise CAIS approach that eliminates the need for an interim prosthesis and minimizes the number of clinical visits, offering notable patient-centered benefits and reducing environmental impact. Careful patient selection and clinician expertise are essential, as the risk of implant non-integration remains a critical consideration. This approach marks a potential advancement in edentulous rehabilitation, meriting further investigation for broader clinical application.

Objectives: To assess the association between depression in individuals with different bruxism classification (i.e., unspecified, sleep and/or awake bruxism). In addition, to assess this association among different depression and bruxism assessment methods, bruxism types, and the changes of this association between 2002 and 2025.

Materials and methods: A systematic review search following the PRISMA guidelines was performed in PubMed/MEDLINE, Embase, Brazilian Dentistry Oral Sciences. Observational (i.e., cross-sectional, case-control, and cohort) studies published since 2002, with young adult population (18-59 years old), and with no restriction regarding diagnostic method for both depression and bruxism were included. Articles selected for systematic review and meta-analysis underwent quality and heterogeneity evaluation.

Results: Forty-eight articles were included in the systematic review, and 26 in the meta-analysis. Depression levels were found to be higher using standardized mean differences in all types of bruxism assessed in the literature (i.e., unspecified bruxism, sleep and/or awake bruxism), regardless of the diagnostic method used for bruxism or depression, with the exception of electromyography for the diagnosis of sleep bruxism, which was non-significant. The positive association found in most studies remained positive overtime (2002-2025), without significant changes. Subjects with bruxism in general (i.e., unspecified, sleep and/or awake) had 2.84 times the odds of having depression than those without bruxism.

Conclusions: Assessment of depression and other psychological conditions should be considered in the multidisciplinary management of both sleep and awake bruxism. Both sleep and awake bruxism must be reported and assessed, separately and in combination, in all association studies with depression.