Abstract Statement of problem Limited evidence is available for the marginal and internal fit of fixed dental restorations fabricated with digital impressions compared with those fabricated with ...conventional impressions. Purpose The purpose of this systematic review was to compare marginal and internal fit of fixed dental restorations fabricated with digital techniques to those fabricated using conventional impression techniques and to determine the effect of different variables on the accuracy of fit. Material and methods Medline, Cochrane, and EMBASE databases were electronically searched and enriched by hand searches. Studies evaluating the fit of fixed dental restorations fabricated with digital and conventional impression techniques were identified. Pooled data were statistically analyzed, and factors affecting the accuracy of fit were identified, and their impact on accuracy of fit outcomes were assessed. Results Dental restorations fabricated with digital impression techniques exhibited similar marginal misfit to those fabricated with conventional impression techniques (P>.05). Both marginal and internal gaps were greater for stone die casts, whereas digital dies produced restorations with the smallest gaps ( P <.05). When a digital impression was used to generate stereolithographic (SLA)/polyurethane dies, misfit values were intermediate. The fabrication technique, the type of restoration, and the impression material had no effect on misfit values ( P >.05), whereas die and restoration materials were statistically associated ( P <.05). Conclusions Although conclusions were based mainly on in vitro studies, the digital impression technique provided better marginal and internal fit of fixed restorations than conventional techniques did.
The transition of patients from failing dentition to complete-arch implant rehabilitation often means that the patient is rendered edentulous and has to wear a removable complete denture for a time. ...Many patients find this objectionable. A staged treatment approach provides a fixed interim prosthesis for use throughout the rehabilitation process, allowing patient comfort and prosthodontic control. This clinical report describes a staged approach protocol with a new type of interim prosthesis. The prosthesis is supported by hopeless teeth and the soft tissues of the maxillary tuberosities and mandibular retromolar pads for the complete-arch implant rehabilitation of a patient with failing dentition. This protocol allows for a fixed interim prosthesis with combined tooth and mucosa or implant support during the entire rehabilitation process, thus avoiding the use of complete dentures. The implants and prostheses were functioning successfully after 3 years of clinical service.
Complete-mouth implant rehabilitation with modified monolithic zirconia FDPs is described. The framework was designed with monolithic zirconia occlusal surfaces to minimise the possibility of ...chipping of the veneering porcelain, and the veneering porcelain was applied only on the facial surfaces to improve the aesthetic outcome. The prostheses provided satisfactory function and aesthetics after 1 year of service. Further long-term clinical studies of monolithic zirconia frameworks are necessary to compare the outcomes with other designs of zirconia-based FDPs.
The transition of patients from failing dentition to complete arch implant rehabilitation often requires that the patient be rendered edentulous and has to wear a complete removable dental prosthesis ...for varying periods of time. This is objectionable to many patients. A staged treatment approach allows a fixed interim restoration, patient comfort, and prosthodontic control throughout the rehabilitation process. CAD/CAM-guided flapless implant surgery has the advantage of prosthetically driven implant placement and minimal postoperative sequelae. A patient with a failing dentition was treated with this combined protocol and was followed up for 3 years after loading. Implant and prosthesis survival rates were 100%, with no technical complications encountered up to the last recall. The purpose of this clinical report is to describe a combination of CAD/CAM-guided flapless surgery and a staged treatment approach, thereby giving the patient a tooth-supported or implant-supported fixed interim prosthesis during the entire rehabilitation process. The various surgical, laboratory, and prosthetic stages are illustrated for the complete arch prosthetic rehabilitation, and the 3-year follow-up outcome is reported.
A vertically deficient posterior maxillary edentulous ridge in conjunction with sinus pneumatization or extensive horizontal bone resorption presents significant challenges for implant placement and ...restoration with an implant-supported fixed prosthesis. Various surgical techniques have been reported for the reconstruction of the vertically deficient posterior maxilla: guided bone regeneration, sinus elevation, block and/or particulate grafting with barrier membranes, and distraction osteogenesis. This clinical report describes the technique, the management of intrasurgical complications, and the 3-year follow-up results of augmenting the vertically deficient posterior maxilla with a segmental osteotomy prior to rehabilitation with an implant-supported fixed prosthesis.
The applications of various technological advances in implant dentistry and in all aspects of the diagnostic, treatment planning, surgical, and restorative phases are gaining popularity. Additive ...rapid prototyping and computer-aided design/computer-aided manufacturing (CAD/CAM) technology are used to generate stereolithographic surgical guides and prefabricated interim prostheses to facilitate implant surgery and immediate loading, respectively. Subtractive rapid prototyping is used for fabrication of zirconia frameworks for definitive implant prostheses. This clinical report describes the comprehensive application of these technological advances in implant rehabilitation to optimize surgical and prosthodontic outcomes as well as patient comfort. (J Prosthet Dent 2008;100:165-172)
Computer-guided flapless surgery for implant placement using stereolithographic templates is gaining popularity. The advantages of this surgical protocol are its minimally invasive nature, accuracy ...of implant placement, predictability, and reduced time required for definitive rehabilitation. One of the disadvantages, however, pertains to complete arch implant rehabilitation. An existing protocol for complete arch flapless computer-guided implant surgery necessitates the patient to be rendered completely edentulous and to wear a removable complete denture for varying periods of time. This may be objectionable to the patient. This article illustrates a technique which uses a modified radiographic template to overcome this limitation. The patient may have a tooth-supported or implant-supported fixed interim prosthesis during the entire rehabilitation process. (J Prosthet Dent 2008;100:232-235)
