scholarly journals Periodontal Behavior and Patient Satisfaction of Anterior Teeth Restored with Single Zirconia Crowns Using a Biologically Oriented Preparation Technique: A 6-Year Prospective Clinical Study

2021 ◽  
Vol 10 (16) ◽  
pp. 3482
Author(s):  
Blanca Serra-Pastor ◽  
Naia Bustamante-Hernández ◽  
Antonio Fons-Font ◽  
María Fernanda Solá-Ruíz ◽  
Marta Revilla-León ◽  
...  

Objectives. The aim of this study was to analyze the behavior of the periodontal tissues around teeth in the anterior region when restored with zirconia single crowns, using a biologically oriented preparation technique (BOPT), over a 6-year follow-up. Methods. The study investigated tooth-supported single crowns in the anterior region that were fabricated with a zirconia core and feldspathic ceramic covering, in 34 patients. Follow-up analysis took place annually for 6 years, assessing periodontal responses by evaluating the following variables: plaque index (PI); probing depth (PD); gingival index (GI); gingival thickness adjacent to the restoration; and stability of the gingival margin (MS). Any (biological and mechanical) complications were also recorded, as well as the patients’ satisfaction with the treatment. Results. After 6 years’ follow-up, a low mean plaque index was obtained, probing depth was stable, and gingival thickness and margin stability had increased. Complications (biological and mechanical) did not present a statistically significant incidence and a crown survival rate of 97.2% was achieved. Patients’ satisfaction obtained a mean VAS score of 9.04 under 10. Conclusion. Teeth that are prepared with BOPT in the anterior region present good periodontal behavior around the restored teeth, particularly in terms of the stability of the gingival margin and increased gingival thickness. Single crowns prepared with BOPT obtain an excellent clinical survival rate, as well as a high score in patients’ satisfaction after 6 years.

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Miren Vilor-Fernández ◽  
Ana-María García-De-La-Fuente ◽  
Xabier Marichalar-Mendia ◽  
Ruth Estefanía-Fresco ◽  
Luis-Antonio Aguirre-Zorzano

Abstract Background Oral implants have helped clinicians to improve the quality of life for many patients. The material of choice for dental implants currently remains titanium type IV, whose mechanical and biological properties have been proven throughout the history of implantology. Yet, this material is not exempt from complications. For these reasons, ceramic alternatives to titanium have emerged. Thus, the purpose of this study is to evaluate peri-implant hard and soft tissue stability with the use of a one-piece ceramic implant (Straumann® PURE Ceramic Implant) during 1 year of follow-up. Study design One-piece all-ceramic zirconia (ZrO2) implants were placed to replace single missing teeth in the esthetic zone. Six to 8 weeks after the procedure, the definitive prosthesis was fabricated. At the time of prosthesis, placement (T0) photographs and periapical radiographs were taken, and the following clinical parameters were recorded: probing depth (PD), plaque index (PI), bleeding on probing (BOP), suppuration on probing (SOP), distance from gingival margin to incisal edge (GM-IE), and Jemt papilla index (JPI). Follow-up appointments were scheduled at 4 (T4), 8 (T8), and 12 (T12) months, when the same parameters were recorded. In addition, plaque control was reinforced and prophylaxis was carried out. In this last appointment, a final periapical radiograph was taken to assess marginal bone loss. Results A total of 32 zirconia implants were placed in 28 patients (16 women and 12 men, aged between 34 and 67 years). The survival and success rate were 96.9%. The increase in probing depth from baseline to 12 months was 0.78 mm. Assessments of plaque index and bleeding on probing showed a slight increase throughout the study. Conclusions The results obtained with the Straumann® PURE Ceramic implants show them to exhibit very good clinical behavior. The survival rate of the implants of our pilot study was 96.9%. For these reasons, we can say that zirconia implants could be an alternative to titanium implants in the esthetic zone.


2018 ◽  
Vol 43 (5) ◽  
pp. 482-487 ◽  
Author(s):  
R Agustín-Panadero ◽  
B Serra-Pastor ◽  
A Fons-Font ◽  
MF Solá-Ruíz

SUMMARY Objectives: To evaluate the clinical behavior of one-piece complete-coverage crowns and fixed partial dentures (FPDs) on teeth with vertical preparation without finish line biologically oriented preparation technique (BOPT). Methods and Materials: This prospective study included 52 patients requiring treatment with restorations in the esthetic region: 74 crowns and 27 FPDs. The sample included a total of 149 teeth that were prepared vertically without finish line. The sample was divided into two groups: one-piece crowns and FPDs, all with zirconia cores, feldspathic ceramic veneer, and a 0.5-mm prosthetic finish line of zirconia. All procedures were carried out at the University of Valencia from 2013 to 2014. The following parameters were evaluated over a two-year follow-up: oral hygiene, periodontal state, gingival thickening, gingival margin stability, the presence of complications, and restoration survival rate. Patient satisfaction with treatment was assessed by means of a visual analogue scale (VAS). Results: Two years after treatment, 80.5% of treated teeth remained free of gingival inflammation and bleeding. Mean gingival thickening was 0.41 ± 0.28 mm for one-piece crowns and 0.38 ± 0.36 mm for FPDs. Gingival margin stability was 100%, but 2% of the sample presented biological complications. The VAS patient satisfaction scores were eight out of a maximum score of 10. Conclusions: Two years after treatment, vertical preparation without finish line produces gingival thickening, margin stability, and optimal esthetics. Neither crowns nor FPDs presented any mechanical complications.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Michele Perelli ◽  
Roberto Abundo ◽  
Giuseppe Corrente ◽  
Paolo Giacomo Arduino

This article describes a nonsurgical approach for treating gingival recessions and increasing gingival thickness around the natural teeth. Two female patients, presenting gingival recessions at the maxillary frontal teeth, were treated. Patient #1 had a discrepancy among the central maxillary incisors’ gingival margin, and tooth UL1 needed to be restored. Patient #2 presented a buccal gingival recession at tooth UL3. In both cases, the sulcular gingival margin was gently disephitelized with a diamond bur leaving the soft tissue healing by itself. After 4 weeks, the procedure was reperformed. After 6 months, the gingival margins appeared thicker and a creeping attachment was achieved in both cases, obtaining gingival symmetry, related to the adjacent or contralateral teeth, and root coverage. Gingival asymmetry, gingival recessions, and gingival thickness may be improved by means of a guided gentle nonsurgical stimulation, providing creeping attachment in the natural and also restored teeth, with a healthy and stable tissue after 24 months of follow-up.


2021 ◽  
Vol 11 (13) ◽  
pp. 6054
Author(s):  
Bianca Török ◽  
Roland Török ◽  
David M. Dohan Dohan Ehrenfest ◽  
Doriana Agop-Forna ◽  
Cristina Dascălu ◽  
...  

Aim: Study aimed to test whether implants inserted in posterior mandible sites augmented with screw-guided bone regeneration (S-GBR) technique differ from implants placed in non-grafted sites regarding the success and survival rate. Materials and Methods: 20 edentulous patients (mean age 59.45 ± 15.220) were divided in a test group (S-GBR) (immediate implants placed simultaneously with grafting procedures) and control group (implants placed in naturally healed sites). Primary outcomes (implants success; implants survival) and secondary outcomes (clinical parameters of soft tissues: mPI; mGI; probing depth; keratinized mucosa; marginal-bone-level) were evaluated at 24-months follow-up. Results: Plaque levels were higher (p = 0.046) in S-GBR group (0.97 ± 0.882 mm) when compared with control (0.66 ± 0.695 mm). Keratinized mucosa width was higher in S-GBR group (4.13 ± 1.033 mm) than control (3.34 ± 0.821 mm) (p = 0.000) Probing depth (PD) width was higher in S-GBR group (3.50 ± 1.372 mm) than control (2.56 ± 1.332 mm) (p = 0.000). mGI was higher among implants placed in S-GBR group (0.90 ± 1.020 mm) than control (0.56 ± 0.794 mm) (p = 0.061). The difference between the average bone loss (MBL) for implants placed in grafted sites (Group S-GBR: 2.20 ± 1.867 mm) and for those placed in naturally healed sites (Group B: 1.09 ± 1.678 mm) was statistically significant (p = 0.000). The overall implant success rate after 24-month follow-up was 76.7% in S-GBR group and 90.6% in control group (p = 0.001). The survival rate after 24-month follow-up was 86.7% in S-GBR group and 93.8% in control group (p = 0.182). The reconstruction of the alveolar bone using S-GBR technique and immediate implant placement is a valid guided bone regeneration strategy for mandibular alveolar bone with severe horizontal resorption. The choice of S-GBR technique should be based on specific indications as implants placed in grafted sites recorded worse marginal success rate, survival rate and bone resorption than those placed in non-grafted sites.


2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Lu Bai

Objective: To investigate the effect of crown lengthening on patients with different periodontal biological types. Methods: 60 patients with different periodontal biotypes treated in our hospital from May 2017 to February 2019 were retrospectively analyzed. According to the different periodontal biotypes, the above-mentioned patients were further divided into control group (thin fan type, 30 cases) and observation group (thick flat type, 30 cases).The periodontal probing depth (PD), plaque index (PLI), bleeding index (BI) and gingival margin position at 1 week, 1 month, 2 months and 3 months after operation were compared between the two groups. Results: The PD, Bi and PLI values of the two groups after treatment were lower than those before treatment (P<0.05);There was no significant difference in gingival margin position between the two groups after 1 week to 1 month and 1 month to 2 months (P>0.05);After 2 months to 3 months of treatment, the gingival margin distance of the observation group was larger than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: Crown lengthening can effectively improve the periodontal indexes of different periodontal biotypes, and the gingival margin of thick and flat type patients moves more toward the crown.


Materials ◽  
2020 ◽  
Vol 13 (5) ◽  
pp. 1029 ◽  
Author(s):  
Pietro Montemezzi ◽  
Francesco Ferrini ◽  
Giuseppe Pantaleo ◽  
Enrico Gherlone ◽  
Paolo Capparè

The present study was conducted to investigate whether a different implant neck design could affect survival rate and peri-implant tissue health in a cohort of disease-free partially edentulous patients in the molar–premolar region. The investigation was conducted on 122 dental implants inserted in 97 patients divided into two groups: Group A (rough wide-neck implants) vs. Group B (rough reduced-neck implants). All patients were monitored through clinical and radiological checkups. Survival rate, probing depth, and marginal bone loss were assessed at 12- and 24-month follow-ups. Patients assigned to Group A received 59 implants, while patients assigned to Group B 63. Dental implants were placed by following a delayed loading protocol, and cemented metal–ceramic crowns were delivered to the patients. The survival rates for both Group A and B were acceptable and similar at the two-year follow-up (96.61% vs. 95.82%). Probing depth and marginal bone loss tended to increase over time (follow-up: t1 = 12 vs. t2 = 24 months) in both groups of patients. Probing depth (p = 0.015) and bone loss (p = 0.001) were significantly lower in Group A (3.01 vs. 3.23 mm and 0.92 vs. 1.06 mm; Group A vs. Group B). Within the limitations of the present study, patients with rough wide-neck implants showed less marginal bone loss and minor probing depth, as compared to rough reduced-neck implants placed in the molar–premolar region. These results might be further replicated through longer-term trials, as well as comparisons between more collar configurations (e.g., straight vs. reduced vs. wide collars).


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Paolo De Angelis ◽  
Giulio Gasparini ◽  
Edoardo Rella ◽  
Silvio De Angelis ◽  
Cristina Grippaudo ◽  
...  

The digital workflow and the application of Computer-Aided Manufacturing (CAM) to prosthodontics present the clinician with the possibility of adopting new materials that confer several advantages. Especially in the case of zirconia, these innovations have profoundly changed daily practice. This paper compares the satisfaction and perception of patients who received implant-supported single crowns (SC) and fixed partial dentures (FPD) made from zirconia, either monolithic or partially veneered, after 3 years of follow-up; the success and survival rate of these restorations were also measured. Forty patients, who had been previously treated with implant-supported SC or FPD, either monolithic or partially veneered, and submitted to a yearly maintenance program, were recalled 3 years after their treatment and requested to complete an 8-question questionnaire regarding their perceptions of the treatment. Any mechanical or biological complication that had occurred from the time of delivery was also recorded. Patients that experienced ≥1 complication were less likely to be prone to repeat the treatment. The 3-year success rate was 92.6% for monolithic restoration and 92.3% for partially veneered restoration, while the survival rate was 100% for both restorations. The 3-year follow-up found that monolithic and partially veneered zirconia restorations are both well-accepted treatment options, and patients preferred the veneered restorations (0.76, p < 0.05 ) from an aesthetic point of view. According to our results, monolithic and veneered zirconia restorations are both reliable treatment options and are both equally accepted by patients.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jake von Hintze ◽  
Mika Niemeläinen ◽  
Harri Sintonen ◽  
Jyrki Nieminen ◽  
Antti Eskelinen

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.


2021 ◽  
Vol 9 (5) ◽  
pp. 232596712199491
Author(s):  
Alberto Grassi ◽  
Gian Andrea Lucidi ◽  
Giuseppe Filardo ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
...  

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.


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