Abutment Screw Research Articles

A New Multi-Axial Functional Stress Analysis Assessing the Longevity of a Ti-6Al-4V Dental Implant Abutment Screw

This study investigates the impact of tightening torque (preload) and the friction coefficient on stress generation and fatigue resistance of a Ti-6Al-4V abutment screw with an internal hexagonal connection under dynamic multi-axial masticatory loads in high-cycle fatigue (HCF) conditions. A three-dimensional model of the implant–abutment assembly was simulated using ANSYS Workbench 16.2 computer aided engineering software with chewing forces ranging from 300 N to 1000 N, evaluated over 1.35 × 107 cycles, simulating 15 years of service. Results indicate that the healthy range of normal to maximal mastication forces (300–550 N) preserved the screw’s structural integrity, while higher loads (≥800 N) exceeded the Ti-6Al-4V alloy’s yield strength, indicating a risk of plastic deformation under extreme conditions. Stress peaked near the end of the occluding phase (206.5 ms), marking a critical temporal point for fatigue accumulation. Optimizing the friction coefficient (0.5 µ) and preload management improved stress distribution, minimized fatigue damage, and ensured joint stability. Masticatory forces up to 550 N were well within the abutment screw’s capacity to sustain extended service life and maintain its elastic behavior.

A method for decontaminating a dental implant and components after abutment screw loosening: A clinical report

Abutment screw loosening is the most common complication in single implant-supported crowns, typically remedied by simply reattaching the restoration, preferably using a new abutment screw. The internal aspect of the implant along with any other components should be decontaminated before reconnection. This clinical report provides information on the appropriate management of the decontamination process, as well as evidence of the foreign material found within the implant body.

The impact of abutment type on abutment screw removal torque value after experimental aging.

To evaluate the changes in abutment screw removal torque value (RTV) of anatomic, original hybrid, and non-original hybrid abutments after simulated clinical use. Ninety-three implant-abutment-crown specimens were divided into groups according to abutment types (n=31): anatomic (stock) (A), original hybrid (OH), and non-original hybrid (NOH). After the initial abutment screw tightening, the specimens were subjected to five screw tightening (insertion/removal) cycles, or to 5000 thermal cycles with 500,000 chewing cycles combined with one or five screw tightening cycles. RTV measurements and surface analysis using scanning electron microscope were performed before and after aging. The impact of abutment types and aging treatments on RTV was determined using two-way repeated measures ANOVA, data were described with mean±SD and range, whereas the differences were significant at p<0.05. A significant interaction was found between abutment types and screw tightening cycles only (p=0.036) or combined with thermomechanical aging (p<0.001) on RTV. RTV was lower in NOH than in A and OH groups after screw tightening and thermomechanical aging (p<0.05). Before aging, the NOH abutment screw was slightly more damaged than OH and A abutment screws. After aging, screw damage was more pronounced on the surfaces of hybrid abutments, and more evident in the NOH group. The abutment screw RTV of anatomic, original hybrid, and non-original hybrid abutments become significantly lower after abutments undergo screw tightening and/or thermomechanical aging cycles, with higher RTV loss in hybrid abutments, especially non-original ones.

Biomechanical Comparative Analysis of Abutment Screw Head Designs on Preload Stability Under Oblique Compressive Forces: An In Vitro Pilot Study.

To examine the impact of abutment screw head sizes on preload stability when secured to a standard external hex implant under oblique compressive forces. Fifteen metal crowns were divided into three equal groups. The first group had five angulated cemented crowns connected to a 3 mm tall straight hexagonal abutment with an external hex abutment screw. The second and third groups each had five straight cemented crowns attached to a tapered abutment with flat slotted and internal hex abutment screws, respectively. Samples were subjected to a static cyclic load until failure. Kruskal-Wallis H, Dunn's, and one-way ANOVA with Tukey HSD tests were performed. Cemented straight crown supported by an angled abutment connected to implants with flat slotted and internal hex abutment screw heads failed at an average of 4.24 x 106 cycles ± 3.31 SD and 12.67 x 106 cycles ± 5.47 SD, respectively. Cemented angled crowns supported by a straight abutment connected to identical implants with an external hex abutment screw survived 18.02 x 106 cycles ± 4.49 SD. Periotest value (PTV) rate of change increased at a higher rate in crowns supported by angled abutments compared to straight abutments (p < 0.05). No cement failure was observed. Under the experimental conditions, larger abutment screw head sizes demonstrated greater stability of the abutment screw joint interface. Based on the in vitro findings, no cement failure was observed between the cemented crown and abutment connection. Future research with standardized comparative setups and larger sample sizes is needed.

Evolving interfaces: A comprehensive review of implant-abutment connections

Studying the implant-abutment connection is crucial, as it primarily determines the strength and stability of an implant-supported restoration, which, in turn, affects prosthetic stability. Traditionally, Brånemark's external hexagon has been used. However, significant complications such as abutment screw loosening, rotational misfit at the implant-abutment interface and microbial penetration have necessitated modifications of the external hexagon and led to the development of internal implant-abutment connection.This review outlines the evolution of various implant-abutment connections from the traditional external hexagon to advanced internal designs. Internal interface designs offer several advantages over the traditional approach. They reduce the vertical height platform for restorative components and distribute lateral loading deep within the implant. These designs also shield the abutment screw and provide long internal wall engagements that create a rigid, unified body resisting joint opening. Additionally, they feature wall engagement with the implant that buffers vibration, offer the potential for a microbial seal, and provide extensive flexibility. Importantly, they allow for the lowering of the restorative interface to the implant level for better aesthetics. These advancements have significantly enhanced the clinical performance and reliability of implant-supported restorations.

INFLUENCE OF ABUTMENT GEOMETRY ON THE MICROGAP SIZE IN THE CONICAL CONNECTION

BACKGROUND: To provide prosthetics for patients on implants, dentists resort to using not only original, but also non-original suprastructures. Previously, the authors carried out an finite element analysis, which showed that the size of the microgap of the conical connection depends on the choice of abutments, which affects the condition of the marginal bone around the implant. AIMS: to find out the factor that distinguishes the original and non-original abutments and largely influences the size of the microgap in the conical connection. MATERIALS AND METHODS: The experiment involved implants and standard abutments of Straumann BL, BioHorizons Tapered Internal and Nobel Biocare CC implant systems, and non-original abutments of ADM Dental. At the first stage of the experiment, four main factors were identified: the material of the screw and abutment, the geometry of the screw and abutment. The calculations were based on data from the authors' previous research and were carried out through the ANSYS Workbench using the finite element analysis. The second stage of the study was carried out on the microtomography complex “Neoscan 80”, where, in order to clarify the geometric features of the samples, the size of the microgap and the length of the conical generatrices between the constituent elements were measured. RESULTS: We can talk about the predominant influence of the abutment geometry on the micro-gap of the conical connection of Straumann and BioHorizons. In Nobel, the width of the microgap depends largely on the geometry of the abutment screw. Measurements of the microtomographic complex determined the difference in the length of the conical “implant-abutment” components for Straumann (0.1 mm) and BioHorizons (0.07 mm), and did not determine it between the original and non-original abutment for Nobel. The conical generatrix of the screw with the original Nobel abutment is smaller than with the non-original one. CONCLUSIONS: As a result of the study, it was determined that the choice between the original and non-original suprastructure has a greater influence on the size of the microgap of the conical connection due to the different geometric configuration of the abutment, in particular, the geometry of its fixing screw.

Torque loss in the abutment screw after implant restoration

Torque loss in the abutment screw after implant restoration

A Conservative Technique for Fractured Implant Abutment Screw Retrieval on an Internal Connection Implant: Proof of Concept.

Broken screw removal from the implant connection is a common but challenging process. Several proposed methods and technical solutions may result in unsuccessful removal; thus, a novel, more conservative, risk-free method is proposed as a first attempt. The proposal is to use a silicon restoration holder to be twisted counterclockwise on the dried surface of the broken fragment inside the implant connection. This method, within the limitations of a minimal case series, yielded 100% results; however, despite previous attempts with less conservative techniques, this approach showed no efficacy. This article aims to promote the use of silicon restoration holders as a minimally invasive first attempt at broken screw retrieval treatment before considering other options.

Implant abutment screw fracture: Two case reports

Implant abutment screw fracture: Two case reports

Impact of Diamond-like Carbon Films on Reverse Torque: Superior Performance in Implant Abutments with Internal Conical Connections

The loosening or fracture of the prosthetic abutment screw is the most frequently reported complication in implant dentistry. Thin diamond-like carbon (DLC) films offer a low friction coefficient and high wear resistance, functioning as a solid lubricant to prevent the weakening of the implant–abutment system. This study evaluated the effects of DLC nanofilms on the reverse torque of prosthetic abutments after simulated chewing. Abutments with 8° and 11° taper connections, with and without DLC or silver-doped DLC coatings, were tested. The films were deposited through the plasma enhanced chemical vapor deposition process. After two million cycles of mechanical loading, reverse torque was measured. Analyses with scanning electron microscopy were conducted on three samples of each group before and after mechanical cycling to verify the adaptation of the abutments. Tribology, Raman and energy-dispersive spectroscopy analyses were performed. All groups showed a reduction in insertion torque, except the DLC-coated 8° abutments, which demonstrated increased reverse torque. The 11° taper groups experienced the most torque loss. The nanofilm had no significant effect on maintaining insertion torque, except for the DLC8 group, which showed improved performance.

Comparison of implant placement at crestal and subcrestal levels in aesthetic zone: A finite element analysis.

The success rate of the implant treatment, including aesthetics and long-term survival, relies heavily on preserving crestal peri-implant bone, as it determines the stability and long-term outcomes. This study aimed to demonstrate the stress differences in the crestal bone resulting from dental implant placement at various depths relative to the crestal bone level using finite element analysis. Three study models were prepared for implant placement at the crestal bone level (CL), 1 mm depth (SL-1),and 2mm depth (SL-2). Implants were placed in the maxillary central incisor region of each model, and 100 N vertical and oblique forces were applied. The von Mises, maximum principal (tensile), and minimum principal (compressive) stresses were evaluated. The CL model exhibited the highest stresses on the implant, abutment, and abutment screws under vertical and oblique forces. For maximum principal stress in the crestal bone under vertical force, the SL-2, SL-1, and CL models recorded values of 6.56, 6.26, and 5.77MPa, respectively. Under oblique forces, stress values for SL-1, SL-2, and CL were 25.3, 24.91, and 23.76MPa, respectively. The CL model consistently exhibited the lowest crestal bone stress at all loads and the highest stress values on the implant and its components. Moreover, considering the yield strengths of the materials, no mechanical or physiological complications were noted. Placing the implant at the crestal level or subcrestally beyond the cortical layer could potentially reduce stress and minimize crestal bone loss. However, further studies are warranted for confirmation.

Three-Dimensional Finite Element Analysis of Stress Distribution in Dental Implant Prosthesis and Surrounding Bone Using PEEK Abutments.

(1) Background: Polyetheretherketone (PEEK) has been used as an alternative to titanium in implant prosthetic systems, but its impact on stress distribution in implant systems needs to be investigated. This study aimed to compare the effect of polyetheretherketone (PEEK) and titanium abutments on implant prosthetic systems and the supporting bone using three-dimensional finite element analysis (FEA). (2) Methods: Three-dimensional finite element analysis was conducted using CATIA V5 and Abaqus V6.12 software to model mandibular first-molar implant systems with titanium and PEEK abutments. Under external loading conditions, finite element analysis was conducted for the stresses in the implant components and surrounding bones of each group. (3) Results: The implant fixture of the PEEK model exhibited the highest von Mises stress (VMS). The lowest VMS was observed in the abutment screw of the titanium model. Both implant systems demonstrated similar stress distributions and magnitudes in cortical and cancellous bones. (4) Conclusion: PEEK abutments show a similar stress distribution in the surrounding bone compared to titanium. However, PEEK absorbs the stresses within the implant system and exhibits the highest VMS values due to its low mechanical and physical properties. Therefore, PEEK abutments need improved mechanical properties for better clinical application.

Effect of Titanium Base Abutment Height and Restorative Material on Torque Maintenance of Hybrid-abutment Restoration with Offset Implant Placement.

The purpose of this in vitro study was to evaluate the effect of titanium base height on torque loss of monolithic zirconia, lithium disilicate, and polymer-infiltrated ceramic hybrid- abutment restorations for offset placed implant. Forty-two hybrid- abutment restorations supported by offset placed implants (diameter: 4.2 mm; length: 10 mm) were divided into 6 groups: short titanium base and zirconia (SZ), long titanium base and zirconia (LZ), short titanium base and lithium disilicate (SE), long titanium base and lithium disilicate (LE), short titanium base and polymer-infiltrated ceramic (SP), and long titanium base and polymer-infiltrated ceramic (LP). An adhesive resin cement was used to bond the restoration to the titanium base. The restoration was secured with titanium screw tightened to 30 Ncm by using a calibrated torque meter device. The specimens were exposed to thermocycling (5000 cycles at 5°C to 55°C), then cyclic loaded (120 000 cycles/50 N/1.6 Hz), where the load was placed vertically in mesial fossa of the restoration. After the loosening torque value of the abutment screw was measured by the torque meter device, the torque loss and its percentage were calculated. Two-way ANOVA, one-way ANOVA, and post hoc Tukey tests were used for statistical analysis of the data (α&#61;.05). The 2-way ANOVA test showed significant differences in loosening torque, torque loss and percentage of torque loss across the restorative material (P<.001), no significant difference across the height of titanium base (P&#61;.213) and no significant interaction (P&#61;.845) between restorative material and height of titanium base. Regarding the restoration type, 1-way ANOVA test showed significant difference (F ratio&#61;15.95, P<.001) in torque loss between groups. The mean torque loss value with monolithic zirconia was significantly higher than with lithium disilicate (P&#61;.039) and polymer-infiltrated ceramic (P<.001), respectively. Between the lithium disilicate and polymer-infiltrated ceramic, a significant difference (P&#61;.013) was also found. The restorative material had a major effect on the torque maintenance in hybrid-abutment-restoration supported by offset placed implant, while the titanium base abutment height had no influence on it. Compared to lithium disilicate and polymer-infiltrated ceramic materials, monolithic zirconia induced higher torque loss when used as hybrid-abutment-restoration.

Influence of CAD/CAM Manufacturing Technique and Implant Abutment Angulation on Loosening of Individual Screw-Retained Implant Crowns

Background: Dental implant abutment screw loosening is an increasingly common problem, as evidenced by multiple studies that have investigated its causes. The objective of this study was to compare the screw loosening torque values before and after cyclic loading and to determine whether they are affected by the CAD/CAM abutment manufacturing technique (machined or laser-sintered) and abutment angulation. Materials and Methods: Ninety implants were used and divided into two groups: 45 implants received machined abutments (group A) and 45 implants received laser-sintered abutments (group B). Each group was further divided into three subgroups, with 15 implants each, based on the abutment angulation involved (0°, 15° and 20°). The abutments were tightened to the torque recommended by the manufacturer, and the reverse torque value was measured before and after cyclic loading (300,000 cycles). Data analysis was performed using one-way ANOVA and Wilcoxon signed-rank tests. Results: Statistically significant differences were observed between the laser-sintered and machined groups (p &lt; 0.01). Additionally, differences were observed between subgroups with different angulations for both machined (16.2 ± 1.75, 14.7 ± 1.74 and 13.4 ± 1.08 Ncm) and laser-sintered abutments (14.6 ± 1.25, 12.7 ± 1.2 and 11.1 ± 1.35 Ncm) (0°, 15° and 20°, respectively). Conclusions: The final screw loosening torque after cyclic loading was lower than the initial loosening torque. Both abutment angulation and the CAD/CAM manufacturing method exerted a statistically significant influence on the final loosening torque. The abutment angulation factor was estimated to have an influence of 34.5%, while the abutment manufacturing method was estimated to have an influence of 21%.

Influence of conical hybrid stock and computer-aided design/computer-aided manufacturing abutments on the strain developed around implant and the screw loosening

Abstract Aim Evaluate effect of conical hybrid stock and computer-aided design/computer-aided manufacturing (CAD/CAM) abutments on the strain developed around implant and the screw loosening. Patients and methods Sixteen epoxy resin blocks containing implant assembly (fixture, abutment, abutment screw, cemented zirconia crown) divided into two equal groups (eight blocks) in each group as fallow: group (A): eight blocks with implants attached to Stock abutment with conical hybrid connection to retain the crown to the implant. Group (B): Eight blocks with implants attached to customized CAD/CAM milled abutment with the same size and connection to retain the crown to the implant. The samples were subjected to dynamic cyclic loading 150 000 cycles using chewing simulator. A digital torque gauge was used to evaluate screw loosening by measuring removal torque value (RTV) before and after cyclic loading. Strain gauge was installed around implants in buccal, palatal aspects of each implant, and a load of 100 N was applied vertically and another load of 65 N was applied obliquely by using universal testing machine and the strain was determined using strain meter. Results For GA, percentage of initial removal torque loss (RTL) was (17.988 ± 1.248%) and significantly increased after loading (30.763 ± 1.176%). For GB, percentage of initial removal torque loss was (24.350 ± 1.239%) and increased significantly after loading (33.313 ± 2.840%). For strain results under vertical and oblique loading, there was no statistically significant difference in both groups in stock and cad cam abutments and the strain measurement under oblique loading were significantly higher than the strains measured under vertical loading in both groups. Conclusions Screw loosening occurred in both stock abutments and CAD/CAM abutments but CAD/CAM abutments yielded greater removal torque reduction (RTV) reduction% than the stock abutments and stock abutments showed little stress values around implant than CAD/CAM abutment without statistically significant difference. Off-axial loads will generate more stresses around implants.

Retrospective, Multi-center, Cohort Study Evaluating Clinical, Technical, Biological, and Esthetic Outcomes of Implant Supported Zirconia Single Crowns Cemented on Titanium-base Abutments: 7-year Mean Follow-up.

To retrospectively evaluate the long-term clinical, technical, biological, and esthetic outcomes of implant supported single zirconia crowns (ISCs) intraorally cemented to Ti-base hybrid-abutments up to 16 years after placement. A total of 63 ISCs (Xive S, Camlog Screw Line, Replace Select TC NP, Branemark MK II, and 3i Osseotite) were evaluated in 36 patients at two different centers. Original Ti-bases were selected and zirconia meso structures and zirconia crowns were designed using CAD/CAM software and then milled from partially stabilized zirconia blocks. After the meso structures were cemented extraorally onto the Ti-bases, the ceramic crowns were intraorally luted to the hybrid abutments. The Ti-base ISC restorations were followed up for up to 16 years, and their clinical, biological, and esthetic outcomes were recorded at distinct time points (T1; T2) at three-year intervals. 36 patients (18 men, 18 women) received 32 ISCs in the anterior region and 31 in the posterior region of the maxilla and mandible. The mean follow-up of the Ti-base ISCs was 6.93 ± 2.60 years. The mean follow-up of the implants amounted to 8.11 ± 3.26 years. No implants were lost during follow-up, resulting in a cumulative implant survival rate of 100%. Abutment screw loosening was observed in two ISCs after one year in service. The overall cumulative restorative survival rate of the Ti-base restorations reached thus 96.83%. At T2 follow-up 24% of the ISCs exhibited an increase in PD despite maintaining clinically healthy peri-implant tissue. An 11% increase in BOP and a 3.17% decrease in PI were recorded. Despite spectrophotometrically measured ΔE values indicating visible discoloration of some restorations and their peri-implant soft tissue, a low incidence of esthetic complications was observed with an average PES/WES score of ≥ 12. No correlation was found between PES (R &#61; -0.25; p &#61; 0.27) and WES (R &#61; -0.18; p &#61; 0.43) scores and digital shade determination. The results of the present retrospective, multicenter, cohort study indicate satisfactory clinical outcomes for intraorally cemented single zirconia crowns (ISCs) supported by Ti-base hybrid abutments. An overall esthetic superiority of Ti-base ISCs could not be confirmed.

The effect of different implant-abutmenttypes and heights on screw loosening in cases with increased crown height space.

The stability of the abutment screw is pivotal for successful implant-supported restorations, yet screw loosening remains a common complication, leading to compromised function and potential implant failure. This study aims to evaluate the effect of different implant-abutment types and heights on screw loosening in cases with increased crown height space (CHS). In this in vitro study, a total of 64 abutments in eight distinct groups based on their type and height were evaluated. These groups included stock, cast, and milled abutments with heights of 4 mm (groups S4, C4, and M4), 7 mm (groups S7, C7, and M7), and 10 mm (groups C10 and M10). Removal torque loss (RTL) was assessed both before and after subjecting the abutments to dynamic cyclic loading. Additionally, the differences between initial RTL and RTL following cyclic loading were analyzed for each group (p < .05). The C10 group demonstrated the highest RTL, whereas the S4 group exhibited the lowest initial RTL percentage (p < .05). Furthermore, the study established significant variations in RTL percentages and the discrepancies between initial and postcyclic loading RTL across different abutment groups (p < .05). Additionally, both abutment types and heights were found to significantly influence the RTL percentage (p < .05). The type and height of the implant abutment affected screw loosening, and in an increased CHS of 12 mm, using a stock abutment with a postheight of 4 mm can be effective in minimizing screw loosening.

A conservative approach to localize loose implant screw through cemented crown: an in vitro experimental study

BackgroundRetrieval of cement-retained implant-supported restorations is intriguing in cases of screw loosening. Detecting the estimated size of the screw access hole (SAH) could decrease destruction to the prosthesis and preserve the crown.ObjectivesTo precisely localize loose implant screws through cemented crowns to reduce crown damage after screw loosening.Materials and methodsIn this in vitro study, 60 cement-retained implants supported 30 zirconia-based, and 30 ceramics fused to metal (CFM) lower molar crowns were invented, and each was subdivided into three subgroups (10 each). In group I (AI/BI) (control), SAH was created with the aid of orthopantomography (OPG). In contrast, in group II (zirconia-crown), SAH was created with the aid of CBCT + 3D printed surgical guide with a 2 mm metal sleeve in subgroups IIA/IIIA and CBCT + MAR was used to develop SAH in subgroups IIB/IIIB. SEM and Micro-CT scanned the SAH openings to determine the diameter of the hole, cracking, chipping, and chipping volume.ResultsRegarding the effect of plane CBCT and CBCT + MAR on prepared crowns, a highly significant association between group I with group II (p = 0.001) and group III (p = 0.002) was detected. Regarding the cracking of SAH, significant differences between the zirconium crown and CFM restoration (p = 0.009) were found, while for the chipping, no significant association was seen between groups (p = 0.19).ConclusionsCBCT, either as a plane CBCT or with MAR, significantly improved the accuracy of drilling the screw channel and decreased injury to the existing restoration and abutment, aiding in better localization of SAH in loosened implant abutment screws.

Dental implant and abutment in PEEK: stress assessment in single crown retainers on anterior region.

Stress distribution assessment by finite elements analysis in poly(etheretherketone) (PEEK) implant and abutment as retainers of single crowns in the anterior region. Five 3D models were created, varying implant/abutment manufacturing materials: titanium (Ti), zirconia (Zr), pure PEEK (PEEKp), carbon fiber-reinforced PEEK (PEEKc), glass fiber-reinforced PEEK (PEEKg). A 50N load was applied 30o off-axis at the incisal edge of the upper central incisor. The Von Mises stress (σvM) was evaluated on abutment, implant/screw, and minimum principal stress (σmin) and maximum shear stress (τmax) for cortical and cancellous bone. The abutment σvM lowest stress was observed in PEEKp group, being 70% lower than Ti and 74% than Zr. On the implant, PEEKp reduced 68% compared to Ti and a 71% to Zr. In the abutment screws, an increase of at least 33% was found in PEEKc compared to Ti, and of at least 81% to Zr. For cortical bone, the highest τmax values were in the PEEKp group, and a slight increase in stress was observed compared to all PEEK groups with Ti and Zr. For σmin, the highest stress was found in the PEEKc. Stress increased at least 7% in cancellous bone for all PEEK groups. Abutments and implants made by PEEKc concentrate less σvM stress, transmitting greater stress to the cortical and medullary bone. The best stress distribution in PEEKc components may contribute to decreased stress shielding; in vitro and in vivo research is recommended to investigate this.

3D-printed short-span hybrid composite implant-supported restorations fabricated through tilting stereolithography: A retrospective clinical study on 85 patients with 1 year of follow-up

PurposeTo report the clinical results obtained with fixed short-span (single crowns [SCs] and fixed partial prostheses [FPPs]) implant-supported hybrid composite restorations fabricated through tilting stereolithography (TSLA). MethodsThis retrospective clinical study included 85 patients who had been restored with 95 fixed short-span implant-supported hybrid composite (Irix Max®, DWS Systems) restorations (70 SCs and 25 FPPs up to three units) fabricated with TSLA. The full-digital model-free workflow was based on intraoral implant scanning, computer-assisted design (CAD) and 3D printing using TSLA (Dfab®, DWS Systems). The primary outcomes were the marginal adaptation, the quality of the occlusal and interproximal contact points, and the chromatic integration of the restorations, assessed independently by two experienced operators (a prosthodontist and a periodontist). A score from 1 to 5 (with 5 as the highest value, 4 for satisfactory quality, 3 for acceptable quality, and 2 and 1 as the lowest values, expressing unsatisfactory quality) was assigned by each operator to each restoration at delivery. The secondary outcomes were the survival and success of the restorations at the 1-year follow-up. The restoration was defined as successful in the absence of any complications throughout the follow-up period. A statistical analysis was conducted. ResultsFor the quality of the marginal closure and occlusal and interproximal contact points, the 3D-printed hybrid composite restorations scored highly; the aesthetic integration was satisfactory. One year after placement, all restorations survived, with a low incidence (4.2 % overall, 5.7 % SCs) of complications (two abutment screw loosenings, two decementation of the restorations, and one upper portion of the hybrid abutment decemented from the titanium base), for a success rate of 95.8 %. ConclusionsWithin the limits of this study (retrospective design, follow-up limited to 1 year from the delivery, and only cemented restorations included) fixed short-span implant-supported hybrid composite crowns and bridges fabricated through TSLA were clinically precise, presenting a low incidence of complications at 1 year. Statement of clinical relevanceThe use of TSLA printing technology can open new perspectives for the treatment of small edentulous gaps with definitive implant-supported prosthetic restorations.