Hallux rigidus is a degenerative arthropathy of the first MTP causing significant discomfort and pain to the patient. Treatment options include a conservative and surgical approach. This report and review describe cases of using all-ceramic implants for 3 patients, conceptualized through a comprehensive literature review. This prospective case series reports 3 patients undergoing surgery on implanting an all-ceramic implant to the first MTP with 6-month follow-up. The comprehensive literature review for the use of ceramic implants was done. 3 patients underwent implantation of an all-ceramic first MTP. The AOFAS score was calculated before surgery and during follow-up. Results show improvement in the AOFAS score and preservation of the results over time. The radiographic examination revealed stability of the implant. The results of this case series align with early reports in the literature suggesting promising short-term benefits of ceramic MTP joint arthroplasty. While case series with longer follow-up report controversial results, the limitations of studies and lack of RCTs show the need for additional investigations. Ceramic MTP joint arthroplasty offers significant short-term relief and functional gains. Longer-term follow-up is essential to identify whether these improvements are sustained and assess the risk of complications.

This study was performed as an adjunct to an existing clinical study to validate the effect of veneer: framework thickness ratio on stress distribution in an implant-supported all-ceramic fixed partial denture. Two commercially available titanium dental implants with corresponding customized abutments and a patient-retrieved all-ceramic fixed partial denture were scanned using a high-resolution micro-CT scanner. Reconstructed 3D objects, along with a simulated bone surface, were incorporated into a non-manifold assembly and meshed simultaneously using Simpleware software (Synopsys Simpleware ScanIP Version P-2019.09; Mountain View, CA). Three such volume meshes (Model A, Model B, Model C) corresponding to veneer: framework thickness ratios of 3:1, 1:1, and 1:3 respectively were created, and exported to a finite element analysis software (ABAQUS). An axial load of 110 N was applied uniformly on the occlusal surfaces to calculate the static stresses and contour plots were generated in the post-processing module. From the data obtained, we observed optimum stress distribution in Model B. Also, the tensile stresses were concentrated in the posterior connector region of the prosthesis in all three models tested. Within the limitations of this study, we can conclude that equal thickness of veneer and framework layers would aid in better stress distribution.

All-ceramic dental implants have been identified as a potential alternative to the traditional titanium-based implant systems used in dentistry to satisfy the demands for esthetic metal-free treatment of edentulous jaws. Among the all-ceramic implants introduced in dentistry, zirconia implants have emerged as the forerunner. The success of zirconia as an implant material has paralleled that of titanium in the short-term, however, few clinical studies assess success in the long-term. Failures of zirconia dental implants have been linked to improper operator techniques, manufacturing defects, and unfavorable loading, thereby necessitating optimal quality control measures by manufacturers and proper treatment planning by an experienced operator to reinforce the favorable properties of zirconia as an implant biomaterial. In this comprehensive review, the various implant-related, tissue-related, prosthesis-related, and patient-related factors affecting the success of zirconia implants have been discussed and compared with those of the titanium implant.

Dental implants are typically composed of 3Y-TZP (3 mol% yttria-stabilized tetragonal zirconia polycrystals). Most dental zirconia implants are currently fabricated via mechanical machining. However, during the machining of zirconia green bodies, many cracks form on the surface. To prevent surface crack formation on the implants, shape forming of the zirconia is necessary using methods such as slip casting. Herein, we fabricated green compacts using slip casting, candidate forming process to reduce surface cracking. To fabricate an optimal 3Y-TZP implant by slip casting and sintering, we prepared a suitable 3Y-TZP slurry for slip casting by adjusting the viscosity via pH, dispersant agent content, and solid loading refinement. Green compacts were prepared by the slip casting of all-ceramic zirconia implants fabricated using optimal slurry conditions, for example, 60 wt% solid content, 1 wt% dispersant, pH 12 and post-sintering at 1450 °C for 2 h. All sintered bodies contained a tetragonal phase with a high sintered density of approximately 6.07 g/cm³, good mechanical hardness of approximately 1367 Hv, grain size of 220 nm, and high surface roughness without cracks.

To assess the methodological quality of published systematic reviews relating to all ceramic implant frameworks, abutments and restorations. Published systematic reviews relating to all ceramic implant restorations for single tooth and multiple teeth replacements were retrieved to assess their methodological qualities. Sixteen systematic reviews were included for methodological quality assessment by two independent assessors using AMSTAR-2 critical appraisal tool. Inter-rater agreement was assessed using the weighted Cohen's Kappa statistic. Most systematic reviews included randomized clinical trials and nonrandomized studies of intervention. The majority of included systematic reviews (15 out of 16) scored critically low on quality with more than one critical flaw when assessed using the AMSTAR-2 tool. Most systematic reviews assessed lacked analysis of the effects of the risk of bias and heterogeneity of the included studies. The inter-rater agreement of the independent assessors was substantial (0.63). Confidence in the evidence presented in these systematic reviews was undermined by their tendency to overlook the effect of risk of bias and heterogeneity in evidence synthesis.

This case presentation displays the workflow and the production steps of two different monolithic implant reconstructions using a chair-side and lab-side system, respectively, for the digital impression and CAD/CAM procedures. The aim of this case report was to compare the two different workflows and their potential benefits and limitations and as well the material properties of two different reconstruction types. Crowns fabricated out of monolithic all-ceramic materials appear to be a clinically good alternative to conventionally produced all-ceramic restorations with a core material and layered veneering ceramic in teeth. For implant-borne reconstructions, monolithic crowns can be adhesively luted on prefabricated titanium implant abutments or titanium resin bases and may also be a suitable solution. Digital technologies can be used to design (computer-aided design – CAD) and fabricate (computer-aided manufacturing – CAM) such reconstructions. By using CAD/CAM procedures, the fabrication time and thus the associated production costs for the reconstructions can be kept low. CAD/CAM systems can be found in both dental laboratories (lab-side) and dental offices (chair-side).

The growing demand for better implant aesthetics has led to increased research on the development of all-ceramic dental implants. The use of microtextured coatings with enhanced properties has been presented as a viable way to improve tissue integrability of all-ceramic implants. The aim of this study was to evaluate the effects of different densities of anisotropic microtextured silica thin films, which served as a model coating, on the behavior of human osteoblast-like cells. The differential responses of human osteoblast-like cells to anisotropic silica microtextures with varying densities, produced via a combination of sol-gel and soft lithography processing, were evaluated in terms of alignment, elongation (using fluorescence microscopy), overall cellular activity, and the expression/activity levels of alkaline phosphatase (ALP). Statistical analysis was conducted using one-way ANOVA/Tukey HSD post hoc test. The thin films were thoroughly characterized via scanning electron microscopy/energy dispersive spectroscopy, Fourier transform infrared, and contact angle measurements. Thin film characterization revealed increased nanoscale roughness and reduced wettability on the micropatterned surfaces. Cell culture experiments indicated that the microtextures induced cell alignment, elongation, and guided colonization on the surface. Cells cultured on denser micropatterns exhibited increased metabolic activity (t = 14-21 days). The early expression/activity levels of ALP released into the medium were found to be significantly higher only on the least dense micropattern. These results suggest the possibility that microstructured silica thin films could be used to guide and enhance peri-implant cell/tissue responses, potentially improving tissue integration for metallic and all-ceramic dental implants.

The All-Ceramic Knee Endoprosthesis—The Gap Between Expectation and Experience with Ceramic Implants

Journal of Esthetic and Restorative DentistryVolume 8, Issue 1 p. 255-262 All-Ceramic Implant Abutments: Esthetic Indications VINCENT PRESTIPINO DDS, Corresponding Author VINCENT PRESTIPINO DDS Private practice, Bethesda, MarylandReprint requests: Dr. Vincent Prestipino, 7830 Old Georgetown Road. Suite 260, Bethesda, MD 20814Search for more papers by this authorABRAHAM INGBER DDS, ABRAHAM INGBER DDS Private practice, Bethesda, MarylandSearch for more papers by this author VINCENT PRESTIPINO DDS, Corresponding Author VINCENT PRESTIPINO DDS Private practice, Bethesda, MarylandReprint requests: Dr. Vincent Prestipino, 7830 Old Georgetown Road. Suite 260, Bethesda, MD 20814Search for more papers by this authorABRAHAM INGBER DDS, ABRAHAM INGBER DDS Private practice, Bethesda, MarylandSearch for more papers by this author First published: January 1996 https://doi.org/10.1111/j.1708-8240.1996.tb00876.xCitations: 47AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume8, Issue1January 1996Pages 255-262 RelatedInformation