Implant-supported Dentures Research Articles

Quality of Life After Microvascular Alveolar Ridge Reconstruction with Subsequent Dental Rehabilitation

Background/Objectives: Defects in maxillary and mandibular alveolar ridges are common in maxillofacial practice. Reconstruction with microvascular bone grafts and subsequent prosthetic rehabilitation is the gold standard treatment. This study investigated patients’ quality of life (QoL) after microvascular alveolar ridge reconstruction with subsequent dental rehabilitation. The effect of the underlying disease and success rates of the prosthetic treatment on QoL were analysed. Methods: OHIP-49 was used to evaluate oral health-related QoL (OHrQoL). The SF-36 was used to assess disease-nonspecific QoL. Results: Fifty-eight patients were enrolled and divided into four diagnostic (malignancy, osteoradionecrosis, benign disease, and cleft palate) and five prosthetic groups (no prosthetics, removable partial dentures, complete dentures, implant-supported removable dentures, and implant-supported fixed dentures). There was a significant difference between the diagnostic groups in the total score of their OHIP-49 (p = 0.008). Patients with malignant disease and osteoradionecrosis had worse QoL scores than those with benign diseases and cleft palate. Implant-supported prostheses had the best OHrQoL. Removable partial dentures and patients in whom dental rehabilitation was not possible had the worst OHrQoL (p = 0.042). The SF-36 subscale score showed no statistically significant differences between the diagnostic and prosthetic groups (p > 0.05). Conclusions: OHrQoL after microvascular alveolar ridge reconstruction differs significantly based on underlying diagnoses and prosthetic restorations. Benign diseases and implant-supported dentures have the highest scores.

Clinical applications and improvement of resin bonding for PEEK in resin-bonded fixed dental prosthesis: A review

Resin-bonded fixed dental prostheses (RBFDPs) are a commonly used precision treatment, such as fixed dental prosthesis (FDP) and implant-supported dentures. Full crown preparation of vital teeth, which is required for traditional FDPs, may result in a risk of pulp reaction as a large portion of the coronal tooth structure must be removed. RBFDP has been recognized as a non-invasive or minimally invasive treatment modality for the replacement of single missing teeth. RBFDPs require much less tooth preparation than conventional FDPs. These dental treatments are restorative solutions used to cover missing teeth and achieve an aesthetic smile. The biomechanical rules, aesthetics, polishability, and bond strength have been emphasized in RBFDP treatments. Polyetheretherketone (PEEK) is one of the most widely used biomaterials in dentistry. The material, which stands out especially with its acceptable aesthetics, biocompatibility and modulus of elasticity close to dentin, has enabled it to be used in RBFDP treatments. Since PEEK is lighter than metal alloys, patients experience less discomfort and a feeling closer to natural teeth. Furthermore, the thermoplastic properties of PEEK are claimed to provide a precise fit, allowing the restoration to better integrate into the natural tooth structure. In addition, its ability to be customized using different modern manufacturing techniques is thought to offer dentists and patients a reliable option for successful long-term treatment. Our review is about the use of PEEK material as an alternative material in RBFDPs with low negative effects on periodontal tissues and their bonding with resins.

IMPLANT-SUPPORTED DENTAL PROSTHESES MAY PRESERVE OROFACIAL HARD AND SOFT TISSUES

De Souza AB, Papaspyridakos P, Weber HP, Vazouras K, Matarazzo F. Effect of dental implant therapy on the preservation of orofacial tissues: A systematic review and meta-analysis. Clin Oral Implants Res. 2023;34 Suppl 26:240-256. doi:10.1111/clr.14106. PMID: 37750525. No private or public funding was received for this research. The authors declare that they have no competing interests. Systematic review (with meta-analysis).

Impact of Dental Prostheses on Occlusal Function in Edentulous Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Dental prostheses can improve oral health and have an impact on occlusal function in edentulous patients. For instance, implant-supported dentures are thought to improve masticatory efficiency and biting power; these more modern instruments have demonstrated to offer greater patient satisfaction than traditional complete dentures. Patient-related characteristics such as age, sex, and associated illnesses or comorbid conditions may influence treatment success. Even though total tooth loss is declining globally, edentulism is still frequent, especially in older persons. Modern prosthetics have a major positive impact on oral health overall and occlusal function. Enhancing patient well-being and optimizing treatment outcomes require an understanding of and attention to patient-specific requirements.

Three-dimensional finite element analysis of the biomechanical behaviour of different dental implants under immediate loading during three masticatory cycles

The study aimed to evaluate the impact of varying modulus of elasticity (MOE) values of dental implants on the deformation and von Mises stress distribution in implant systems and peri-implant bone tissues under dynamic cyclic loading. The implant-bone interface was characterised as frictional contact, and the initial stress was induced using the interference fit method to effectively develop a finite element model for an immediately loaded implant-supported denture. Using the Ansys Workbench 2021 R2 software, an analysis was conducted to examine the deformation and von Mises stress experienced by the implant-supported dentures, peri-implant bone tissue, and implants under dynamic loading across three simulated masticatory cycles. These findings were subsequently evaluated through a comparative analysis. The suprastructures showed varying degrees of maximum deformation across zirconia (Zr), titanium (Ti), low-MOE-Ti, and polyetheretherketone (PEEK) implant systems, registering values of 103.1 μm, 125.68 μm, 169.52 μm, and 844.06 μm, respectively. The Zr implant system demonstrated the lowest values for both maximum deformation and von Mises stress (14.96 μm, 86.71 MPa) in cortical bone. As the MOE increased, the maximum deformation in cancellous bone decreased. The PEEK implant system exhibited the highest maximum von Mises stress (59.12 MPa), whereas the Ti implant system exhibited the lowest stress (22.48 MPa). Elevating the MOE resulted in reductions in both maximum deformation and maximum von Mises stress experienced by the implant. Based on this research, adjusting the MOE of the implant emerged as a viable approach to effectively modify the biomechanical characteristics of the implant system. The Zr implant system demonstrated the least maximum von Mises stress and deformation, presenting a more favourable quality for preserving the stability of the implant-bone interface under immediate loading.

The Perfect Timing-Immediate versus Delayed Microvascular Reconstruction of the Mandible.

In this retrospective study, the clinical and economic implications of microvascular reconstruction of the mandible were assessed, comparing immediate versus delayed surgical approaches. Utilizing data from two German university departments for oral and maxillofacial surgery, the study included patients who underwent mandibular reconstruction following continuity resection. The data assessed included demographic information, reconstruction details, medical history, dental rehabilitation status, and flap survival rates. In total, 177 cases (131 male and 46 females; mean age: 59 years) of bony free flap reconstruction (72 immediate and 105 delayed) were included. Most patients received adjuvant treatment (81% with radiotherapy and 51% combined radiochemotherapy), primarily for tumor resection. Flap survival was not significantly influenced by the timing of reconstruction, radiotherapy status, or the mean interval (14.5 months) between resection and reconstruction. However, immediate reconstruction had consumed significantly fewer resources. The rate of implant-supported masticatory rehabilitation was only 18% overall. This study suggests that immediate jaw reconstruction is economically advantageous without impacting flap survival rates. It emphasizes patient welfare as paramount over financial aspects in clinical decisions. Furthermore, this study highlights the need for improved pathways for masticatory rehabilitation, as evidenced by only 18% of patients with implant-supported dentures, to enhance quality of life and social integration.

Hygiene and Care Protocols for Implant-supported Dental Prostheses in Patients with Diabetes

Background: Prophylactic dental procedures following implant placement are critical to the long-term success of implants and are also dependent on the patient maintaining effective home care. Purpose: Evaluation of the effectiveness of preventive measures in patients with diabetes during long periods after prosthetic treatment with implants. Materials and methods: The study included 62 patients with diabetes with edentulism using 146 dental implants. Patients underwent constant monitoring, including regular occupational hygiene during follow-up examinations. Their frequency was set individually from 2 to 4 times A clinical index including Bleeding on Probing (BOP), Probing Depth (PD), and Marginal Bone Loss (MBL). Results: In patients included in the preventive protocol after 12 months, the mean BOP was 1.4 ± 0.15, and PPD was 2.46 ± 0.42. After 12 months in patients mean MBL was 0.72 ± 0.6 mm, after 3 years MBL was 1.24 ± 0.25 mm. For patients who were excluded from preventive services after 12 months, the mean BOP 1.9 ± 0.25, and the mean PPD was 3.56 ± 0.28). After 12 months in patients mean MBL was 0.87 ± 0.7 mm, after 3 years MBL was 1.52 ± 0.32 mm (p > 05). Compared to persons enrolled in the preventive protocol, those in the group without services were more likely to develop peri-implantitis (42.4% vs. 12,6%). The survival rate of implants after 3 years was 98.4%. The survival rate of implants in those patients who were excluded from preventive services after 3 years was 95.4%. Conclusion: For patients with diabetes, regular medical examinations, accompanied by professional oral hygiene procedures, prevent the development of negative reactions of the soft tissues surrounding the implant.

The Effect of Diabetes on Implanted Dentures, A Systematic Review

Background: Dentures are removably inserted dental prosthetics that fill up tooth gaps. There are many types of dentures, including complete, partial and implant-supported dentures. As long-term supports for tooth replacements, dental implants have significantly changed the treatment philosophies of conventional prosthodontics. However, the success and durability of these prosthetic devices may be impacted if a person seeking denture implants has diabetes. Diabetes affects the body in many ways, including the mouth's oral health. Immediate dentures have many benefits, including better oral functions, preservation of lower facial height, preservation of tooth sockets, improvement of aesthetics, and replication of natural teeth's shape, form, and location by artificial teeth. Diabetes mellitus has been reported to be associated strongly with the oral health. The higher glucose microenvironment prolongs healing of tooth extraction sockets. Thus, encouraging the healing of tooth extraction sockets is crucial from a therapeutic perspective for people with diabetes mellitus. Methods: An electronic search of English peer-reviewed dental literature on PubMed, Science Direct and Google Scholar was conducted to identify all publications reporting on how diabetes affect dentures until August 2023. Overall, 977 publications were found through an electronic and manual search, out of which 130 articles were selected after screening based on title and abstract. A total of 52 publications passed the second review phase after assessment for eligibility, from which 24 studies were excluded after full-text screening. Finally, a total of 28 studies were selected. A total of 10 articles were found to match our eligibility criteria to the full and were included in the final systematic review. Conclusion: Diabetes negatively impacts implanted dentures' success and longevity, leading to complications like Candida infection, poor bone integration, peri-implantitis, and compromised healing. Larger clinical trials are needed to understand diabetes's impact on implant therapy outcomes. Clinicians should assess patients' overall health, monitor glycemic control, maintain oral hygiene, and perform regular maintenance for optimal outcomes.

Dental rehabilitation in irradiated oral cancer patients using patient-specific dental implants – Clinical outcome and oral health-related quality of life

IntroductionDental rehabilitation in oral cancer patients is essential for good oral health-related quality of life (OHRQoL). Patient-specific dental implants are suitable for treating tumor-related bony defects, resulting in satisfactory OHRQoL. However, knowledge concerning the clinical outcome and OHRQoL following tumor irradiation is lacking. Material and MethodsA retrospective analysis was carried out to evaluate clinical outcomes and OHRQoL in eight patients who received patient-specific dental implants and implant-supported dentures after surgical treatment for oral cancer with additional irradiation. OHRQoL assessment was performed using the German long version of the oral health impact profile (OHIP) questionnaire (OHIP-G53). ResultsClinical examination revealed successful dental rehabilitation in all the patients with only minor impairments. Restricted stability and function of implants were not observed. OHIP sum-scores of all the patients indicated acceptable OHRQoL, but this varied between patients treated in the upper or lower jaw. Single-item sum-scores concerning the adverse events “difficulty in chewing,” “food catching,” “sore jaw,” “sore spots,” and “unclear speech” were detected to be the worst, and pain-related OHIP dimensions demonstrated the highest scores (followed by functional limitation, physical disability, and psychosocial impact) with a worse OHRQoL following lower jaw treatment. Other dimension sum-scores were overall lower and nearly equally distributed in patients. ConclusionsDental rehabilitation of irradiated oral cancer patients using patient-specific dental implants may be suitable, leading to acceptable OHRQoL. However, implant insertion in the upper jaw seems to be more favorable. Further studies on patient-specific dental implants are warranted to validate the current results.

Comparison of the Passivity between CAD/CAM Implant Frameworks and Three Different Conventional Techniques Before and After Applying Veneering Porcelain

Background: The passivity of the fit may be at risk during the casting as well as the firing of the veneering ceramic. In this study, the comparison of the passivity between computer-aided design/computer-assisted manufacturing (CAD/CAM) implant frameworks and three different conventional techniques before and after applying veneering porcelain was investigated. Methods: In this laboratory cross-sectional study, four groups (n=6) of 3-unit screw-retained implant-supported denture prostheses (ISDPs) were fabricated on a master model with 2 implants. The study groups were as follows: conventional casting with Ni-Cr alloy (group 1), casting with Ni-Cr alloy followed by sectioning and soldering the samples (group 2), double casting with Ni-Cr framework (group 3), and using CAD/CAM-fabricated framework (group 4). All frameworks received porcelain veneer. The one-screw test was performed before and after veneering to measure the vertical misfit at the abutment-framework interface using a stereomicroscope. The mean vertical misfit values were determined at the buccal, lingual, and proximal aspects. The data were analyzed using the Kruskal-Wallis and post hoc tests (α=0.05). Results: The accuracy of the fit varied significantly before and after veneering among the study groups (P<0.001). Frameworks prepared with CAD/CAM showed lower mean marginal misfit values compared to the other fabrication methods (P<0.001). Conclusions: Firing the veneering porcelain attached to a screw-retained ISDP may have an adverse effect on the accuracy of the fit. Soft non-pre-sintered CAD/CAM frameworks had better passivity compared to other three conventional methods applied.

Ektodermal Displazili Çocuk Hastaların Protetik Tedavisi: İki Olgu Raporu

Ectodermal dysplasia (ED) is a hereditary disorder characterized by anomalies in the ectodermal structures. The most common dental anomalies are oligodontia and/or anodontia of the primary and permanent dentition. Therefore, pediatric patients with ED may be need prosthetic rehabilitations. Several prosthodontics treatment options, such as complete, removable partial, over-denture, fixed and implant-supported dentures are avaible to rehabilate patients with ED. The aim of this clinical case report is to present the clinical characteristics and prosthetic treatment of two cases with ED.

Investigating the challenges faced by denture wearers, such as denture stability, comfort, and esthetics, and their preferences for different types of dentures

ABSTRACT Background: Dentures are common prosthetic devices used to replace missing teeth; however, wearers often encounter challenges related to stability, comfort, and esthetics. Understanding these challenges and preferences for different denture types is crucial for improving oral health outcomes and quality of life. Materials and Methods: We conducted a comprehensive study involving 500 denture wearers. Participants were assessed for denture stability, comfort, and esthetics using standardized measures. In addition, their preferences for various denture types, including conventional complete dentures, implant-supported overdentures, and partial dentures, were explored through structured interviews. Results: In this study, 25% of participants found denture stability to be “very challenging,” 40% considered it “somewhat challenging,” and 35% did not find it challenging. Twenty percent of participants found denture comfort to be “very challenging,” 36% considered it “somewhat challenging,” and 44% did not find it challenging. In the study, 15% of participants found denture esthetics to be “very challenging,” 30% considered it “somewhat challenging,” and 55% did not find it challenging. Thirty percent of participants prefer implant-supported dentures, while 70% do not prefer them. Conclusions: Denture wearers commonly experience challenges associated with stability, comfort, and esthetics. Preferences for denture types differ, highlighting the need for personalized treatment options based on individual needs and circumstances.

Flexural Behavior of Biocompatible High-Performance Polymer Composites for CAD/CAM Dentistry

High-performance polymeric materials have been used in computer-assisted design/ computer-assisted milling (CAD/CAM) dental restorative treatments due to their favorable esthetics as well as their mechanical and biological properties. Biocompatible poly-ether-ether-ketone (PEEK) and glass-fiber-reinforced composite techno-polymer (FRC) resins reportedly possess good flexural and shock absorption properties. However, intraoral thermal fluctuations may adversely affect them. This study aimed to investigate the flexural strength and effect of thermal aging on two commercially available high-performance polymers intended for CAD/CAM milled frameworks for definitive restorations. A total of 20 bar specimens were prepared using two CAD/CAM materials (n = 10); PEEK(P) and Bioloren FRC(F). Specimens from each material group were randomly divided into two sub-groups (n = 5): before aging (uP and uF) and after aging, with 10,000 thermocycles (5–55 °C) (aP and aF). All specimens were subjected to a three-point bending test in a universal testing machine. Flexural strength (Fs) values were calculated for all specimens, and their means were statistically analyzed using a t-test, and a general linear model (GLM) repeated measure ANOVA (p < 0.05). There was a statistically significant decrease in the Fs of (F) materials after aging (p = 0.03). (F) specimens exhibited significantly higher Fs than (P) before and after aging (p < 0.001). This type of material had a significant effect on Fs (p < 0.001). Within the limitations of this study, both materials exceeded the ISO recommendations of dental resins for flexural strength. However, FRC materials may benefit CAD/CAM milled long-span fixed partial dentures and implant-supported denture frameworks.

Use of strain elastography in comparative evaluation of elasticity of masseter muscle in complete denture as against implant supported overdenture.

Introduction The masticatory muscles play an important role in natural function and functional disorders of craniomandibular system. Occlusal variables have an impact on the masticatory muscles' action and strength. The masticatory muscles cannot contract as forcefully as they do when natural teeth are present, which is caused by pathological ageing and tooth loss. Consequently, it can be demonstrated that edentulous patients have lower masticatory cycle amplitude, efficiency, and masticatory force than dentulous individuals. Objectives Using strain elastography, evaluate and compare the elasticity of the masseter muscle in complete edentulous individuals and have undergone rehabilitation with complete dentures against those who have undergone rehabilitation with implant-supported dentures. Methodology Two groups of totally edentulous patients would be chosen. The rehabilitation of one group would involve complete dentures, whereas the rehabilitation of the other group would use implant-supported dentures. At the moment of denture insertion and three months later, strain elastography will be used to scan both sides of the masseter muscle. Both groups' values would be compared. Expected results The study's anticipated result is that patients who receive rehabilitation with implant-supported overdentures have greater masseter muscle elasticity than patients who receive rehabilitation with complete dentures. Conclusion The study would give dental professionals a way to efficiently assess the masseter muscle's elasticity in patients who are completely edentulous. Also, it would compare the flexibility of the masseter muscle between a denture supported by implants and a complete denture.

Role of Immediate Loading in the Success of Implants and Implant-Supported Dentures

Role of Immediate Loading in the Success of Implants and Implant-Supported Dentures

Functional Differences between Chewing Sides of Implant-Supported Denture Wearers

Humans are said to have habitual and non-habitual chewing sides; however, the functional differences between the chewing sides of implant-supported denture wearers have not been sufficiently clarified. This study aimed to clarify the presence or absence of functional differences between the chewing sides in implant-supported denture wearers. Forty-five patients with bilateral posterior implants were included in this study. The participants were asked to chew a gummy jelly on one side, and the masticatory movement was recorded using a Motion Visi-trainer (MVT V1). For 10 cycles from the fifth cycle after the start of mastication, the pattern of the movement path, the opening distance, the masticatory width, and the cycle time were calculated as parameters of masticatory movement. The amount of glucose eluted during the chewing of gummy jelly was measured and used as a parameter of masticatory performance. Each parameter representing masticatory movement and masticatory performance was compared between the right and left chewing sides and between the habitual and non-habitual chewing sides using a chi-squared test or a paired t-test. There was no difference in the frequency of masticatory path patterns between the right and left chewing sides. Most participants had a normal pattern on the habitual chewing side; however, abnormal patterns were also observed on the non-habitual chewing side. When comparing right and left chewing, no significant difference was observed between chewing sides in terms of opening distance, masticatory width, cycle time, or amount of glucose eluted (p > 0.05). When comparing the habitual and non-habitual chewing sides, masticatory movement on the habitual chewing side showed a larger opening distance (p < 0.001) and masticatory width (p = 0.008), shorter cycle time (p = 0.004), and higher masticatory performance (p < 0.001). It was suggested that there is a functional difference between the habitual and non-habitual chewing sides in the masticatory movement and masticatory performance of implant-supported denture wearers.

Evaluation of Panoramic Radiographs of Totally Edentulous Jaws: A Retrospective Study

Aim: This retrospective study aimed to determine the incidence of random findings in digital panoramic images acquired from edentulous patients presenting for conventional prosthetic rehabilitations or implant-supported dentures. Materials and Methods: In this retrospective study, of the patients aged 16 years and older, 950 of 1100 panoramic films were evaluated by two maxillofacial radiologists (MA and IBY) in ambient light on an LCD monitor. The final classification and radiographic status of each finding were recorded after inter-observer consensus. Radiographs with low image quality and artifacts that did not include the demographic information of the patients were not included in the study. In the present study; impacted teeth, root remnants, radiolucent (RL) lesions, radiopaque (RO) lesions (including idiopathic osteosclerosis), foreign bodies, crest atrophies, soft tissue calcifications, maxillary sinus opacities, and Stafne bone defects were examined. Lesions affecting the alveolar region were divided into three regions as anterior (incisors and canines region), premolars and molars region. Results: Tonsillitis was observed in a total of 55 individuals, 26 men and 29 women. Sialolith was seen in a total of 3 patients, 2 male and 1 female, but phleboliths were not found in any of them. Styloid ligament ossification(SLO) was seen in a total of 125 patients, 69 of these cases were female and 56 were male, however calcified atherosclerotic plaque is the most common calcification with 156 individuals and a rate of 16.4% among calcifications. Laryngeal cartilage calcification, which is seen in 36 female and 23 male individuals. Conclusion: The outcome of this study indicated that the ratio of advantageous findings fixed in digital panoramic images of totally edentulous patients was highly rated. There are indispensable for patients with total edentulism such as routine use and careful examination of panoramic images.

Which Patient-Related Factors Influence the Outcome of Telescopic-Retained Removable Implant-Supported Dental Prostheses in Edentulous Patients?

To survey the clinical performance of telescopic-retained removable implant-supported dental prostheses (TR-RISDPs) in edentulous patients, as well as incidental maintenance measures and technical complications. In this retrospective analysis, the former presence of oral cancer, prosthesis location (maxilla or mandible), and participation in a follow-up program were analyzed as possible factors with an influence on survival and maintenance treatments of the TR-RISDPs and dental implants using Kaplan-Meier estimates. A total of 86 TR-RISDPs (mean follow-up: 4.62 ± 3.24 years; maximum 13.8 years) and 465 implants (mean follow-up: 5.67 ± 3.59 years; maximum 16.5 years) were observed. Six (6.9%) of the TR-RISDPs had to be remade, and 11 (2.3%) implants failed. Regular attendance in the follow-up program showed significantly higher survival times and fewer maintenance treatments for the TRRISDPs (P < .05). Implants in patients with former oral cancer showed significantly lower survival times (P < .001). TR-RISDPs in edentulous patients show excellent clinical outcomes. Regular check-ups are decisive for success.

FACTORS OF MARGIN BONE STABILITY AROUND IMPLANTS: LITERATURE REVIEW

Implant-supported dentures are increasingly used in dental practice since last century. The purpose of this review is to assess the effect of the transmucosal surface of restorations and implants on peri-implant tissues.&#x0D; Factors that affect bone loss around implants can be divided into local, systemic and social. Local factors include implant geometry, occlusal loading, and biological aspects. Biological factors include peri-implantitis, poor bone quality, surgical implant placement procedure, early implant loading, and poor osseointegration. Among other factors that can lead to bone loss, systemic factors (patient age, general condition, genetic predisposition) as well as social factors (socioeconomic status of the patient, oral hygiene, drug use) play an important role.&#x0D; The article compares and discusses the properties of different materials. The advantages, disadvantages and biomechanical concept of different implant-abutment connections are presented. The location of the connections relative to the bone level and the effect of the micro-gap between the abutment and the implant are described. The article focuses on the following issues:&#x0D; &#x0D; exposure to the material from which the implants and abutment are made, with an emphasis on titanium alloys and zirconium dioxide;&#x0D; implant systems, which are classified according to their location in relation to the level of the bone;&#x0D; type of connection between implants and abutments: external (external hexagon), internal (internal hexagon and octagon) and their modifications, such as conical (Morse taper);&#x0D; the influence of the precision of abutments to the implants` connection;&#x0D; type of fixation;&#x0D; features of transmucosal surfaces;&#x0D; biological factors around the implant-abutment joint.&#x0D; &#x0D; Scientists and manufacturers offer advanced solutions that reduce the number of complications and ensure a longer service life of implants-supported restorations. With proper procedures and the right selection of systems and tools, you can reduce bone loss and preserve soft tissue. Finding a balance between function and aesthetics in implant rehabilitation is a crucial issue.&#x0D; The use of solutions aimed at achieving the expected result in each individual patient, which allow individual consideration of the above risk factors for marginal bone loss, will probably become a standard part of the examination at the preoperative stage of treatment.

Digital workflow effectiveness: preliminary results

Objective: The aim of this observational study was to evaluate the effectiveness of the complete digital workflow in the manufacture of implant-supported screw-retained prostheses regarding to their passive fitting. Materials and Methods: This study presents a preliminary result, part of the project approved by the Ethics Committee of Centro Universitário José Campos Andrade (UNIANDRADE) under number 3,367,320. The sample consisted of 9 patients who had partially edentulous areas with 2 to 3 healed implants, selected at clinic of Faculdade Ilapeo according to the inclusion criteria. All were rehabilitated with metal ceramics multiple implant-supported screw-retained partial dentures. The abutments were selected according to the characteristics of the peri-implant tissues. The frameworks were milled in cobalt-chrome and veneered. The passive fitting of infrastructure was used as a criterion for evaluating the effectiveness of the complete digital workflow through the Sheffield Test criteria. Printed models were used to apply the veneering ceramics. Results: This preliminary result presents 14 implant-supported screw-type fixed prostheses, installed in nine patients. All infrastructures showed a positive result according to the evaluation criteria. Conclusions: Based on the preliminary results presented, it seems fair to conclude that the complete digital workflow shows the necessary effectiveness for obtaining metal ceramic multiple implant-supported screw-retained partial dentures, as a prevalence of prostheses that presented passive sfitting was observed.