OBJECTIVES: The aim of the current review was to describe the prevalence of peri-implant diseases including peri-implant mucositis and peri-implantitis. MATERIAL AND METHODS: A MEDLINE search (PubMed) until December 2007 was conducted and different keywords related to the prevalence of peri-implant diseases were used. Cross-sectional and longitudinal studies including < or =50 implant-treated subjects exhibiting a function time of < or =5 years were considered. RESULTS AND CONCLUSION: The current review revealed that only a few studies provided data on the prevalence of peri-implant diseases. Cross-sectional studies on implant-treated subjects are rare and data from only two study samples were available. Peri-implant mucositis occurred in approximately 80% of the subjects and in 50% of the implants. Peri-implantitis was found in 28% and < or =56% of subjects and in 12% and 43% of implant sites.

Definition and prevalence of peri-implant diseases.

Objectives
The objective of this systematic review was to assess the 5- and 10-year survival of implant-supported fixed dental prostheses (FDPs) and to describe the incidence of biological and technical complications.

Methods
An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies and case series on FDPs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year and 10-year survival and complication rates.

Results
The updated search provided 979 titles and 257 abstracts. Full-text analysis was performed for 90 articles resulting in a total 32 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants supporting FDPs of 95.6% after 5 years and 93.1% after 10 years. When machined surface implants were excluded from the analysis and only rough surface implants included, the survival rate increased to 97.2% after 5 years. The survival rate of implant-supported FDPs was 95.4% after 5 years and 80.1% after 10 years of function. When the analysis was done exclusively for metal–ceramic FDPs, hence the old gold–acrylic FDPs were excluded, the survival rate increased significantly. The survival rate of metal–ceramic implant-supported FDPs was 96.4% after 5 years and 93.9% after 10 years. Only 66.4% of the patients were free of any complications after 5 years. The most frequent complications over the 5-year observation period were fractures of the veneering material (13.5%), peri-implantitis and soft tissue complications (8.5%), loss of access hole restoration (5.4%), abutment or screw loosening (5.3%), and loss of retention of cemented FDPs (4.7%).

Conclusion
It may be concluded that implant-supported fixed dental prostheses (FDPs) are a safe and predictable treatment method with high survival rates. However, biological and technical complications were frequent (33.6%). To minimize the incidence of complications, dental professionals should make great effort in choosing reliable components and materials for implant-supported FDPs and the patients should be placed in well-structured maintenance system after treatment.

A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years.

3D printing has been hailed as a disruptive technology which will change manufacturing. Used in aerospace, defence, art and design, 3D printing is becoming a subject of great interest in surgery. The technology has a particular resonance with dentistry, and with advances in 3D imaging and modelling technologies such as cone beam computed tomography and intraoral scanning, and with the relatively long history of the use of CAD CAM technologies in dentistry, it will become of increasing importance. Uses of 3D printing include the production of drill guides for dental implants, the production of physical models for prosthodontics, orthodontics and surgery, the manufacture of dental, craniomaxillofacial and orthopaedic implants, and the fabrication of copings and frameworks for implant and dental restorations. This paper reviews the types of 3D printing technologies available and their various applications in dentistry and in maxillofacial surgery.

3D printing in dentistry.

Objectives: The objective of this systematic review was to assess and compare the 5- and 10-year survival of different types of tooth-supported and implant-supported fixed dental prosthesis (FDPs) and single crowns (SCs) and to describe the incidence of biological and technical complications. Methods: Three electronic searches complemented by manual searching were conducted to identify prospective and retrospective cohort studies on FDPs and SCs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using random-effects Poisson’s regression models to obtain summary estimates of 5- and 10-year survival proportions. Results: Meta-analysis of the included studies indicated an estimated 5-year survival of conventional tooth-supported FDPs of 93.8%, cantilever FDPs of 91.4%, solely implantsupported FDPs of 95.2%, combined tooth-implant-supported FDPs of 95.5% and implantsupported SCs of 94.5%. Moreover, after 10 years of function the estimated survival decreased to 89.2% for conventional FDPs, to 80.3% for cantilever FDPs, to 86.7% for implant-supported FDPs, to 77.8% for combined tooth-implant-supported FDPs and to 89.4% for implant-supported SCs. Despite high survival rates, 38.7% the patients with implant-supported FDPs had some complications after the 5-year observation period. This is compared with 15.7% for conventional FDPs and 20.6% for cantilever FDPs, respectively. For conventional tooth-supported FDPs, the most frequent complications were biological complications like caries and loss of pulp vitality. Compared with tooth-supported FDPs, the incidence of technical complications was significantly higher for the implant-supported reconstructions.The most frequent technical complications were fractures of the veneer material (ceramic fractures or chipping), abutment or screw loosening and loss of retention. Conclusion: On the basis of the results of the present systematic review, planning of prosthetic rehabilitations should preferentially include conventional end abutment tooth-supported FDPs, solely implant-supported FDPs or implant-supported SCs. Only for reasons of anatomical structures or patient-centered preferences and as a second option should cantilever toothsupported FDPs or FDPs supported by combination of implants and teeth be chosen.

http://coimplante.odo.br/Biblioteca/Biomecanica/complication%20rates%20of%20tooth-supported%20and%20implant-supported%20FDPs%20-%20Pjetursson%20et%20al.pdf

Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs)

Background: 
Immediate-function Branemark System® implants (Nobel Biocare AB, Gothenburg, Sweden) have become an accepted alternative for fixed restorations in edentulous mandibles, based on documented high success rates. Continuous development is ongoing to find simple protocols for their use.

Purpose: 
The purpose of this study was to develop and document a simple, safe, and effective surgical and prosthetic protocol for immediate function (within 2 hours) of four Branemark System implants supporting fixed prostheses in completely edentulous mandibles: the “All-on-Four” concept.

Materials and Methods: 
This retrospective clinical study included 44 patients with 176 immediately loaded implants, placed in the anterior region, supporting fixed complete-arch mandibular prostheses in acrylic. In addition to the immediately loaded implants, 24 of the 44 patients had 62 rescue implants not incorporated in the provisional prostheses but incorporated in final prostheses later on.

Results: 
Five immediately loaded implants were lost in five patients before the 6-month follow-up, giving cumulative survival rates of 96.7 and 98.2% for development and routine groups, respectively. The prostheses' survival was 100%, and the average bone resorption was low.

Conclusions: 
The high cumulative implant and prostheses survival rates indicate that the “All-on-Four” immediate-function concept with Branemark System implants used in completely edentulous mandibles is a viable concept.

“All-on-Four” Immediate-Function Concept with Brånemark System® Implants for Completely Edentulous Mandibles: A Retrospective Clinical Study

The fit of cobalt-chromium three-unit fixed dental prostheses fabricated with four different techniques: a comparative in vitro study

A 3-year retrospective and clinical follow-up study of zirconia single crowns performed in a private practice

Purpose The purpose of this study was to investigate and compare the precision of fabrication in repeatqdly produced computer numeric controlled (CNC)-milled frameworks with consventional castings, and to analyze the distortion from application of different veneering materials. Materials and methods Twenty identical titanium frameworks were fabricated by means of a CNC milling technique for the same master model. Five conventional frameworks were cast as a control group to the same model. The frames were measured with regard to fit in a coordinate measuring machine linked to a computer. Measurements were made during different stages of handling of the titanium framework, and after veneering materials had been applied. Results The CNC frameworks showed a statistically better fit and precision of fabrication compared to conventional castings (P .05). Conclusion It is possible to fabricate implant-supported frameworks by means of the present CNC technique with a very high precision and repeatability.

Comparisons of precision of fit between cast and CNC-milled titanium implant frameworks for the edentulous mandible.

A 5-year retrospective study of survival of zirconia single crowns fitted in a private clinical setting.

Background: No long-term clinical studies covering more than 5 years are available on Computer Numeric Controlled (CNC) milled titanium frameworks.

Aim: To evaluate and compare the clinical and radiographic performance of implant-supported prostheses provided with CNC titanium frameworks in the edentulous jaw with prostheses with cast gold-alloy frameworks during the first 10 years of function.

Material and Methods: Altogether, 126 edentulous patients were by random provided with 67 prostheses with titanium frameworks (test) in 23 maxillas and 44 mandibles, and with 62 prostheses with gold-alloy castings (control) in 31 maxillas and 31 mandibles. Clinical and radiographic 10-year data were collected for the groups and statistically compared on patient level.

Results: The 10-year prosthesis and implant cumulative survival rate was 95.6% compared with 98.3%, and 95.0% compared with 97.9% for test and control groups, respectively (p > .05). No implants were lost after 5 years of follow-up. Smokers lost more implants than nonsmokers after 5 years of follow-up (p   .05), respectively. One prosthesis was lost in each group due to loss of implants, and one prosthesis failed due to framework fracture in the test group. Two metal fractures were registered in each group. More appointments of maintenance were needed for the prostheses in the maxilla compared with those in the mandible (p < .001).

Conclusion: The frequency of complications was low with similar clinical and radiological performance for both groups during 10 years. CNC-milled titanium frameworks are a viable alternative to gold-alloy castings for restoring patients with implant-supported prostheses in the edentulous jaw.

Anders Örtorp

Papers

The fit of cobalt-chromium three-unit fixed dental prostheses fabricated with four different techniques: a comparative in vitro study

A 3-year retrospective and clinical follow-up study of zirconia single crowns performed in a private practice

Comparisons of precision of fit between cast and CNC-milled titanium implant frameworks for the edentulous mandible.

A 5-year retrospective study of survival of zirconia single crowns fitted in a private clinical setting.

CNC-milled titanium frameworks supported by implants in the edentulous jaw: a 10-year comparative clinical study.