Introduction The patient-centered SafetyCrown-workflow enables the immediate restoration of posterior missing teeth and short free-end situations following one-abutment/one-time within three visits and only one surgical approach. This prosthodontic rehabilitation aims to combine the advantages of cemented and screw-retained restorations. Report The concept has been performed with 4 restorations in 3 patients and followed up for up to 1 year (mean: 11.2 months) without technical and/or biological complication. Visit 1: Intraoral optical impression, CBCT, and tooth shade selection. Virtual implant planning is performed, and a surgical guide is printed. After exporting the planned implant position, a tooth-colored abutment is fabricated from zirconia with a 1-mm supragingival cementation line, adhesively bonded to a titanium base. Visit 2: Fully navigated implant placement with insertion of the definitive abutment. Subsequently, optical impressions are prepared for A: immediate restoration using a PMMA crown without functional contacts; B: definitive crown fabricated from monolithic zirconia and individualized. The localization of the screw channel is marked using stain thus permitting precise screw channel access, if necessary. Visit 3: After osseointegration of the implant, the definitive crown is adhesively cemented supragingival. In a retrospective analysis of PROMs (‘How stressful was the treatment process […]?’ (0 = not stressful at all, 100 = very stressful), mean VAS score for SafetyCrown of 14 (SD 11.7) and 29.8 (SD 23.1) for standard procedure were present. Conclusion The SafetyCrown offers a shortened, patient-oriented concept for implant-supported single-tooth reconstructions omitting second-stage surgery. Clinical performance and hypothesized prosthodontic benefits require confirmation via an RCT.
Dental implants are considered to be the most appropriate treatment modality for the rehabilitation of partly or completely edentulous jaws, reporting good short-term as well as long-term results (Buser et al., 2012). Nevertheless, failures and complications have also been reported, both in the early phase after implantation and later after prosthodontic restoration. While failures after loading occur mostly due to peri-implant disease originating from various biological factors or mechanical overload (Salvi et al., 2018), the cause
Background : During dental implant site preparation, heat is generated due to friction. Overheating of the bone during implant osteotomy can induce cell necrosis and may inhibit successful osseointegration of the implant. Several in vitro studies accessing intraosseous temperature rise with temperature recorded either using thermocouples or infrared thermography. However, few studies have compared these measuring methods and quantified differences in temperature recording. Aim/Hypothesis : The aim of this in vitro study was to evaluate the intraosseous temperature rise measured by thermocouples and infrared thermography in a standardized setup. Materials and Methods : A surgical device with a surgical handpiece was mounted on a labside drilling unit. The setup recorded the temperature changes using k-type thermocouples (HH147U, Omega Engineering, UK) at depths of 3 mm, 6 mm and 9 mm and with an infrared thermometer (VarioCAM HD, InfraTec, Germany). Infrared temperature data were evaluated at the same drilling depth. Forty bovine rib samples were divided into four subgroups (n = 10): thermocouple (TC) with external irrigation (TC-1, 50 ml/min) and without irrigation (TC-2); infrared thermography (IT) with external irrigation (IT-1, 50 ml/min) and without (IT-2). The rotational speed was set to 800 rpm and implant preparation was performed using a 2.2 mm pilot drill followed by a 2.8 mm twist drill at a depth of 10 mm both with a load of 2 kg. Kruskal-Wallis test and Mann-Whitney-U test were used for statistical analysis. Results : The overall mean temperature rises (95%-CI) were 8.5°C (7.0-9.9) for group TC and 11.4°C (9.8-11.4) for group IT, respectively. This difference is statistically significant (P < 0.001). For the subgroups mean temperature rises were as follows: TC-1: 4.9 (3.4-6.3), TC-2: 12.04 (9.9-14.2), IT-1: 6.2 (5.5-6.9), IT-2: 16.5 (14.1-19.0). The differences between measurement methods and between different cooling were significant for all subgroups except for TC-2/IT-2 (P < 0.018). The setup investigating IT allowed the measurement of peak temperature additional to the standardized measuring spots (3 mm, 6 mm, 9 mm depth). Mostly peak temperature was reached between or above these spots. On average peak temperature was 2.3°C higher than the highest temperature increase recorded at either 3 mm, 6 mm or 9 mm depth. Conclusions and Clinical Implications : In a standardized setup infrared thermography records are about 30% higher than the measurement with thermocouples. Furthermore, thermography enables to record a thermal profile, whereas thermocouples only allow spot measurement.
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