Aim To test whether or not the use of a collagen matrix (VCMX) results in short‐term soft tissue volume increase at implant sites non‐inferior to an autogenous subepithelial connective tissue graft (SCTG), and to evaluate safety and tissue integration of VCMX and SCTG. Methods In 20 patients with a volume deficiency at single‐tooth implant sites, soft tissue volume augmentation was performed randomly allocating VCMX or SCTG. Soft tissue thickness, patient‐reported outcome measures (PROMs), and safety were assessed up to 90 days (FU‐90). At FU‐90 (abutment connection), tissue samples were obtained for histological analysis. Descriptive analysis was computed for both groups. Non‐parametric tests were applied to test non‐inferiority for the gain in soft tissue thickness at the occlusal site. Results Median soft tissue thickness increased between BL and FU‐90 by 1.8 mm (Q1:0.5; Q3:2.0) (VCMX) (p = 0.018) and 0.5 mm (−1.0; 2.0) (SCTG) (p = 0.395) (occlusal) and by 1.0 mm (0.5; 2.0) (VCMX) (p = 0.074) and 1.5 mm (−2.0; 2.0) (SCTG) (p = 0.563) (buccal). Non‐inferiority with a non‐inferiority margin of 1 mm could be demonstrated (p = 0.020); the difference between the two group medians (1.3 mm) for occlusal sites indicated no relevant, but not significant superiority of VCMX versus SCTG (primary endpoint). Pain medication consumption and pain perceived were non‐significantly higher in group SCTG up to day 3. Median physical pain (OHIP‐14) at day 7 was 100% higher for SCTG than for VCMX. The histological analysis revealed well‐integrated grafts. Conclusions Soft tissue augmentation at implant sites resulted in a similar or higher soft tissue volume increase after 90 days for VCMX versus SCTG. PROMs did not reveal relevant differences between the two groups.

The outcomes of the survey analyses demonstrated predictably high implant survival rates for short implants and longer implants placed in augmented sinus and their respective reconstructions. Given the higher number of biological complications, increased morbidity, costs and surgical time of longer dental implants in the augmented sinus, shorter dental implants may represent the preferred treatment alternative.

VCMX and SCTG can be used for soft tissue augmentation at implant sites resulting in an at least short-term increase in volume.

Between crown insertion and 1 year, the buccal peri-implant soft tissue dimensions remained stable without relevant differences between sites that had previously been grafted with VCMX or SCTG.

STATEMENT OF PROBLEM Trials comparing the overall performance of digital with that of conventional workflows in restorative dentistry are needed. PURPOSE The purpose of the third part of a series of investigations was to test whether the marginal and internal fit of monolithic crowns fabricated with fully digital workflows differed from that of crowns fabricated with the conventional workflow. MATERIAL AND METHODS In each of 10 participants, 5 monolithic lithium disilicate crowns were fabricated for the same abutment tooth according to a randomly generated sequence. Digital workflows were applied for the fabrication of 4 crowns using the Lava, iTero, Cerec inLab, and Cerec infinident systems. The conventional workflow included a polyvinyl siloxane impression, manual waxing, and heat-press technique. The discrepancy between the crown and the tooth was registered using the replica technique with polyvinyl siloxane material. The dimensions of the marginal discrepancy (Discrepancymarginal) and the internal discrepancy in 4 different regions of interest (Discrepancyshoulder, Discrepancyaxial, Discrepancycusp, and Discrepancyocclusal) were assessed using light microscopy. Post hoc Student t test with Bonferroni correction was applied to detect differences (=.05). RESULTS Discrepancymarginal was 83.6 ±51.1 m for the Cerec infinident, 90.4 ±66.1 m for the conventional, 94.3 ±58.3 m for the Lava, 127.8 ±58.3 m for the iTero, and 141.5 ±106.2 m for the Cerec inLab workflow. The differences between the treatment modalities were not statistically significant (P>.05). Discrepancyshoulder was 82.2 ±42.4 m for the Cerec infinident, 97.2 ±63.8 m for the conventional, 103.4 ±52.0 m for the Lava, 133.5 ±73.0 m for the iTero, and 140.0 ±86.6 m for the Cerec inLab workflow. Only the differences between the Cerec infinident and the Cerec inLab were statistically significant (P=.036). The conventionally fabricated crowns revealed significantly lower values in Discrepancycusp and Discrepancyocclusal than all the crowns fabricated with digital workflows (P<.05). CONCLUSIONS In terms of marginal crown fit, no significant differences were found between the conventional and digital workflows for the fabrication of monolithic lithium disilicate crowns. In the occlusal regions, the conventionally manufactured crowns revealed better fit than the digitally fabricated crowns. Chairside milling resulted in less favorable crown fit than centralized milling production. Purpose. The purpose of the fourth part of a series of investigations was to test whether the marginal and internal fit of monolithic crowns fabricated with fully digital workflows differed from that of crowns fabricated with the conventional workflow. Material and methods.In each of 10 participants, 5 monolithic lithium disilicate crowns were fabricated for the same abutment tooth according to a randomly generated sequence.Digital workflows were applied for the fabrication of 4 crowns with Lava, iTero, Cerec inLab, and Cerec infinident systems. The conventional workflow ...

The results of this meta-analysis, favour the use of internal implant-abutment connections in combination with either titanium or zirconia abutment materials. Number of cycles had a significant impact on the fracture strength after cyclic loading.

STATEMENT OF PROBLEM Trials comparing the overall performances of digital and conventional workflows in restorative dentistry are lacking. PURPOSE The purpose of the third part of this clinical study was to test whether the fit of zirconia 3-unit frameworks for fixed partial dentures fabricated with fully digital workflows differed from that of metal frameworks fabricated with the conventional workflow. MATERIAL AND METHODS In each of 10 participants, 4 fixed-partial-denture frameworks were fabricated for the same abutment teeth according to a randomly generated sequence. Digital workflows were applied for the fabrication of 3 zirconia frameworks with Lava, iTero, and Cerec infiniDent systems. The conventional workflow included a polyether impression, manual waxing, the lostwax technique, and the casting of a metal framework. The discrepancies between the frameworks and the abutment teeth were registered using the replica technique with polyvinyl siloxane. The dimensions of the marginal discrepancy (Discrepancy) and the internal discrepancy in 4 different regions of interest (Discrepancy, Discrepancy, Discrepancy, and Discrepancy) were assessed using a light microscope. Post hoc t tests with Bonferroni correction were applied to detect differences (=.05). RESULTS Discrepancy was 96.1 ±61.7 m for the iTero, 106.9 ±96.0 m for the Lava, 112.2 ±76.7 m for the Cerec infiniDent, and 126.5 ±91.0 m for the conventional workflow. The difference between the iTero and the conventional workflow was statistically significant (P=.029). Discrepancy was 153.5 ±66.8 m for the iTero, 203.3 ±127.9 m for the Lava, 179.7 ±63.1 m for the Cerec infiniDent, and 148.8 ±66.8 m for the conventional workflow. Discrepancy was significantly lower for the conventional workflow than for the Lava and the Cerec infindent workflows (P<.01). The iTero resulted in significantly lower values of Discrepancy than the Lava and the Cerec infiniDent workflows (P<.01). CONCLUSIONS In terms of framework fit in the region of the shoulder, digitally fabricated zirconia 3-unit frameworks presented similar or better fit than the conventionally fabricated metal frameworks. In the occlusal regions, the conventionally fabricated metal frameworks achieved a more favorable fit than the CAD-CAM zirconia frameworks.

No abstract