Background: The introduction of the new generation of particle-filled and high strength ceramics, hybrid composites and technopolymers in the last decade has offered an extensive palette of dental materials broadening the clinical indications in fixed prosthodontics, in the light of minimally invasive dentistry dictates. Moreover, last years have seen a dramatic increase in the patients' demand for non-metallic materials, sometimes induced by metal-phobia or alleged allergies. Therefore, the attention of scientific research has been progressively focusing on such materials, particularly on lithium disilicate and zirconia, in order to shed light on properties, indications and limitations of the new protagonists of the prosthetic scene. Methods: This article is aimed at providing a narrative review regarding the state-of-the-art in the field of these popular ceramic materials, as to their physical-chemical, mechanical and optical properties, as well as to the proper dental applications, by means of scientific literature analysis and with reference to the authors' clinical experience. Results: A huge amount of data, sometimes conflicting, is available today. Both in vitro and in vivo studies pointed out the outstanding peculiarities of lithium disilicate and zirconia: unparalleled optical and esthetic properties, together with high biocompatibility, high mechanical resistance, reduced thickness and favorable wear behavior have been increasingly orientating the clinicians' choice toward such ceramics. Conclusions: The noticeable properties and versatility make lithium disilicate and zirconia materials of choice for modern prosthetic dentistry, requiring high esthetic and mechanical performances combined with a minimal invasive approach, so that the utilization of such metal-free ceramics has become more and more widespread over time.
A correlation between the failure rates of fiber posts and the type of prosthetic restorations just like SCs and FDPs cannot be found to date. Further randomized controlled clinical studies are required to achieve evidence-based conclusions, particularly about the use of fiber posts with FDPs.
Background: This study was aimed at comparing the accuracy of impressions of a reference typodont (RT) reproducing a totally edentulous maxilla made with three impression materials: polysulfide, polyether, and polyvinyl-siloxane. Methods: The RT was scanned using a desktop scanner, obtaining a reference scan. Ten impressions for each of the three tested materials were made using a mechanical device with a standardized and consistent modality. A laboratory scanner performed the digitization of each impression. We produced digital models by processing “in reverse” the scans of the physical impressions using a dedicated software, obtaining three groups (n = 10), respectively. The groups were titled: “polysulfide,” “polyvinyl-siloxane,” and “polyether”. The scans in .stl format were imported into Geomagic Control X and then compared to RT to evaluate the accuracy of each scan by calculating trueness and precision in µm. Recorded data were subjected to descriptive statistics. Results: Trueness (arithmetic proximity) values (95%CI) were: polysulfide = 249.9 (121.3–378.5), polyvinyl-siloxane = 216.8 (123.1–310.6), polyether = 291.1 (219.9–362.3). Precision values (95% CI) were: polysulfide = 261.9 (108.8–415), polyvinyl-siloxane = 209.4 (111.9–306.8), polyether = 283 (227.9–338.1). Statistically significant differences were not detected between the means of the experimental groups, both for trueness and precision. Conclusions: The accuracy of the scans obtained from polyvinyl-siloxane, polysulfide, and polyether impressions can be considered comparable in a fully edentulous maxilla.
The main objectives of the present prospective clinical study were to evaluate the marginal bone resorption and the peri-implant soft tissue conditions around narrow diameter implants, as well as the clinical performances of metal–ceramic and all-ceramic single crowns in the implant–prosthetic treatment of maxillary lateral incisors agenesis. Seventy-two patients affected by monolateral or bilateral agenesis of the maxillary lateral incisors were included in the study, and a total of 105 narrow diameter implants were inserted. The final single crowns were fabricated 4 months after the surgical procedures by means of either titanium abutments with Auro-Galvan Crowns (AGC) veneered with feldspathic ceramics or zirconia abutments with all-ceramic (alumina or zirconia) crowns layered with dedicated veneering ceramics. Both marginal bone resorption and soft tissue quality were evaluated after a maximum period of 16 years. Two independent survival curves for patients wearing AGC or all-ceramic crowns were calculated by means of Kaplan–Meier analysis, and a log-rank test was performed in order to compare these curves (p < 0.05). After 16 years of clinical function, a mean marginal bone resorption of 1.2 ± 0.61 mm and good response of peri-implant soft tissues were observed. Descriptive statistics resulted in 80% and 87.1% cumulative success rates for patients provided with AGC prostheses onto titanium abutments and all-ceramic crowns on-to zirconia abutments, respectively. The cumulative survival rate calculated for AGC group was 93.3%, whereas all-ceramic group showed a cumulative survival rate of 95.7%. No statistically significant differences were found with the log-rank tests. The overall success and survival rates calculated were 85% and 95% for all the restorations, respectively. Mucositis, abutment unscrewing, loss of retention, chipping, core fracture, and esthetic failure were the major complications reported. The implant–prosthetic approach can be considered an effective and viable solution to treat cases of maxillary lateral incisor agenesis in the long term.
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