Group 2 ITI Consensus Report: Technological developments in implant prosthetics

Abstract

ObjectivesGroup‐2 reviewed the scientific evidence in the field of «Technology». Focused research questions were: (1) additive versus subtractive manufacturing of implant restorations; (2) survival, complications, and esthetics comparing prefabricated versus customized abutments; and (3) survival of posterior implant‐supported multi‐unit fixed dental prostheses.Materials and MethodsLiterature was systematically screened, and 67 publications could be critically reviewed following PRISMA guidelines, resulting in three systematic reviews. Consensus statements were presented to the plenary where after modification, those were accepted.ResultsAdditively fabricated implant restorations of zirconia and polymers were investigated for marginal/internal adaptation and mechanical properties without clear results in favor of one technology or material. Titanium base abutments for screw‐retained implant single crowns compared to customized abutments did not show significant differences concerning 1‐year survival. PFM, veneered and monolithic zirconia implant‐supported multi‐unit posterior fixed dental prostheses demonstrated similar high 3‐year survival rates, whereas veneered restorations exhibited the highest annual ceramic fracture and chipping rates.ConclusionsFor interim tooth‐colored implant single crowns both additive and subtractive manufacturing are viable techniques. The clinical performance of additively produced restorations remains to be investigated. Implant single crowns on titanium base abutments show similar clinical performance compared to other type of abutments; however, long‐term clinical data from RCTs are needed. The abutment selection should be considered already during the planning phase. Digital planning facilitates 3D visualization of the prosthetic design including abutment selection. In the posterior area, monolithic zirconia is recommended as the material of choice for multi‐unit implant restorations to reduce technical complications.

Material and abutment selection for CAD/CAM implant‐supported fixed dental prostheses in partially edentulous patients – A narrative review

“…Both dental technician and dentist require detailed knowledge in manufacturing procedures and handling guidelines in order to ensure an optimal material selection tailored to each clinical situation (Zhang & Kelly, 2017). While additive and subtractive manufacturing are both viable techniques for provisional restorations, only subtractive manufacturing (SM) is recommended for definitive restorations at the moment (Derksen et al, 2023). In the posterior region and in patients with lower esthetic expectations, monolithic FDPs can be solely stained and polished, so that veneering is not necessary (Janyavula et al, 2013).…”

Clinical performance and risk factors of all‐ceramic screw‐retained implant crowns in the posterior region based on a retrospective investigation

“…One option for manufacturing screw-retained SICs represents a single unit out of a crown and a titanium base abutment (TBA) that is adhesively luted in the dental laboratory (Figure 1; Chantler et al, 2023;Derksen et al, 2023). At present, survival rates after 1 year in function are stated 98.6% in a meta-analysis of Chantler et al (2023).…”