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Current Trends and Future Directions in Prosthetic and Implant Dentistry...
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Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (25 January 2024) | Viewed by 16849

Special Issue Editors

Dr. Adolfo Di Fiore

E-Mail Website
Guest Editor
School of Dentistry, Department of Neurosciences, Section of Prosthodontics and Digital Dentistry, University of Padova, 35122 Padova, Italy
Interests: digital dentistry; dental materials; prosthodontics; CAD-CAM technology; intraoral scanner; additive manufacturing; subtractive manufacturing; implant-supported fixed dental prosthesis; facial scanners
Special Issues, Collections and Topics in MDPI journals
Dr. Giulia Brunello

E-Mail Website
Guest Editor
1. Department of Oral Surgery, University Clinic of Düsseldorf, Düsseldorf, Germany
2. Department of Neuroscience, School of Dentistry, University of Padova, Padova, Italy
Interests: dental implants; bone regeneration; scaffolds; biomaterials; bone tissue engineering; 3D printing
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In our previous Special Issue entitled "Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era", we collected high-standard original articles and review papers covering a wide area of topics. Digital technologies have been proven to be increasingly used, given their various advantages, from the treatment planning to the assessment of the outcomes.

After the successful release of our first Special Issue on digital dentistry, recognizing the importance of spreading up-to-date knowledge throughout the international community, we decided to further support the publication of high-quality papers in this field.

This second Special Issue welcomes original research articles, reviews, case series, and case reports on contemporary digital technologies used in dentistry, with a special focus on prosthodontics and implant dentistry. Topics of interest include, but are not limited to, the following:

  • 3D printing;
  • Additive manufacturing;
  • Milling technologies;
  • CAD/CAM ;
  • Digital implant planning;
  • Digital workflow;
  • Facial scanners;
  • Computer-guided implant surgery;
  • Intraoral scanners;
  • Digital design and fabrication of dental prostheses.

Dr. Adolfo Di Fiore
Dr. Giulia Brunello
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • 3D printing
  • additive manufacturing
  • milling technologies
  • CAD/CAM
  • digital implant planning
  • digital workflow
  • facial scanners
  • computer-guided implant surgery
  • intraoral scanners
  • digital design and fabrication of dental prostheses

Related Special Issue

Published Papers (9 papers)

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Research

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13 pages, 2041 KiB  
Article
Clinical and Radiographic Outcomes of Single Implant-Supported Zirconia Crowns Following a Digital and Conventional Workflow: Four-Year Follow-Up of a Randomized Controlled Clinical Trial
by Florian Beck, Lana Zupancic Cepic, Stefan Lettner, Andreas Moritz, Christian Ulm, Werner Zechner and Andreas Schedle
J. Clin. Med. 2024, 13(2), 432; https://doi.org/10.3390/jcm13020432 - 12 Jan 2024
Viewed by 652
Abstract
Purpose: This study aimed to compare the clinical and radiographic outcomes of single posterior screw-retained monolithic implant crowns following a digital and conventional workflow and to report on the survival/complication rate after a mean 4-year follow-up. Materials and Methods: Thirty patients with a [...] Read more.
Purpose: This study aimed to compare the clinical and radiographic outcomes of single posterior screw-retained monolithic implant crowns following a digital and conventional workflow and to report on the survival/complication rate after a mean 4-year follow-up. Materials and Methods: Thirty patients with a single posterior tooth missing were rehabilitated with a bone-level implant. After a healing period of ≥3 months, they were subjected to both a digital and conventional workflow to fabricate two screw-retained monolithic implant crowns. The quantitative clinical adjustments to both crowns (intrasubject comparison) and a questionnaire were recorded at try-in. Thereafter, a crown of the digital and conventional workflows was randomly inserted. At the last follow-up, the marginal bone level (MBL), peri-implant health-related parameters (bleeding on probing (BoP), plaque, pocket probing depth (PPD)), and functional implant prosthodontic score (FIPS) were assessed. Furthermore, the implant survival and success rates and technical complications were evaluated. Results: A total of 27 patients were followed for a mean period of 4.23 ± 1.10 years. There was no significant difference between the digital and conventional workflows regarding clinical adjustments and questionnaire outcomes. More than twice as many participants recommended digital (n = 16) compared to conventional impressions (n = 7) to friends. The implant survival and success rate were 100% and 96.3%, respectively. Furthermore, two de-cementations and one fracture of the ti-base abutment occurred. There were no significant differences in BoP, plaque, and PPD metrics between the two groups. The changes in the MBL between implant crown insertion (baseline) and the last follow-up were 0.07 ± 0.19 mm and 0.34 ± 0.62 mm in the digital and conventional groups, respectively (p = 0.195). The mean overall FIPS score was 8.11 ± 1.37 (range: 5–10). Conclusions: The clinical and radiographic outcomes of single screw-retained monolithic implant crowns were similar between both workflows after a mean of 4 years of service. The patients did not clearly prefer an impression technique for their restoration, although they would recommend the digital impression more often to friends. Thus, decision regarding clinical workflows may be based on the patient’s and/or clinician’s preference. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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15 pages, 4084 KiB  
Article
Correlation between Accuracy in Computer-Guided Implantology and Peri-Implant Tissue Stability: A Prospective Clinical and Radiological Pilot Study
by Pier Paolo Poli, Mattia Manfredini, Carlo Maiorana, Federica E. Salina and Mario Beretta
J. Clin. Med. 2023, 12(15), 5098; https://doi.org/10.3390/jcm12155098 - 03 Aug 2023
Viewed by 766
Abstract
The present pilot study was designed by hypothesizing a possible correlation between lack of accuracy in implant placement and peri-implant hard and soft tissue health. A total of five patients underwent computer-guided implant surgery and full-arch immediate loading between 2013 and 2014. They [...] Read more.
The present pilot study was designed by hypothesizing a possible correlation between lack of accuracy in implant placement and peri-implant hard and soft tissue health. A total of five patients underwent computer-guided implant surgery and full-arch immediate loading between 2013 and 2014. They subsequently underwent postoperative cone-beam computed tomography (CBCT). After a follow-up of 5 years, all patients were recalled for a clinical-radiographic evaluation of peri-implant health status. The mean linear deviation was 0.5 ± 0.2 mm at the implant’s head and 0.6 ± 0.2 mm at the implant’s apex, while the mean angular deviation of the long axis was 2.8° ± 1.2°. A mean marginal bone loss (MBL) of 1.16 ± 0.94 mm and 2.01 ± 1.76 mm was observed after 1 and 5 years of follow-up, respectively. At 5 years, the mean peri-implant probing depth (PPD) was 4.09 ± 1.44 mm, 66.6% of the evaluated implants showed peri-implant bleeding on probing (BOP), keratinized mucosa (KM) was <2 mm in 48.4% of cases, and mucosal recession (REC) ≥ 1 mm was assessed in 45.4% of the included implants. A negative correlation was observed between bucco-palatal/lingual linear inaccuracy and MBL, PPD, BOP, and KM. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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11 pages, 1842 KiB  
Article
Immediate Implant and Customized Healing Abutment for a Periodontally Compromised Socket: 1-Year Follow-Up Retrospective Evaluation
by Giovanni-Battista Menchini-Fabris, Saverio Cosola, Paolo Toti, Myoung Hwan Hwang, Roberto Crespi and Ugo Covani
J. Clin. Med. 2023, 12(8), 2783; https://doi.org/10.3390/jcm12082783 - 09 Apr 2023
Cited by 6 | Viewed by 3038
Abstract
Immediate dental implant placement with or without immediate loading is reported in daily dentistry and implantology, but these procedures are not common in the case of periradicular and periapical lesions around the tooth needed to be replaced. In the following retrospective evaluation, 10 [...] Read more.
Immediate dental implant placement with or without immediate loading is reported in daily dentistry and implantology, but these procedures are not common in the case of periradicular and periapical lesions around the tooth needed to be replaced. In the following retrospective evaluation, 10 cases with a 1-year follow-up were selected to propose the technique of an immediate provisional non-loading prosthesis being delivered on the same day of the post-extraction implant placement in multiradicular teeth affected by chronic periradicular and periapical lesions. Post-extractive sockets underwent immediate dental implant placement by filling the empty space with sterile, re-absorbable gelatin sponges. The widths of the alveolar ridge were measured on three-dimensional radiographs before and after the operation, 4 and 12 months later. Non-parametric statistics were performed to compare the outcomes over time with a level of significance of 0.05. Comparing the preoperative cross-sectional images of cone beam computerized tomography (CBCT) scans to the postoperative ones, it was noted that changes in the crestal ridge width, ΔCW, (compared to baseline) were negligible and not clinically appreciable. However, while ΔCW at 4 months appeared to be negative (−0.17 ± 045 mm), crestal width at 12 months was at the same level as the baseline (ΔCW = 0.02 ± 0.48 mm), with a significant difference between 4 and 12 months (p-value = 0.0494). Immediate implant placement with an immediate non-loading provisional customized healing abutment of polyether-ether-ketone placed into the post-extractive sockets with asymptomatic and large chronic periapical and periradicular lesions could represent a further treatment strategy for patients’ rehabilitation and soft tissue preservation to replace a hopeless tooth. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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11 pages, 1134 KiB  
Article
Digital versus Conventional Dentures: A Prospective, Randomized Cross-Over Study on Clinical Efficiency and Patient Satisfaction
by Lana Zupancic Cepic, Reinhard Gruber, Jaryna Eder, Tom Vaskovich, Martina Schmid-Schwap and Michael Kundi
J. Clin. Med. 2023, 12(2), 434; https://doi.org/10.3390/jcm12020434 - 05 Jan 2023
Cited by 2 | Viewed by 3628
Abstract
Digital technology facilitates the manufacturing of complete dentures; however, clinical and patient-reported outcomes are underreported. This prospective, randomized, single-blind cross-over study reports the clinical and patient-related outcomes of 10 edentulous patients receiving digital dentures prepared with the Vita Vionic System and conventional dentures [...] Read more.
Digital technology facilitates the manufacturing of complete dentures; however, clinical and patient-reported outcomes are underreported. This prospective, randomized, single-blind cross-over study reports the clinical and patient-related outcomes of 10 edentulous patients receiving digital dentures prepared with the Vita Vionic System and conventional dentures produced from heat-polymerized polymethylmethacrylate resin. Clinical efficiency was stated based on the Sato score for quantitative assessment of complete denture quality. Patient satisfaction was evaluated with the oral health-related quality of life questionnaire (OHIP-20). We report here that the Sato score was slightly higher in patients receiving digital versus conventional dentures with a mean of 73.2 ± 12.3 and 67.4 ± 11.8, respectively (p = 0.16). Moreover, upper and lower stability was superior in digital dentures (p = 0.03 and p = 0.10, respectively), while denture polish was better in conventional dentures (p = 0.03). Quality of life was slightly higher in patients receiving conventional compared to digital dentures with an OHIP-20 of 101.7 ± 12.0 and 95.6 ± 24.2, respectively (p = 0.33). Taken together and when considering the low power of the study, our findings suggest a trend towards better clinical efficiency of digital compared to conventional dentures, while patient satisfaction remained unaffected by the type of manufacturing. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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Review

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13 pages, 2379 KiB  
Review
Potential Benefits of Photon-Counting CT in Dental Imaging: A Narrative Review
by Chiara Zanon, Alessia Pepe, Filippo Cademartiri, Costanza Bini, Erica Maffei, Emilio Quaia, Edoardo Stellini and Adolfo Di Fiore
J. Clin. Med. 2024, 13(8), 2436; https://doi.org/10.3390/jcm13082436 - 22 Apr 2024
Viewed by 254
Abstract
Background/Objectives: Advancements in oral imaging technology are continually shaping the landscape of dental diagnosis and treatment planning. Among these, photon-counting computed tomography (PCCT), introduced in 2021, has emerged as a promising, high-quality oral technology. Dental imaging typically requires a resolution beyond the standard [...] Read more.
Background/Objectives: Advancements in oral imaging technology are continually shaping the landscape of dental diagnosis and treatment planning. Among these, photon-counting computed tomography (PCCT), introduced in 2021, has emerged as a promising, high-quality oral technology. Dental imaging typically requires a resolution beyond the standard CT systems achievable with the specialized cone-beam CT. PCCT can offer up to 100 µm resolution, improve soft-tissue contrast, and provide faster scanning times, which are crucial for detailed dental diagnosis and treatment planning. Using semiconductor detectors, PCCT produces sharper images and can potentially reduce the number of scans required, thereby decreasing patient radiation exposure. This review aimed to explore the potential benefits of PCCT in dental imaging. Methods: This review analyzed the literature on PCCT in dental imaging from January 2010 to February 2024, sourced from PubMed, Scopus, and Web of Science databases, focusing on high-resolution, patient safety, and diagnostic efficiency in dental structure assessment. We included English-language articles, case studies, letters, observational studies, and randomized controlled trials while excluding duplicates and studies unrelated to PCCT’s application in dental imaging. Results: Studies have highlighted the superiority of PCCT in reducing artifacts, which are often problematic, compared to conventional CBCT and traditional CT scans, due to metallic dental implants, particularly when used with virtual monoenergetic imaging and iterative metal artifact reduction, thereby improving implant imaging. This review acknowledges limitations, such as the potential for overlooking other advanced imaging technologies, a narrow study timeframe, the lack of real-world clinical application data in this field, and costs. Conclusions: PCCT represents a promising advancement in dental imaging, offering high-resolution visuals, enhanced contrast, and rapid scanning with reduced radiation exposure. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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13 pages, 604 KiB  
Review
Assessment Methods for Marginal and Internal Fit of Partial Crown Restorations: A Systematic Review
by Adolfo Di Fiore, Andrea Zuccon, Filippo Carraro, Michele Basilicata, Patrizio Bollero, Giovanni Bruno and Edoardo Stellini
J. Clin. Med. 2023, 12(15), 5048; https://doi.org/10.3390/jcm12155048 - 31 Jul 2023
Cited by 1 | Viewed by 1283
Abstract
Background: Different methods are used for the analysis of marginal and internal fit of partial crowns, but not all of them are applicable for in vivo studies. The aim of this review is to search the available methods, described in the current literature, [...] Read more.
Background: Different methods are used for the analysis of marginal and internal fit of partial crowns, but not all of them are applicable for in vivo studies. The aim of this review is to search the available methods, described in the current literature, to assess marginal and internal fit in partial crowns. Methods: an electronic search was performed on Pubmed and Web of Science databases to find studies published from 1 January 2017 up to 2 March 2023, following PRISMA guidelines and Cochrane handbook for systematic reviews. The search strategy applied was: “(marginal) AND (fit OR gap OR adaptation OR discrepancy) AND (inlay OR onlay OR partial crown)”. In vitro studies which evaluated marginal and internal fit on CAD CAM or 3D printed partial crowns were included in this review. Quality of the studies was assessed by using Quality Assessment Tool For In Vitro Studies (QUIN tool). Results: 22 studies were included. Among conventional methods, direct view with microscope, indirect view on resin replicas, and silicone replica technique (SRT) were used. Considering new digital methods, micro-CT, SRT 3D and triple scan technique (TST) were applied. Conclusions: Among 2D methods, direct view technique is the most used marginal fit analysis. For a more comprehensive evaluation, a 3D digital analysis is suggested. SRT and indirect view are the only 2D methods available for in vivo analysis. A protocol for the application of TST for assessment in vivo is now available, but no studies are reported in literature yet. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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Other

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16 pages, 2191 KiB  
Systematic Review
CAD/CAM Abutments in the Esthetic Zone: A Systematic Review and Meta-Analysis of Soft Tissue Stability
by Diego Lops, Eugenio Romeo, Magda Mensi, Giuseppe Troiano, Khrystyna Zhurakivska, Massimo Del Fabbro and Antonino Palazzolo
J. Clin. Med. 2023, 12(11), 3847; https://doi.org/10.3390/jcm12113847 - 04 Jun 2023
Viewed by 1230
Abstract
Computer-aided design and computer-aided manufacturing customized abutments are increasingly used in everyday clinical practice. Nevertheless, solid scientific evidence is currently lacking regarding their potential advantages in terms of soft tissue stability. The main aim of this systematic review and meta-analysis was to compare [...] Read more.
Computer-aided design and computer-aided manufacturing customized abutments are increasingly used in everyday clinical practice. Nevertheless, solid scientific evidence is currently lacking regarding their potential advantages in terms of soft tissue stability. The main aim of this systematic review and meta-analysis was to compare the soft tissue outcomes of prefabricated versus customized (CAD/CAM) abutments. The present review was registered with PROSPERO (CRD42020161875) and the protocol was developed according to the PRISMA statement. An electronic search was performed on three databases (PubMed, Embase and Cochrane Central) up to May 2023. Data extraction was followed by qualitative and quantitative analysis of the included studies. Three randomized controlled clinical trials and three controlled clinical trials (number of patients = 230; number of dental implants = 230) with a follow-up of between 12 and 36 months were included. No significant differences were observed between prefabricated versus customized (CAD/CAM) abutments regarding midfacial mucosal recession, interproximal papillae and pink aesthetic score (PES) after 12 months. Conclusion: The potential benefits of CAD/CAM abutments on soft tissues should be better clarified in future investigations. The usage of customized CAD/CAM abutments in everyday clinical practice should be based on a careful case-by-case evaluation (CRD42020161875). Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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13 pages, 63598 KiB  
Brief Report
Immediate vs. Delayed Placement of Immediately Provisionalized Self-Tapping Implants: A Non-Randomized Controlled Clinical Trial with 1 Year of Follow-Up
by Paolo Carosi, Claudia Lorenzi, Riccardo Di Gianfilippo, Piero Papi, Andrea Laureti, Hom-Lay Wang and Claudio Arcuri
J. Clin. Med. 2023, 12(2), 489; https://doi.org/10.3390/jcm12020489 - 06 Jan 2023
Cited by 4 | Viewed by 1838
Abstract
This study aimed to examine the clinical and esthetic outcomes of immediately provisionalized self-tapping implants placed in extraction sockets or healed edentulous ridges one year after treatment. Sixty patients in need of a single implant-supported restoration were treated with self-tapping implants (Straumann BLX) [...] Read more.
This study aimed to examine the clinical and esthetic outcomes of immediately provisionalized self-tapping implants placed in extraction sockets or healed edentulous ridges one year after treatment. Sixty patients in need of a single implant-supported restoration were treated with self-tapping implants (Straumann BLX) and immediate provisionalization. The implant stability quotient (ISQ) and insertion torque were recorded intraoperatively. After one year in function, the implant and prosthesis survival rate, pink esthetic score (PES), white esthetic score (WES), and marginal bone levels (MBL) were assessed. Sixty patients received 60 self-tapping implants. A total of 37 implants were placed in extraction sockets and 23 in edentulous ridges, and then all implants were immediately provisionalized. All implants achieved a high implant stability with a mean insertion torque and ISQ value of 58.1 ± 14.1 Ncm and 73.6 ± 8.1 Ncm, respectively. No significant differences were found between healed vs. post-extractive sockets (p = 0.716 and p = 0.875), or between flap vs. flapless approaches (p = 0.862 and p = 0.228) with regards to the insertion torque and ISQ value. Nonetheless, higher insertion torque values and ISQs were recorded for mandibular implants (maxilla vs. mandible, insertion torque: 55.30 + 11.25 Ncm vs. 62.41 + 17.01 Ncm, p = 0.057; ISQ: 72.05 + 8.27 vs. 76.08 + 7.37, p = 0.058). One implant did not osseointegrate, resulting in an implant survival rate of 98.3%. All implants achieved PES and WES scores higher than 12 at the 1-year follow-up. The clinical use of newly designed self-tapping implants with immediate temporization was safe and predictable. The implants achieved a good primary stability, high implant survival rate, and favorable radiographic and esthetic outcomes, regardless of the immediate or delayed placement protocols. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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11 pages, 7948 KiB  
Case Report
Autonomous Robotic Surgery for Immediately Loaded Implant-Supported Maxillary Full-Arch Prosthesis: A Case Report
by Shuo Yang, Jiahao Chen, An Li, Ping Li and Shulan Xu
J. Clin. Med. 2022, 11(21), 6594; https://doi.org/10.3390/jcm11216594 - 07 Nov 2022
Cited by 25 | Viewed by 3300
Abstract
Robotic systems have emerged in dental implant surgery due to their accuracy. Autonomous robotic surgery may offer unprecedented advantages over conventional alternatives. This clinical protocol was used to show the feasibility of autonomous robotic surgery for immediately loaded implant-supported full-arch prostheses in the [...] Read more.
Robotic systems have emerged in dental implant surgery due to their accuracy. Autonomous robotic surgery may offer unprecedented advantages over conventional alternatives. This clinical protocol was used to show the feasibility of autonomous robotic surgery for immediately loaded implant-supported full-arch prostheses in the maxilla. This case report demonstrated the surgical protocol and outcomes in detail, highlighting the pros and cons of the autonomous robotic system. Within the limitations of this study, autonomous robotic surgery could be a feasible alternative to computer-assisted guided implant surgery. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era—Part II)
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