Although advancements in CAD/CAM technology allow for more personalized treatments, it is not clear how modifications in the CAD/CAM milling process could affect the restoration surface conditions and their mechanical behavior. The objective of this study was to evaluate the effect of different CAD/CAM milling protocols on the topography and fracture behavior of zirconia monolithic crowns (3Y-PSZ) subjected to a chewing simulation. Monolithic 3Y-PSZ premolar crowns were milled using three protocols (n = 13) (slow (S), normal (N), and fast (F)). Crowns were cemented on a dentin analog abutment and subjected to mechanical aging (200 N, 2 Hz, 1,500,000 cycles, 37 °C water). Surviving crowns were subjected to compressive load test and analyzed using fractography. Fracture load data were analyzed with two-parameter Weibull analysis. The surface topography of the crowns was examined with a stereomicroscope and a 3D non-contact profiler. All crowns survived the chewing simulation. Crowns milled using the F protocol had the greatest characteristic fracture load, while crowns produced with the S protocol showed high Weibull modulus. Groups N and S had a more uniform surface and detailed occlusal anatomy than group F. The CAD/CAM milling protocol affected the topography and mechanical behavior of 3Y-PSZ monolithic crowns.

OBJECTIVE: Familial isolated hypoparathyroidism is a rare genetic disorder due to no or low production of the parathyroid hormone, disturbing calcium and phosphate regulation. The resulting hypocalcemia may lead to dental abnormalities, such as enamel hypoplasia. The aim of this paper was to describe the full-mouth rehabilitation of a 15-year-old girl with chronic hypocalcemia due to a rare congenital hypoparathyroidism.
METHODS: In this patient, in the young adult dentition, conservative care was preferred. Onlays or stainless-steel crowns were performed on the posterior teeth, and direct or indirect (overlays and veneerlays) were performed on the maxillary premolars, canines, and incisors, using a digital wax-up. The mandibular incisors were bleached. The treatment clearly improved the patient\'s oral quality of life, with fewer sensitivities, better chewing, and aesthetic satisfaction. The difficulties were the regular monitoring and the limited compliance of the patient.
CONCLUSIONS: Despite no clinical feedback in the literature, generalized hypomineralized/hypoplastic teeth due to hypoparathyroidism in a young patient can be treated as amelogenesis imperfecta (generalized enamel defects) with a conservative approach for medium-term satisfactory results.
CONCLUSIONS: This study provides new insights into the management of enamel hypoplasia caused by familial isolated hypoparathyroidism, helping to improve patient outcomes in similar cases.

BACKGROUND: Over the years, implant therapy has been a commonly used treatment option for individuals who are partially or totally edentulous, with a long-term success rate of over 90%. With significant advancements in biomaterials and technology, implant dentistry can now conduct prosthetic rehabilitations in the majority of patients catering to all types of needs. However, in order to meet the demands of a patient base that is always growing, new trends in implantology are emerging in recent years that are focused on minimally invasive surgery and financial sustainability. In certain clinical scenarios, connecting teeth and implants to support fixed partial prosthesis (FPPs) may be a predictable and workable course of treatment.
METHODS: 22 patients were selected for this study who had tooth and implant supported prosthesis placed as a final restoration. Out of these 22 patients; 12 were male and 10 were female patients. Implants were placed following proper protocol and if grafting procedures were required they were carried out. A second stage surgical procedure was carried out and delayed loading protocols were followed. The statistical analysis was done using the IBM SPSS 24.0, Chicago, USA. The survival of the implants and teeth were measured by the Kaplan Meier survival scale. Bone loss was assessed at baseline(upon loading), 12 months and 24 months.
RESULTS: The implant survival rate was measured at 6 months, 12 months, 18 months and 24 months. At 24 months, one implant showed failure, so the survival rate of the implants were 95.4%. Bone loss of 1 mm was seen around one implant at 12 months. Bone loss of 1 and 2 mm was present around two implants and one implant respectively at 24 months.
CONCLUSIONS: From the results of this study, we can conclude that tooth implant supported prosthesis show very good survival when used in rehabilitation cases.

An abutment having edentulous space on both sides is referred to as a pier abutment. The rehabilitation of a patient whose primary concern when they first came to the hospital was missing teeth is discussed in this case report. When using a pier abutment for a fixed dental prosthesis, there is a problem with fulcrum and torqueing pressures at the intermediate abutment. Forces on the pier abutment may become localized as a result of using a rigid connector. It has been suggested that non-rigid connectors be used to overcome this. Here, using a non-rigid connector as a stress breaker resulted in less stress being placed on the prosthetic assembly and abutment. This article offers a clinical case report that details the use of a non-rigid connector in a pier abutment scenario for rehabilitation.

BACKGROUND: The objective of the study was to retrospectively assess the clinical performance of dental prostheses, single crowns, and three-unit bridges to identify clinical biological and mechanical complications in the Ha\'il province of Saudi Arabia.
METHODS: The study was conducted between March 2021 to October 2021 and included 421 patients who underwent crown and tooth-supported fixed partial denture (FPD) procedures at the Dental Polyclinics Center in the Ha\'il region of Saudi Arabia from 2010-2020. The planned sampling approach was applied. Patients who underwent crown and FPD placements at the dental center within the scheduled period were identified through clinical assessments. The inclusion criteria were met by patients with three-unit FPDs and a single crown containing a natural contralateral tooth or teeth. A total of six general dentists conducted clinical exams. Patient satisfaction and technical and biological issues were the evaluation criteria for crowns and FPDs. The frequency and percentage of the various characteristics employed in the current investigation were ascertained using cross-tabulation. The Chi-square test was employed to assess the associations between categorical variables, with p-values ≤ 0.05 considered significant.  Results: Marginal integrity was recorded in 332 participants (78.9%), which was satisfactory for the majority of the restoration. The acceptance morphology was present in 252 (59.9%) restorations. The highest rate of the restorations 274 (66.2%) had satisfactory color. In 86 cases (20.4%), there was visible periodontal depth of at least 5 mm. Three hundred and six (72.7%) of the fixed restorations had gingival bleeding connected to them, and 96 (22.8%) teeth had periapical lesions. A total of 311 patients (73.9%) reported they were satisfied with their fixed restorations.
CONCLUSIONS: The technical and biological complications noted in the current study were not higher compared with other studies of crowns and fixed dental prostheses. The majority of patients were satisfied with the restoration.

To meet the challenges of rehabilitating anterior teeth and achieving natural-looking restorations, it is essential to address issues such as improper shape, size, irregular gingival contour, and unaesthetic shades. The increasing demand for aesthetically pleasing and metal-free solutions has popularized materials like dental zirconia, offering optimal aesthetics and desirable mechanical properties. Within this context, a case report highlights clinical experiences with layered zirconia fixed dental prostheses designed specifically for anterior teeth. The report focuses on the prosthetic rehabilitation of both endodontically treated and vital abutments, exploring the influence of zirconia composition, design, layering technique, shade selection, occlusion, and the unique clinical challenges associated with each condition. The selection of zirconia composition, framework design, and shade in layered zirconia prostheses is intricately tied to the characteristics of the abutments. This interconnectedness underscores the importance of a thoughtful and customized approach to address the specific requirements of each clinical scenario.

BACKGROUND: Traditional screw or cemented connections in dental implants present limitations, prompting the exploration of alternative methods. This study assesses the clinical outcomes of single crowns and fixed partial prostheses supported by conometric connections after one year of follow-up.
METHODS: Twenty-two patients received 70 implants, supporting 33 rehabilitations. Biological responses and prosthodontic complications were evaluated at baseline, 6 months, and 12 months.
RESULTS: All implants exhibited successful osseointegration, with no losses or peri-implant inflammation. Marginal bone levels showed minimal changes, well below pathological thresholds. The difference in marginal bone loss (MBL) was -0.27 ± 0.79 mm between T0 and T1, and -0.51 ± 0.93 mm between T0 and T2. No abutment screw loosening or crown chipping occurred. However, coupling stability loss was observed in nine cases.
CONCLUSIONS: The conometric connection demonstrated successful integration and minimal complications after one year. This alternative shows promise, particularly in simplifying handling and improving marginal adaptation. Further research with larger sample sizes and longer follow-up is warranted for comprehensive validation.

OBJECTIVE: To investigate the influence of cantilever prosthetic arm on the marginal bone loss (MBL) over time around dental implants supporting short fixed partial dentures (FPDs), in a record-based retrospective study.
METHODS: All cases of 3-unit implant-supported FPDs, supported by 2-3 implants, from the database of cases treated at one specialist clinic were considered for inclusion. Only implants with a minimum of 36 months of radiological follow-up were considered. Univariate linear regression models were used to compare MBL over time between 12 clinical covariates, after which a linear mixed-effects model was built.
RESULTS: One-hundred-thirty-nine patients (64 men, 75 women) with 164 3-unit implant-supported FPDs (333 implants supporting non-cantilevered FPDs, 94 supporting cantilevered FPDs) were included in the study. The patients were followed up clinically and radiographically for a mean of 154.1 ± 78.0 (min-max, 37.3-364.6) and 132.9 ± 77.3 months (min-max, 36.8-329.9), respectively. The total number of marginal bone level double measurements (mesial and distal sides of each implant) was 2909. FPDs with cantilever presented an estimated greater MBL over time compared to FPDs without cantilever. Bruxism, sex (women), implant (modified) surface, and (poor) bone quality were also associated with higher MBL over time.
CONCLUSIONS: The use of a cantilever extension is suggested to negatively affect the bone marginal level over time around implants supporting 3-unit FPDs. Due to the small difference of the estimated MBL over long periods of follow-up between the groups, it is a matter of debate if the observed negative effect may be of clinical significance.

Implant-supported prostheses have considerable biomechanical advantages in partially edentulous patients when compared to other prosthetic options. Given the steady drop in the frequency of patients reporting with complete edentulism, it is not unusual to see situations where teeth and implants can be splinted to provide support for fixed prostheses. A tooth implant prosthesis differs majorly from an implant-supported prosthesis in terms of force dissipation and design. The aim of this systematic review was to compare the survival rates of tooth-implant-supported prostheses with fully implant-supported and fully tooth-supported prostheses. Using the appropriate search terms, PubMed, Google Scholar, and other indexed journals were used to search the English-language literature. According to the review protocols and the PICOS inclusion criteria, the pertinent studies were chosen. The screening of appropriate studies, evaluation of study quality, and data extraction were carried out independently by two reviewers. The pooling of survival data by prostheses failure, implant failure, and marginal bone loss was used in the meta-analysis. The cumulative data of all included studies indicated that tooth-implant-supported prostheses showed a 5-year survival rate of 77%-84% and a 10-year survival rate of 72%. The pooled risk ratio for prostheses failure and implant failure was 0.99 and 1.76, respectively. These results were not statistically significant (P > 0.05). The pooled standard mean difference for marginal bone loss was 0.59, and the results were statistically significant (P < 0.05). A tooth-implant-supported fixed partial denture (FPD) has a similar survival rate when compared to implant-supported FPD or T-FPD.

OBJECTIVE: The purpose of this study was to determine the effect of the connector configuration on the fracture load in conventional and translucent zirconia of three-unit fixed dental prostheses (FDPs).
METHODS: Six different three-unit FDPs were prepared (n = 6) from three types of zirconia (3Y-TZP (Katana ML®), 4Y-TZP (Katana STML®), and 5Y-TZP (Katana UTML®)) in combination with two connector configurations (4 × 2.25, 3 × 3 mm). The Co-Cr master models were scanned, and the FDPs were designed and fabricated using CAD-CAM. The FDPs were cemented on the metal model and then loaded with a UTM at a crosshead speed of 1 mm/min until failure. Two-way ANOVA and Tukey\'s test were used for statistical analysis (α = .05).
RESULTS: Fracture loads of 3Y-TZP (2740.6 ± 469.2 and 2718.7 ± 339.0 N for size 4 × 2.25 mm and 3 × 3 mm, respectively) were significantly higher than those of 4Y-TZP (1868.3 ± 281.6 and 1663.6 ± 372.7 N, respectively) and 5Y-TZP (1588.0 ± 255.0 and 1559.1 ± 110.0 N, respectively) (P < .05). No significant difference was found between fracture loads of 4Y-TZP and 5Y-TZP (P > .05). The connector configuration within 9 mm2 was found to have no effect on the fracture loads on all three types of zirconia (P > .05).
CONCLUSIONS: Fracture loads of three-unit FDPs were affected by the type of zirconia. The fracture loads of conventional zirconia were higher than those of translucent zirconia. However, it was not affected by the connector configuration when the connector had a cross-sectional area of 9 mm2.