OBJECTIVE: To compare the clinical, radiographic, and immunological outcomes between one-piece versus two-piece zirconia abutments supported single implant crowns in the esthetic region.
METHODS: The study followed a split-mouth, double-blind, and randomized controlled clinical design for a duration of 3 years. Twenty-two eligible patients with 44 implants were randomly assigned to two groups: Group 1 (one-piece zirconia abutment with zirconia base, n = 22) and Group 2 (two-piece zirconia abutment with titanium base, n = 22). The primary outcome was the technical complication rate. Additionally, survival rates, cytokines concentrations in peri-implant crevicular fluid (PICF), peri-implant conditions, marginal bone loss, and pink/white esthetics score (PES/WES) were assessed as secondary outcomes.
RESULTS: Twelve of 22 patients attended the 1-year follow-up (due to the COVID pandemic), and 19 patients attended the 3-year examination. Two abutments in Group 1 were fractured after 10 and 12 months in function. Additionally, one screw loosening occurred in Group 1 at 1-year follow-up. The 3-year technical complication rate was significantly higher in Group 1 than that in Group 2 (15.79% vs. 0%, p < .001). The 3-year implant survival rate was 100% in both groups. The concentration of IFN-γ in PICF was significantly upregulated in Group 2 (p = .018). Furthermore, the IL-6 concentration was positively correlated with BOP% (p = .020).
CONCLUSIONS: Two-piece zirconia abutments exhibited superior technical performance compared to one-piece designs during a 3-year follow-up in the anterior region. However, further long-term research is necessary to verify the immunological stability of two-piece zirconia abutments.

BACKGROUND: The aim of this study was to compare the 3-year clinical outcomes of narrow-diameter implants (NDI) with standard-diameter implants (SDI) in conjunction with lateral bone augmentation in atrophic posterior jaws.
METHODS: Fifty patients were included and randomly assigned into two groups: Patients in Group 1 received NDI (Ø3.5 mm); patients in Group 2 received SDI (Ø4.3 mm) with simultaneous lateral bone augmentation. Implant survival rates, complications, crestal bone loss, peri-implant conditions, treatment cost, and patient satisfaction were compared.
RESULTS: Three patients dropped out the follow-up. No implant loss was observed. The difference in technical complication rates between the two groups was 3.8% (95% CI: -13.7% to 21.3%). No significant differences in crestal bone loss were found between two groups at 3-year follow-up (0.55 ± 0.76 vs 0.41 ± 0.41 mm, p = .429). A total of 20.8% (5/24) of NDI were diagnosed with mucositis and 8.3% (2/24) with peri-implantitis. A total of 17.4% (4/23) of SDI showed mucositis and (1/23) 4.3% showed peri-implantitis. The total cumulative cost of treatment per patient in Group 1 (2849.6 USD, 95% CI: 2726.8-2972.4) was significantly lower than that in Group 2 (3581.4 USD, 95% CI, 3460.9-3701.9) over the 3-year follow-up (p < .01). The patient satisfaction rating of operation was significantly higher in Group 1 (85.42 ± 7.41 vs 80.48 ± 7.95, p = .033).
CONCLUSIONS: NDI yielded favorable implant survival, acceptable technical and biological complications, and high patient satisfaction supporting single crowns in the atrophic posterior region after 3-year follow-up. NDI might be a reasonable alternative in horizontally deficient posterior jaws.
BACKGROUND: Clinicaltrials.gov identifier: ChiCTR1800020426.

The metal-ceramic fixed partial prosthesis is the golden standard for posterior tooth restorations. Following the demands of patients and clinicians for metal-free restorations, all-ceramic materials were developed as they offer an adequate alternative with better optical qualities and good mechanical properties. This study aims to carry out a bibliographic review to assess the survival rate and the biological and technical complications of all-ceramic and metal-ceramic fixed partial dentures. An electronic search for articles in the English language literature was performed using PubMed (MEDLINE). This literature review focused on research studies between 2010 and 2020 that performed clinical studies on tooth-supported fixed partial dentures with a mean follow-up of at least 3 years. All the studies, which analyzed the survival and complications of tooth-supported fixed partial dentures, were included. Thus, 14 studies reporting on 756 all-ceramic and 160 metal-ceramic fixed partial dentures met the inclusion criteria. A comparative analysis was carried out based on all the data existing in the studies included in this review. The metal-ceramic fixed partial dentures showed survival rates of 95% to 100% at 3-, 5-, and 10-year follow-up periods. Zirconia fixed partial dentures were reported to have survival rates of 81% to 100% at 3-, 5-, 9-, 10-year follow-up evaluations. The reinforced glass-ceramic fixed partial dentures showed survival rates of 70% to 93.35% at 5 years, while the alumina FPDs showed a survival rate of 68% at 3 years follow-up. The incidence of caries and loss of vitality were reported as higher for all-ceramic prostheses as compared to the metal-ceramic ones. A significant framework fracture was reported for glass-infiltrated alumina fixed partial dentures in comparison to metal-ceramic fixed partial dentures. All-ceramic and metal-ceramic restorations showed similar survival rates after 3 years, although all-ceramic restorations have problems with technical complications such as chipping, which can lead to framework fractures over time.

BACKGROUND: Implant-supported prosthetic treatment options are reliable for elderly edentulous patients with systemic health problems. These patients often need cost- and time-efficient solutions to avoid complications. However, it is a challenge for clinicians to treat these patients without surgical interventions, placement of additional implants, or the need to renew existing prostheses.
METHODS: A 75-year-old medically compromised caucasian male patient using multiple medications was referred for prosthetic rehabilitation of his edentulous maxilla after several implant failures. Because the patient\'s health was compromised, further surgical interventions were ruled out and the treatment was centered on the use of the remaining implants by placing a fixed attachment system and altering the existing prosthesis. The stepwise management of the patient\'s situation through the use of a new attachment system and adjustment of existing prosthesis is described in the present case report.
CONCLUSIONS: Although implant therapy is not always contraindicated for medically compromised patients, it is preferable not to perform extensive surgeries to avoid complications. This clinical report describes an alternative, safe option based on a novel fixed attachment system to salvage an existing maxillary implant-supported fixed complete dental prosthesis of a patient with systemic health problems.

Clinical studies regarding zirconia implant abutments reported good survival rates in the short-term observation period. The purpose of this study was to assess the six-year clinical performance of zirconia abutments supporting all-ceramic crowns in anterior and premolar regions.
The patients received zirconia implant abutments to support all-ceramic crowns in Chang-Gung Medical Center during the period August 2010 to August 2011 were enrolled. In the following six years of observation period after the implant-crown had finished, the clinical parameters of all of the included patients were registered on a special form. The records regarding the following variables: age, gender, implant location, the condition of edentulous site before implant placement, esthetic performance at baseline, presence or absence of technical complications, and biological outcomes were registered and scrutinized for evaluation.
Out of the 32 zirconia implant abutments and 32 all-ceramic crowns that were followed for six years. Neither abutments nor crowns were lost, yielding 100% survival rates for both zirconia abutments and crowns. The esthetic outcomes were excellent except that a score of 2 was given to two restorations. With regard to technical complications, there was one instance of abutment screw loosening, two cases of veneering ceramic chipping, one restoration with occlusal roughness, and three instances of crowns loosening. Overall, the success rates were 96.8% and 81.2% for abutments and crowns respectively. In biological performance, only 1 implant was classified in group II (satisfactory survival) in the Misch classification, while all the others were classified in group I (excellent).
Zirconia abutments supporting all-ceramic crowns demonstrated high survival rate, good biological and esthetic results. While some technical complications were frequently observed, the complication-free rates were 96.8% for abutments and 81.2% for crowns in the medium-term observation period.

Long-term follow-up of oral implant therapy seldom report all biological and technical complications. The objective of this study was to evaluate the long-term (9-15 years) outcome after dental implant therapy, assess survival and complication rates. In addition, to identify the risk indicators of these complications at patient and implant levels. Patients (n = 376) treated with dental implants (n = 1095) between 1999 and 2005 at a specialist clinic in Stockholm, Sweden, were included. Longitudinal data were collected retrospectively from digital dental records. A subset of the included patient underwent a clinical examination at the 9-15 years follow-up (n = 163). Chi-square tests, Kaplan-Meier analyses and the general estimating equations (GEE) procedure were adopted for multilevel analyses. The cumulative implant survival rate up to 15 years was 82.6% (SE 4.1%). The prevalences of biological and technical complications at patient level were 52% and 32%, respectively. In total, 763 complications occurred, 65% of patients experienced at least one complications. Implant loss occurred significantly more frequently in subjects with a history of treated severe periodontitis Stage III-IV (P = .008) and in cases when complications were registered during implant surgery (P = .010). Smoking was a significant risk indicator for peri-implantitis (P = .006). The long-term implant survival and complication rates at patient level were 83% and 79%, respectively. Implant loss was significantly more frequent for subjects with a history of treated severe periodontitis and if complication was registered during implant surgery. Smoking was a significant risk indicator for peri-implantitis.

BACKGROUND: Continuous invasive analgesia remains the gold-standard method for managing acute post-operative pain after major surgery. However, this procedure is not exempt from complications that may have detrimental effects on the patient and affect the post-operative recovery process. Data of the complications of continuous catheter analgesic techniques (CCATs) and their impact on pain relief are scarce in the literature.
METHODS: We conducted a prospective longitudinal study and patients who underwent a surgical procedure and received continuous invasive analgesia after surgery were included. Post-operative analgesic strategy, pain scores (NRS), CCAT\'s characteristics and technical complications were recorded. Patient satisfaction was determined. Descriptive statistics and Student\'s t-tests were applied for the comparative analyses.
RESULTS: We collected data from 106 patients. Mean duration of the CCAT was 47.52±21.23hours and 52 patients (49.1%) were controlled in conventional hospitalisation units whereas 54 patients (50.9%) were controlled on intensive or high-dependency care units. The overall incidence of technical complications was 9.43%. The most common complications were catheter displacement (2.38%), inflammation at the IV catheter insertion point (2.38%) and excessive dosing of analgesic drugs (2.38%). Mean NRS scores were ≤3 during the permanence of CCATs. Maximum pain intensity was significantly higher in patients who suffered technical complications (mean±standard deviation [x̅ ± SD]: 4.4 ± 2.8 vs. 2.9 ± 1.9; P<0.05). Satisfaction levels with the technique and overall satisfaction with the pain management strategy were negatively impacted by the occurrence of complications.
CONCLUSIONS: The incidence of technical complications of CCATs was 9.43% and had a negative impact in pain control and patient\'s satisfaction.

♦ BACKGROUND: Clinical results of long-term peritoneal dialysis (PD) therapy in patients with liver cirrhosis (LC) and end-stage renal disease (ESRD) are controversial. This study evaluated the clinical outcomes of LC patients undergoing PD. ♦ METHODS: Clinical records were retrospectively collected from a single center between January 2007 and December 2014. An analysis of PD patients with LC and without liver disease was performed using propensity score matching. We further restricted matching by age, gender, and the presence of diabetes mellitus. Two cohorts of 33 patients each were selected. Early technical complications were defined as the presence of catheter-related complications, including malposition, leakage, omental wrapping, obstruction, and requiring a transfer to hemodialysis (HD) within 6 months of initiating PD. ♦ RESULTS: Mean PD duration was lower in LC patients (57.2 ± 46.1 months) than in controls (85.8 ± 64.2 months). Blood urea nitrogen, creatinine, and albumin levels were significantly lower in LC patients than in the control group. Cystatin C and cystatin C-based glomerular filtration rates were not significantly different in the LC group compared with those in the controls. We found that the risks for early technical complications, peritonitis, and long-term PD and patient survival were not higher in patients with LC than in those without LC. Ascites were easily controlled, and hepatic encephalopathy did not affect PD maintenance in LC patients. ♦ CONCLUSIONS: The clinical outcomes, including technical complications, peritonitis, and patients\' survival, suggest that PD can be used as a renal replacement therapy in ESRD patients with LC.

OBJECTIVE: To assess survival, as well as technical and biological complication rates of partial fixed dental prostheses (FDPs) supported by implants and teeth.
METHODS: An electronic Medline search was conducted to identify articles, published in dental journals from January 1980 to August 2015, reporting on partial FDPs supported by implants and teeth. The search terms were categorized into four groups comprising the PICO question. Manual searches of published full-text articles and related reviews were also performed.
RESULTS: The initial database search produced 3587 relevant titles. Three hundred and eighty-six articles were retrieved for abstract review, while 39 articles were selected for full-text review. A total of 10 studies were selected for inclusion. Overall survival rate for implants ranged between 90% and 100%, after follow-up periods with a mean range of 18-120 months. The survival of the abutment teeth was 94.1-100%, while the prostheses survival was 85-100% for the same time period. The most frequent complications were \"periapical lesions\" (11.53%). The most frequent technical complication was \"porcelain occlusal fracture\" (16.6%), followed by \"screw loosening\" (15%). According to the meta-analysis, no intrusion was noted on the rigid connection group, while five teeth (8.19%) were intruded in the non-rigid connection group [95% CI (0.013-0.151)].
CONCLUSIONS: The tooth-implant FDP seems to be a possible alternative to an implant-supported FDP. There is limited evidence that rigid connection between teeth and implants presents better results when compared with the non-rigid one. The major drawback of non-rigidly connected FDPs is tooth intrusion.

BACKGROUND: There is a lack of data concerning implant-supported overdentures (IODs) retained by double crowns in the edentulous maxilla.
OBJECTIVE: To perform a retrospective evaluation of clinical outcomes (survival/success rates) of maxillary overdentures retained on four implants via double crowns.
METHODS: Between 1993 and 2011, 28 patients with edentulous maxillae were restored with overdentures supported by four implants with a Morse taper connection (Ankylos, Dentsply Friadent, Mannheim, Germany) and double crowns according to the Marburg Double Crown (MDC) technique in a private practice. For retrospective evaluation of implant and prosthetic survival (in situ criterion) and success (event-free observational period), only patients attending a professional maintenance program were included (n = 20).
RESULTS: Twenty patients (13 female/ seven male, mean age: 63.45 ± 7.18 years) with 80 implants met the inclusion criteria. The mean follow-up period was 5.64 ± 3.50 years. One implant was lost (cumulative survival rate: 98.75%). Eight implants (10.1%) in two patients (10%) showed peri-implantitis; both patients were active smokers (cumulative success rate: 88.75%). All dentures were still functional (prosthetic survival rate 100%) at the time of investigation. Technical maintenance procedures (e.g., abutment loosening, screw loosening, acrylic fracture or relining) were required at a rate of 0.222/patient-year.
CONCLUSIONS: Within the limitations of this study, we conclude that MDC-IODs are a promising treatment alternative for edentulous maxillae offering high implant and prosthesis survival rates > 98% and a limited incidence of biological and technical complications after a mean observational period of >5 years.