Background: Artificial intelligence (AI) is a branch of computer science concerned with building smart software or machines capable of performing tasks that typically require human intelligence. We present a protocol for the use of AI to fabricate implant-supported monolithic zirconia crowns (MZCs) cemented on customized hybrid abutments. Methods: The study protocol consisted of: (1) intraoral scan of the implant position; (2) design of the individual abutment and temporary crown using computer-aided design (CAD) software; (3) milling of the zirconia abutment and the temporary polymethyl-methacrylate (PMMA) crown, with extraoral cementation of the zirconia abutment on the relative titanium bonding base, to generate an individual hybrid abutment; (4) clinical application of the hybrid abutment and the temporary PMMA crown; (5) intraoral scan of the hybrid abutment; (6) CAD of the final crown with automated margin line design using AI; (7) milling, sintering and characterisation of the final MZC; and (8) clinical application of the MZC. The outcome variables were mathematical (quality of the fabrication of the individual zirconia abutment) and clinical, such as (1) quality of the marginal adaptation, (2) of interproximal contact points and (3) of occlusal contacts, (4) chromatic integration, (5) survival and (6) success of MZCs. A careful statistical analysis was performed. Results: 90 patients (35 males, 55 females; mean age 53.3 ± 13.7 years) restored with 106 implant-supported MZCs were included in the study. The follow-up varied from 6 months to 3 years. The quality of the fabrication of individual hybrid abutments revealed a mean deviation of 44 μm (± 6.3) between the original CAD design of the zirconia abutment, and the mesh of the zirconia abutment captured intraorally at the end of the provisionalization. At the delivery of the MZCs, the marginal adaptation, quality of interproximal and occlusal contacts, and aesthetic integration were excellent. The three-year cumulative survival and success of the MZCs were 99.0% and 91.3%, respectively. Conclusions: AI seems to represent a reliable tool for the restoration of single implants with MZCs cemented on customised hybrid abutments via a full digital workflow. Further studies are needed to confirm these positive results.

Peri-implant soft tissues play a role of paramount importance, not only on the esthetic appearance, but also on the maintenance and long-term stability of implants. The present report presents the conclusions from the Consensus Conference of the South European North African Middle Eastern Implantology & Modern Dentistry Association (SENAME) (4–6 November 2016, Cairo, Egypt). The conference focused on the topic of the soft tissue around dental implants, and in particular, on the influence of implant configurations on the marginal soft tissues, soft tissue alterations after immediate, early or delayed implant placement and immediate loading, the long-term outcomes of soft tissue stability around dental implants, and soft tissue augmentation around dental implants. Thirty world experts in this field were invited to take part in this two-day event; however, only 29 experts were in the final consensus voting process.

Background: This retrospective clinical study aims to present results of experience with a novel guided surgery system with a sleeveless, open-frame structure, in which the surgical handpiece (not the drills used for preparation) is guided.Methods: This study was based on an evaluation of the records of partially edentulous patients who had been treated with a sleeveless open-frame guided surgery system (TWIN-Guide®, 2Ingis, Brussels, Belgium), between January 2015 and December 2017. Inclusion criteria were patients with good systemic/oral health and a minimum follow-up of 1 year. Exclusion criteria were patients who had been treated without a guide, or with a guide with sleeves, patients with systemic/oral diseases and who did not have a follow-up of 1 year. The main outcomes were surgical (fit and stability of the surgical guide, duration of the intervention, implant stability, and any intra-operative or immediate post-operative complication), biologic, and prosthetic.Results: Thirty-eight patients (24 males, 14 females; mean age 56.5 ± 14.0 years) were included in the study. These patients had been treated with 110 implants inserted by means of 40 sleeveless, open-frame guides. With regard to fit and stability, 34 guides were excellent, 4 acceptable, and 2 inadequate for use. The mean duration of the intervention was 23.7 (± 6.7) minutes. Immediately after placement, 2 fixtures were not stable and had to be removed. Two patients experienced pain/swelling after surgery. The 108 surviving implants were restored with 36 single crowns and 32 fixed partial prostheses (24 two-unit and 8 three-unit bridges); these restorations survived until the 1-year follow-up, with a low incidence of biologic and prosthetic complications.Conclusions: Within the limits of this study, this novel guided surgery system with sleeveless, open frame–structure guides seems to be clinically reliable; further studies on a larger sample of patients are needed to confirm these outcomes.

To present the clinical results obtained using a novel coded healing abutment (CHA). We evaluated 103 patients with fixed implant-supported zirconia restorations (90 single crowns, 26 partial dentures, and 6 full arches) manufactured via computer-aided-design/computer-assisted-manufacturing and starting from the point of intraoral scans of novel CHAs (i-Physio®, LYRA-ETK, Sallanches, France). Patients were followed for one year. We assessed the clinical precision of the final restorations at delivery (quality, fit, and occlusal and interproximal contacts), as well as hard and soft tissues stability and patient satisfaction at the one-year follow-up. All complications were recorded. The quality of the restorations was high, with satisfactory marginal fits (96.8% of the cases), occlusal contacts (95.1%), and interproximal contacts (94.3%). Excellent hard and soft tissues stability were found at the one-year follow-up assessment, with few complications (0.9% biological, 4.9% mechanical, and 1.6% technical) for an overall restoration success rate of 92.3% at the patient level and 91.9% at the restoration level. Patient satisfaction was high. Within the limits of this study (retrospective design, short follow-up time) this novel CHA, with high prosthetic precision and esthetics, was clinically reliable and promoted hard and soft tissue stability. Further studies on a larger sample of patients and a longer follow-up period are needed to confirm these preliminary clinical outcomes. High prosthetic precision can be achieved when scanning CHAs. CHAs simplify digital impressions, reduce the manipulation of soft tissues, and prepare them for scanning, thereby promoting tissue healing and stability over time. Additionally, CHAs can serve as temporary abutments for immediate, nonfunctional loading.