Objectives: The aim of Working Group 3 was to focus on three topics that were assessed using patient‐reported outcome measures (PROMs). These topics included the following: (a) the aesthetics of tooth and implant‐supported fixed dental prostheses focusing on partially edentulous patients, (b) a comparison of fixed and removable implant‐retained prostheses for edentulous populations, and (c) immediate versus early/conventional loading of immediately placed implants in partially edentate patients. PROMs include ratings of satisfaction and oral health‐related quality of life (QHRQoL), as well as other indicators, that is, pain, general health‐related quality of life (e.g., SF‐36).Materials and methods: The Consensus Conference Group 3 participants discussed the findings of the three systematic review manuscripts. Following comprehensive discussions, participants developed consensus statements and recommendations that were then discussed in larger plenary sessions. Following this, any necessary modifications were made and approved.Results: Patients were very satisfied with the aesthetics of implant‐supported fixed dental prostheses and the surrounding mucosa. Implant neck design, restorative material, or use of a provisional restoration did not influence patients’ ratings. Edentulous patients highly rate both removable and fixed implant‐supported prostheses. However, they rate their ability to maintain their oral hygiene significantly higher with the removable prosthesis. Both immediate provisionalization and conventional loading receive positive patient‐reported outcomes.Conclusions: Patient‐reported outcome measures should be gathered in every clinical study in which the outcomes of oral rehabilitation with dental implants are investigated. PROMs, such as patients’ satisfaction and QHRQoL, should supplement other clinical parameters in our clinical definition of success.

Objectives: New generation intraoral scanners are promoted to be suitable for digital scans of long-span edentulous spaces and completely edentulous arches; however, the evidence is lacking. The current study evaluated the accuracy of intraoral scanning (IOS) in partially and completely edentulous arch models and analyzed the influence of operator experience on accuracy. Materials and methods: Four different resin models (completely and partially edentulous maxilla and mandible) were scanned, using a new generation IOS device (n = 20 each). Ten scans of each model were performed by an IOS-experienced and an inexperienced operator. An industrial high-precision scanner was employed to obtain reference scans. IOS files of each model-operator combination, their respective reference scan files (n = 10 each; total = 80), as well as the IOS files from each model generated by the same operator, were superimposed (n = 45; total = 360) to calculate trueness and precision. An ANOVA for mixed models and post hoc t tests for mixed models were used to assess group-wise differences (α = 0.05). Results: The median overall trueness and precision were 24.2 μm (IQR 20.7–27.4 μm) and 18.3 μm (IQR 14.4–22.1 μm), respectively. The scans of the inexperienced operator had significantly higher trueness in the edentulous mandibular model (p = 0.0001) and higher precision in the edentulous maxillary model (p = 0.0004). Conclusion: The accuracy of IOS for partially and completely edentulous arches in in vitro settings was high. Experience with IOS had small influence on the accuracy of the scans. Clinical relevance: IOS with the tested new generation intraoral scanner may be suitable for the fabrication of removable dentures regardless of clinician’s experience in IOS.

The information in the literature on the effect of printing layer thickness on interim 3D-printed crowns is limited. In the present study, the effect of layer thickness on the trueness and margin quality of 3D-printed composite resin crowns was investigated and compared with milled crowns. The crowns were printed in 3 different layer thicknesses (20, 50, and 100 μm) by using a hybrid resin based on acrylic esters with inorganic microfillers or milled from polymethylmethacrylate (PMMA) discs and digitized with an intraoral scanner (test scans). The compare tool of the 3D analysis software was used to superimpose the test scans and the computer-aided design file by using the manual alignment tool and to virtually separate the surfaces. Deviations at different surfaces on crowns were calculated by using root mean square (RMS). Margin quality of crowns was examined under a stereomicroscope and graded. The data were evaluated with one-way ANOVA and Tukey HSD tests. The layer thickness affected the trueness and margin quality of 3D-printed interim crowns. Milled crowns had higher trueness on intaglio and intaglio occlusal surfaces than 100 μm-layer thickness crowns. Milled crowns had the highest margin quality, while 20 μm and 100 μm layer thickness printed crowns had the lowest. The quality varied depending on the location of the margin.

Objectives: The aim of this systematic review and meta‐analysis was to summarize the existing evidence on patient‐reported aesthetic outcome measures (PROMs) of implant‐supported, relative to tooth‐supported fixed dental prostheses.Material and Methods: In April 2017, two reviewers independently searched the Medline (PubMed), EMBASE, and Cochrane electronic databases, focusing on studies including patient‐reported aesthetic outcomes of implant‐ and tooth‐supported fixed dental prostheses (FDPs). Human studies with a mean follow‐up period of at least 1 year, a minimum of ten patients, and English, German, or French publication were included. For the comparison of subgroups, random‐effects meta‐regression for aggregate‐level data was used.Results: The systematic search for implant‐supported prostheses focusing on patient‐reported outcomes identified 2,675 titles, which were screened by two independent authors. Fifty full‐text articles were analyzed, and finally, 16 publications (including 19 relevant study cohorts) were included. For tooth‐supported prostheses, no studies could be included. A total of 816 implant‐supported reconstructions were analyzed by patients. Overall aesthetic evaluation by the patients’ visual analogue scale (VAS) rating was high in implant‐supported FDPs (median: 90.3; min–max: 80.0–94.0) and the surrounding mucosa (median: 84.7; min–max: 73.0–92.0). Individual restorative materials, implant neck design (i.e., tissue or bone level type implants), and the use of a fixed provisional had no effect on patients’ ratings of the definitive implant‐supported FDPs.Conclusions: Aesthetics is an important patient‐reported measure, which lacks in standardized methods; however, patients’ satisfaction was high for implant‐ supported FDPs and the surrounding mucosa.

Objectives: The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient‐reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant‐retained/supported dental prostheses were addressed.Materials and Methods: Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal.Results: Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant‐supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness.Conclusions: Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.

Evaluating the impact of the prosthetic material on implant- and prosthetic survival of implant-supported fixed complete dentures. Electronic and hand searches were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify clinical studies including at least 10 patients restored with implant-supported dentures. The primary outcome was to evaluate the implant survival rate according to the applied restorative materials. The prosthetic survival rate was evaluated as secondary outcomes. Forty-one of 2254 studies were finally selected. A statistically significant difference (p = 0.0337) was found between implant survival rates in the main restorative groups (metal-ceramic:97%(95%CI [0.96;0.98]), all-ceramic:99%(95%CI [0.98;1.00]), metal-resin:97%(95%CI [0.96;0.98])). Prosthetic survival rates were: (metal-ceramic:95%(95%CI [0.89;0.97]), all-ceramic:97%(95%CI [0.92;0.99]), metal-resin:97%(95%CI [0.95;0.98]), with no statistically significant difference (p = 0.3796) between the groups. Chipping incidence rates were as follows: metal-ceramic:8%(95%CI[0.03;0.20]), all-ceramic:15%(95%CI [0.06;0.32]), and metal-resin:22%(95%CI [0.13;0.33]). Five types of exact restorative materials were identified (porcelain-fused-to-non-precious alloy, porcelain-fused-to-zirconia, precious-metal-acrylic-resin, non-precious-metal-acrylic resin, and PMMA). Again, implant survival rates were statistically significantly influenced by the applied restorative materials (p = 0.0126), whereas, no significant differences were reported regarding prosthetic survival rate. Prosthetic material selection seems to have no clinically relevant influence on implant- and prosthetic survival rate in implant-supported fixed complete dentures. Due to the high chipping rate, quantifying prosthetic survival alone does not seem to be a reliable tool for evaluating the outcome of the restorations and providing recommendations. These results, along with the obvious lack of evidence, suggest that clinicians must exercise caution whenever porcelain-fused-to-zirconia or metal-resin restorations are considered.