Objective: This review aimed at evaluating the survival and technical complication rates of all‐ceramic implant‐supported single crowns (SC).Material and Methods: Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant‐supported all‐ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5‐ and 10‐year survival and complication estimates.Results: Forty‐one included studies reported on implant‐supported SCs made of veneered and monolithic high‐strength oxide ceramics, monolithic, and veneered glass‐based ceramics and of a monolithic resin‐nano‐ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%–96.4%) after 5 years and 94.4% (95% CI: 91.1%–96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%–97.7%) and 96.2% (95% CI: 95.1%–97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%–14.8%)/2.7% (95% CI: 2.1%–3.5%), framework fractures 1.9% (95% CI: 0.7%–4.9%)/1.2% (95% CI: 1%–1.5%), screw loosening 3.6% (95% CI: 1.6%–8.4%)/5.2% (95% CI: 3.6%–7.5%), and decementations with 1.1% (95% CI: 0.4%–2.8%) after 5 years. Some confounding variables influenced the above‐mentioned estimates significantly.Conclusions: All‐ceramic implant‐supported SCs showed—with the exception of a RNC material—high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant‐supported all‐ceramic SCs.

Objective: To assess the survival and technical complication rate of partial and full‐arch all‐ceramic implant‐supported fixed dental prostheses (P‐FDP/FA‐FDP) and supporting implants.Materials and methods: An electronic search through three databases (MEDLINE/Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients. Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5‐year survival and complication estimates.Results: A total of five studies for the P‐FDP group and seven studies for the FA‐FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P‐FDP group, reconstructions were located in posterior regions. Meta‐analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for P‐ and FA‐FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5‐year complication rates of 22.8% (P‐FDPs) and 34.8% (FA‐FDPs). Five‐year survival estimates of implants supporting P‐FDPs and FA‐FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, one screw‐loosening and 11 de‐cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates.Conclusions: All‐ceramic implant‐supported P‐ and FA‐FDPs comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long‐term outcome needs to be further evaluated.

Plasma-treatment of oral implant biomaterials prior to clinical insertion is envisaged as a potential surface modification method for enhanced implant healing. To investigate a putative effect of plasma-functionalized implant biomaterials on oral tissue cells, this investigation examined the response of alveolar bone osteoblasts and gingival fibroblasts to clinically established zirconia- and titanium-based implant surfaces for bone and soft tissue integration. The biomaterials were either functionalized with oxygen-plasma in a plasma-cleaner or left untreated as controls, and were characterized in terms of topography and wettability. For the biological evaluation, the cell adhesion, morphogenesis, metabolic activity and proliferation were examined, since these parameters are closely interconnected during cell-biomaterial interaction. The results revealed that plasma-functionalization increased implant surface wettability. The magnitude of this effect thereby depended on surface topography parameters and initial wettability of the biomaterials. Concerning the cell response, plasma-functionalization of smooth surfaces affected initial fibroblast morphogenesis, whereas osteoblast morphology on rough surfaces was mainly influenced by topography. The plasma- and topography-induced differential cell morphologies were however not strong enough to trigger a change in proliferation behaviour. Hence, the results indicate that oxygen plasma-functionalization represents a possible cytocompatible implant surface modification method which can be applied for tailoring implant surface wettability.

Background: Nowadays, stabilization splints for the management of bruxism and temporomandibular disorders (TMD) can be produced utilizing a digital workflow comprising a digital impression of the teeth, digital splint design, and computer-aided manufacturing of the splints. The latter is usually a milling process, however, more recently 3D printing gained popularity due to its better cost and time efficiency. It remains unknown whether 3D printed stabilization splints are inferior to milled splints regarding clinical outcomes. Methods: This clinical trial assesses the non-inferiority of 3D printed occlusal splints compared to milled occlusal splints in a monocentric prospective randomized single-blinded crossover trial with two cohorts. One cohort includes 20 participants with bruxism, the other 20 participants with pain-related TMD, i.e., myalgia, myofascial pain, or arthralgia of the jaw muscles/the temporomandibular joint(s) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Michigan-type stabilization splints are fabricated in a digital workflow by milling or 3D printing using CE-marked materials within their intended purpose. The participants wear a milled and a 3D printed splint in a randomized order for 3 months each, with follow-up visits after 2 weeks and 3 months. Investigated outcome parameters are oral health-related quality of life (OHRQoL) evaluated by the Oral Health Impact Profile (OHIP-G14), participant satisfaction as rated on a visual analog scale, therapeutic efficacy, and technical result of the splints. In this context, therapeutic efficacy means antagonist wear and—in the TMD group—reduction of pain/disability assessed by the Graded Chronic Pain Scale (GCPS v2.0) and clinical assessment following the DC/TMD standard, while technical outcome measures splint fit, wear and fracture rate. Discussion: The trial will provide important information on the clinical outcome of 3D printed stabilization splints in comparison to milled splints and will, therefore, enable an evidence-based decision in favor of or against a manufacturing process. This, in turn, will guarantee for a maximum of the patient’s OHRQoL during splint therapy, therapeutic efficacy, and longevity of the splints. Trial registration: German Clinical Trials Register (DRKS) DRKS00033904. Registered on March 15, 2024.