Digital technology facilitates the manufacturing of complete dentures; however, clinical and patient-reported outcomes are underreported. This prospective, randomized, single-blind cross-over study reports the clinical and patient-related outcomes of 10 edentulous patients receiving digital dentures prepared with the Vita Vionic System and conventional dentures produced from heat-polymerized polymethylmethacrylate resin. Clinical efficiency was stated based on the Sato score for quantitative assessment of complete denture quality. Patient satisfaction was evaluated with the oral health-related quality of life questionnaire (OHIP-20). We report here that the Sato score was slightly higher in patients receiving digital versus conventional dentures with a mean of 73.2 ± 12.3 and 67.4 ± 11.8, respectively (p = 0.16). Moreover, upper and lower stability was superior in digital dentures (p = 0.03 and p = 0.10, respectively), while denture polish was better in conventional dentures (p = 0.03). Quality of life was slightly higher in patients receiving conventional compared to digital dentures with an OHIP-20 of 101.7 ± 12.0 and 95.6 ± 24.2, respectively (p = 0.33). Taken together and when considering the low power of the study, our findings suggest a trend towards better clinical efficiency of digital compared to conventional dentures, while patient satisfaction remained unaffected by the type of manufacturing.

Objectives This study aimed to characterize surface properties such as roughness (Ra) and surface-free energy (SFE) of glazed and polished yttria-stabilized zirconia and to evaluate in vitro adherence of fungus Candida albicans and salivary bacteria, Staphylococcus epidermidis, mixed with C. albicans to these substrata. Additionally, the influence of salivary proteins (albumin, mucin and alpha-amylase) on yeast adhesion was studied. Material and methods Ra and SFE of glazed and polished zirconia discs were measured. Specimens were wetted with saliva and salivary proteins prior to incubation with C. albicans and mixed suspension of C. albicans and S. epidermidis for 24 hr, respectively. Microbial adhesion was quantified by counting colony-forming units (CFU). Differences in physicochemical properties were proved by t test. "Linear mixed model" with the factors "type of surface" and "wetting media" was applied to analyse the effects on fungal adhesion (p < .05). Results SFE and Ra of glazed specimens were significantly higher than corresponding values of polished ones. The wetting media significantly changed the fungal binding (p = .0016). Significantly higher quantities of adhering fungi were found after mucin incubation compared to saliva (p = .004). For the factor "surface" as well as the interaction between "surface" and "wetting media," no statistically significant differences have been found. In mixed suspension, the growth of Candida was completely prevented. Conclusions Glazed and polished zirconia differs in terms of physicochemical surface properties. These differences appear to be modulated by pellicle coating affecting the biomass of adhered Candida. Mucin seems to be good binding sites for adhesion of C. albicans.

Background. The inaccurate maxillomandibular relationship of virtual casts following alignment by the vestibular scan may result in intersection (intermesh penetration) between opposing dental arch surfaces. Intersection occurs at short interocclusal distances in the occlusal contact area (OCA) and may result in infra-occluded definitive restorations. The purpose of this clinical study was to compare initial (by the proprietary scanner software) and new alignments (by a standalone 3D software) of virtual casts regarding OCA and intersection failure. New alignments aimed to rectify intersections by refinement of occlusal contacts. Material and Methods. The virtual casts of 30 patients following digital and conventional impression-taking were analyzed, which were acquired for single implant restoration in the posterior site. Digital impressions were performed by both IOS 1 (3M True Definition) and IOS 2 (TRIOS 3), either as complete- or partial-arch scans, respectively. Mounted gypsum casts were digitized as complete-arch by a laboratory scanner (LS) in enabled and disabled mode to avoid intersection [LS (+)/LS (−)]. All virtual casts were newly aligned by a 3D software. The difference of the OCA and the area of intersection were calculated for initial and new alignments, using interocclusal distance ranges of 0–100 μm, 0–10 μm or <0 μm (=intersection). The difference of the OCA was compared using a linear mixed model. The distribution of occlusal contact points per modality and alignment was assessed independently by three observers and estimated by inter- and intraclass correlation (ICC) coefficients. Results. Virtual casts following initial alignment demonstrated intersections irrespective of the modality. The mean area of the intersection was most for IOS 2 (79.23 mm²), followed by IOS 1 (48.28 mm²), LS (−) (2.77 mm²), and LS (+) (2.01 mm²) in partial-arch scans. Complete-arch scans demonstrated an area of intersection of 70.63 mm² for IOS 1 followed by 65.52 mm² (IOS 2), 6.13 mm² [LS (−)] and 2.76 mm² [LS (+)]. Newly aligned scans showed no intersections. The overall distribution of occlusal contact points demonstrated moderate reliability (ICC 0.63). Good reliability could be observed (ICC 0.9) for LS (−) scans. Conclusions. Intersections in the area of occlusal contact points are a phenomenon restricted to virtual casts, which should be considered in CAD/CAM. Initial alignments of LS are less affected by this virtual phenomenon, and contact points may be more distinct according to their anatomic region compared to IOS. Furthermore, intersections can be rectified in a 3D software by adjustment of the maxillomandibular relationship.

Purpose: This study aimed to compare the clinical and radiographic outcomes of single posterior screw-retained monolithic implant crowns following a digital and conventional workflow and to report on the survival/complication rate after a mean 4-year follow-up. Materials and Methods: Thirty patients with a single posterior tooth missing were rehabilitated with a bone-level implant. After a healing period of ≥3 months, they were subjected to both a digital and conventional workflow to fabricate two screw-retained monolithic implant crowns. The quantitative clinical adjustments to both crowns (intrasubject comparison) and a questionnaire were recorded at try-in. Thereafter, a crown of the digital and conventional workflows was randomly inserted. At the last follow-up, the marginal bone level (MBL), peri-implant health-related parameters (bleeding on probing (BoP), plaque, pocket probing depth (PPD)), and functional implant prosthodontic score (FIPS) were assessed. Furthermore, the implant survival and success rates and technical complications were evaluated. Results: A total of 27 patients were followed for a mean period of 4.23 ± 1.10 years. There was no significant difference between the digital and conventional workflows regarding clinical adjustments and questionnaire outcomes. More than twice as many participants recommended digital (n = 16) compared to conventional impressions (n = 7) to friends. The implant survival and success rate were 100% and 96.3%, respectively. Furthermore, two de-cementations and one fracture of the ti-base abutment occurred. There were no significant differences in BoP, plaque, and PPD metrics between the two groups. The changes in the MBL between implant crown insertion (baseline) and the last follow-up were 0.07 ± 0.19 mm and 0.34 ± 0.62 mm in the digital and conventional groups, respectively (p = 0.195). The mean overall FIPS score was 8.11 ± 1.37 (range: 5–10). Conclusions: The clinical and radiographic outcomes of single screw-retained monolithic implant crowns were similar between both workflows after a mean of 4 years of service. The patients did not clearly prefer an impression technique for their restoration, although they would recommend the digital impression more often to friends. Thus, decision regarding clinical workflows may be based on the patient’s and/or clinician’s preference.

This study aimed to address the predictive value of a micro-computed tomography (μCT)-based finite element (μFE) model of a human cadaveric edentulous posterior mandible, rehabilitated by short dental implants. Hereby, three different prosthetic/implant configurations of fixed partial dentures ("Sp"-3 splinted crowns on 3 implants, "Br" - Bridge: 3 splinted crowns on 2 implants, and "Si"- 3 single crowns) were analysed by comparing the computational predictions of the global stiffness with experimental data. Experimental displacement of the bone/implant/prosthesis system was measured under axial and oblique loads of 100 N using an optical deformation system (GOM Aramis) and the overall movement of the testing machine (Zwick Z030). Together with the measured machine force, an "Aramis" (optical markers) and "Zwick" (test machine) stiffness were calculated. FE models were created based on μCT-scans of the cadaveric mandible sample (n = 1) before and after implantation and using stl-files of the crowns. The same load tests and boundary conditions were simulated on the models and the μFE-results were compared to experimental data using linear regression analysis. The regression line through a plot of pooled stiffness values (N/mm) for the optical displacement recording (true local displacement) and the test machine (machine compliance included) had a slope of 0.57 and a correlation coefficient R² of 0.82. The average pooled correlation of global stiffness between the experiment and FE-analysis (FEA) showed a R² of 0.80, but the FEA-stiffness was 7.2 times higher. The factor was highly dependent on the test configuration. Sp-configuration showed the largest stiffness followed by Br-configuration (17% difference in experiment and 21% in FEA). The current study showed good qualitative agreement between the experimental and predicted global stiffness of different short implant configurations. It could be deduced that 1:1 splinting of the short implants by the crowns is most favorable for the stiffness of the implant/prosthesis system. However, in the clinical context, the absolute in silico readings must be interpreted cautiously, as the FEA showed a considerable overestimation of the values.