Background and Objectives: Cement-retained implant restorations are widely used because they offer favorable esthetics and a passive fit. Their long-term performance is strongly influenced by cement selection and surface conditioning. This study compared the clinical performance of a resin-modified glass ionomer cement (Fuji Plus^®) with a provisional acrylic-urethane cement (DentoTemp™) in partial implant restorations. Materials and Methods: A retrospective cohort of 40 patients with three-unit implant-supported fixed dental prostheses was followed for at least three years. Restorations were fabricated from zirconia or metal-ceramic frameworks and cemented with either Fuji Plus^® or DentoTemp™. Clinical outcomes included retention, failure events, marginal adaptation, and peri-implant tissue response. In order to illustrate the impact of cement type and abutment height, mechanical testing was also carried out on standardized in vitro models; however, these tests were not powered for formal hypothesis testing. Although OCT images were included in this study only as illustrative examples from our clinical database and were not obtained from the analyzed cohort, OCT may be a useful tool for non-invasive assessment of marginal fit. Results: Zirconia restorations showed a retention rate of 95 percent, while metal-ceramic restorations reached 85 percent. All four failures occurred in cases cemented with DentoTemp™, giving an overall retention rate of 80 percent for this group. Fuji Plus^® achieved complete retention in all cases. Re-cementation with Fuji Plus^® successfully resolved the failures. Marginal adaptation was evaluated qualitatively because radiographic analysis did not enable accurate measurement of marginal gaps. When cement remnants were found, mild peri-implant inflammation was seen. Conclusions: Within the limitations of this small retrospective, non-randomized cohort, Fuji Plus^® demonstrated a tendency toward better peri-implant tissue response and longer-term retention than DentoTemp™. These findings should be interpreted as preliminary and exploratory rather than conclusive. Fuji Plus^® may be a suitable option for definitive cementation in partial implant restorations, while DentoTemp™ may be considered in selected situations where retrievability is important.

Background: This retrospective comparative clinical study aimed to evaluate the performance of digital versus conventional impression techniques in the fabrication of implant-supported prosthetic restorations. Materials and Methods: A total of 40 cases were included: 20 impressions obtained with conventional elastomeric materials (polyvinyl siloxane and polyether), and 20 impressions acquired digitally using two intraoral scanners (TRIOS 3 and Medit i700). All patients received partial fixed implant restorations and were documented across all stages of prosthetic treatment. Accuracy and passive fit were assessed using radiographic measurements and the Sheffield test. Linear distances (mm) at the implant–abutment interface, chairside time (min), and VAS scores (1–10) were analyzed. Clinical efficiency was evaluated based on procedural steps, chairside time, and adjustment frequency. Patient satisfaction was assessed through a structured 10-item Visual Analog Scale (VAS) questionnaire. Results: Results showed a lower misfit rate in the digital group (15%) compared to the conventional group (25%), with no final-stage misfits in digital cases. Digital workflows demonstrated shorter impression times, fewer procedural steps, and reduced the need for prosthetic adjustments. Patient satisfaction scores were significantly higher in the digital group across all VAS parameters (p < 0.001), particularly in comfort and esthetic satisfaction. Conclusions: These findings support the use of digital impressions as a clinically efficient and patient-preferred alternative to conventional methods for partial implant restorations. However, conventional impressions remain a viable option in settings where digital technology is not available. Further studies with larger sample sizes and long-term follow-up are recommended to assess outcomes in full-arch rehabilitation.

Background: Stabilization of surgical guides in fully edentulous patients remains a clinical challenge due to mucosal resilience and potential micromovement, even when fixation pins are used. Guide instability may affect drilling accuracy and overall workflow predictability. This proof-of-concept case series describes a stabilization approach based on pre-placed tripod reference implants with multi-unit coupling, designed to create a mechanically defined prosthetic docking platform for fully guided implant surgery. Methods: Three fully edentulous patients requiring implant-supported rehabilitation were treated using a two-stage protocol. Three temporary reference implants were inserted in a tripod configuration 7–10 days prior to definitive surgery. Multi-unit abutments were mounted on the reference implants, and intraoral scanning was performed to design a surgical guide indexed to the prosthetic interfaces. During implant placement, the guide was screw-retained to the reference implants via the multi-unit connections. Postoperative implant positions were evaluated radiographically by superimposing postoperative datasets onto the preoperative planning model. Intraoperative guide stability, surgical events, and early postoperative outcomes were recorded. Results: Stable guide fixation was achieved in all three cases without detectable intraoperative displacement. Implant placement was completed as planned in each patient, and removal of the temporary reference implants was uneventful. No intraoperative or early postoperative complications were observed. Mean coronal, apical, and angular deviations between planned and achieved implant positions were 0.70 ± 0.16 mm, 0.39 ± 0.13 mm, and 3.30 ± 0.59°, respectively. These preliminary findings, derived from four treated arches, were comparable to ranges reported in selected studies on fully guided implant surgery; however, no direct statistical comparison with previously published datasets was performed. Conclusions: Within the limitations of this proof-of-concept case series, temporary reference implants arranged in a tripod configuration provided a stable and reproducible prosthetic indexing platform for guided implant surgery in fully edentulous patients. Further prospective studies involving larger patient cohorts and controlled comparative designs with conventional mucosa-supported or fixation-pin-supported surgical guides are required to evaluate the reproducibility, clinical performance, and long-term applicability of this stabilization concept.

Background: Material choice in full-arch implant-supported restorations significantly impacts longevity, complication rates, and patient satisfaction. This retrospective study compared monolithic zirconia versus hybrid metal–ceramic full-arch designs over a minimum three-year follow-up. Methods: Twenty patients (9 female, 11 male; mean age 55.4 ± 7.5 years) treated with full-arch implant-supported restorations were reviewed. Ten received monolithic zirconia restorations; ten received hybrid metal–ceramic. Clinical outcomes, including mechanical complications, prosthetic maintenance needs, opposing dentition wear, and patient-reported satisfaction (esthetics, comfort, masticatory function via VAS), were recorded. Statistical analyses were performed using Chi-square, independent t-tests, or Mann–Whitney U tests, with a significance level set at p < 0.05. Results: All implants (100%) and prostheses (>95%) survived. Monolithic zirconia exhibited no veneering chipping, while two events were observed in hybrid restorations (difference not statistically significant), and one bulk fracture occurred (monolithic). Hybrids had no framework fractures. Screw loosening occurred in one zirconia case. Mean VAS scores exceeded 9.0 in both groups; zirconia scored slightly higher for esthetics (9.4 ± 0.5 vs. 8.8 ± 0.6) and comfort (9.2 ± 0.6 vs. 9.0 ± 0.7). Polished zirconia resulted in no clinically detectable enamel wear, whereas hybrids with glaze loss caused occasional mild enamel wear but without functional impairment. Conclusions: Both restoration types show excellent survival and patient satisfaction over three years. Monolithic zirconia reduces veneering-related complications and maintenance, suggesting a possible advantage in functionally demanding cases with high occlusal loads or limited prosthetic space; hybrids may remain preferable when esthetic customization and gingival contour reproduction are paramount.

Background: The use of prosthetic caps in screw-retained implant restorations aims to enhance passivity and protect abutment threads; however, these components may increase prosthetic volume and impair esthetics. Advances in high-strength zirconia have raised the question of whether such caps remain necessary. Methods: A retrospective clinical analysis was conducted on 20 partial screw-retained zirconia restorations comparing cases fabricated with and without a prosthetic cap. All restorations were followed for 3–5 years. Clinical outcomes included screw stability, marginal adaptation, esthetics (VAS), hygiene access, and biological response. A supplementary mechanical verification was performed on four standardized zirconia crowns fabricated through digital and conventional impression workflows to qualitatively assess their behavior under 30 N·cm torque and compressive loading above 1200 MPa. Results: Throughout follow-up, no mechanical or biological complications were recorded in either group. One restoration with a cap required screw re-tightening, while none failed in the cap-free group. Radiographic analysis showed smaller mean marginal gaps in cap-free restorations (0.183 mm) compared to those with caps (0.289 mm; p < 0.01). Esthetic satisfaction scores were higher in the cap-free group (VAS = 9.3 ± 0.1 vs. 8.2 ± 0.1; p < 0.001). Mechanical verification confirmed that all zirconia crowns tolerated torque and compressive loads without visible fracture or deformation. Conclusions: Within the study limitations, cap-free screw-retained zirconia restorations exhibited excellent 5-year clinical stability, improved esthetics, and better hygiene access compared with capped designs. The small-scale mechanical verification supported the clinical findings, indicating that cap omission does not compromise mechanical performance when accurate fit and digital workflow precision are ensured.

Aim of the study Implant positioning is determinant for clinical outcomes of oral rehabilitation on implants, influencing factors such as marginal bone loss, implant stability, and soft tissue integration. Usually, conical connection implants are placed subcrestally. The CopaSKY conical implant system, Bredent Group GmbH&Co.KG (Senden, Germany) offers flexibility in placement, accommodating both subcrestal and bone-level positioning to address diverse clinical needs. This study aimed to evaluate and compare the clinical and radiographic outcomes of CopaSKY implants, Bredent Group GmbH&Co.KG (Senden, Germany) placed subcrestally and at bone level. Materials and methods A prospective clinical study was conducted using CopaSKY implants with a diameter of 4 mm and a length of 10 mm. Radiographic images from patients with subcrestal and bone-level implant placement were analyzed. Marginal bone levels and bone density were assessed to evaluate the impact of implant positioning. Results Radiographic analysis demonstrated that subcrestal positioning did not provide a significant clinical advantage over bone-level placement, except in cases where additional soft tissue thickness was required for optimal gingival support. Marginal bone loss or growth and implant stability were comparable between the two groups (P > 0.05). Bone regenerated consistently (1.0–1.5 mm), irrespective of implant position. Conclusions Subcrestal placement of CopaSKY implants, Bredent Group GmbH&Co.KG (Senden, Germany) should be considered only when increased soft tissue support is clinically indicated. These findings simplify decision-making for implant placement and highlight the adaptability and clinical reliability of the CopaSKY implant system, Bredent Group GmbH&Co.KG (Senden, Germany) across various treatment scenarios. The system offers an advantage over other implants that are not specifically crafted and treated to facilitate rapid osteointegration and soft tissue adaptation.