The achievement of the optimal implant position is a critical consideration in implant surgery, as it can facilitate the ideal prosthesis design and allow adequate oral hygiene maintenance. The switch from bone-driven to prosthetic-driven implant placement, through a comprehensive diagnosis and adequate treatment plan, is a prerequisite for long-term successful implant-based therapy. The aim of the present case report is to describe a step-by-step prosthetic retreatment of a patient with primary treatment failure due to incorrect dental implant placement. Although dental implants achieve high survival rates, the success of implant prosthetic therapy significantly relies on an appropriate implant position. Malpositioned implants can cause damage to vital structures, like nerves or vessels. Moreover, improper implant positioning can result in esthetic, biological, and technical complications and can, in extreme situations, render the desired prosthetic rehabilitation impossible to achieve.

Purpose: To analyze implant and prosthetic survival rates, complications, patient satisfaction, and biological parameters of patients rehabilitated with implant overdentures (IOV) on splinted and nonsplinted implants and different attachment systems, in function for one to 17 years. Methods: This retrospective study evaluated data collected from patients rehabilitated with implant overdentures between January 2001 and December 2016 in nine different centers. Outcome measures were implant and prosthetic success rates, mechanical complications, marginal bone loss (MBL), oral health impact profile (OHIP), bleeding on probing, and plaque index. Results: A total of 581 implants were installed in 194 patients. Patients were followed for a mean period of 60.6 months (range 6–206). Eighty-nine patients received 296 low profile attachment (OT Equator), 62 patients received 124 ball attachments, and 43 patients received 107 Locator attachments. In eighty-three patients the implants were splinted with computer aided design/computer aided manufacturing (CAD/CAM) or casted bar. At the last follow-up, 10 implants failed in eight patients. Statistical significance was found for failed prostheses (P = 0.0723) and complications (P = 0.0165), with better values for splinted implants. No statistically significant differences were found in proportion of implant and prosthetic failure (P > 0.05). At a five-year follow-up, proportion of complications (P = 0.0289) and failed prostheses (P = 0.0069) were statistically higher for IOV on Locator attachments. No difference was founded in MBL at one- and two-year follow-up between different attachment systems (P > 0.05). Statistically significant improvement in all the OHIP categories was reported in all the patients, after one year of function. Conclusions: Implant overdenture showed high implant and prosthetic survival rates, low complications, high patient satisfaction, and good biological parameters in the long-term follow-up. Splinting the implants may reduce number of mechanical complications. Locator attachments showed higher number of complications. Further studies are needed to confirm these preliminary results.

This case study concerns a patient who had lost all of his teeth, needing a rehabilitation with total prosthesis, who went to the dentist looking for help to overcome psycho-physical trauma and to overcome functional and social problems related to being a prosthesis wearer. Tooth loss occurs most in old age, even if it is not a direct consequence of aging. The rehabilitation of oral functions allows the patient to speak, chew, smile and feel confident in his own aesthetics and therefore improve, even a lot, his well-being in social relations. It is very important in oral rehabilitations to evaluate their type and therapeutic timing. This study stems from the idealization of a new protocol to simplify the supported oral rehabilitations. In this manuscript, a patient was considered and shown according to a complete photographical documentation all the phases. Rehabilitation included the use of Osstem (Osstem, Seoul, Korea) and equator type abutments (Rhein83, Bologna, Italy). This manuscript claims to represent the first of a whole series of cases demonstrating the utility of this protocol.

Background: Intraoral scanners (IOSs) in implantology represent a viable approach for single teeth or partial arches. However, when used for complete edentulous arches or long-span edentulous areas, it has been demonstrated that there is a need for improvement of IOS-related techniques. Therefore, the aim of this in vitro study was to assess the trueness and precision of a complete arch digital impression on four and six implants taken with or without a customized, prosthetic-based impression template. Materials and Methods: Two experimental models were prepared, representative of a complete edentulous mandible restored with four and six implants with built-in scan abutments. Models were scanned with (test group, TG) or without (control group, CG) the prosthetic-based impression template. Eight scans were taken for each model. The time needed to take impressions, error, trueness, and precision were evaluated. A statistical analysis was performed. Results: In the case of four implants, the time needed for the impression was 128.7 ± 55.3 s in the TG and 81.0 ± 23.5 s in the CG (p = 0.0416). With six scan abutments, the time was 197.5 ± 26.8 and 110.6 ± 25.2 s in the TG and CG, respectively (p = 0.0000). In the TG, no errors were experienced, while in the CG, 13 impressions were retaken due to incorrect stitching processes. In the four-implant impression, the mean angle deviation was 0.252 ± 0.068° (95% CI 0.021–0.115°) in the CG and 0.134 ± 0.053° (95% CI 0.016–0.090°) in the TG. The difference was statistically significant (p = 0.002). In the six-implant impression, the mean angle deviation was 0.373 ± 0.117° (95% CI 0.036–0.198°) in the CG and 0.100 ± 0.029° (95% CI 0.009–0.049°) in the TG (p = 0.000). In the TG, there were no statistically significant differences in the mean angle deviation within the group (p > 0.05), but there were in the CG. A colorimetric analysis showed higher deviations from the original model for the six-implant impression without a prosthetic template. Conclusions: Although all of the impressions exhibited deviation from the original model in the range of clinical acceptability, the prosthetic-based impression template significantly improved the trueness and precision of complete edentulous arches rehabilitated with four or six implants, making the complete arch digital impression more predictable.

Implants fracture is a rare but possible complication that leads to implants failure after prostheses delivery. Mechanical properties play a key role in the failure of dental implant systems. The aim of this narrative review was to evaluate the existing evidence in identifying etiology risk factors for implants fracture. The focused question was to evaluate whether there was any possible factors influencing the fracture of dental implants. A literature search of papers written in English, published from 1967 to July 2021, and reporting incidence of implants fracture in human with at least 15 participants (and one year of follow-up) was conducted using PubMed database including MeSH and free text terms and filters. Selected manuscripts were analyzed and discussed. The outcomes were the incidence of implants failure due to a fracture and the associated risk factors. A total of 96 articles were initially selected, but only eight articles were included according to the search criteria (two systematic reviews and six retrospective evaluation). Incidence of implants fracture ranged from 0.2 to 2.3%, with a mean value of 0.52%. Poor implant planning, including implant design and diameter, and occlusal overloading, were the most common variables associated with implants fracture. Implant removal is the only possible treatment and hence prevention, including stability of the marginal bone loss, is mandatory.

Fully digital workflow in implant dentistry is ever increasing. Treatment of partial edentulous cases is well-documented; nevertheless, complete edentulous cases are still a challenge. To present several innovations in the treatment of complete edentulous patients using digital solutions, both for implant placement and restoration delivery, was the objective of this study. It was designed as a retrospective case series study, aimed to tune further research with larger sample size, and a longer follow-up. Patients requiring complete, implant-supported restoration were asked to participate in this study. Enrolled patients were treated with four implants, immediate loading and a definitive complete arch restoration. Patients were treated using computer-assisted, template-based surgery. Multi-piece surgical templates were used to accurately place the implants, to manage the bone if needed and to make immediate loading procedure quicker and easier. After osseointegration period, definitive, extra-oral, digital impressions were taken using newly developed scan analogs, connected in the patient mouth using temporary cylinders and stabilized by means of the low-shrinkage, flowable, resin composite. Outcomes were implant and prosthesis survival rate, complications, accuracy, and patient satisfaction. Radiographic evaluation performed with a preliminary, radiopaque aluminum try-in, was used to test the accuracy of the digital impressions. Overall, 20 implants were placed in five patients. All the implants osseointegrated without complications. One impression was taken a second time due to inaccuracy of the aluminum tray-in. Finally, all of the patients were completely satisfied with both surgical and prosthetic procedures. Within the limitations of this case series, multi-piece surgical templates showed promising results improving the clinician’s confidence in the case of bone reduction, post-extractive implants and immediate loading. The prosthetic template increased the trueness of the digital impression for complete edentulous patients. Finally, even if an impression was performed again, the scan-analog used for extra-oral chair-side digital impressions seemed to be a promising tool. Continuous improvements and further study are needed to confirm these preliminary results.