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Background Proximal contact loss (PCL) between implant-supported restorations and adjacent natural teeth is a frequent clinical complication, potentially leading to food impaction, caries, and periodontal issues. However, the risk factors contributing to PCL remain incompletely understood. Methods This retrospective cohort study included patients who received single implant-supported crowns adjacent to natural teeth between June 2015 and June 2025. Eligible cases met stringent inclusion criteria based on radiographic, clinical, and periodontal assessments. PCL was diagnosed using floss resistance and radiographic separation tests, and quantified via calibrated shim stock measurements. Data on demographic, prosthetic, anatomical, and periodontal variables were extracted. Univariate and multivariate Cox proportional hazards regression analyses were used to identify independent predictors of PCL. Results A total of 206 patients (395 contact points) were included. The incidence of PCL was 67.5% at the patient level and 40.3% at the contact-point level. Multivariate analysis revealed that clinical food impaction (HR 2.75; 95% CI, 1.70–4.58; P  < 0.001), residual ridge height discrepancy (HR 2.51; 95% CI, 1.37–4.58; P  = 0.003), and advanced alveolar bone loss in adjacent teeth (HR 5.83; 95% CI, 1.05–32.33; P  = 0.044) were independently associated with PCL. Conclusions PCL is a prevalent complication following implant-supported prosthetic restoration. Local anatomical and prosthetic factors—particularly food impaction, ridge discrepancy, and bone loss—are key predictors. Proactive identification and management of these risk factors may help preserve interproximal contact integrity over time.

Objective This study aimed to compare the stress distribution after folded and single-layer fibular reconstruction with implant-supported restoration for Brown Class Ⅱ mandibular defects using finite element analysis (FEA), to provide a theoretical basis for selecting an optimal mandibular reconstruction strategy in clinical practice. Methods A healthy adult female volunteer from Bengbu Medical University underwent spiral computed tomography (CT) scans of the mandible and fibula. The CT data were imported into Mimics 21.0 software to reconstruct three-dimensional models of the intact mandible, dentition, and fibula. These models were further processed in Geomagic Studio 2014, Materialise 3-matic 18.0, and Exocad to establish FEA models of the intact mandible, as well as single-layer (Model A) and folded (Model B) fibular reconstruction with implant-supported restoration for Brown Class Ⅱ mandibular defects. The geometric models were then imported into Ansys 19.0 software for FEA to evaluate biomechanical characteristics and stress distribution patterns on implants, the reconstructed fibula, and surrounding bone tissues were compared between the two reconstruction methods. Results (1) Under identical loading conditions, stress concentration areas in the intact mandible were observed at the bilateral condylar necks, sigmoid notches, mandibular angles, and junctions between the mandibular body and ramus, with the maximum stress (57.627 MPa) located at the affected-side mandibular angle. (2) In Model A and Model B, the maximum stresses in the residual mandible were 82.619 MPa and 80.842 MPa, respectively, both at the affected-side mandibular angle, representing increases of 43.4% and 40.3% compared to the intact mandible (57.627 MPa). (3) The maximum stress in the reconstructed fibula was 65.31 MPa in Model B, which was lower than the 73.922 MPa in Model A. (4) The maximum stresses in implants 1, 2, and 3 were 19.496 MPa, 50.638 MPa, and 78.747 MPa in Model B, and 32.537 MPa, 99.558 MPa, and 123.14 MPa in Model A, all located at the implant necks. Conclusion Compared with the single-layer fibular flap, the folded fibular flap is a superior choice for the reconstruction of Brown Class Ⅱ mandibular defects with subsequent implant restoration.

Osseointegrated dental implants represent a successful treatment modality for partial and complete edentulism. However, concerns persist regarding their impact on adjacent natural teeth. Conflicting literature exists regarding complications such as caries, mobility, and fractures in neighboring teeth, with few studies comparing these effects with those observed in contralateral natural teeth. This retrospective study aimed to assess the impact of single posterior implant-supported rehabilitation on adjacent natural teeth compared to contralateral teeth. We retrospectively screened and analyzed electronic records of all patients who underwent treatment with a single posterior implant-supported restoration (premolar or molar) at a single public dental clinic between August 2010 and August 2020. We evaluated adjacent natural teeth for four potential complications: primary caries, secondary caries, tooth cracks or fractures, and tooth mobility. Chi-square tests compared the occurrence and rates of complications between teeth adjacent to single implants and contralateral teeth. Additionally, we conducted statistical comparisons to analyze the types of complications observed in teeth adjacent to single implants. Among the 1100 patients who received posterior single implants during the study period, 167 patients (15.1%) experienced complications in a tooth adjacent to the implant. The majority of these complications were attributed to either primary (41.3%) or secondary (53.3%) caries. A significant correlation was observed between the type of complication in the adjacent tooth and the status of the control tooth (χ2 = 21.73, p  = 0.01). Specifically, in cases of primary caries, the majority (68.1%) of control teeth remained classified as intact. Furthermore, in a comparison between teeth with crack/fracture complications and control teeth, 83.3% of control teeth remained intact ( p  = 0.01). Mobility complications were significantly associated with diabetic patients ( p  = 0.041) and a longer duration until implant rehabilitation ( p  = 0.006). Patients experiencing crack/fracture and mobility complications required a higher number of dental implants compared to other categories ( p  = 0.043). This study revealed a significant correlation between posterior single implants and the occurrence of complications in adjacent teeth, while most of the contralateral teeth remained intact. Clinical relevance. Meticulous monitoring of implant patients is crucial for assessing the condition of adjacent teeth and effectively manage potential complications, particularly in high-risk patients.

The purpose of this study is to outline relevant elements regarding the biochemical interactions between prosthetic materials used for obtaining implant-supported restorations and the oral environment. Implant-supported prostheses have seen unprecedented development in recent years, benefiting from the emergence of both new prosthetic materials (with increased biocompatibility and very good mechanical behavior), and computerized manufacturing technologies, which offer predictability, accuracy, and reproducibility. On the other hand, the quality of conventional materials for obtaining implant-supported prostheses is acknowledged, as they have already proven their clinical performance. The properties of PMMA (poly (methyl methacrylate))—which is a representative interim material frequently used in prosthodontics—and of PEEK (polyether ether ketone)—a biomaterial which is placed on the border between interim and final prosthetic use—are highlighted in order to illustrate the complex way these materials interact with the oral environment. In regard to definitive prosthetic materials used for obtaining implant-supported prostheses, emphasis is placed on zirconia-based ceramics. Zirconia exhibits several distinctive advantages (excellent aesthetics, good mechanical behavior, biocompatibility), through which its clinical applicability has become increasingly wide. Zirconia’s interaction with the oral environment (fibroblasts, osteoblasts, dental pulp cells, macrophages) is presented in a relevant synthesis, thus revealing its good biocompatibility.

The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology.

Dimensional accuracy of 3D-printed implant models is essential for precise implant-supported restorations. The objective of this study was to evaluate the influence of printing orientation and model base design on the accuracy of implant position transfer. A standardized maxillary model with four implants was scanned using an intraoral scanner. Solid and hollow models were designed and printed using digital light processing (DLP) technology at orientations of 0°, 45°, and 90° (n = 10 per group). All models were digitized with a high-precision industrial scanner, and implant position deviations were determined by comparing corresponding reference points with the master model. Data were analyzed using two-way analysis of variance and post hoc tests (α = 0.05). Printing orientation significantly affected accuracy (p < 0.001). Models printed at 45° showed the highest deviations, whereas those printed at 0° and 90° exhibited comparable and superior accuracy. Model design (solid vs. hollow) had no significant influence at 0° and 90°, but hollow models were more accurate at 45° (p < 0.001). Mean deviations ranged from 131 μm to 382 μm. Printing at 0° or 90° is recommended, while 45° orientations should be avoided. Model design showed minimal effect on accuracy.

Assessment of the subjective experiences of individuals with maxillary anterior (ie, the upper front region of the mouth) single-tooth implants is limited mainly to quantitative measurements of satisfaction with appearance. Interestingly, there is unexplained variability in the relationship between satisfaction and appearance.BACKGROUNDAssessment of the subjective experiences of individuals with maxillary anterior (ie, the upper front region of the mouth) single-tooth implants is limited mainly to quantitative measurements of satisfaction with appearance. Interestingly, there is unexplained variability in the relationship between satisfaction and appearance.This qualitative study protocol aims to explore and better understand the satisfaction with appearance and function in a Canadian population with maxillary anterior single-tooth implants treated at a postgraduate university clinic. Thus, we aim to obtain diversity among participants relating to the identification of esthetically pleasing and displeasing cases from a clinician perspective.OBJECTIVEThis qualitative study protocol aims to explore and better understand the satisfaction with appearance and function in a Canadian population with maxillary anterior single-tooth implants treated at a postgraduate university clinic. Thus, we aim to obtain diversity among participants relating to the identification of esthetically pleasing and displeasing cases from a clinician perspective.A qualitative research design using interpretative phenomenology analysis (IPA) will provide an adaptable inductive research approach. The participants will be recruited, and consent documents, photographs, digital intraoral scans, and self-administered questionnaire responses will be obtained from them. The transcribed verbatim data from audio-recorded, in-depth, semistructured, one-to-one interviews of the participants will be managed, coded, and analyzed thematically with computer-assisted qualitative data analysis software. The IPA will consider the COnsolidated criteria for REporting Qualitative (COREQ) guidelines when applicable.METHODSA qualitative research design using interpretative phenomenology analysis (IPA) will provide an adaptable inductive research approach. The participants will be recruited, and consent documents, photographs, digital intraoral scans, and self-administered questionnaire responses will be obtained from them. The transcribed verbatim data from audio-recorded, in-depth, semistructured, one-to-one interviews of the participants will be managed, coded, and analyzed thematically with computer-assisted qualitative data analysis software. The IPA will consider the COnsolidated criteria for REporting Qualitative (COREQ) guidelines when applicable.For the qualitative interview, we plan to include at least eight patients to conduct up to 1.5 hours of open-ended interviews with each participant aided by an interview guide. Ethical approval was granted by the University of British Columbia Behavioral Research Ethics Board (H19-00107) in May 2019. Two American dental foundations funded this study.RESULTSFor the qualitative interview, we plan to include at least eight patients to conduct up to 1.5 hours of open-ended interviews with each participant aided by an interview guide. Ethical approval was granted by the University of British Columbia Behavioral Research Ethics Board (H19-00107) in May 2019. Two American dental foundations funded this study.The analysis in this study will elucidate the aspects (including their value) that influence participant satisfaction at different dental implant treatment stages. This will be the first qualitative study on this group of the population to explore and obtain a better understanding of their satisfaction with appearance and function, as well as any other patient-reported outcome measures that could be identified.CONCLUSIONSThe analysis in this study will elucidate the aspects (including their value) that influence participant satisfaction at different dental implant treatment stages. This will be the first qualitative study on this group of the population to explore and obtain a better understanding of their satisfaction with appearance and function, as well as any other patient-reported outcome measures that could be identified.DERR1-10.2196/25767.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)DERR1-10.2196/25767.

ObjectivesThe objective of this clinical study was to compare and assess the clinical performance of tooth-supported and implant-supported zirconia single crowns with sintered veneering caps.MethodsIn this prospective study, 118 patients with a total of 220 single crowns placed on 106 teeth (69 vital teeth, 37 endodontically treated teeth) and 114 implants in molar and premolar regions were examined during a mean observation period of 42 months. The restorations were evaluated for technical failures such as veneering porcelain fractures (chipping), surface quality, marginal fit, and the interface quality of the coping and sintered veneering. The soft tissue status was assessed using the modified Silness and Löe’s plaque and gingival index (mPI) and the modified Muhlemann sulcus bleeding index (mSBI). Tooth-supported crowns were checked for secondary caries and hypersensitivity during the follow-up period. Recalls were performed every 6 months.ResultsThe 3-year Kaplan-Meier success probability was 98.2% and 100% for implant- and tooth-supported crowns, respectively. A significant difference could be detected between the implant-supported and tooth-supported zirconia single crowns, in terms of their chipping rate (p = 0.039). Veneering material fractures were recorded on two implant-supported restorations (1.8%). No veneering fractures occurred on tooth-supported single crowns. The plaque and gingival index and sulcus bleeding index showed stable and healthy soft peri-implant and periodontal tissues. Neither loss of vitality nor secondary caries occurred on tooth-supported crowns.ConclusionsZirconia-based single crowns with a sintered veneering cap showed promising clinical results on both tooth and implant abutments; however, the dental implants were more prone to complications. In terms of clinical significance, high-strength ceramic with a sintered veneering cap can be recommended for prosthetic treatment of both tooth- and implant-supported single crowns in molar regions.Clinical relevanceThis study provides valuable information for further application of all-ceramic restorations.

Background Self-glazed zirconia (SGZ), produced using a novel additive 3D gel deposition technology, has recently been employed to fabricate zirconia abutments. This in vitro study aimed to evaluate the adaptation of one-piece and two-piece all-ceramic SGZ implant abutments in comparison to conventional milled zirconia abutments. Methods One-piece zirconia abutments and two-piece Ti-base zirconia abutments, sharing an identical 3D design, were fabricated using self-glazed zirconia via 3D gel deposition and conventional zirconia via milling, forming four groups: SGZ-A, SGZ-Ti, Lava-A, and Lava-Ti. Marginal gaps between the zirconia abutments and Ti-base were evaluated using micro-CT data, while gaps between the abutments and implant analogs were assessed on specimen cross-sections by using a stereomicroscope. Statistical analyses were conducted using the non-parametric Mann-Whitney U and Kruskal-Wallis tests with α set at 0.05. Results For the two-piece zirconia abutments, the SGZ-Ti group(external gaps:31 ± 20 μm, internal gaps:4 ± 7 μm) exhibited significantly smaller marginal gaps between the zirconia abutment and the Ti-base compared to the Lava-Ti group(external gaps:79 ± 48 μm, internal gaps:51 ± 44 μm) ( P <0.001). For the one-piece zirconia abutments, the SGZ-A group(18.5 ± 5.5 μm) demonstrated a significantly smaller gap between the abutment and the implant analog compared to the Lava-A group(26.5 ± 10.0 μm) ( P  = 0.044). No significant difference was observed among SGZ-A, SGZ-Ti and Lava-Ti groups ( P >0.05). Conclusion SGZ abutments demonstrate superior adaptation compared to conventional milled zirconia abutments at both the Ti base-abutment interface and the implant-abutment interface. The adaptation of one-piece SGZ abutments is comparable to that of prefabricated Ti-base abutments.

Background/Objectives: Prosthodontic restoration design plays a key role in the long-term success of implant-supported treatments and in maintaining peri-implant tissue health. Inadequate emergence angles and profiles can compromise tissue stability and negatively influence clinical outcomes. Generative design, as an algorithm-driven optimization approach, requires the definition of key parameters in advance to guide the process and determine the final shape of the hybrid implant abutment. Methods: A detailed literature review of the PubMed and Scopus databases was performed to find appropriate studies published up to 1 December 2025. Studies that investigated the emergence angle and emergence profile of implant-supported restorations were included. Seventeen studies fulfilled criteria and were included in the final analysis. Results: While the optimal emergence angle is still debatable, the literature suggests that an angle less than 30° may be beneficial. However, a concave emergence profile of implant-supported restoration has a significant role in improving stability and maintaining peri-implant health. Conclusions: Careful characterization and evaluation of the included parameters provide useful insights for generative design workflows, enabling the creation of implant abutment designs that maintain a balance between mechanical performance and biological compatibility.