Complete digital workflow and immediate functional loading of implant-supported monolithic glass ceramic crowns
16321 Poster Display Clinical Research – Prosthetics
Background
Survival and success rates of immediate implant loading may vary widely according to literature. Advances in digital technologies create an opportunity for fast fabrication and delivery of final restorations. There is a very limited data on clinical outcomes of immediate loading of implants with final full-contour ceramic restorations produced using completely digital workflow.
Aim/Hypothesis
The aim of this study was to evaluate surgical and prosthetic aspects of immediate implant loading with glass ceramic screw-retained single crowns that could be associated with biologic and prosthetic outcomes.
Material and Methods
Nineteen subjects, who required single tooth implant supported crown in the posterior region of the mandible received one or more implant (patients with bad or parafunctional habits were excluded). In total 22 implants were placed. Primary stability measured and recorded in Ncm and ISQ values. Cerec® (Dentsply Sirona) implant scan post and scanbody was attached to the implant. Omnicam® (Dentsply Sirona) intraoral scanner (IOS) (CEREC AC software 4.3) was used to take the digital impressions and bite registrations. Within 24 hours functional glass ceramic (N!CE, Straumann) crowns were delivered (Fig. 1 and Fig. 2). For every crown occlusal and interproximal contacts were adjusted and recorded. Quality of contact points were measured with shimstock occlusal foil (Hanel, Coltene). Restorations were followed-up for 1, 3, 6 months.
Results
1 implant failed and was removed after 4 weeks. The rest implants and crowns were in function with no technical or biological complications after 6 months of use (survival rate of our study was 95,5%). Statistically significant effect on marginal bone loss (MBL) was not found considering factors such as implant size, time after extraction, bone type, soft tissue thickness, and primary stability measured in Ncm and ISQ values. Mean MBL mesially was 0.3 mm (SD 0.42) and distally - 0.4 mm (SD 0.66). These findings are similar to those in other studies reporting MBL on delayed or immediate loading. One distal and one mesial proximal contacts were missing during 6 months check-up, similarly as during insertion of the crowns - 1 and 2, accordingly.
Conclusion and Clinical Implications
Fully digital workflow without 3D printed model could be successfully employed for immediate functional loading with a single-unit implant-supported crowns fabricated from glass ceramics. When patients are carefully selected, it can provide clinically acceptable biologic and prosthetic outcomes in a follow-up period of 6 months. The protocol should be further evaluated with longer observational periods.
