Archive & Observations
Recent publications from the prosthodontic, restorative and implant dentistry literature — reviewed for clinical relevance.
A 12-patient proof-of-concept study using tissue-level Straumann TLX implants and a fully digital workflow reports 100% 6-month survival for immediate placement and immediate loading in posterior single-tooth sites, though the sample is tiny and the follow-up brief.
A 528-implant observational study after alveolar ridge preservation finds that pristine bone engagement below 1.1 mm roughly doubles failure risk — a useful planning threshold when regenerated socket walls look more reassuring than they are.
An in vitro study of 50 maxillary central incisors with no ferrule finds that CAD/CAM glass-fibre post-cores and hybrid ceramic endocrowns produce the highest fracture strength, while conventional glass-fibre posts achieve 100% repairable failures — making the choice less about strength and more about what happens when things go wrong.
A systematic review and meta-analysis of 13 studies found stereophotogrammetry more reliable than intraoral scanning for complete-arch implant impressions, while also reminding clinicians that the in vivo evidence is still thin and the rigid prototype try-in remains sensible.
A 26-patient randomized trial of flapless immediate implants in the anterior maxilla found no significant 1-year difference in marginal bone, Pink Esthetic Score, or OHIP when the definitive zirconia abutment was placed at 4 days rather than 3 months.
A systematic review and meta-analysis of 17 RCTs finds that single implant-supported mandibular overdentures deliver equivalent implant survival to two-implant designs at up to 5 years, but carry roughly twice the risk of denture fracture and need for full denture replacement — a trade-off with real implications for patients who can only afford one.
Deflorian and colleagues turn immediate anterior implant placement into a practical risk filter: primary stability first, then buccal plate integrity, gingival phenotype, and recession. The paper is not a guideline, but it is a useful reminder that implant timing should follow tissue risk rather than surgical enthusiasm.
A 2026 PRISMA-registered systematic review of 20 studies finds that optical jaw tracking systems offer real precision advantages over mechanical articulators, but high risk of bias across the literature and the absence of standardised protocols mean this technology is further from routine adoption than the marketing suggests.
A 4-year case report describes a 15-year-old patient whose post-orthodontic white spot lesions darkened after unsupervised use of fluoride-free activated charcoal powder, with microabrasion only partly resolving the staining before direct composite veneers were needed.
A 1:1 matched case–control study from Mumbai finds that chairside bis-acryl mock-ups and chairside-only shade matching are strongly associated with patient-initiated esthetic dissatisfaction within 12 months of ceramic veneer delivery — with adjusted odds ratios of 5.87 and 4.41 respectively — while cost tier has no significant effect.
An in vitro study from Stony Brook University places 80 short (6 × 7 mm) and conventional (3.75 × 10 mm) Ditron implants in hard and soft bone simulants, finding that short wide implants outperform their conventional-length counterparts on insertion torque and Periotest values in both bone types — challenging the assumption that more length automatically means more stability.
Pabst et al. survey 276 oral and maxillofacial surgeons in Germany, revealing the gap between evidence-based ideals and real-world implant practice patterns.
A dual-centre retrospective study finds that adjunctive systemic azithromycin added to non-surgical debridement produces meaningful pocket depth reduction and radiographic bone gain in peri-implantitis cases with intrabony defects. Here's what the numbers mean for your clinic.
A prospective study of 150 patients finds that a deep neural network combined with grey relational analysis achieves 93.2% shade matching accuracy for anterior restorations — outperforming both visual assessment and spectrophotometry alone.
A novel transformer-based implicit neural network reconstructs missing tooth morphology across molars, premolars, and incisors with high dimensional accuracy — matching original crowns more closely than an experienced technician in some dimensions.
A major systematic review and meta-analysis of 44 studies finds cigarette smokers face 60% lower odds of implant survival and 0.64 mm additional crestal bone loss, while evidence on e-cigarettes and vaping remains virtually nonexistent.
Hongseok An at Oregon Health & Science University outlines four distinct shade-masking strategies for CAD-CAM ceramic restorations on discoloured teeth, from opaque monolithic zirconia with external staining to a bi-layered zirconia-lithium disilicate 'CAD-on' construction, each balancing masking power against the illusion of translucency.
Doliveux and colleagues show that 95% of guided immediate implants in the anterior maxilla deviate buccally, and that planning outside the socket's long axis makes it significantly worse.
While the 1st Global Consensus for Clinical Guidelines (GCCG) reached clear agreement on surgical and augmentation questions for the edentulous maxilla — as covered in the companion Fiorellini consensus report — this companion survey by Schoenbaum and colleagues found that the prosthetic planning variables (implant number, timing, and loading) told a different story: 117 experts from 42 countries, and strong consensus on precisely nothing.
A systematic review finds that maxillary full-arch fixed prostheses deliver high survival rates and patient satisfaction regardless of implant number — but direct comparative evidence remains surprisingly thin.
The 1st Global Consensus for Clinical Guidelines on edentulous maxilla rehabilitation has formalised expert agreement on CBCT imaging, membrane fixation, soft tissue augmentation, and sinus membrane perforation management — giving clinicians a practical, evidence-backed playbook for full-arch implant cases.
Salih et al. show that vertical (90°) build orientation produces DLP-printed implant surgical guides with 40–110 µm less deviation than horizontal (0°), and the molar region is the biggest offender — an in vitro study with real workflow implications.
A 2026 network meta-analysis of 18 studies and 780 immediately placed implants finds that every guided surgical protocol significantly outperforms freehand placement in angular, platform, and apex deviation — with robotic and dynamic navigation ranking highest, though their advantage over fully-guided static approaches narrows under RCT-restricted sensitivity analysis.
A fully digital workflow for occlusal adjustment — from virtual articulator simulation to 3D-printed grinding guides — offers a glimpse of how technology might tame one of prosthodontics' most unpredictable chairside procedures.
A randomised controlled trial of 100 patients comparing five osteotomy protocols finds that moderate-speed drilling at 300 rpm delivers the most consistent implant stability gains over three months, while bone condensation shows a worrying ISQ decline.
An in vitro study of 50 molar teeth finds that finishing CAD-CAM crown preparations with a fine-grit red diamond bur after coarser preparation cuts the mean marginal gap roughly in half, from 64 µm down to 28 µm.
A Korean retrospective study finds proximal contact loss in more than half of implants functioning for over a decade. Here is what the data means for how you monitor long-term implant patients.
A retrospective study of 256 immediately loaded full-arch implants in 50 patients identifies smoking, maxillary placement, female sex, and age over 65 as significant risk factors for marginal bone loss — while reporting a 98% implant survival rate and a mechanical complication rate that should prompt a frank preoperative conversation with every full-arch candidate.
Manfredini et al. wade through 1,961 records to propose a unified three-tier healing abutment classification — and discover that the field has been arguing about things nobody agreed to define in the first place.
A prospective study of 332 implant patients finds preoperative dental anxiety independently predicts postoperative pain, but only up to a critical threshold score. What this means for how you screen patients before surgery.
Kizilkaya and colleagues test whether standardised digital photography with colour-analysis software can match the spectrophotometer for shade matching — and the answer is complicated.
A multifactorial analysis of 404 implants identifies deep probing, absent keratinised mucosa, microgap abutments, inadequate transmucosal height, and periodontitis history as the key drivers of peri-implant bone loss.
Clinton Stevens' 2026 commentary in the International Journal of Periodontics & Restorative Dentistry argues that monolithic zirconia's reputation as the most biocompatible ceramic in dentistry is not supported by evidence — and that when soft-tissue response, enamel wear, tooth structure conservation, and clinical retrievability are assessed together, the claim quietly falls apart.
Hsieh et al. compare half-grafted and full-grafted alveolar ridge preservation using serial CBCT over 12 months — and while the full graft holds its horizontal dimensions better, volumetric outcomes and implant health are equivalent.
A scoping review of 126 studies maps the repair protocol landscape for fractured ceramics — hydrofluoric acid plus silane wins for glass ceramics, while air abrasion with MDP-containing primers leads for zirconia.
A retrospective study of 125 patients finds that in-situ bone onlay grafting — harvesting from the apical area of the implant site itself — produces significantly less resorption than ex-situ grafts from the chin or external oblique line during initial healing.
A nationwide Korean study reveals that nearly 9 in 10 patients over 65 receiving implants have at least one systemic disease — and the medications that worry clinicians most may not be the ones causing failures.
Kim et al. quantify the vertical dimension threshold at which facial changes become perceptible, finding 4 mm is the tipping point for observer detection.
A new in vitro study from Sichuan University finds that 3D print offset settings for surgical guide sleeves have a dramatic effect on implant placement accuracy — and the margin between too tight and too loose is just 0.04 mm.
Niakou et al.'s systematic review and meta-analysis finds endocrowns offer comparable survival and complication rates to conventional crowns on structurally compromised teeth.
A scanner-agnostic Python workflow interpolates dynamic mandibular motion paths from four static interocclusal records, exporting motion files compatible with dental CAD software — no proprietary jaw tracker required.
Laser-microtextured implant collars may neutralise the bone loss risks of wider emergence angles and convex profiles — a 10-year retrospective study suggests the surface treatment matters more than the restoration contour.
Kader et al. expose 120 provisional restoration specimens to cigarette smoke and find that milled PMMA outperforms both conventional bis-acryl and 3D-printed resins for colour and translucency stability — with brushing only partially reversing the damage.
Çankaya et al. train an XGBoost model on thermal images of the anterior maxillary gingiva and achieve 92.7% accuracy classifying gingival inflammation — no probing, no contact, no operator variability.
A narrative review from the University of Florida catalogues the ways AI segmentation in implant planning software can fail — from misidentifying the inferior alveolar nerve to hallucinating anatomy that isn't there — and why clinicians must verify before they trust.
Zhang et al.'s systematic review finds MRI and ultrasound produce clinically acceptable measurements for implant planning, challenging CBCT's monopoly on preoperative imaging.
A case report with 10-year follow-up shows two adjacent implants placed just 1 mm apart maintained interproximal crestal bone 1.40 mm above the implant shoulder, challenging the longstanding 3 mm interimplant distance guideline.
Lower sintering temperatures produce mechanically superior conventional zirconia, whilst translucent formulations stubbornly resist this advantage regardless of heat protocol — Brunetto et al. clarify what the firing chart has been trying to tell us.
A clinical study from Yonsei University comparing removable partial denture frameworks fabricated via intraoral scanning versus conventional impression methods finds intraoral scanning delivers significantly better rest-seat accuracy, with the advantage most pronounced at the terminal abutments of distal-extension cases.
Griffin and colleagues mine the US Veterans Affairs database — 132,675 patients, 468,496 implants, 21 years — and find that prior failure history, not smoking or diabetes, is the strongest predictor of future failure, with an 86% intraclass correlation at the patient level.
A systematic review of eight prospective studies finds that implant-supported crowns, initially set light on purpose, progressively increase in occlusal force, contact area, and contact duration until they match or exceed adjacent natural teeth — often within months, sometimes years.
Flowable composite resin markers placed between scan bodies significantly improve intraoral scanning accuracy for edentulous mandibular arches, offering a simple, low-cost enhancement to digital implant workflows.
A randomised clinical trial compares chairside composite and prefabricated zirconia sealing socket abutments for posterior immediate implants — finding that composite preserves buccal volume while zirconia delivers shallower probing depths.
An in vitro study of 135 additively manufactured zirconia crowns finds that a 30 µm cement gap combined with Panavia 21 produces the best fit and highest pull-out resistance when bonding AM-Z crowns to Ti-base abutments — a clinically actionable finding for digital implant workflows.
A systematic review of 20 studies and 1,245 patients finds that sinus augmentation and combined sinus-onlay grafting produce similarly high implant survival rates in the resorbed posterior maxilla — but the evidence base is thin, and crown-to-implant ratio remains a largely unexamined complication driver.
A systematic review and meta-analysis of 11 studies finds that stereophotogrammetry significantly outperforms intraoral scanning for full-arch implant impressions in precision, trueness, and angular accuracy.
Chang et al. find no correlation between directional ISQ values and bone-to-implant contact in a cadaver study — suggesting the reassuring beep from your Osstell is measuring implant shoulder engagement, not total osseointegration.
An in vitro study finds that the shade of composite resin cavity bases in endocrown preparations significantly affects intraoral scanner accuracy — with lighter shades (A1 and B1) producing higher RMS trueness errors than darker shades (A2 and A3), a finding with direct workflow implications for clinicians planning digital impressions after root canal treatment.
Ballesteros et al. compare 3D-printed and milled surgical guides with and without metal sleeves — and find that sleeveless guides consistently outperform sleeved ones for implant placement accuracy.
A systematic review of 24 clinical studies finds that platform-switching implants improve soft tissue esthetics and stabilise marginal bone — but the advantage over conventional designs is partial, not absolute.
Reused healing abutments develop surface roughness, protein contamination, and microgaps averaging 43 µm — creating conditions for bacterial leakage that sterile components avoid entirely. A tightening torque of 15 N·cm largely eliminates the gap, but the fundamental case for single-use remains.
Abduljabbar and colleagues compare single-retainer lithium disilicate RBFDPs with implant-supported single crowns in the esthetic zone across five Swedish clinics, finding 87.9% vs 96.7% five-year survival but equivalent patient satisfaction.
An in vitro study comparing five zirconia surface treatments confirms that alumina air-particle abrasion delivers the highest and most durable bond strengths — and that heated hydrofluoric acid matches it, but at a practical cost nobody should pay.
A systematic review of 42 laboratory studies reveals that ultrasonic scaling and air polishing damage dental restorations, with material-specific effects on surface roughness and marginal quality. Glycine and erythritol powders emerge as the least destructive options.
A novel marker-assisted IOS workflow from the University of Michigan enables accurate complete denture digitisation using a TRIOS4 and free Meshmixer software, without modifying the denture's critical border or intaglio surface.
Pachiou et al.'s 2025 systematic review and meta-analysis of 2,741 narrow-diameter implants finds 97.7% pooled survival in posterior sites — comparable to standard-diameter fixtures.
Static and dynamic computer-aided implant surgery show comparable accuracy — clinical context, not assumed superiority, should drive the choice between them.
The AiDENTAL RPD Surveyor and Designer is a lightweight web app that digitises diagnostic surveying, automates framework design, and closes the last major gap in the removable partial denture digital workflow.
Ashurko et al. pit a xenogeneic volume-stable collagen matrix against the subepithelial connective tissue graft for buccal soft tissue augmentation at simultaneous implant placement — and the results flip between three and six months.
A systematic review and meta-analysis of 11 RCTs finds the 'one abutment one time' protocol produces statistically significant reductions in marginal bone loss at 6 months, with a consistent directional trend at 12 months that narrowly missed significance after sensitivity analysis — the absolute benefit is modest and best realised with platform switching and taller abutments.
A clinical trial of 75 implant-supported fixed dental prostheses finds that generic and non-original scan bodies produce clinically equivalent restorations and statistically indistinguishable implant position transfers compared to original brand-matched scan bodies — suggesting the aftermarket option is a legitimate choice in the complete digital workflow.
An in vitro study by Alkhazaleh and colleagues at Oregon Health & Science University finds that lithium disilicate alone — even at 2.0 mm — cannot mask amalgam show-through to acceptable levels, but a single layer of resin-based opaquer changes everything, with IPS e.max CAD reaching excellent masking at 2.0 mm when the substrate is opaqued.
Donker and colleagues test a fully digital workflow for immediate implant placement and provisionalization in the maxillary aesthetic zone — prefabricated temporaries, guided surgery, excellent aesthetics — but a 10% early failure rate complicates the narrative.
Goodacre and Goldstein's 2025 review finds zero clinical trials comparing occlusal schemes for tooth-supported FPDs, forcing the profession back to First Principles.
Fasbinder et al. track 100 IPS e.max CAD crowns over ten years and find 92% survival — with a twist: cement choice barely affects longevity overall, but determines whether your crown debonds or fractures.
A retrospective cohort of 243 scanbodies at Hacettepe University finds that successful CAD library alignment does not guarantee adequate scan quality — nearly half showed rough texture representation, and original cylindrical PEEK scanbodies were over six times more likely to degrade than non-original aluminium alternatives.
Dong and colleagues analyse 2,620 anterior implants across 2,023 patients and find that insertion torque below 30 N/cm carries a staggering 13-fold increase in early failure risk — dwarfing every other variable in the model.
A systematic review and meta-analysis of 18 studies finds that implant diameter has surprisingly little influence on most prosthesis complications — but narrow-diameter implants do show significantly fewer abutment fractures than standard ones.
Younis et al. compare the Remebot robot-assisted system against freehand implant placement across 95 implants — and the accuracy gap is not marginal. It's threefold.
A 2024 PRISMA-compliant systematic review of five clinical studies finds that customised healing abutments consistently trend toward better peri-implant soft and hard tissue outcomes than prefabricated titanium alternatives, with significantly improved Pink Aesthetic Scores and less chairside pain during crown delivery — though the evidence base remains small and the call for larger trials is urgent.
Gseibat et al.'s 5-year prospective RCT finds translucent monolithic zirconia posterior crowns achieve 100% survival and comparable clinical performance to metal-ceramic restorations fabricated via digital workflow.
Breunig et al. follow 162 implants for up to twenty years and discover that gingival phenotype predicts crestal bone loss and peri-implantitis risk — with thick, flat tissue emerging as the long-term troublemaker nobody expected.
