Purpose: The aim of this review was to summarize the existing scientific literature investigating on cervical margin relocation technique (CMR) performed prior to the adhesive cementation of the indirect restorations.

Study selection: An electronic search with no date restriction was conducted in the MEDLINE database, accessed through PubMed. The following main keywords were used: "cervical margin relocation", "coronal margin relocation", "deep margin elevation" and "proximal box elevation".

Results: Seven in vitro studies and 5 clinical reports investigating on CMR are taken into consideration for the present review. The most frequently investigated parameter in almost all of the in vitro studies was the marginal adaptation of the indirect restorations. One study additionally assessed the influence of CMR on the fracture behavior of the restored teeth and one study assessed the bond strength of the indirect composite restoration to the proximal box floor. Clinical reports provided documentation with a detailed description of the treatment protocol. In the current literature no randomized controlled clinical trials or prospective or retrospective clinical studies on CMR technique could be found.

Conclusions: On the basis of the reviewed literature, it can be concluded that currently there is no strong scientific evidence that could either support or discourage the use of CMR technique prior to restoration of deep subgingival defects with indirect adhesive restorations. Randomized controlled clinical trials are necessary to provide the reliable evidence on the influence of CMR technique on the clinical performance, especially on the longevity of the restorations and the periodontal health.

Purpose: Fiber-reinforced composite (FRC) fixed dental prostheses (FDPs) have shown good performance in clinical applications due to their good mechanical properties and minimally invasive approach. However, typical failure patterns of FRC FDPs are often localized at the pontic site. That reflects the structural considerations at the framework and pontic location that need to be examined when creating these kinds of prostheses.

Study selection: Peer-reviewed articles and other scientific literature were reviewed for providing up-todate information on how pontics of FRC FDPs can be made. A thorough literature search was done using PubMed and Google Scholar. Two individuals did an assessment of the articles in order to include those related to pontics and framework design of FRC FDPs. The search terms used were "fiber-reinforced dental prosthesis" and "Pontics of fiber-reinforced dental prosthesis".

Results: These findings indicate that a cross-sectional fiber design, substructure and thicker pontics made of a variety of materials might reduce failures at the pontic site.

Conclusions: The thickness of pontics of FRC FDPs interrelated with the vertical positioning of the FRC framework influences the load-bearing capacities of prostheses of these kinds. The understanding of the factors involved in the fabrication of pontics of FRC FDPs may overcome the drawbacks identified in these prostheses, thus extending their longevity.

Purpose: The purpose of this study was to ascertain whether computer aided design/computer aided manufacturing (CAD/CAM) composite resin crowns have sufficient strength to withstand the bite force of the molar teeth. The null hypothesis was that the fracture strength of CAD/CAM composite resin crowns is lower than the average maximum bite force of the molar tooth.

Methods: The crowns, which shape is the right maxillary first molar, were fabricated using four CAD/CAM blanks made of composite resins (Block HC: HC, KZR-CAD HR: HR, KZR-CAD HR2: HR2, Avencia Block: AVE) and one CAD/CAM blank made of lithium disilicate glass-ceramic (IPS e.max CAD: IPS), which was used as a control. Fracture strength of fabricated crowns bonded to metal abutment and biaxial flexural strength of the materials were evaluated.

Results: The results of fracture strength test and biaxial flexural strength test showed different tendencies. The fracture strength of CAD/CAM composite resin crowns except HC ranged from 3.3 kN to 3.9 kN, and was similar to that of IPS (3.3 kN). In contrast, biaxial flexural strength of CAD/CAM composite resins ranged from 175 MPa to 247 MPa, and was significantly lower than that of IPS (360 MPa).

Conclusions: All CAD/CAM composite resin crowns studied presented about 3–4 times higher fracture strength than the average maximum bite force of the molar tooth (700–900 N), which result leads to the conclusion that CAD/CAM composite resin crowns would have sufficient strength to withstand the bite force of the molar teeth.

Purpose: The purpose of this in vitro study was to assess the effect of varying the margin designs and the occlusal thicknesses on the fracture resistance and mode of failures of endodontically treated teeth restored with polymer infiltrated ceramic endocrown restorations.

Methods: Root canal treated mandibular molars were divided into four groups (n = 8) and were prepared to receive Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) fabricated polymer infiltrated ceramic endocrowns (ENAMIC blocks). Group B2 represents teeth prepared with a butt joint design receiving endocrowns with 2 mm occlusal thickness and the same for group B3.5 but with 3.5 mm occlusal thickness. Group S2 represents teeth prepared with 1 mm shoulder finish line receiving endocrowns with 2 mm occlusal thickness and the same for group S3.5 but with 3.5 mm occlusal thickness. After cementation and thermal aging, fracture resistance test was performed and failure modes were observed.

Results: Group S3.5 showed the highest mean fracture load value (1.27±0.31 kN). Endocrowns with shoulder finish line had significantly higher mean fracture resistance values than endocrowns with butt margin (p < 0.05). However, the results were not statistically significant regarding the restoration thickness. Evaluation of the fracture modes revealed no statistically significant difference between the modes of failure of tested groups.

Conclusions: For the restoration of endodontically treated teeth, adding a short axial wall and shoulder finish line can increase the fracture resistance. However, further investigations, especially the fatigue behavior, are needed to ensure this effect applies with small increases of restoration thickness.

Purpose: Occlusal trauma, resulting in the destruction of alveolar bone, is a form of periodontal disease caused by excessive mechanical stress (MS) during hyperocclusion. Previously, we showed that C--C chemokine ligand (CCL) 2/CCR2 receptor axis plays a crucial role in MS-dependent osteoclastogenesis. However, in the previous work, we were unable to precisely measure changes in alveolar bone profiles. In the present study, we sought to establish a precise method for evaluating alveolar bone resorption induced by hyperocclusion using micro-computed tomography.

Methods: Under anesthesia, a stainless steel wire was attached to the molars of 5-week-old C57/BL6 wildtype (WT) mice, CCL2^-/- mice, and CCR2^-/-mice to induce occlusal force overload. At days 0 and 7, hard tissue samples were harvested and analyzed by micro-computed tomography.

Results: In the WT mice, bone mineral density of the alveolar bone was significantly decreased at day 7 as compared with day 0, with marked alveolar bone resorption observed. Similarly, significant alveolar bone resorption was observed in the CCL2^-/- and CCR2^-/- mice at day 7 as compared with day 0.

Conclusions: Micro-computed tomographic images can be used to measure changes in bone mineral density in a mouse model of hyperocclusion. This method may be useful for further investigating bone changes in other periodontal disease research fields.

Purpose: Tongue movement with unstable swallowing cause artifacts on magnetic resonance imaging (MRI). This may be associated with loss of occlusal support. This study aimed to clarify whether motion artifacts can be mitigated by denture wearing during MRI examination in patients without occlusal support, and whether denture wearing affect tongue stability, form, and position were also evaluated.

Methods: Ten subjects without occlusal support (6 male, 4 female; mean age 73.20±10.12 years) participated in the study. MRI was performed with dentures worn (DW), followed with removal of dentures (NDW). Luminance standard deviation (LSD) was measured in regions of interest in the axial and sagittal planes. The position of the base of the tongue (TB), tip of the tongue apex (TA), and tongue's long diameter (TLD) were compared between DW and NDW.

Results: NDW evoked ambiguous MR images in the axial and sagittal planes compared with DW. There were significant differences in LSD between DW and NDW in both the axial (p = 0.047) and sagittal planes (p = 0.02). No significant difference in the position of TB were observed (p = 0.78). The position of TA was significantly more protruded with DW (p = 0.007). Also, TLD was significantly longer with DW (p = 0.001).

Conclusions: Results of this study suggest that wearing the dentures during MRI examination reduces motion artifacts in edentulous patients without occlusal support, and maintained the normal form of the tongue during imaging.

Purpose: The purpose of this survey was to examine the overview of maxillofacial prosthetic treatment at our department, in order to ascertain the actual status of patients and discuss future needs.

Methods: Subjects were all patients who visited Clinic for Maxillofacial Prosthetics, Dental Hospital, Tokyo Medical and Dental University (TMDU) in the period from January 1, 1980 to December 31, 2014. Using medical records of the Clinic for Maxillofacial Prosthetics, Dental Hospital, TMDU, patients' data including sex, address, referring institution, and primary condition were analyzed throughout the period.

Results: The number of patients over 35 years was 6219, with a man-to-woman ratio of 6:4. The number of patients in their 60s, 70s, and 80s showed an increasing trend. Patients with tumors accounted for about 50 % of cases in 1980–1984 and increased to 80 % in 2010–2014.

Conclusions: The survey showed an increasing number of elderly patients and patients with tumors. This suggests that more awareness and education about maxillofacial prosthetics are needed.

Purpose: A single implant can be placed to retain an overdenture in the edentulous mandible. This study aimed at the development of Oral Health-related Quality of Life comparing immediate and delayed implant loading, i.e., loading after 3 months of submerged healing.

Methods: In a randomized controlled trial, 158 participants received a single mandibular implant in the midline. Quality of life was measured using the summary score of the German 49-item Oral Health Impact Profile at baseline, one month after implant placement (direct loading group) as well as one and four months after loading.

Results: Mean scores at baseline were comparable. Four months after implantation, a decrease of mean scores was recognized for both groups, indicating a significantly enhanced quality of life after treatment. When comparing the groups after both 1 and 4 months of loading, quality of life was insignificantly higher in the delayed loading group (1 month: 42.1 vs. 32.3; 4 months: 33.6 vs. 27.7). For immediate loading, an insignificant tendency to an earlier improvement was recognized (Δ_{1 month-baseline}: 9.7, compared to Δ_{1 month-baseline}: 6.4).

Conclusions: The single mandibular implant concept was associated with a positive impact on quality of life. However, no statistically significant influence of implant loading on quality of life was found.

Purpose: Concomitant occurrence of respiratory events can be often overlooked in the clinical practice of SB. This study assessed physiological characteristics of rhythmic masticatory muscle activity (RMMA) and concomitant respiratory events in young sleep bruxism (SB) subjects asymptomatic to obstructive sleep apnea (OSA).

Methods: Twenty-two subjects (age: 24.1±1.9 years; F 8: M 14; BMI: 20.2±1.9 kg/m²) were polysomnographically diagnosed as moderate-severe SB. Sleep architecture, oromotor (RMMA and nonspecific masseter activity [NSMA]) and apnea/hypopnea events were scored.

Results: All subjects showed normal sleep architecture whereas 6 exhibited respiratory events at a mild level of OSA. In all subjects, RMMA predominantly occurred in Stage N1 + N2 while NSMA occurred in Stage N1 + N2 (approximately 60 %) and in Stage R (up to 30 %). Up to 50 % of respiratory events were scored in Stage R. RMMA occurred more frequently in close association (e.g., within 10 s) with respiratory events in 6 subjects with OSA than those without. The percentage of RMMA occurring closely to respiratory events was positively correlated with apnea–hypopnea index (AHI) in Stage N1 + N2 only while that of NSMA was positively correlated with AHI in Stage N1 + N2 and Stage R. A sub-analysis in 6 subjects with OSA, RMMA after respiratory events was followed to arousals while those before respiratory events were mostly associated with central apnea.

Conclusions: A subpopulation of young SB subjects can show concomitant respiratory events. Further large sample studies are needed to demonstrate that the occurrence of subclinical respiratory events represents a clinical subtype of SB.

Purpose: This study evaluated the influence of illuminance and color temperature of ambient light on the trueness, precision, and scanning time of a digital impression.

Methods: Master data were acquired with a high-accuracy coordinate-measuring machine. The illuminance of ambient light was set at 0 lux, 500 lux, and 2500 lux with a light-emitting diode (LED). Using a conversion filter, the color temperature was set at 3900 Kelvin (K) (yellow), 4100 K (orange), 7500 K (white), and 19,000 K (blue). There were thus a total of 12 possible lighting conditions. The reference model was scanned five times under each condition by an intraoral scanner. Trueness was calculated as the mean difference between the master data and experimental data. Precision was calculated as the mean difference between the repeated scans in each test group. Statistical analysis was performed with two-way analysis of variance (ANOVA) and post hoc Tukey's multiple comparison test. The significance level was 0.05.

Results: For trueness, the mean deviation was significantly lower at 500 lux than at 0 lux and 2500 lux. At 500 lux, the mean deviation was significantly lower at 3900 K than at other temperatures. Regardless of the color temperature, the scanning time was significantly longer at 2500 lux than at other illuminance levels.

Conclusions: The 3900 K and 500 lux condition is the most appropriate lighting condition for taking a digital impression. This condition is typical of clinical settings. High illuminance ambient light increased the scanning time.

Purpose: The use of warm air-blowing to evaporate solvents of one-step self-etch adhesive systems (1-SEAs) has been reported to be a useful method. The purpose of this study was to evaluate the effect of warm air-blowing on root canal dentin.

Methods: Four 1-SEAs (Clearfil Bond SE ONE, Unifil Core EM self-etch bond, Estelink, BeautiDualbond EX) were used. Each 1-SEA was applied to root canal dentin according to the manufacturers' instructions. After the adhesives were applied, solvent was evaporated using either normal air (23±1 °C) or warm air (80±1 °C) for 20 s, and resin composite was placed in the post spaces. The air from the dryer, which could be used in normal- or hot-air-mode, was applied at a distance of 5 cm above the root canal cavity in the direction of tooth axis. The temperature of the stream of air from the dryer in the hot-air-mode was 80±1 °C, and in the normal mode, 23±1 °C. After water storage of the specimens for 24 h, the μTBS were evaluated at the coronal and apical regions. The μTBSs were statistically analyzed using three-way ANOVA and Student's t-test with Bonferroni correction (α = 0.05).

Results: The warm air-blowing significantly increased the μTBS of all 1-SEAs at the apical regions, and also significantly increased the μTBS of two adhesives (Estelink and BeautiDualBond EX) at coronal regions.

Purpose: One of the most prominent issues in a super-aging society is the rapid increase in dementia patients. Cross-sectional studies in dentistry have indicated that patients with dementia have worse oral health compared to healthy people. The purpose of this study was to clarify the influence of tooth loss on brain structure by comparing the volumes of gray matter (GM) and white matter (WM) between edentulous and dentulous subjects.

Methods: Subjects were recruited from the Denture Clinic at Iwate Medical University Hospital Dental Center. Experiments were performed on edentulous (5 males, 8 females, 81.8±1.24 years) and dentulous subjects (4 males, 7 females, 77.1±4.25 years). Patients with dementia were excluded from this study. Brain volumes of GM and WM in edentulous and dentulous subjects were compared using intracranial volume, age, gender and history of hypertension as covariates. Analyzed brain areas were identified by transforming the Montreal Neurological Institute coordinate into the anatomical coordinate in edentulous subjects.

Results: The analysis of WM structural images found no morphological differences between dentulous and edentulous subjects. However, significant atrophy of GM was observed in the hippocampus, caudate nucleus and temporal pole of the right hemisphere in edentulous subjects.

Conclusions: The results of this study suggest that tooth loss was a causal factor for volume reduction in brain areas related to memory, learning and cognition.

Purpose: With computer-aided design and computer-aided manufacturing (CAD/CAM), the study was conducted to create a removable partial denture (RPD) framework using repeated laser sintering rather than milling and casting techniques. This study experimentally evaluated the CAM clasp and compared it to a conventional cast clasp.

Methods: After the tooth die was scanned, an Akers clasp was designed using CAD with and without 50 μm of digital relief on the occlusal surface of the tooth die. Cobalt-chromium (Co-Cr) alloy clasps were fabricated using repeated laser sintering (RLS) and milling as one process simultaneously (hybrid manufacturing; HM). The surface roughness of the rest region, gap distances between clasp and tooth die, initial retentive forces, and changes of retentive forces up to 10,000 insertion/removal cycles were measured before and after heat treatment. The HM clasp was compared to the cast clasp and the clasp made by repeated laser sintering only without a milling process.

Results: The HM clasp surface was smoother than those of cast and RLS clasps. With the digital relief, the fitness accuracy of the HM clasp improved. The retentive forces of the HM clasps with relief and after heat treatment were significantly greater than for the cast clasp. HM clasps demonstrated a constant or slight decrease of retention up to 10,000 cycles.

Conclusions: HM clasp exhibited better fitness accuracy and retentive forces. The possibility of clinically using HM clasps as well as conventional cast clasps can be suggested

Purpose: It remains unclear whether digital impressions obtained using an intraoral scanner are sufficiently accurate for use in fabrication of removable partial dentures. We therefore compared the trueness and precision between conventional and digital impressions in the partially edentulous mandible.

Methods: Mandibular Kennedy Class I and III models with soft silicone simulated-mucosa placed on the residual edentulous ridge were used. The reference models were converted to standard triangulated language (STL) file format using an extraoral scanner. Digital impressions were obtained using an intraoral scanner with a large or small scanning head, and converted to STL files. For conventional impressions, pressure impressions of the reference models were made and working casts fabricated using modified dental stone; these were converted to STL file format using an extraoral scanner. Conversion to STL file format was performed 5 times for each method. Trueness and precision were evaluated by deviation analysis using three-dimensional image processing software.

Results: Digital impressions had superior trueness (54–108 μm), but inferior precision (100–121 μm) compared to conventional impressions (trueness 122–157 μm, precision 52–119 μm). The larger intraoral scanning head showed better trueness and precision than the smaller head, and on average required fewer scanned images of digital impressions than the smaller head (p < 0.05). On the color map, the deviation distribution tended to differ between the conventional and digital impressions.

Conclusions: Digital impressions are partially comparable to conventional impressions in terms of accuracy; the use of a larger scanning head may improve the accuracy for removable partial denture fabrication.

Purpose: Effective denture plaque control is necessary in elderly individuals to prevent oral and systemic diseases. However, comparative studies of denture cleaning methods are limited, especially those investigating patient satisfaction. The present study aimed to evaluate effectiveness of a mechanical denture cleaning method versus a combination of mechanical and chemical methods in terms of denture cleanliness, patient satisfaction, and oral health-related quality of life (OHRQoL).

Methods: Thirty edentulous participants were allocated to one of two groups: mechanical or combination method. The mechanical method group was instructed to brush dentures after each meal for 2 min using tap water and a denture brush, and to soak them in saline solution while sleeping. The combination method group was instructed to brush dentures the same way, but to soak them in denture cleansers while sleeping. Both groups cleaned their dentures according to the respective method for 3 weeks. Denture cleanliness, patient satisfaction, and OHRQoL were examined.

Results: There were significant differences in adenosine triphosphate bioluminescence (p = 0.00003), staining (p = 0.003), and Candida albicans (C. albicans) abundance in upper complete dentures (p = 0.002) between methods. There were no significant differences in oral mucosa C. albicans abundance, participant satisfaction, ease of cleaning, comfort, esthetics, or Oral Health Impact Profile for edentulous patients (Japanese version) scores between methods.

Conclusions: A combination of mechanical and chemical denture cleaning methods was more effective at cleaning dentures than the mechanical method alone. Even if denture cleaning improves denture hygiene, it may not increase patient satisfaction or OHRQoL.

Purpose: The purpose of this study was to investigate the combined effects of fiber loading and pigmentation on the color differences and flexural properties of glass fiber-reinforced thermoplastics (GFRTPs), for use in non-metal clasp dentures (NMCDs).

Methods: The GFRTPs consisted mainly of E-glass fibers, a polypropylene matrix, and a coloring pigment: the GFRTPs with various fiber loadings (0,10, and 20 mass%) and pigmentations (0,1, 2, and 4 mass%) were fabricated by using an injection molding. The color differences of GFRTPs were measured based on the Commission Internationale de l'Eclairage (CIE) Lab color system, by comparing with a commercially available NMCD. The flexural properties of GFRTPs were evaluated by using a three-point bending test, according to International Standards Organization (ISO) specification number 20795-1.

Results: The visible colors of GFRTPs with pigment contents of 2 mass% were acceptable for gingival color, and the glass fibers harmonized well with the resins. The ΔE^* values of the GFRTPs with pigment contents of 2 mass% obtained by using the CIE Lab system were lowest at all fiber loadings. For GFRTPs with fiber contents of 10 and 20 mass% at 2 mass% pigment content, these GFRTPs surpassed the ISO 20795-1 specification regarding flexural strength (> 60 MPa) and modulus (> 1.5 GPa).

Conclusions: A combination of the results of color difference evaluation and mechanical examination indicates that the GFRTPs with fiber contents of 10 or 20 mass%, and with pigment contents of 2 mass% have acceptable esthetic appearance and sufficient rigidity for NMCDs.

Purpose: This study analyzed risk factors for post-loading implant loss in cases of implant-supported prostheses applied to edentulous jaws of Japanese patients.

Methods: In total, 245 dental implant fixtures placed in 54 edentulous jaws of 46 patients performed at Niigata University Hospital were retrospectively analyzed. Kaplan–Meier curves were used to estimate the cumulative survival rate (SR) of implants, and multiple Cox regression analysis was used to identify predictive factors of implant loss. The following risk factors for implant failure were examined: age, sex, survival time, implant length, implant location, smoking habit, bone density, bone augmentation, opposing dentition, loading period, and type of final restoration. The Cochran–Mantel–Haenszel test was used to examine difference in survival curves of the extracted predictors.

Results: Sixteen implants failed during the observation period (SR = 92.8 %). Multiple Cox regression analysis revealed that male sex [hazard ratio (HR) = 16.1; p = 0.007] and use of maxillary removable restorations (HR = 12.7; p < 0.000) were risk factors for implant failure. Other factors had no significant effect on implant failure. The SR of implants for males (SR = 86.9 %) was significantly lower than that for females (SR = 99.1 %). The SR of implants for maxillary removable restorations (SR = 76.4 %) was significantly lower than for maxillary fixed restorations (SR = 99.1 %) and mandibular fixed restorations (SR = 97.8 %).

Conclusions: Maxillary implants with removable restorations and male sex were risk factors for implant failure among Japanese edentulous patients.

Purpose: To clarify the relationship between masticatory performance and oral health-related quality of life (OHRQoL) before and after complete denture treatment.

Methods: Thirty patients wearing complete dentures were asked to chew a gummy jelly on their habitual chewing side, and the amount of glucose extraction during chewing was measured as the parameter of masticatory performance. Subjects were asked to answer the Oral Health Impact Profile (OHIP-J49) questionnaire, which consists of 49 questions related to oral problems. The total score of 49 question items along with individual domain scores within the seven domains (functional limitation, pain, psychological discomfort, physical disability, psychological disability, social disability and handicap) were calculated and used as the parameters of OHRQoL. These records were obtained before treatment and 3 months after treatment. Each parameter of masticatory performance and OHRQoL was compared before treatment and after treatment. The relationship between masticatory performance and OHRQoL was investigated, and a stepwise multiple linear regression analysis was performed.

Results: Both masticatory performance and OHRQoL were significantly improved after treatment. Furthermore, masticatory performance was significantly correlated with some parameters of OHRQoL. The stepwise multiple linear regression analysis showed functional limitation and pain as important factors affecting masticatory performance before treatment and functional limitation as important factors affecting masticatory performance after treatment.

Conclusions: These results suggested that masticatory performance and OHRQoL are significantly improved after treatment and that there is a close relationship between the two. Moreover, functional limitation was found to be the most important factor affecting masticatory performance.

Purpose: To clarify whether the occlusal state affects the masticatory performance of elderly adults.

Methods: Elderly women were asked to chew a gummy jelly, and the amount of glucose extraction was measured as the parameter for masticatory performance. Subjects were divided into five groups depending on occlusal support on the habitual chewing side (G1: no occlusal support of posterior teeth, G2: occlusal support of first premolar, G3: occlusal support of premolars, G4: occlusal support from first premolar to first molar, and G5: occlusal support from first premolar to second molar). It was also investigated whether or not the subjects were wearing dentures. The amount of glucose extraction was compared among the five groups and then between subjects with removable denture and subjects without removable denture. The relationship between age and glucose extraction were also investigated.

Results: The amount of glucose extraction progressively increased with increase in number of occlusal support. There were no fixed tendencies between age and glucose extraction, when occlusal state was taken into account. The amount of glucose extraction of subjects without removable denture was significantly larger than that of subjects with removable denture. It was also found that 67 % of subjects with removable denture were within the normal range when it was set based on G5 data.

Conclusions: It was suggested that the occlusal state affected the masticatory performance of elderly adults.

Purpose: Patients treated with maxillofacial prosthetics often experience emotional problems because of the remaining facial skin concavity such as a surgical scar. In such cases, cosmetic treatment can potentially correct their skin tone imperfections and deformities. This study aimed to evaluate the clinical availability of novel cosmetics-based material for craniofacial small concavity by initiating a cosmetic treatment in a preliminary case.

Methods: Eighteen patients with aesthetic problems such as craniofacial deformities, small defects, and concavities on their faces underwent cosmetic treatment that was performed by makeup practitioners. Data were collected from the patient's charts and a survey questionnaire. A visual analog scale was used to conduct a survey regarding the satisfaction levels of the patients following cosmetic treatment with a novel cosmetics-based material. The cosmetic treatment was performed for a concavity on the left midface of a 67-year-old woman with partial maxillectomy. The novel cosmetics-based material was manufactured from a semi-translucent oil base.

Results: The satisfaction level of the patient increased after undergoing the cosmetic treatment. Regarding clinical applications, the novel cosmetics-based material can help reduce their cosmetic disturbance and restore the small deformity.

Conclusions: These results suggest that the cosmetic treatment with the novel cosmetics-based material can be used as a subsidiary method for facial prostheses or an independent new method for correcting patients' small craniofacial concavity and for reducing visible deformity

Purpose: The aim of this technical procedure was to use a fully digital technique (FDT) for full-arch implant support rehabilitation. The FDT was used to transfer the provisional restoration parameters to definitive restorations using intraoral scanners.

Methods: Three sets of digital impressions were obtained. Through the first set, standard tessellation language 1 (STL1), provisional restorations screwed to implants and the surrounding gingival tissue was captured. STL2 consisted of intraoral scans of standardized scanbodies screwed to implants to collect 3D positioning data of implants. STL3 included the digital impression of provisional restoration out of the mouth in order to capture the gingival architecture and the peri-implant soft tissue that was not possible to transfer with the previous impressions. STL1, STL2, and STL3 were combined using computer-aided design (CAD) functions into a single file, STL4. Thus, STL4 contained information on the 3D implant positions, soft tissue architectures, occlusal relationships, correct occlusal vertical dimension and aesthetic features. Using STL4, the master models with implant analogues were 3D printed. Computer-aided design and computer-aided manufacturing milled (CAD/CAM-milled) aluminium bars and a resin prototype were produced to test the accuracy and the functional and aesthetic parameters. Titanium frameworks were digitally designed using STL4, milled using CAD/CAM, and finalized with pink resin and resin teeth.

Conclusion: The FDT provided an effective fully digital protocol to capture all information for provisional full-arch implant restorations using an intraoral scanner and transfer that information to definitive restorations.

Patient: A 65-year-old non-smoker man with stabilized chronic periodontitis and in good general health conditions presented to our observation. The patient reported crown mobility, gingival inflammation and localized pain, corresponding to the mandibular right first molar rehabilitated with a cement-retained implant crown. This clinical situation suspected a fracture of an implant-prosthetic component. Through the described diagnostic algorithm, an abutment hexagon fracture was revealed. Thus, a minimally invasive treatment was carried out in order to use the residual implant-prosthetic components for a new implant-prosthetic rehabilitation.

Discussion: Fractures of implant-prosthetic components are clinical occurrences that may result in irreversible failures. The main causes of a possible fracture are dependent on biomechanical considerations and production processes of implant-prosthetic components. The respect of the rigorous planning and the employment of the implant-prosthetic devices of the same manufacturer are recommended.

Conclusions: Specific employments and protocols have to be offered in order to manage the fractures of implant-prosthetic components. This work showed that through the described diagnostic and therapeutic algorithm, the clinician can be guided towards a proper diagnosis and a correct management of the cases where a fracture of implant-prosthetic components may occur.