Urs Christoph Belser

Peri-implant soft tissue conditioning with provisional restorations in the esthetic zone: the dynamic compression technique.

An optimal esthetic implant restoration is a combination of a visually pleasing prosthesis and surrounding peri-implant soft tissue architecture. This article introduces a clinical method, the dynamic compression technique, of conditioning soft tissues around bone-level implants with provisional restorations in the esthetic zone. The technique has several goals: to establish an adequate emergence profile; to recreate a balanced mucosa course and level in harmony with the gingiva of the adjacent teeth, including papilla height/width, localization of the mucosal zenith and the tissue profiles triangular shape; as well as to establish an accurate proximal contact area with the adjacent tooth/implant crown.

Full-mouth Minimally Invasive Adhesive Rehabilitation to Treat Severe Dental Erosion: A Case Report

Dental erosion is increasing, and only recently are clinicians starting to acknowledge the problem. A prospective clinical trial investigating which therapeutic approach must be undertaken to treat erosion and when is under way at the University of Geneva (Geneva Erosion Study). All patients affected by dental erosion who present with signs of dentin exposure are immediately treated using only adhesive techniques. In this article, the full-mouth adhesive rehabilitation of one of these patients affected by severe dental erosion (ACE class IV) is illustrated. By the end of the therapy, a very pleasing esthetic outcome had been achieved (esthetic success), all of the patients teeth maintained their vitality, and the amount of tooth structure sacrificed to complete the adhesive full-mouth rehabilitation was negligible (biological success).

Fatigue resistance and failure mode of CAD/CAM composite resin implant abutments restored with type III composite resin and porcelain veneers

OBJECTIVES This study assessed the fatigue resistance and failure mode of type III porcelain and composite resin veneers bonded to custom composite resin implant abutments. MATERIAL AND METHODS Using the CEREC 3 machine, 28 composite resin implant abutments (Paradigm MZ100) were fabricated along with non-retentive type III veneers, milled either in ceramic Paradigm C (n=14) or in composite resin Paradigm MZ100 (n=14). The intaglio surfaces of the veneers were hydrofluoric acid etched and silanated (Paradigm C) or airborne-particle abraded and silanated (MZ100). The fitting surface of the abutments was airborne-particle abraded, cleaned, silanated and inserted into a bone level implant (10 mm, BLI RC). All veneers were luted with adhesive resin (Optibond FL) and a preheated light curing composite resin (Filtek Z100). Cyclic isometric chewing (5 Hz, 30° angle) was simulated, starting with a load of 40 N, followed by stages of 80, 120, 160, 200, 240 and 280 N (20,000 cycles each). Samples were loaded until fracture or to a maximum of 140,000 cycles. Groups were compared using the life table survival analysis (Log rank test at P=0.05). Previously published data using same-design zirconia abutments were included for comparison. RESULTS Paradigm C and MZ100 specimens fractured at an average load of 243 and 206 N (survival rate of 21% and 0%), respectively, with a significant difference in survival probability (P=0.02). Fractured specimens presented mixed failure modes and solely adhesive failures were not observed. The survival of composite resin abutments was similar to that of identical zirconia abutments from a previous study (P=0.76). CONCLUSIONS Non-retentive porcelain veneers bonded to custom composite resin implant abutments presented a higher survival rate when compared with composite resin veneers. Survival of composite resin abutment did not differ from zirconia ones.