Alfonso Gil is receiving a 5-year post-graduate education in Fixed and Removable Prosthodontics and Dental Material Sciences from the University of Zurich. He obtained his DDS Degree from the University of the Basque Country (2013). His Master of Science and Advanced Periodontology Implantology Certificate from the University of Southern California (USC) (2013-2016) were followed by a Certificate in Advanced Surgical Implant Dentistry from the University of California Los Angeles (UCLA) (2016-2017). He is a Diplomate of the American Board of Periodontology. He obtained his PhD with highest honors from the University International of Catalunya in November 2019. His research focuses on the treatment of peri-implant disease, soft tissue augmentation of teeth and implants and fixed prosthodontics.
Purpose: To investigate the effect of aging on the morphology of the interface between monolithic implant crowns and standardized titanium base abutments.
Materials and Methods: Four groups of hybrid abutment crowns differing in restorative material (lithium disilicate [LD] or polymer-infiltrated ceramic network [PICN]) and in fabrication procedure of the interfacial zone for luting to a titanium abutment (milled during CAD/ CAM procedure [M] or prefabricated [P]) were formed: LDS-M, LDS-P, PICN-M, and PICN-P (n = 10 each). The morphology of the crown-abutment interface was examined before and after artificial aging using scanning electron microscopy. The total gap length per specimen was measured at both time points, and intergroup (Kruskal-Wallis [KW]) plus pairwise (Wilcoxon Mann-Whitney [WMW]) comparisons were performed (α = .05).
Results: Before aging, statistically significant differences in gap length were identified among groups (KW: P = .0369) for PICN-P > LDS-P (WMW: P = .0496) and LDS-M > LDS-P (WMW: P = .0060). The effect of aging among the groups, expressed as an increment of total gap length, was 50% in LDS-M, 30% in LDS-P, 20% in PICN-M, and 30% in PICN-P. After aging, the statistically significant differences in gap length identified among groups (KW: P = .0048) were for PICN-P > LDS-P (WMW: P = .0134); LDS-M > PICN-M (WMW: P = .0204); PICN-P > PICN-M (WMW: P = .0486); and LDS-M > LDS-P (P = .0022). However, comparison of the difference in gap length from before to after aging among the groups was not statistically significant (KW: P = .3549).
Conclusion: The cementation interfaces of CAD/CAM crowns on standardized titanium base abutments demonstrated a high percentage of gaps before and after thermomechanical loading. The composition of the restorative material and the nature of the interface influenced the interfacial gap dimension.
This study sought to evaluate gingival volume changes following root coverage with the vestibular incision subperiosteal tunnel access (VISTA) procedure. Pre- and postoperative surface scans of 21 patients (154 teeth) treated with VISTA using various graft materials were digitally superimposed to quantify volumetric changes. A linear gingival thickness gain of approximately 1 mm and volumetric gain of 5.47 mm3 were achieved. A negative correlation was found between linear thickness gain and root prominence. The thickness achieved was not different with various graft materials. Since gingival thickness has been identified as an important predictor of periodontal root coverage, the methodology described in the present study, along with the identification of predictors of outcome, has important therapeutic implications.