Newsletter #3

ITI Consensus on Full Arch - The Latest Advice

Hey there—

This issue will review the ITI consensus on full arch recommendations. I realize that many of you may not know what the ITI is. The acronym stands for the International Team for Implantology and it's the oldest and largest academically focused implant group in the world. It was founded in conjunction with Straumann with the goal of providing research based implant knowledge. I would highly recommend joining even just for access to the webinar content and attending the US ITI Congress. The last consensus, the 7th one so far, occurred in Lisbon in 2023 and involved 90 of the top clinicians in the world reviewing the literature and providing guidance on implant related protocols. Details below!

Gratitude Quote of the Day:

“Enjoy the little things, for one day you may look back and realize they were the big things.” — Robert Brault

7th ITI Consensus Summary

Below is a breakdown of the full arch recommendations from a high level perspective (only two of interest from this consensus). The nerds that want to take a full deep dive can find the entire consensus pdf by clicking here: Proceedings of the Seventh ITI Consensus Conference_2023.pdf​

1.Additively and subtractively manufactured implant-supported fixed dental prostheses: A systematic review

Summary: comparing printed provisionals for single and full arch (additive manufacturing) vs. milled structures in PMMA or zirconia. Not enough literature to make clear conclusions and fracture rates vary widely. Anecdotally, I still find milled PMMA to last longer with printed provisionals fracturing in abnormal way (potentially due to water absorption in the oral environment?). This is probably not a popular opinion. Of course I still print them due to time constraints, but if I have the time I'm milling. I use double milling on my Zirkonzahn which cuts down the 2nd mill to 45-60 minutes. If I print, I'm printing two or three and sending all of them (they're going to break). An aside, I put together a bike rack in my garage over the weekend which needed four specific screws. My boys "lost one" and now I'm having to specially order an extra one. The screw was massive. Makes sense that it's very possible to lose a tiny MUA screw. Thus, we're sending an extra screw for every temp and final full arch we send out! Value > Price = Win

2.Treatment effect of implant-supported fixed complete dentures and implant overdentures on patient-reported outcomes: A systematic review and meta-analysis

Summary: Patient recorded outcomes high across the board for full arch fixed or implant overdentures compared to complete dentures (duh!). Mandibular implant patients had the highest positive reported outcomes (also duh). However, patient satisfaction did not statistically increase from two implants to more than two! I've treatment planned a ton of cases with three implants in an attempt to "tripod" the prosthesis. Problem is that all three end up between #22 and #27 so the cumulative result is not necessarily better than just two.

That's your five minute boost! Next week's topic: the #1 urgent question I get regarding iCAM data processing and a photogrammetry checklist.

-Charles