Hey there, friends.
Recently got notice that some of you haven't been receiving the recent newsletters (thanks, Debra!). We migrated to a new service and looks like some of the emails didn't get moved over. What I'll do is re-publish the last few months as new entries over the next few weeks. Good news is that you'll have extra fun reading for awhile!
This entry covers some fun gems I gleaned from the Napa ITI meeting. I gotta say, of all the US meetings, this one is by far my favorite. For one, most of the main podium speakers are the ones writing the full arch papers and doing research that we are all following (Panos, Kostas, Bedrossian, etc). Second, they are always trying to find fun new formats to keep things interesting vs. the standard one hour blah. Enjoy!
Dose of gratitude: "Silent gratitude isn't much use to anyone." - Gertrude Stein
Full Arch Updates from ITI USA Congress
1.Contemporary updates to full arch hygiene recommendations
The most cited statement regarding hygiene for fixed edentulous restorations was from the American College of Prosthodontics in 2016. The summary of this was that the prosthesis needed to be removed only if hygiene was not possible with it in place (improper intaglio design), there were signs of peri implant disease, or if there were other mechanical complications.
The new recommendations come from a new paper by Marta Revilla-Leon. Here's the citation: Revilla-León M, Yilmaz B, Kois JC, Att W. Prevention of peri-implant disease in edentulous patients with fixed implant rehabilitations. Clin Implant Dent Relat Res. 2023 Aug;25(4):743-751. doi: 10.1111/cid.13182. Epub 2023 Jan 27. PMID: 36707075.The paper recommends a 4-3-2 titration of hygiene appointments. This translates into the first year seeing the patient four times for hygiene. Assuming no issues, the second year they come in three times and then finally two times a year.
Often I'm having warranty conversations with other lab owners and they are fielding questions from their clinicians about proper cleaning protocol. I think this is a great one to forward over and makes a lot sense.
2.Zirconia is a predictable material with high survival rates with proper restorative space
Dr. Chochlidakis showed some current clinical studies in progress showing the survival of zirconia full arch fixed prosthetics (shout out to Marisa Notturno listed on this one, yay dental technicians!). Most of you reading this are like "DUH!". This study to be released shows that fixed zirconia restorations have a 95.9% survival rate up to 8-year follow up (that's great info to convince those that are still doing acrylic hybrids which have a complication rate of at least 73%!).
Most importantly, the study suggests 80 mm square connector surface area and 11 mm linear length to prevent fracture. As far as I know, this is the first suggestion of connector surface area specifically for full arch zirconia (we have other recommendations for implant supported smaller bridge segments or bridges on preps). Super useful especially for lower anterior teeth on a full arch.
That's your five minute boost! As always, written by my little fingers and not AI (hence, the typos to keep it geniune). Will repost another entry from the last six months later this week as part of our catch up!
-Charles
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