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Item Clinical performance of immediately placed and immediately loaded single implants in the esthetic zone: A systematic review and meta-analysis(Wiley, 2023-09) Wittneben, Julia-Gabriela; Molinero-Mourelle, Pedro; Hamilton, Adam; Alnasser, Muhsen; Obermaier, Barbara; Morton, Dean; Galluci, German O.; Wismeijer, Daniel; Prosthodontics, School of DentistryObjectives The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone (15–25), what is the influence of an immediate implant placement and immediate loading protocol on the clinical performance (primary aim) and esthetic outcomes (secondary aim) focusing on investigations published after 2010. Material and Methods An electronic search in Medline (PubMed), the Cochrane Central Register of Controlled Trials, and EMBASE databases up to April 2022 was performed to identify clinical studies investigating the outcome of single implants subjected to immediate placement with immediate restoration/loading (Type 1A). Results Sixty-three studies (10 randomized controlled trials, 28 prospective and 25 retrospective cohort studies) were included with a follow-up ranging from 12 to 96 months. One thousand nine hundred sixty-one implants reported survival rates of 99.2 (98.6–99.5) % at 1 year, 97.5 (95.9–98.4) % after 3 years, and 95.8 (93.3–97.4) % after 5 years; 1064 immediately loaded restorations presented survival rates of 98.9 (97.8–99.5) % after 1 year, 96.8 (93.6–98.4) % after 2 years, and 94.8 (89.6–97.4) % after 5 years. Comparing baseline to 12-month data using the Hedges' g effect size (95% CI), papilla height presented an overall effect size of −0.71 (−1.25, −0.1) mm, midfacial recession change of −0.15 (−0.66, 0.36) mm, and a 0.82 (0.37, 1.28) gain in PES. Conclusions Immediate implant placement and immediate loading can be considered a predictable and safe treatment option for single maxillary anterior restorations with adequate survival rates and favorable esthetics outcomes for up to 5 years.Item Group 2 ITI Consensus Report: Prosthodontics and implant dentistry(Wiley, 2018-10) Morton, Dean; Gallucci, German; Lin, Wei-Shao; Pjetursson, Bjarni; Polido, Waldemar; Roehling, Stefan; Sailer, Irena; Aghaloo, Tara; Albera, Hugo; Bohner, Lauren; Braut, Vedrana; Buser, Daniel; Chen, Stephen; Dawson, Anthony; Eckert, Steven; Gahlert, Michael; Hamilton, Adam; Jaffin, Robert; Jarry, Christian; Karayazgan, Banu; Laine, Juhani; Martin, William; Rahman, Lira; Schlegel, Andreas; Shiota, Makato; Stilwell, Charlotte; Vorster, Christiaan; Zembic, Anja; Zhou, Wenjie; Prosthodontics, School of DentistryObjectives Working Group 2 was convened to address topics relevant to prosthodontics and dental implants. Systematic reviews were developed according to focused questions addressing (a) the number of implants required to support fixed full‐arch restorations, (b) the influence of intentionally tilted implants compared to axial positioned implants when supporting fixed dental prostheses (FDPs), (c) implant placement and loading protocols, (d) zirconia dental implants, (e) zirconia and metal ceramic implant supported single crowns and (f) zirconia and metal ceramic implant supported FDPs. Materials and methods Group 2 considered and discussed information gathered in six systematic reviews. Group participants discussed statements developed by the authors and developed consensus. The group developed and found consensus for clinical recommendations based on both the statements and the experience of the group. The consensus statements and clinical recommendations were presented to the plenary (gathering of all conference attendees) and discussed. Final versions were developed after consensus was reached. Results A total of 27 consensus statements were developed from the systematic reviews. Additionally, the group developed 24 clinical recommendations based on the combined expertise of the participants and the developed consensus statements. Conclusions The literature supports the use of various implant numbers to support full‐arch fixed prostheses. The use of intentionally tilted dental implants is indicated when appropriate conditions exist. Implant placement and loading protocols should be considered together when planning and treating patients. One‐piece zirconia dental implants can be recommended when appropriate clinical conditions exist although two‐piece zirconia implants should be used with caution as a result of insufficient data. Clinical performance of zirconia and metal ceramic single implant supported crowns is similar and each demonstrates significant, though different, complications. Zirconia ceramic FDPs are less reliable than metal ceramic. Implant supported monolithic zirconia prostheses may be a future option with more supporting evidence.Item Group 5 ITI Consensus Report: Implant placement and loading protocols(Wiley, 2023-09) Morton, Dean; Wismeijer, Daniel; Chen, Stephen; Hamilton, Adam; Wittneben, Julia; Casentini, Paolo; Gonzaga, Luiz; Lazarin, Rafael; Martin, William; Molinero-Mourelle, Pedro; Obermailer, Barbara; Polido, Waldemar D.; Tahmaseb, Ali; Thoma, Daniel; Zembic, Anja; Prosthodontics, School of DentistryObjectives Working Group 5 was convened to discuss and find consensus on the topics of implant placement and loading protocols associated with single missing teeth in the anterior maxilla (aesthetic zone). Consensus statements, clinical recommendations, patient perspectives and future research suggestions were developed and presented to the plenary for discussion and approval. Materials and Methods Two systematic reviews were developed and submitted prior to the conference. The group considered in detail the systematic reviews and developed statements, clinical recommendations, patient perspectives and future research suggestions based on the findings of the reviews and experience of group members. Definitive versions were developed after presentation to and discussion by the plenary. Results Five consensus statements were developed and approved from each systematic review. Twelve clinical recommendations were developed by the group based on both reviews and experience. Three patient perspectives were developed, and five suggestions made for future research. Conclusions Based on the findings of the systematic reviews and experience of group members, the Type 1A protocol (immediate placement and immediate loading), when utilized in the anterior maxilla under favorable conditions, is considered predictable and is associated with high survival rates. The procedure is considered clinically viable and is associated with aesthetic outcomes, although surgical, technical, and biological complications can occur.