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    Influence of age, training, intraoral scanner, and software version on the scan accuracy of inexperienced operators
    (Wiley, 2023) Zarauz, Cristina; Pradies, Guillermo Jesus; Chebib, Najla; Donmez, Mustafa Borga; Karasan, Duygu; Sailer, Irena
    Purpose: To evaluate the effect of operator age on the scan accuracy (trueness and precision) of inexperienced operators when compared with experienced operators, and how training, intraoral scanner (IOS), and software version affect scan accuracy.Material and Methods: Thirty-four operators were sorted into groups: G1 (operators <25 years old, no experience), G2 (operators >40 years old, no experience), and G3 (experienced IOS operators). They conducted partial-arch scans before and after a 4-session training with two IOSs (Trios 3 and True Definition) and two software versions. These scans were compared with the reference scans obtained from conventional impressions and a laboratory scanner (IScan D103i) to evaluate trueness (mean root mean square values) and precision (standard deviation of root mean square values) with a software program (Geomagic Control X). Kruskal-Wallis and post-hoc Dunn's tests were used to evaluate the effect of age on the scan accuracy of inexperienced groups when compared with experienced operators, while the effect of training, IOS, and software version on scan accuracy was evaluated with Wilcoxon or Mann-Whitney U tests (alpha = 0.05).Results: Before training, G1 and G2 scans had similar accuracy (p >= 0.065). After training, G1 scans had higher accuracy when IOS data was pooled and had higher precision with TD (p <= 0.004). Training increased the scan accuracy (p < 0.001), while newer software increased the trueness of inexperienced operator scans (p = 0.015).Conclusions: Age affected the scan accuracy of inexperienced operators after training, indicating that extended training may be required for older operators. Training increased the scan accuracy, and newer software increased the trueness of inexperienced operator scans.
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    Prosthetic complications with monolithic or micro-veneered implant-supported zirconia single-unit, multiple-unit, and complete-arch prostheses on titanium base abutments: a single center retrospective study with mean follow-up period of 72.35 months
    (WILEY, 2022) Saponaro, Paola C.; Karasan, Duygu; Dönmez, Mustafa Borga; Johnston, William Michael; Yılmaz, Burak
    Background The influence of prosthetic design on prosthetic complications when monolithic or micro-veneered zirconia prostheses are supported with titanium base (ti-base) abutments is not well-known. Purpose The purpose of this single center, retrospective study was to assess the prevalence of prosthetic complications with monolithic or micro-veneered single-unit, multi-unit, and complete-arch zirconia prostheses supported with ti-base abutments (implant level or multi-unit abutment level). Material and Methods This study retrospectively evaluated the electronic health record (EHR) of participants who received either monolithic or micro-veneered implant-supported single-unit, multi-unit, and/or complete-arch prostheses supported by ti-base or zirconia-ti-base hybrid abutments delivered between the years 2010 and 2021. Data were analyzed by using logistic regression and Exact Mantel-Haenszel chi-square test (alpha = 0.05) to assess the clinical performance of prostheses and complications including crown decementation, feldspathic porcelain chipping, prosthesis fracture, zirconia-ti-base hybrid abutment decementation, abutment screw loosening, screw fracture, abutment fracture, implant loss, and prosthesis remake. Results The study included 94 participants (50 female, 44 male) with a mean age of 59.5 years (range: 24-101 years of age). The retrospective EHR evaluation yielded 82 single-unit, 51 multi-unit, and 20 complete-arch prostheses on 325 implants. Among 153 prostheses delivered, 108 were micro-veneered (47 single-unit, 41 multi-unit, and 20 complete-arch prostheses) and 45 were monolithic. The average duration was 72.35 months (6.02 years) with a follow-up period of 5-132 months. From the time of insertion to the time of EHR review, of 153 prostheses, 78.43% did not exhibit any prosthetic complication. However, 33 prostheses (21.57%) from 29 participants (30.85%) had at least one prosthetic complication. Only four patients (4.25%) experienced two or more prosthetic complications. Prosthetic design affected the probability of having a complication (p = 0.005); complete-arch prostheses had higher probability (p <= 0.028). Single-unit prostheses had lower probability of complication than multi-unit prostheses (p = 0.005). The most commonly observed complication was fracture of veneering material (5.88%) followed by prosthetic screw loosening (4.57%) and decementation between the zirconia and the ti-base abutment (2.61%). Micro-veneered complete-arch prostheses had higher probability of having chipping than that of not having (p < 0.001), and other micro-veneered prosthetic designs had similar probability of chipping with that of complete-arch prostheses (p >= 0.082). Frequency of chipping was affected by veneering (p < 0.001). Monolithic prostheses had lower probability of chipping than micro-veneered prostheses, regardless of the prosthetic design (p < 0.001). Conclusions The frequency of prosthetic complications varied depending on prosthetic design. Complete-arch prostheses had the highest probability of complications while the single-unit prostheses had the lowest. Micro-veneered prostheses had higher probability for chipping than monolithic prostheses. Probability of chipping was similar for micro-veneered single-unit, multi-unit, and complete-arch zirconia prostheses.