What are the significant developments in Prosthodontics, including implantology and maxillofacial (maxilofacial) prosthetics, over the last 5 years?

From the Guidelines

Recent developments in prosthodontics, including implantology and maxillofacial prosthetics, have significantly enhanced treatment options and patient outcomes over the last 5 years, with a focus on personalized and minimally invasive approaches. The field of prosthodontics has witnessed significant advancements, particularly in implantology, where techniques such as maxillary sinus floor augmentation, either with delayed or simultaneous implant placement, have been recognized as viable options for the rehabilitation of posterior edentulous maxillary segments 1. Key developments include:

• Maxillary sinus floor augmentation with delayed or simultaneous implant placement, short dental implants, tilted implants, and distal cantilever extensions as therapeutic options for posterior edentulous maxillary segments 1
• Emphasis on meticulous assessment of patient-related factors, including subantral remaining bone height, and consideration of patient preferences, surgical, and prosthetic factors for long-term satisfactory outcomes 1
• Advances in digital dentistry, including CAD/CAM technology and intraoral scanners, for more precise and comfortable prosthesis fabrication
• Surface modifications in implants, such as hydrophilic surfaces and nanostructured coatings, to enhance osseointegration
• Immediate loading protocols and guided implant surgery using CBCT imaging and 3D-printed surgical guides to improve placement precision and reduce treatment time
• 3D printing in maxillofacial prosthetics for highly customized silicone prostheses and the use of high-performance polymers like PEEK for metal-free alternatives
• Digital smile design software for virtual treatment planning and patient preview of expected outcomes, contributing to more predictable, comfortable, and aesthetically pleasing prosthetic solutions.

From the Research

Important Developments in Prosthodontics

• Implantology has seen significant advancements in recent years, with a focus on osseointegration and implant surfaces 2, 3.
• The understanding of osseointegration mechanisms and the development of new implant surfaces have improved clinical results, with moderately rough implant surfaces showing promising outcomes 2.
• Maxillofacial prosthetics has also evolved, with the use of zygomatic implants as a primary option for maxillary implant reconstruction, and the development of bar-retained overdentures as a first line of treatment 4.

Implant-Supported Overdentures

• The ZAAG attachment system has been used to connect overdentures to implants, providing retention, stability, and resiliency to patients 5.
• Bar-retained zygomatic implant overdentures have been introduced as an alternative to traditional fixed-hybrid prostheses, offering a delayed loading approach 4.

Osseointegration and Implant Surfaces

• Osseointegration is critical for implant stability and long-term clinical success, and is influenced by factors such as implant surface roughness, chemical composition, and mechanical properties 2, 3.
• Research has shown that isotropic, moderately rough implant surfaces can improve clinical results, but more studies are needed to determine the ideal implant surface characteristics 2.

Future Directions

• Further research is needed to investigate the influence of prosthetic suprastructures on the long-term success of implant-supported constructions 6.
• The development of new technologies, such as digitized imaging and electronic devices, is expected to continue shaping the field of prosthodontics, including implantology and maxillofacial prosthetics 6.