Clinical experience, misunderstood concepts and frequently asked questions. Notes from many years of practice.
The ridge keeps shrinking under a denture: a systematic review of 20 human studies found horizontal bone loss of 29 to 63 percent within the first year after extraction. In a randomised trial of 60 edentulous patients, satisfaction with a two-implant overdenture ran about 36 percent higher than with a conventional denture.
Claims deserve a source: a prospective cohort placed 162 zirconia single crowns and evaluated 158 over a mean 5.8 years, reporting failure-free survival of 93.1% for monolithic and 96.2% for partially veneered designs, while monolithic designs chipped less across 6,370 restorations. Where zirconia genuinely leads.
Creams, powders and strips are not interchangeable, and the evidence has a ceiling: a systematic review of 13 randomised trials with 516 participants found adhesives significantly improve retention, stability and masticatory performance, but rated the certainty of that evidence only low to moderate.
A crown on a front tooth is a different decision from one at the back, and the data support anterior use: five-year survival was 96.8% for monolithic densely-sintered zirconia and 97.3% for veneered zirconia across a meta-analysis of 64 studies covering 8,051 all-ceramic crowns. Translucency, thickness and the trade-off.
Severe periodontitis is the sixth most prevalent condition worldwide at 11.2 percent age-standardised prevalence across 72 studies and 291,170 people, with incidence peaking around the age of 38.
A dental crown caps the whole tooth; five-year survival runs from 96.8% (monolithic zirconia) to 98.5% (lithium disilicate) in a 64-study meta-analysis.
A Hollywood smile is a result; veneers are one way to get there. The materials have numbers: ceramic veneers pooled at 96.13 percent survival for feldspathic, 93.70 percent for leucite-reinforced and 96.81 percent for lithium disilicate at 10.4 years, and bonding to enamel rather than dentin cuts failure roughly tenfold.
Implant brands differ in surface, alloy and connection, but bone, gum health and planning weigh more; pooled 10-year survival is 96.4% across 18 studies.
Across 13 studies and 227 additively manufactured subperiosteal implants, 97.8% were in function at a mean 21.4 months, with 25.6% partial exposure. These serve jaws too resorbed for standard implants.
