Clinical Oral Implants Research最新文献

Objectives: To assess the reproduction accuracy of a surgical guide during both the manufacturing phase (from designed files to manufactured surgical guides) and the application phase (from manufactured surgical guides to post-plasma sterilization) across four three-dimensional (3D) printing technologies.

Materials and methods: Twenty-four surgical guides were designed and categorized into four groups (six surgical guides per group) based on the printing technology used: stereolithography apparatus (SLA), digital light processing (DLP), laser cladding deposition (LCD), and selective laser melting (SLM). The surgical guide files were collected in three conditions: design, post-printing, and post-plasma sterilization. The integrated precision, regional precision, and implant precision of the surgical guides were evaluated by measuring (1) T-vertex marker distance and angle, (2) surgical guide deformation after superimposition, and (3) implant 3D displacement.

Results: SLA printers exhibited the lowest reproduction accuracy and implant precision during the manufacturing phase (p < 0.001) and demonstrated the lowest implant precision during the application phase. In contrast, SLM printers displayed the highest reproduction accuracy and implant precision across both phases (p < 0.001). LCD printers showed slightly lower reproduction accuracy and implant precision than SLM during both the manufacturing and application phases.

Conclusion: SLM printers provide superior precision for implant surgery. Their use is recommended for printing surgical guides due to their high reproduction accuracy and implant precision during the manufacturing and application phases. In cases where SLM technology is unavailable, LCD printers offer a reliable alternative.

Objectives: This study evaluated the effectiveness of force-feedback-based autonomous dental implant robotic systems combined with osseodensification (OD) for transcrestal sinus floor elevation (TSFE), to understand patterns of force-feedback curves, visualize the TSFE process through mechanical vision, and offer new perspectives on surgical strategies.

Materials and methods: The included patients required simultaneous implant placement and TSFE. Preoperative planning was performed, and during surgery, using an OD drill, the robotic arm was guided to create a microfracture on the sinus floor, elevate the sinus membrane, and place the implant, all under the surgeon's supervision. Postoperative cone-beam computed tomography evaluated sinus lift and implant accuracy. The visual analog scale was used to measure patient-reported outcomes. Mechanical curves were plotted using extracted force-feedback values. Data are reported as mean ± standard deviation and Pearson's correlation for linear relationships (p < 0.05 was statistically significant).

Results: Overall, 17 patients (18 implants) were included, with a 94.4% implant retention rate at 6 months postoperatively. The Fz force-feedback curve showed a critical peak followed by a sharp drop at the sinus-floor breakthrough point and a gradual rise followed by a steep decrease as the bone graft entered the sinus cavity. Cortical bone density at the sinus floor positively correlated with force feedback (p < 0.05).

Conclusions: Force-feedback-based implant robotics combined with OD is an innovative and reliable approach for TSFE. Integrating mechanical vision with force-feedback curves allows for precise identification of microfracture points and safe sinus membrane elevation, overcoming the limitations of traditional blind techniques and enhancing procedural safety and predictability.

Trial registration: Chinese Clinical Trial Registry: ChiCTR2300072248.

Objective: This randomised clinical trial aimed to compare the effects of multimedia information and verbal explanations on patients' knowledge and anxiety as primary outcomes and decision-making as a secondary outcome.

Materials and methods: One hundred patients needing dental replacement were randomly assigned (1:1) to either a multimedia group (n = 50) or a verbal group (n = 50). They completed self-administered questionnaires covering demographics, confidence with their awareness level, knowledge (score 0-5), anxiety (score 5-25) and decision-making before and after receiving either a multimedia or verbal explanation of implant surgery.

Results: Knowledge scores increased significantly in both groups (p < 0.001), rising from 1.96 to 3.90 in the multimedia group and from 2.00 to 3.98 in the verbal group. Anxiety levels also declined markedly over time (p < 0.001), dropping from 12.76 to 11.48 (multimedia) and from 13.92 to 12.16 (verbal). Neither the group effect nor the interaction effect was significant. No significant difference in decision change was observed in either the multimedia (p = 0.289) or verbal (p = 0.146) groups. Most patients in both groups relied on their dentist's recommendation regarding whether to proceed with freehand or CAIS, even after receiving the interventions. Meanwhile, cost remained a significant barrier to proceeding with implant therapy in both groups.

Conclusions: Both multimedia and verbal interventions significantly improved patient knowledge and reduced anxiety, although the magnitude of anxiety reduction was modest. Changes in decision-making were limited and largely influenced by cost and the dentist's recommendation. Given this single-centre design and modest sample size, caution is advised when generalising these findings.

Aim: To compare the dimensional outcomes of horizontal augmentation with the retentive-flap technique using particulate and cross-linked collagenated bone substitutes.

Materials and methods: This two-centre, two-arm randomized clinical trial investigated 69 subjects: 34 in the particulate group and 35 in the collagenated group. Patients were randomly assigned to receive single implant placement with simultaneous guided bone regeneration (GBR) using either particulate deproteinized porcine bone material (DPBM) or cross-linked collagenated DPBM. Quantitative evaluations were conducted for horizontal width, augmented area, and augmented volume in both hard and soft tissue dimensions.

Results: Immediately after surgery, the collagenated group exhibited higher hard tissue dimensions in terms of horizontal width and augmented area. After 4 months, the difference between the two groups decreased to a non-significant level, mainly attributable to the high shrinkage rate of the collagenated group (32.32 [20.79] %) compared to the particulate group (19.90 [14.33] %). No significant difference was observed regarding the soft tissue contour analyses between the two groups after 4 months.

Conclusions: There were no significant differences between cross-linked collagenated and particulated DPBMs regarding the dimensional outcomes of horizontal augmentation with the retentive-flap technique. The high resorption rate of the collagenated bone substitute negates its initial superiority in both radiographic and soft tissue dimensions (no. KCT0005348).

Objectives: To systematically appraise the evidence on premature ridge resorption following various vertical ridge augmentation (VRA) techniques in healthy adult patients undergoing staged VRA procedures. The study aimed to identify VRA techniques resulting in the least premature bone resorption and to rank them using Bayesian Network Meta-Analysis (NMA).

Material and methods: Searches were conducted in six databases to identify randomised clinical trials (RCT) comparing staged VRA techniques with a minimum of 3 months follow-up. Relative premature bone resorption (PBR%) overall (primary) and in sites with uneventful versus complicated healing and need for additional bone grafting (NAG) (secondary) were chosen as outcomes. The risk of bias and certainty in evidence were assessed using Cochrane RoB 2.0 and GRADE tools. Bayesian models estimated treatment effects and rankings.

Results: Ten RCTs, involving 220 participants and 236 defects, were included. Nine RCTs reported mean PBR%, with a range from 6% to 44%, averaging 26%. Seven treatment groups were evaluated: onlay, onlay + barrier, inlay, guided bone regeneration, distraction osteogenesis (DO), tissue expansion + tunnelling (TET), and cortical tenting. Eight RCTs, involving 160 participants and 176 defects, contributed to the NMA. Compared to onlay, all groups had lower mean PBR%. Inlay had the highest probability of being ranked first (Pr = 0.55), followed by DO (Pr = 0.27) and TET (Pr = 0.15). Healing complications significantly increased PBR% (MD 10%, 95% CrI 4.4-15.7).

Conclusion: VRA techniques preserving the periosteum (inlay, DO, and TET) exhibit less PBR compared with other techniques. When techniques involve full flap elevation, clinicians should anticipate volume loss at re-entry and consider greater grafting volumes to offset PBR. PROTOCOL REGISTRATION: PROSPERO ID: CRD42023394396; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394396.

Objectives: This randomized clinical study compared the profilometric measurements of the buccal tissue volume at sites augmented using a volume-stable collagen matrix (VCMX) or connective tissue graft (CTG) simultaneously to implant placement in the presence of small buccal bone dehiscence (SBBD ≤ 3 mm).

Methods: Forty-four patients with SBBD were treated with soft tissue augmentation (STA) simultaneous to implant placement using VCMX or SCTG. Clinical measurements and 3D intraoral scans were collected prior to STA (BL), at 1, 3 months, and 1 year after prosthetic loading. Digital files were superimposed to compare profilometric volume on the buccal profile (primary outcome); peri-implant health, radiographic bone levels, and patient-reported outcome measures (PROMs) were also assessed.

Results: Both treatments achieved a significant STA at 3 months, with a slight decrease observed from 1 month. At 3 months, the mean increase was 1.07 mm (SD 0.22) for VCMX and 1.22 mm (SD 0.44) for the CTG group (p = 0.156). PROMs revealed a difference in the perception of the bleeding at day 1, pain at 2 and 3 days, and swelling at 3 days favoring VCMX (p < 0.05). At 1 year, no intergroup difference in probing pocket depth, bleeding, and recession was detected, but CTG provided higher stability than VCMX in terms of profilometric measurements (0.21 mm [SD 0.32] vs. -0.05 mm [SD 0.36], respectively; p = 0.014) and radiographic bone levels (0.09 mm [SD 0.65] vs. -0.34 mm [SD 0.70]; p = 0.038).

Conclusion: For implant placement at posterior sites with small buccal bone dehiscences, CTG and VCMX resulted in an initially comparable volume augmentation and clinical parameters, with VCMX leading to better PROMs. At 1 year, CTG maintained slightly higher profilometric stability and bone levels.

Trial registration: ClinicalTrials.gov identifier: NCT05466006 (https://classic.

Clinicaltrials: gov/ct2/show/NCT05466006).

Objective: To assess if immediate-loaded zygomatic implant-supported fixed rehabilitation meets the expectations of and satisfies patients with atrophic edentulous maxilla.

Methods: This study included an analysis of data obtained from the dental records of 22 consecutive patients with atrophic edentulous maxillae who received immediate-loaded zygomatic implant-supported fixed rehabilitation between 2017 and 2020. Patients' expectations and satisfaction scores were recorded on a validated 100-mm visual analog scale (VAS). Data was analysed using descriptive statistics and generalized estimating equations.

Results: The results showed a majority of patients had high expectations (VAS > 90) of the rehabilitation with regard to their general satisfaction (71%), aesthetics (71%), chewing (66%), speech (66%), and influence on social life (81%). At 6 months, a majority of the patients showed high general satisfaction (72%), and high satisfaction with aesthetics (77%), chewing (72%), speech (66%), and social life (72%) (VAS > 90). There was a statistically significant increase in the level of satisfaction with chewing from 2 weeks to 6 months after immediate loading (B = 0.309, SE = 0.138, 95% CI: 0.038, 0.580, p = 0.025). A statistically significant association was found between pre-treatment expectations and satisfaction with the rehabilitation's impact on speech, aesthetics, and social life. The satisfaction levels were not influenced by age and sex. All participants agreed that they would recommend this procedure to their peers.

Conclusions: The results of this study suggest that immediate-loaded zygomatic implant-supported fixed rehabilitation could meet the expectations and satisfy edentulous patients with atrophic maxilla.