Karl Paeßens, Leonard van Bebber, Holger Zipprich, Paul Weigl
Objectives
This study aimed to evaluate the impact of drill diameter, rotational speed, and irrigation on critical heat generation (≥ 47°C) at the dynamic bone-drill interface during dental implant osteotomy in pre-existing pilot bone cavities.
Material and Methods
Bone samples were cut such that immediate and direct thermographic measurements at the dynamic bone-drill interface were possible. Osteotomy cavities of 2.4 mm width were expanded to either 3.2 or 3.8 mm in cortical bovine bone with a thickness of 3.5 mm, using two-bladed twist drills at rotational speeds of 200, 600, or 1000 rpm, with or without saline irrigation. A logistic regression model was developed to predict the likelihood of reaching temperatures ≥ 47°C during osteotomy based on these parameters.
Results
The absence of irrigation, major osteotomy diameter expansion, and higher rotational speeds were identified as significant risk factors for increasing the bone-drill interface temperature by more than 10°C (OR: irrigation 177.53; expansion step 9.94; speed by 400 rpm 4.94). No osteotomy performed at a low rotational speed (200 rpm) resulted in a critical temperature rise in either drill diameter group when irrigation was provided. However, temperatures exceeded 47°C across all groups when irrigation was absent.
Conclusions
Dental implant osteotomy procedures without irrigation result in critical heat stress at the bone-drill interface, even at low drilling speeds. Shortened protocols with large drill diameter differences of up to 1.4 mm can be safely implemented when drilling at 200 rpm with irrigation. Osteotomy protocols can therefore be shortened while maintaining safety.
{"title":"Effect of Irrigation, Bur Size and Rotational Speed on Thermographic Heat at Implant Site Osteotomy Interface. An In Vitro Study","authors":"Karl Paeßens, Leonard van Bebber, Holger Zipprich, Paul Weigl","doi":"10.1111/clr.14462","DOIUrl":"10.1111/clr.14462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the impact of drill diameter, rotational speed, and irrigation on critical heat generation (≥ 47°C) at the dynamic bone-drill interface during dental implant osteotomy in pre-existing pilot bone cavities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Bone samples were cut such that immediate and direct thermographic measurements at the dynamic bone-drill interface were possible. Osteotomy cavities of 2.4 mm width were expanded to either 3.2 or 3.8 mm in cortical bovine bone with a thickness of 3.5 mm, using two-bladed twist drills at rotational speeds of 200, 600, or 1000 rpm, with or without saline irrigation. A logistic regression model was developed to predict the likelihood of reaching temperatures ≥ 47°C during osteotomy based on these parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The absence of irrigation, major osteotomy diameter expansion, and higher rotational speeds were identified as significant risk factors for increasing the bone-drill interface temperature by more than 10°C (OR: irrigation 177.53; expansion step 9.94; speed by 400 rpm 4.94). No osteotomy performed at a low rotational speed (200 rpm) resulted in a critical temperature rise in either drill diameter group when irrigation was provided. However, temperatures exceeded 47°C across all groups when irrigation was absent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Dental implant osteotomy procedures without irrigation result in critical heat stress at the bone-drill interface, even at low drilling speeds. Shortened protocols with large drill diameter differences of up to 1.4 mm can be safely implemented when drilling at 200 rpm with irrigation. Osteotomy protocols can therefore be shortened while maintaining safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>No clinical trial was included in the study</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 9","pages":"1126-1135"},"PeriodicalIF":5.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.14462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luís Azevedo, Andrea Laureti, Tiago Marques, João Pitta, Vincent Fehmer, Alessandro Pozzi, Irena Sailer
Objective
To evaluate the interaction between intraoral scan body (ISB) type, operator, and intraoral scanner (IOS) selection on the trueness of complete-arch digital implant impressions. This study also compared horizontal ISBs (H-ISBs) and vertical ISBs (V-ISBs) across four IOS devices.
Material and Methods
Digital impressions of a definitive mandibular cast with six multi-unit analogs were made using four H-ISBs from different manufacturers (denoted as H-NB, H-NS, H-M6, and H-SF), with a V-ISB (V-EA) as the reference. Each ISB was scanned using a desktop scanner and by two operators who scanned each ISB system 10 times using four IOS devices i5D, PS, T3, T4, generating 400 digital impressions. Deviations were measured using root-mean-square (RMS) error (α = 0.05).
Results
All independent variables (operator, IOS, ISB) significantly affected trueness (p < 0.05). V-EA with i5D had the lowest trueness (78 [27] μm), while H-NS on PS showed the highest (12 [3] μm). H-M6 maintained high trueness across IOS devices. PS was the most stable IOS, while T4 showed the most variability.
Conclusions
Complete-arch digital impressions are influenced by ISBs, IOSs, and operators. H-ISBs demonstrated better trueness and consistency across IOSs and operators.
{"title":"Effect of Horizontal and Vertical Intraoral Scan Bodies on the Trueness of Complete-Arch Digital Implant Impressions: A Comparative In Vitro Study With Six Implants","authors":"Luís Azevedo, Andrea Laureti, Tiago Marques, João Pitta, Vincent Fehmer, Alessandro Pozzi, Irena Sailer","doi":"10.1111/clr.14463","DOIUrl":"10.1111/clr.14463","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the interaction between intraoral scan body (ISB) type, operator, and intraoral scanner (IOS) selection on the trueness of complete-arch digital implant impressions. This study also compared horizontal ISBs (H-ISBs) and vertical ISBs (V-ISBs) across four IOS devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Digital impressions of a definitive mandibular cast with six multi-unit analogs were made using four H-ISBs from different manufacturers (denoted as H-NB, H-NS, H-M6, and H-SF), with a V-ISB (V-EA) as the reference. Each ISB was scanned using a desktop scanner and by two operators who scanned each ISB system 10 times using four IOS devices i5D, PS, T3, T4, generating 400 digital impressions. Deviations were measured using root-mean-square (RMS) error (<i>α</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All independent variables (operator, IOS, ISB) significantly affected trueness (<i>p</i> < 0.05). V-EA with i5D had the lowest trueness (78 [27] μm), while H-NS on PS showed the highest (12 [3] μm). H-M6 maintained high trueness across IOS devices. PS was the most stable IOS, while T4 showed the most variability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Complete-arch digital impressions are influenced by ISBs, IOSs, and operators. H-ISBs demonstrated better trueness and consistency across IOSs and operators.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 9","pages":"1136-1145"},"PeriodicalIF":5.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samir Abou-Ayash, Monika Bjelopavlovic, Pedro Molinero-Mourelle, Martin Schimmel
Objectives
To evaluate implant survival and success rates in elderly patients, comparing younger old adults (65–75 years) to older implant patients (> 75 years).
Methods
A systematic search was conducted using Medline, Cochrane Library, and PubMed Central for clinical studies on implant therapy in patients aged 65 and older. Outcomes included implant survival and success rates, peri-implant parameters, bone-level changes (BLC), and type of restoration and retention. Three- and five-year survival and success rates, as well as implant loss per 100 implant-years, were estimated with 95% confidence intervals (CI). Poisson regression models and incidence rate ratios (IRR) were used to compare study groups, and meta-regression with restricted maximum likelihood estimation (REML) assessed BLC.
Results
Twenty-seven studies with a total of 3892 implants were included. Patients > 75 years had significantly higher five-year survival rates (96.8%, CI: 95.9–97.5) compared to the 65–75 age group (92.1%, CI: 83.0–96.4; p = 0.031), with lower implant loss rates per 100 implant-years. No significant difference in success rates was observed (p = 0.229). Although plaque and bleeding on probing (BOP) were more frequent in the older group, there was no significant difference in BLC (mean difference: 0.41 mm; p = 0.189). In patients > 65 with implant overdentures, single attachments showed significantly higher implant loss rates than bars (p = 0.035).
Conclusions
Dental implants are a reliable treatment for older adults, including those over 75 years. Despite more frequent plaque and BOP in the older group, peri-implant bone remained stable. Splinting implants in overdenture wearers aged > 65 is associated with 5.6 times higher survival rates.
{"title":"Implant Survival in Patient Populations With a Mean Age of 65–75 Years Compared to Older Cohorts: A Systematic Review and Meta-Analysis","authors":"Samir Abou-Ayash, Monika Bjelopavlovic, Pedro Molinero-Mourelle, Martin Schimmel","doi":"10.1111/clr.14456","DOIUrl":"10.1111/clr.14456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate implant survival and success rates in elderly patients, comparing younger old adults (65–75 years) to older implant patients (> 75 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted using Medline, Cochrane Library, and PubMed Central for clinical studies on implant therapy in patients aged 65 and older. Outcomes included implant survival and success rates, peri-implant parameters, bone-level changes (BLC), and type of restoration and retention. Three- and five-year survival and success rates, as well as implant loss per 100 implant-years, were estimated with 95% confidence intervals (CI). Poisson regression models and incidence rate ratios (IRR) were used to compare study groups, and meta-regression with restricted maximum likelihood estimation (REML) assessed BLC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven studies with a total of 3892 implants were included. Patients > 75 years had significantly higher five-year survival rates (96.8%, CI: 95.9–97.5) compared to the 65–75 age group (92.1%, CI: 83.0–96.4; <i>p</i> = 0.031), with lower implant loss rates per 100 implant-years. No significant difference in success rates was observed (<i>p</i> = 0.229). Although plaque and bleeding on probing (BOP) were more frequent in the older group, there was no significant difference in BLC (mean difference: 0.41 mm; <i>p</i> = 0.189). In patients > 65 with implant overdentures, single attachments showed significantly higher implant loss rates than bars (<i>p</i> = 0.035).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Dental implants are a reliable treatment for older adults, including those over 75 years. Despite more frequent plaque and BOP in the older group, peri-implant bone remained stable. Splinting implants in overdenture wearers aged > 65 is associated with 5.6 times higher survival rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 9","pages":"1053-1074"},"PeriodicalIF":5.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.14456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Fernanda Silva da Andrade-Bortoletto, Thanatchaporn Jindanil, Rocharles Cavalcante Fontenele, Reinhilde Jacobs, Deborah Queiroz Freitas
Objective
Identification of the mandibular incisive canal (MIC) prior to anterior implant placement is often challenging. The present study aimed to validate an enhanced artificial intelligence (AI)-driven model dedicated to automated segmentation of MIC on cone beam computed tomography (CBCT) scans and to compare its accuracy and time efficiency with simultaneous segmentation of both mandibular canal (MC) and MIC by either human experts or a previously trained AI model.
Materials and Methods
An enhanced AI model was developed based on 100 CBCT scans using expert-optimized MIC segmentation within the Virtual Patient Creator platform. The performance of the enhanced AI model was tested against human experts and a previously trained AI model using another 40 CBCT scans. Performance metrics included intersection over union (IoU), dice similarity coefficient (DSC), recall, precision, accuracy, and root mean square error (RSME). Time efficiency was also evaluated.
Results
The enhanced AI model had IoU of 93%, DSC of 93%, recall of 94%, precision of 93%, accuracy of 99%, and RMSE of 0.23 mm. These values were significantly higher than those of the previously trained AI model for all metrics, and for manual segmentation for IoU, DSC, recall, and accuracy (p < 0.0001). The enhanced AI model demonstrated significant time efficiency, completing segmentation in 17.6 s (125 times faster than manual segmentation) (p < 0.0001).
Conclusion
The enhanced AI model proved to allow a unique and accurate automated MIC segmentation with high accuracy and time efficiency. Besides, its performance was superior to human expert segmentation and a previously trained AI model segmentation.
{"title":"Comparison of AI-Powered Tools for CBCT-Based Mandibular Incisive Canal Segmentation: A Validation Study","authors":"Maria Fernanda Silva da Andrade-Bortoletto, Thanatchaporn Jindanil, Rocharles Cavalcante Fontenele, Reinhilde Jacobs, Deborah Queiroz Freitas","doi":"10.1111/clr.14455","DOIUrl":"10.1111/clr.14455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Identification of the mandibular incisive canal (MIC) prior to anterior implant placement is often challenging. The present study aimed to validate an enhanced artificial intelligence (AI)-driven model dedicated to automated segmentation of MIC on cone beam computed tomography (CBCT) scans and to compare its accuracy and time efficiency with simultaneous segmentation of both mandibular canal (MC) and MIC by either human experts or a previously trained AI model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An enhanced AI model was developed based on 100 CBCT scans using expert-optimized MIC segmentation within the Virtual Patient Creator platform. The performance of the enhanced AI model was tested against human experts and a previously trained AI model using another 40 CBCT scans. Performance metrics included intersection over union (IoU), dice similarity coefficient (DSC), recall, precision, accuracy, and root mean square error (RSME). Time efficiency was also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The enhanced AI model had IoU of 93%, DSC of 93%, recall of 94%, precision of 93%, accuracy of 99%, and RMSE of 0.23 mm. These values were significantly higher than those of the previously trained AI model for all metrics, and for manual segmentation for IoU, DSC, recall, and accuracy (<i>p</i> < 0.0001). The enhanced AI model demonstrated significant time efficiency, completing segmentation in 17.6 s (125 times faster than manual segmentation) (<i>p</i> < 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The enhanced AI model proved to allow a unique and accurate automated MIC segmentation with high accuracy and time efficiency. Besides, its performance was superior to human expert segmentation and a previously trained AI model segmentation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 9","pages":"1086-1094"},"PeriodicalIF":5.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.14455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yiping Wei, Anqi Tao, Wenjie Hu, Liping Zhao, Tao Xu, Yunsong Liu
Objective
To compare the histological outcomes and 1 year implant treatment outcomes following alveolar ridge preservation (ARP) in extraction sockets of periodontally compromised molars with and without primary wound closure.
Material and Methods
Patients requiring molar extraction owing to severe periodontitis were allocated to one of the following groups: (1) ARP with primary wound closure (control group), and (2) ARP with minimally invasive open healing (test group). Six months after ridge preservation, trephine cores were harvested for histologic and histomorphometric analysis. Implants were then placed, and implant stability was measured immediately as well as 6 months after placement. Clinical and radiographic examinations were performed after the final crown insertion and again at 1 year post-procedure.
Results
Thirty-nine patients (39 implants) completed the study. Histomorphometrically, based on 30 participants, the percentage of newly formed bone was 33.7% ± 16.0% and 30.5% ± 14.4% in control and test groups, respectively. Control and test groups showed no significant differences in primary and secondary implant stabilities. No statistically significant differences in any of the clinical measurements were detected between the two groups (p > 0.05). Marginal bone levels remained stable with minimal changes from crown placement to 1 year, measuring 0.32 ± 0.57 mm for the control group and 0.23 ± 0.31 mm for the test group. The survival rates of the implants were 100% in both groups at 1-year post-loading.
Conclusions
ARP with/without primary wound closure resulted in no significant differences in new bone formation and 1 year implant treatment outcomes.
Trial Registration
This study was registered in the Chinese Clinical Trial Registry (ChiCTR-ONN-16009433)
{"title":"Ridge Preservation in Extraction Sockets of Periodontally Compromised Molars With and Without Primary Wound Closure: Histological and 1-Year Implant Outcomes of a Clinical Trial","authors":"Yiping Wei, Anqi Tao, Wenjie Hu, Liping Zhao, Tao Xu, Yunsong Liu","doi":"10.1111/clr.14459","DOIUrl":"10.1111/clr.14459","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the histological outcomes and 1 year implant treatment outcomes following alveolar ridge preservation (ARP) in extraction sockets of periodontally compromised molars with and without primary wound closure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Patients requiring molar extraction owing to severe periodontitis were allocated to one of the following groups: (1) ARP with primary wound closure (control group), and (2) ARP with minimally invasive open healing (test group). Six months after ridge preservation, trephine cores were harvested for histologic and histomorphometric analysis. Implants were then placed, and implant stability was measured immediately as well as 6 months after placement. Clinical and radiographic examinations were performed after the final crown insertion and again at 1 year post-procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-nine patients (39 implants) completed the study. Histomorphometrically, based on 30 participants, the percentage of newly formed bone was 33.7% ± 16.0% and 30.5% ± 14.4% in control and test groups, respectively. Control and test groups showed no significant differences in primary and secondary implant stabilities. No statistically significant differences in any of the clinical measurements were detected between the two groups (<i>p</i> > 0.05). Marginal bone levels remained stable with minimal changes from crown placement to 1 year, measuring 0.32 ± 0.57 mm for the control group and 0.23 ± 0.31 mm for the test group. The survival rates of the implants were 100% in both groups at 1-year post-loading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ARP with/without primary wound closure resulted in no significant differences in new bone formation and 1 year implant treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This study was registered in the Chinese Clinical Trial Registry (ChiCTR-ONN-16009433)</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 9","pages":"1106-1114"},"PeriodicalIF":5.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kiri N. Lang, Niklaus P. Lang, Fernando M. Muños Guzon, Nikola Saulacic
Aim
To evaluate the application of a synthetic bi-layered biphasic calcium-phosphate (BBCP) bone substitute for its capacity for new bone formation in Guided Bone Regeneration (GBR) in an acute-defect model in Beagle dogs.
Material and Methods
Standardized bone defects were created following the extraction of the maxillary 1P1, 2P2, 4P4 and the mesial root of 3P3 in six Beagle dogs. The defects were treated according to the GBR principle using the tested material, synthetic bi-layered biphasic calcium-phosphate bone substitute (Group T), deproteinized bovine bone mineral (DBBM, positive control = PC), a mixture of the test substance and DBBM in a ratio of 1:1 (Group M) and a sham-operated empty control (negative control = NC). The defects were covered with a resorbable collagen barrier membrane. Bone formation was evaluated radiologically, microtomographically, and histomorphometrically after 11 weeks of healing.
Results
All biomaterials resulted in increased volume of the augmented bone compared to the negative control. The augmented ridge volume developed to a greater extent in the tested area and in the combination of the tested bone substitute and the DBBM compared to the positive control alone (DBBM). A significant increment in a mineralized tissue and bone-biomaterial contact was observed between the test groups and the positive control.
Conclusions
The synthetic BBCP appeared to result in greater bone formation volumes than the positive control (DBBM) and resulted in less contact with soft tissue. Hence, the tested material appeared to be at least as effective as the applied standard for lateral bone augmentation (DBBM).
{"title":"Bi-Layered Biphasic Calcium Phosphate Bone Substitute to Improve Bone Formation in Lateral Jaw Defects Applying the Principle of Guided Bone Regeneration (GBR)—A Pre-Clinical Randomized Controlled Study","authors":"Kiri N. Lang, Niklaus P. Lang, Fernando M. Muños Guzon, Nikola Saulacic","doi":"10.1111/clr.14460","DOIUrl":"10.1111/clr.14460","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the application of a synthetic bi-layered biphasic calcium-phosphate (BBCP) bone substitute for its capacity for new bone formation in Guided Bone Regeneration (GBR) in an acute-defect model in Beagle dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Standardized bone defects were created following the extraction of the maxillary <sup>1</sup>P<sup>1</sup>, <sup>2</sup>P<sup>2</sup>, <sup>4</sup>P<sup>4</sup> and the mesial root of <sup>3</sup>P<sup>3</sup> in six Beagle dogs. The defects were treated according to the GBR principle using the tested material, synthetic bi-layered biphasic calcium-phosphate bone substitute (Group T), deproteinized bovine bone mineral (DBBM, positive control = PC), a mixture of the test substance and DBBM in a ratio of 1:1 (Group M) and a sham-operated empty control (negative control = NC). The defects were covered with a resorbable collagen barrier membrane. Bone formation was evaluated radiologically, microtomographically, and histomorphometrically after 11 weeks of healing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All biomaterials resulted in increased volume of the augmented bone compared to the negative control. The augmented ridge volume developed to a greater extent in the tested area and in the combination of the tested bone substitute and the DBBM compared to the positive control alone (DBBM). A significant increment in a mineralized tissue and bone-biomaterial contact was observed between the test groups and the positive control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The synthetic BBCP appeared to result in greater bone formation volumes than the positive control (DBBM) and resulted in less contact with soft tissue. Hence, the tested material appeared to be at least as effective as the applied standard for lateral bone augmentation (DBBM).</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 9","pages":"1115-1125"},"PeriodicalIF":5.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.14460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Weie Song, Chen Deng, Chenyu Rao, Yilin Luo, Xingmei Yang, Yingying Wu, Yili Qu, Yi Man
Objectives
To investigate the clinically acceptable deviation threshold and the factors associated with trueness across three computer-assisted implant surgery (CAIS) approaches: static CAIS (s-CAIS), dynamic CAIS (d-CAIS), and robotic CAIS (r-CAIS).
Materials and Methods
A total of 314 implants in 194 patients were retrospectively included, with preoperative and postoperative CBCT scans collected. Outcome measures included platform, apex, and angular deviations, which were assessed by registering postoperative CBCT scans to preoperative implant plans using a jawbone matching technique. Generalized linear mixed models (GLMM) were employed to identify significant factors associated with implant trueness.
Results
In r-CAIS, mean global deviations were 0.65 ± 0.137 mm (platform), 0.73 ± 0.39 mm (apex), and 1.66° ± 0.99° (angular), significantly smaller than s-CAIS and d-CAIS (p < 0.01). Deviations in d-CAIS were 1.15 ± 0.55 mm, 1.23 ± 0.56 mm, and 2.87° ± 1.71°, whereas s-CAIS showed 0.96 ± 0.56 mm, 1.32 ± 0.67 mm, and 3.42° ± 1.85°. No significant differences were found between s-CAIS and d-CAIS (p > 0.01). All approaches met clinical acceptability thresholds of 1.5 mm for linear and 5° for angular deviation (p < 0.01). Analysis revealed that bone inclinations exceeding 45° significantly increased implant deviations at apex and angular (p < 0.01). Additionally, deviations were greater in the molar region, particularly at the second molar (p < 0.01).
Conclusion
All three CAIS approaches demonstrated clinically acceptable trueness, with the r-CAIS showing superior performance. Bone inclination and molar placement were identified as key factors contributing to increased deviations.
{"title":"Multifactorial Analysis of Trueness in Computer-Assisted Implant Surgery: A Retrospective Study","authors":"Weie Song, Chen Deng, Chenyu Rao, Yilin Luo, Xingmei Yang, Yingying Wu, Yili Qu, Yi Man","doi":"10.1111/clr.14458","DOIUrl":"10.1111/clr.14458","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the clinically acceptable deviation threshold and the factors associated with trueness across three computer-assisted implant surgery (CAIS) approaches: static CAIS (s-CAIS), dynamic CAIS (d-CAIS), and robotic CAIS (r-CAIS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 314 implants in 194 patients were retrospectively included, with preoperative and postoperative CBCT scans collected. Outcome measures included platform, apex, and angular deviations, which were assessed by registering postoperative CBCT scans to preoperative implant plans using a jawbone matching technique. Generalized linear mixed models (GLMM) were employed to identify significant factors associated with implant trueness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In r-CAIS, mean global deviations were 0.65 ± 0.137 mm (platform), 0.73 ± 0.39 mm (apex), and 1.66° ± 0.99° (angular), significantly smaller than s-CAIS and d-CAIS (<i>p</i> < 0.01). Deviations in d-CAIS were 1.15 ± 0.55 mm, 1.23 ± 0.56 mm, and 2.87° ± 1.71°, whereas s-CAIS showed 0.96 ± 0.56 mm, 1.32 ± 0.67 mm, and 3.42° ± 1.85°. No significant differences were found between s-CAIS and d-CAIS (<i>p</i> > 0.01). All approaches met clinical acceptability thresholds of 1.5 mm for linear and 5° for angular deviation (<i>p</i> < 0.01). Analysis revealed that bone inclinations exceeding 45° significantly increased implant deviations at apex and angular (<i>p</i> < 0.01). Additionally, deviations were greater in the molar region, particularly at the second molar (<i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All three CAIS approaches demonstrated clinically acceptable trueness, with the r-CAIS showing superior performance. Bone inclination and molar placement were identified as key factors contributing to increased deviations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trial Registry: ChiCTR2400083777</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 9","pages":"1095-1105"},"PeriodicalIF":5.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yi Cheng, Gang Chen, Chao Wang, Dan Chen, Pengyu Zhao, Haitao Huang
Objective
This study aimed to evaluate the accuracy of three-dimensional printed individualised titanium mesh (3D-PITM) placement in protected bone regeneration surgery for alveolar bone defects.
Material and Methods
This study included 15 patients with alveolar bone defects who underwent protected bone regeneration surgery using 3D-PITM as a scaffold. The 3D-PITM was removed 6–9 months post-bone regeneration surgery. Cone-beam computed tomography (CBCT) data allowed for digital comparison between the actual titanium mesh and the preoperative design, analyzing the overall deviation and deformation angle of the titanium mesh. Additionally, morphology modification of the augmented areas was analyzed, and the volume was calculated.
Results
The deviation of the titanium mesh immediately post-bone regeneration surgery from the preoperative design was 0.93 ± 0.22 mm. The maximum deformation angle of the titanium mesh immediately post-bone regeneration surgery was 21.49°, averaging 10.85° ± 6.70°. Correlation analysis indicated that a larger deformation angle post-bone regeneration surgery resulted in a greater deviation from the preoperative titanium mesh design. With one failure case excluded, the average actual bone augmentation achieved was 92.83% ± 26.12% of the design. Due to the small sample size, no significant correlation was found between the actual percentage of bone fill and the Root Mean Square (RMS) deviation and deformation angle of the titanium mesh.
Conclusion
Although 3D-PITM-protected bone regeneration provided effective bone augmentation, a noticeable deviation remained between the titanium mesh's actual position and preoperative design. However, due to the small sample size, there was a non-significant correlation between the actual percentage of bone fill volume and the RMS deviation and deformation angle of the titanium mesh.
{"title":"The Effect of Placement Accuracy of Customized Titanium Mesh on Bone Regeneration: A Retrospective Study","authors":"Yi Cheng, Gang Chen, Chao Wang, Dan Chen, Pengyu Zhao, Haitao Huang","doi":"10.1111/clr.14447","DOIUrl":"10.1111/clr.14447","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the accuracy of three-dimensional printed individualised titanium mesh (3D-PITM) placement in protected bone regeneration surgery for alveolar bone defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This study included 15 patients with alveolar bone defects who underwent protected bone regeneration surgery using 3D-PITM as a scaffold. The 3D-PITM was removed 6–9 months post-bone regeneration surgery. Cone-beam computed tomography (CBCT) data allowed for digital comparison between the actual titanium mesh and the preoperative design, analyzing the overall deviation and deformation angle of the titanium mesh. Additionally, morphology modification of the augmented areas was analyzed, and the volume was calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The deviation of the titanium mesh immediately post-bone regeneration surgery from the preoperative design was 0.93 ± 0.22 mm. The maximum deformation angle of the titanium mesh immediately post-bone regeneration surgery was 21.49°, averaging 10.85° ± 6.70°. Correlation analysis indicated that a larger deformation angle post-bone regeneration surgery resulted in a greater deviation from the preoperative titanium mesh design. With one failure case excluded, the average actual bone augmentation achieved was 92.83% ± 26.12% of the design. Due to the small sample size, no significant correlation was found between the actual percentage of bone fill and the Root Mean Square (RMS) deviation and deformation angle of the titanium mesh.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although 3D-PITM-protected bone regeneration provided effective bone augmentation, a noticeable deviation remained between the titanium mesh's actual position and preoperative design. However, due to the small sample size, there was a non-significant correlation between the actual percentage of bone fill volume and the RMS deviation and deformation angle of the titanium mesh.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 8","pages":"1000-1016"},"PeriodicalIF":5.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ettore Amerio, Francesco Sparano, Agustín Muñoz-Sanz, Cristina Valles, Jose Nart, Alberto Monje
Objectives
The study aimed to investigate the relationship between cigarette smoking and macrophage polarization in peri-implantitis (PI) lesions. Additionally, it sought to characterize clinical, radiological, microbiological, and immunological features of PI in smokers and non-smokers.
Materials and Methods
A cross-sectional study included 40 patients (20 smokers, ≥ 10 cigarettes/day, and 20 non-smokers) requiring surgical treatment for PI. Samples of peri-implant crevicular fluid (PICF) and granulation tissue were collected during surgery for immunofluorescence and cytokine analyses. Smoking exposure was assessed through cotinine levels. Macrophage polarization (M1/M2) was determined using immunofluorescence. Clinical, radiological, and microbiological parameters were also evaluated.
Results
Smokers showed a significantly higher proportion of M1 macrophages (70.23%) compared to non-smokers (25.09%, p < 0.005). This pro-inflammatory shift correlated positively with cotinine levels (ρ = 0.694; p < 0.005) and pack-years (ρ = 0.81; p < 0.005). No significant differences in M2 macrophage counts, cytokine concentrations, or microbiota diversity were observed between the groups. However, smokers exhibited more severe PI lesions (p = 0.04).
Conclusions
Smoking is associated with a pro-inflammatory shift at the cellular level due to an increase in M1 macrophage polarization in PI lesions, suggesting a pro-inflammatory response that may exacerbate tissue destruction and hinder treatment outcomes. These findings highlight the need for incorporating smoking cessation into comprehensive peri-implant care strategies to improve disease management and implant prognosis.
{"title":"Effects of Smoking on Macrophage Polarization in Peri-Implantitis Lesions","authors":"Ettore Amerio, Francesco Sparano, Agustín Muñoz-Sanz, Cristina Valles, Jose Nart, Alberto Monje","doi":"10.1111/clr.14448","DOIUrl":"10.1111/clr.14448","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The study aimed to investigate the relationship between cigarette smoking and macrophage polarization in peri-implantitis (PI) lesions. Additionally, it sought to characterize clinical, radiological, microbiological, and immunological features of PI in smokers and non-smokers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A cross-sectional study included 40 patients (20 smokers, ≥ 10 cigarettes/day, and 20 non-smokers) requiring surgical treatment for PI. Samples of peri-implant crevicular fluid (PICF) and granulation tissue were collected during surgery for immunofluorescence and cytokine analyses. Smoking exposure was assessed through cotinine levels. Macrophage polarization (M1/M2) was determined using immunofluorescence. Clinical, radiological, and microbiological parameters were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Smokers showed a significantly higher proportion of M1 macrophages (70.23%) compared to non-smokers (25.09%, <i>p</i> < 0.005). This pro-inflammatory shift correlated positively with cotinine levels (<i>ρ</i> = 0.694; <i>p</i> < 0.005) and pack-years (<i>ρ</i> = 0.81; <i>p</i> < 0.005). No significant differences in M2 macrophage counts, cytokine concentrations, or microbiota diversity were observed between the groups. However, smokers exhibited more severe PI lesions (<i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Smoking is associated with a pro-inflammatory shift at the cellular level due to an increase in M1 macrophage polarization in PI lesions, suggesting a pro-inflammatory response that may exacerbate tissue destruction and hinder treatment outcomes. These findings highlight the need for incorporating smoking cessation into comprehensive peri-implant care strategies to improve disease management and implant prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 8","pages":"1017-1029"},"PeriodicalIF":5.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.14448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiao-Jiao Fu, Zheng-Zhen Cai, Jun-Yu Shi, Shi-Chong Qiao, Maurizio S. Tonetti, Hong-Chang Lai, Bei-Lei Liu
Objectives
To compare the accuracy of complete-arch implant impressions using four digital techniques: extraoral photogrammetry (EPG), intraoral scanning with original scan body (IOS), intraoral scanning with prefabricated aids (IOSA), and intraoral photogrammetry (IPG).
Materials and Methods
One edentulous maxillary master model with six parallel abutment analogs was scanned by a laboratory scanner as the reference scan. EPG, IOS, IOSA, and IPG were used to scan the master model with respective scan bodies as test scans. Ten scanning data were gained for each technique. Trueness and precision of root mean square (RMS) errors were measured between the test and reference scans. Deviations in distance and angle relative to the reference scan between all pairs of abutment analogs were measured. Scanning time was recorded.
Results
IPG showed significantly best trueness in RMS errors (IPG, 26.37 ± 1.02 μm; EPG, 31.72 ± 0.59 μm; IOS, 39.93 ± 7.98 μm; IOSA, 50.60 ± 12.46 μm), (all p < 0.050). EPG showed significantly best precision in RMS errors (EPG, 2.30 ± 1.31 μm; IPG, 4.12 ± 0.87 μm; IOS, 33.38 ± 13.95 μm; IOSA, 28.35 ± 11.48 μm), (all p < 0.001). IPG demonstrated significantly best performance in distance deviation (IPG, 28.59 ± 24.75 μm; EPG, 55.55 ± 37.82 μm; IOS, 62.97 ± 50.60 μm; IOSA, 93.37 ± 72.15 μm), (all p < 0.050). No significant differences were found regarding angle deviation (p = 0.313). IOSA showed the longest scanning duration (IPG: 50.30 ± 6.77 s; EPG: 57.40 ± 5.19 s; IOS: 91.10 ± 20.31 s; IOSA: 125.00 ± 18.74 s), (all p < 0.001).
Conclusions
IPG achieved comparable accuracy with EPG in complete-arch implant digital impressions in vitro. IPG offers an efficient and straightforward workflow, making it a valuable alternative method; however, further clinical studies are needed to validate its efficacy.
{"title":"Accuracy of a Novel Intraoral Photogrammetry Technique for Complete-Arch Implant Impressions: An In Vitro Study","authors":"Xiao-Jiao Fu, Zheng-Zhen Cai, Jun-Yu Shi, Shi-Chong Qiao, Maurizio S. Tonetti, Hong-Chang Lai, Bei-Lei Liu","doi":"10.1111/clr.14445","DOIUrl":"10.1111/clr.14445","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the accuracy of complete-arch implant impressions using four digital techniques: extraoral photogrammetry (EPG), intraoral scanning with original scan body (IOS), intraoral scanning with prefabricated aids (IOSA), and intraoral photogrammetry (IPG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>One edentulous maxillary master model with six parallel abutment analogs was scanned by a laboratory scanner as the reference scan. EPG, IOS, IOSA, and IPG were used to scan the master model with respective scan bodies as test scans. Ten scanning data were gained for each technique. Trueness and precision of root mean square (RMS) errors were measured between the test and reference scans. Deviations in distance and angle relative to the reference scan between all pairs of abutment analogs were measured. Scanning time was recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>IPG showed significantly best trueness in RMS errors (IPG, 26.37 ± 1.02 μm; EPG, 31.72 ± 0.59 μm; IOS, 39.93 ± 7.98 μm; IOSA, 50.60 ± 12.46 μm), (all <i>p</i> < 0.050). EPG showed significantly best precision in RMS errors (EPG, 2.30 ± 1.31 μm; IPG, 4.12 ± 0.87 μm; IOS, 33.38 ± 13.95 μm; IOSA, 28.35 ± 11.48 μm), (all <i>p</i> < 0.001). IPG demonstrated significantly best performance in distance deviation (IPG, 28.59 ± 24.75 μm; EPG, 55.55 ± 37.82 μm; IOS, 62.97 ± 50.60 μm; IOSA, 93.37 ± 72.15 μm), (all <i>p</i> < 0.050). No significant differences were found regarding angle deviation (<i>p</i> = 0.313). IOSA showed the longest scanning duration (IPG: 50.30 ± 6.77 s; EPG: 57.40 ± 5.19 s; IOS: 91.10 ± 20.31 s; IOSA: 125.00 ± 18.74 s), (all <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IPG achieved comparable accuracy with EPG in complete-arch implant digital impressions in vitro. IPG offers an efficient and straightforward workflow, making it a valuable alternative method; however, further clinical studies are needed to validate its efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 8","pages":"991-999"},"PeriodicalIF":5.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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