Andrea Alonso‐Español, Enrique Bravo, Ana Carrillo de Albornoz, María Martínez, Katharina Doll‐Nikutta, Andreas Winkel, Meike Stiesch, David Herrera, Bettina Alonso, Mariano Sanz
AimTo evaluate in vitro the antibacterial efficacy and cytocompatibility of different implant‐decontamination methods, using both 2D and 3D peri‐implant mucosa models.MethodsFour decontamination methods [chlorhexidine (CHX), electrolytic treatment (GS), curcumin (CUR), xanthohumol (XN)] were compared in four independent experiments, three with a 2D peri‐implant mucosa model on titanium surfaces and another on a 3D peri‐implant mucosa model. These decontamination procedures were tested for their antibacterial effect using a multispecies biofilm model with Streptococcus oralis, Actinomyces naeslundii, Veillonella dispar, and Porphyromonas gingivalis for 24 h. Direct cytocompatibility evaluating the impact of the treatments on tissue cells as well as indirect cytocompatibility (colonization of treated implant surfaces by tissue cells) were also tested. Both outcomes were assessed by confocal laser scanning microscopy supported by neural networks.ResultsCHX demonstrated a strong alteration of cytocompatibility and antibacterial effect, but did not remove biofilm biomass. XN and CUR demonstrated antibacterial effect and biofilm removal action, as well as cytocompatibility. GS showed antibacterial capacity with a combination of areas completely clean of biofilm with others in which a non‐vital biofilm remained. In the 3D peri‐implant mucosa model, XN and CUR showed maintenance of the mucosa integrity after treatment, whereas CHX and GS displayed disruption in the mucosal layers.ConclusionsPhytotherapeutics (CUR and XN) were the most cytocompatible substances and showed the largest antimicrobial effect. GS displayed antibiofilm activity with a localized “bubble‐shaped effect” and impaired tissue cell morphology and integrity, compromising cytocompatibility, and CHX showed antimicrobial capacity, without reducing biofilm biomass and with altered cytocompatibility.
{"title":"Antimicrobial Effect and Cytocompatibility After Using Different Decontamination Methods on Titanium Implant Surfaces: An In Vitro Study","authors":"Andrea Alonso‐Español, Enrique Bravo, Ana Carrillo de Albornoz, María Martínez, Katharina Doll‐Nikutta, Andreas Winkel, Meike Stiesch, David Herrera, Bettina Alonso, Mariano Sanz","doi":"10.1111/clr.14410","DOIUrl":"https://doi.org/10.1111/clr.14410","url":null,"abstract":"AimTo evaluate in vitro the antibacterial efficacy and cytocompatibility of different implant‐decontamination methods, using both 2D and 3D peri‐implant mucosa models.MethodsFour decontamination methods [chlorhexidine (CHX), electrolytic treatment (GS), curcumin (CUR), xanthohumol (XN)] were compared in four independent experiments, three with a 2D peri‐implant mucosa model on titanium surfaces and another on a 3D peri‐implant mucosa model. These decontamination procedures were tested for their antibacterial effect using a multispecies biofilm model with <jats:styled-content style=\"fixed-case\"><jats:italic>Streptococcus oralis</jats:italic></jats:styled-content>, <jats:styled-content style=\"fixed-case\"><jats:italic>Actinomyces naeslundii</jats:italic></jats:styled-content>, <jats:styled-content style=\"fixed-case\"><jats:italic>Veillonella dispar</jats:italic></jats:styled-content>, and <jats:styled-content style=\"fixed-case\"><jats:italic>Porphyromonas gingivalis</jats:italic></jats:styled-content> for 24 h. Direct cytocompatibility evaluating the impact of the treatments on tissue cells as well as indirect cytocompatibility (colonization of treated implant surfaces by tissue cells) were also tested. Both outcomes were assessed by confocal laser scanning microscopy supported by neural networks.ResultsCHX demonstrated a strong alteration of cytocompatibility and antibacterial effect, but did not remove biofilm biomass. XN and CUR demonstrated antibacterial effect and biofilm removal action, as well as cytocompatibility. GS showed antibacterial capacity with a combination of areas completely clean of biofilm with others in which a non‐vital biofilm remained. In the 3D peri‐implant mucosa model, XN and CUR showed maintenance of the mucosa integrity after treatment, whereas CHX and GS displayed disruption in the mucosal layers.ConclusionsPhytotherapeutics (CUR and XN) were the most cytocompatible substances and showed the largest antimicrobial effect. GS displayed antibiofilm activity with a localized “bubble‐shaped effect” and impaired tissue cell morphology and integrity, compromising cytocompatibility, and CHX showed antimicrobial capacity, without reducing biofilm biomass and with altered cytocompatibility.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056499","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}
Ralf-Joachim Kohal, Kirstin Vach, Frank Butz, Sebastian Berthold Maximilian Patzelt, Felix Burkhardt
Objectives: The purpose of the present prospective case series was to investigate the clinical and radiological outcome of one-piece zirconia implants fabricated from 3Y-TZP with a moderately roughened endosseous surface (Sa = 1.24 μm) to support three-unit fixed dental prostheses (FDP) after five years in function.
Materials and methods: Twenty-seven patients received a total of 54 implants in a one-stage surgery with immediate provisionalization. Peri-implant bone loss was assessed using standardized radiographs. Additionally, soft-tissue parameters were analyzed. Statistical analyses were conducted using linear mixed regression models and Wilcoxon Signed Rank tests (p < 0.05). All patients participated in an annual maintenance program.
Results: Eighteen implants were lost up to the 5-year follow-up, resulting in a cumulative survival rate of 66.67%. The mean marginal bone loss of the remaining implants amounted to 1.89 mm. Probing depth, clinical attachment loss, and bleeding on probing increased from prosthesis insertion to the 5-year follow-up, while the plaque index showed no significant changes during the same period.
Conclusions: The investigated one-piece zirconia implant showed low survival rates as compared to previously reported survival rates of one-piece zirconia or two-piece titanium implants. Implant failure was attributed to peri-implantitis, leading to the necessity of implant removal. The implant is not commercially available.
{"title":"Five-Year Results of One-Piece Zirconia Oral Implants Supporting Three-Unit Fixed Dental Prostheses.","authors":"Ralf-Joachim Kohal, Kirstin Vach, Frank Butz, Sebastian Berthold Maximilian Patzelt, Felix Burkhardt","doi":"10.1111/clr.14407","DOIUrl":"https://doi.org/10.1111/clr.14407","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of the present prospective case series was to investigate the clinical and radiological outcome of one-piece zirconia implants fabricated from 3Y-TZP with a moderately roughened endosseous surface (Sa = 1.24 μm) to support three-unit fixed dental prostheses (FDP) after five years in function.</p><p><strong>Materials and methods: </strong>Twenty-seven patients received a total of 54 implants in a one-stage surgery with immediate provisionalization. Peri-implant bone loss was assessed using standardized radiographs. Additionally, soft-tissue parameters were analyzed. Statistical analyses were conducted using linear mixed regression models and Wilcoxon Signed Rank tests (p < 0.05). All patients participated in an annual maintenance program.</p><p><strong>Results: </strong>Eighteen implants were lost up to the 5-year follow-up, resulting in a cumulative survival rate of 66.67%. The mean marginal bone loss of the remaining implants amounted to 1.89 mm. Probing depth, clinical attachment loss, and bleeding on probing increased from prosthesis insertion to the 5-year follow-up, while the plaque index showed no significant changes during the same period.</p><p><strong>Conclusions: </strong>The investigated one-piece zirconia implant showed low survival rates as compared to previously reported survival rates of one-piece zirconia or two-piece titanium implants. Implant failure was attributed to peri-implantitis, leading to the necessity of implant removal. The implant is not commercially available.</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045805","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}
ObjectivesTo evaluate the treatment of peri‐implant mucositis (PM) using a nonsurgical submarginal peri‐implant instrumentation (NSPI) with or without chlorhexidine (CHX) solutions.MethodsFifty‐six patients (28 per group) were randomly assigned to the test (NSPI + 0.12% mouthwash and subgingival CHX irrigation plus tongue brushing with 1% CHX gel) or the control group (NSPI + placebo mouthwash and subgingival placebo irrigation plus tongue brushing with placebo gel). At baseline, 1, 3, 6 months, bleeding on probing (BOP), probing pocket depth (PPD), modified gingival index (mGI), modified plaque index (mPlI), full‐mouth plaque score (FMPS), full‐mouth bleeding score (FMBS), and the proportions of <jats:styled-content style="fixed-case"><jats:italic>Aggregatibacter actinomycetemcomitans</jats:italic></jats:styled-content>, <jats:styled-content style="fixed-case"><jats:italic>Porphyromonas gingivalis</jats:italic></jats:styled-content>, <jats:styled-content style="fixed-case"><jats:italic>Tannerella forsythia</jats:italic>,</jats:styled-content> and <jats:styled-content style="fixed-case"><jats:italic>Treponema denticola</jats:italic></jats:styled-content> were recorded. The BOP reduction was set as a primary outcome. Data were analyzed to assess BOP reduction at a 6‐month follow‐up and to identify significant predictors of implant‐site BOP through mixed generalized linear regression.ResultsAfter 6 months in both groups, a significant reduction of BOP, PD, mPlI, mGI, FMBS, and FMPS was noted (<jats:italic>p</jats:italic> < 0.05). However, at 6 months, the test group was more effective than the controls in reducing median BOP (∆values control/test: 39.3% [95% CI 37.4–42.3] vs. 48.7 [95% CI 46.5–51.2], <jats:italic>p</jats:italic> = 0.044), as well as mPlI (<jats:italic>p</jats:italic> = 0.041) and the proportion of <jats:styled-content style="fixed-case"><jats:italic>Treponema denticola</jats:italic></jats:styled-content> (<jats:italic>p</jats:italic> = 0.039). Moreover, the implant‐sites BOP reduction was significantly influenced by test treatment (<jats:italic>p</jats:italic> < 0.001), history of periodontitis (<jats:italic>p</jats:italic> = 0.003), and a high number of cigarettes/day (<jats:italic>p</jats:italic> = 0.002), the proportion of <jats:styled-content style="fixed-case"><jats:italic>Porphyromonas gingivalis</jats:italic></jats:styled-content> (<jats:italic>p</jats:italic> = 0.021) and <jats:styled-content style="fixed-case"><jats:italic>Tannerella forsythia</jats:italic></jats:styled-content> (<jats:italic>p</jats:italic> = 0.032).ConclusionsNSPI + CHX showed better results compared to placebo in implant‐sites BOP reduction. The high number of cigarettes/day and the proportion of <jats:styled-content style="fixed-case"><jats:italic>Porphyromonas gingivalis</jats:italic></jats:styled-content> and <jats:styled-content style="fixed-case"><jats:italic>T. forsythia</jats:italic></jats:styled-content> negatively influenced the BOP reduc
{"title":"Effect of Nonsurgical Mechanical Debridement With or Without Chlorhexidine Formulations in the Treatment of Peri‐Implant Mucositis. A Randomized Placebo‐Controlled Clinical Trial","authors":"Gaetano Isola, Alessandro Polizzi, Maria Santagati, Angela Alibrandi, Vincenzo Iorio‐Siciliano, Luca Ramaglia","doi":"10.1111/clr.14405","DOIUrl":"https://doi.org/10.1111/clr.14405","url":null,"abstract":"ObjectivesTo evaluate the treatment of peri‐implant mucositis (PM) using a nonsurgical submarginal peri‐implant instrumentation (NSPI) with or without chlorhexidine (CHX) solutions.MethodsFifty‐six patients (28 per group) were randomly assigned to the test (NSPI + 0.12% mouthwash and subgingival CHX irrigation plus tongue brushing with 1% CHX gel) or the control group (NSPI + placebo mouthwash and subgingival placebo irrigation plus tongue brushing with placebo gel). At baseline, 1, 3, 6 months, bleeding on probing (BOP), probing pocket depth (PPD), modified gingival index (mGI), modified plaque index (mPlI), full‐mouth plaque score (FMPS), full‐mouth bleeding score (FMBS), and the proportions of <jats:styled-content style=\"fixed-case\"><jats:italic>Aggregatibacter actinomycetemcomitans</jats:italic></jats:styled-content>, <jats:styled-content style=\"fixed-case\"><jats:italic>Porphyromonas gingivalis</jats:italic></jats:styled-content>, <jats:styled-content style=\"fixed-case\"><jats:italic>Tannerella forsythia</jats:italic>,</jats:styled-content> and <jats:styled-content style=\"fixed-case\"><jats:italic>Treponema denticola</jats:italic></jats:styled-content> were recorded. The BOP reduction was set as a primary outcome. Data were analyzed to assess BOP reduction at a 6‐month follow‐up and to identify significant predictors of implant‐site BOP through mixed generalized linear regression.ResultsAfter 6 months in both groups, a significant reduction of BOP, PD, mPlI, mGI, FMBS, and FMPS was noted (<jats:italic>p</jats:italic> < 0.05). However, at 6 months, the test group was more effective than the controls in reducing median BOP (∆values control/test: 39.3% [95% CI 37.4–42.3] vs. 48.7 [95% CI 46.5–51.2], <jats:italic>p</jats:italic> = 0.044), as well as mPlI (<jats:italic>p</jats:italic> = 0.041) and the proportion of <jats:styled-content style=\"fixed-case\"><jats:italic>Treponema denticola</jats:italic></jats:styled-content> (<jats:italic>p</jats:italic> = 0.039). Moreover, the implant‐sites BOP reduction was significantly influenced by test treatment (<jats:italic>p</jats:italic> < 0.001), history of periodontitis (<jats:italic>p</jats:italic> = 0.003), and a high number of cigarettes/day (<jats:italic>p</jats:italic> = 0.002), the proportion of <jats:styled-content style=\"fixed-case\"><jats:italic>Porphyromonas gingivalis</jats:italic></jats:styled-content> (<jats:italic>p</jats:italic> = 0.021) and <jats:styled-content style=\"fixed-case\"><jats:italic>Tannerella forsythia</jats:italic></jats:styled-content> (<jats:italic>p</jats:italic> = 0.032).ConclusionsNSPI + CHX showed better results compared to placebo in implant‐sites BOP reduction. The high number of cigarettes/day and the proportion of <jats:styled-content style=\"fixed-case\"><jats:italic>Porphyromonas gingivalis</jats:italic></jats:styled-content> and <jats:styled-content style=\"fixed-case\"><jats:italic>T. forsythia</jats:italic></jats:styled-content> negatively influenced the BOP reduc","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"35 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034994","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}
Jingxian Zhu, Wei Sun, Shanyi Yang, Zhili Du, Rui Yang, Bin Shi, Wei Ji
ObjectivesTo assess the long‐term clinical outcomes and patient satisfaction with narrow‐diameter implants (NDIs) in the posterior jaws and to identify the risk indicators for NDI failure.Materials and MethodsThis retrospective study reviewed 479 patients with 666 NDIs (diameter ≤ 3.5 mm) ‐supported fixed prostheses in posterior jaws, with a minimum 10‐year follow‐up. Implant survival, success, complications, demographics, and implantation characteristics were collected. Risk indicators for posterior NDI failure were analyzed using multilevel Cox regression analyses with mixed effects. Patient satisfaction and oral health impact profile (OHIP) were surveyed in a random 10% sample.ResultsOver a mean follow‐up of 14.0 ± 3.6 years, implant survival was 95.9% at the implant level and 94.6% at the patient level. Success rates were 93.5% at the implant level and 91.6% at the patient level. Multilevel Cox regression analysis identified an implant length of 10 mm or less (p = 0.001) and the use of single crowns (p = 0.005) as significant risk indicators for posterior NDI failure. Patients showed high satisfaction (4.54/5) with posterior NDIs, and the mean OHIP score of 1.15 reflected an acceptable level of oral health.ConclusionNDIs in the posterior jaws demonstrated robust long‐term success and high patient satisfaction. An implant length of 10 mm or less and the use of single crowns are potential risk indicators for posterior NDI failure.Trial RegistrationChinese Clinical Trial Registry: ChiCTR2200062337 on 2022/08/02
{"title":"Long‐Term Clinical Outcomes and Risk Indicator Analyses of Narrow‐Diameter Implants in the Posterior Jaw: A Retrospective Cohort Study of 10 to 27 Years","authors":"Jingxian Zhu, Wei Sun, Shanyi Yang, Zhili Du, Rui Yang, Bin Shi, Wei Ji","doi":"10.1111/clr.14409","DOIUrl":"https://doi.org/10.1111/clr.14409","url":null,"abstract":"ObjectivesTo assess the long‐term clinical outcomes and patient satisfaction with narrow‐diameter implants (NDIs) in the posterior jaws and to identify the risk indicators for NDI failure.Materials and MethodsThis retrospective study reviewed 479 patients with 666 NDIs (diameter ≤ 3.5 mm) ‐supported fixed prostheses in posterior jaws, with a minimum 10‐year follow‐up. Implant survival, success, complications, demographics, and implantation characteristics were collected. Risk indicators for posterior NDI failure were analyzed using multilevel Cox regression analyses with mixed effects. Patient satisfaction and oral health impact profile (OHIP) were surveyed in a random 10% sample.ResultsOver a mean follow‐up of 14.0 ± 3.6 years, implant survival was 95.9% at the implant level and 94.6% at the patient level. Success rates were 93.5% at the implant level and 91.6% at the patient level. Multilevel Cox regression analysis identified an implant length of 10 mm or less (<jats:italic>p</jats:italic> = 0.001) and the use of single crowns (<jats:italic>p</jats:italic> = 0.005) as significant risk indicators for posterior NDI failure. Patients showed high satisfaction (4.54/5) with posterior NDIs, and the mean OHIP score of 1.15 reflected an acceptable level of oral health.ConclusionNDIs in the posterior jaws demonstrated robust long‐term success and high patient satisfaction. An implant length of 10 mm or less and the use of single crowns are potential risk indicators for posterior NDI failure.Trial RegistrationChinese Clinical Trial Registry: ChiCTR2200062337 on 2022/08/02","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"3 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034995","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}
PurposeTo identify the current status and development of zirconia barriers in bone augmentation procedures in the maxillofacial area of adult human patients.Materials and MethodsTwo independent reviewers conducted an electronic literature search in PubMed/MEDLINE, Web of Science, Scopus, EBSCO, the Cochrane Library, and LILACS databases, as well as a manual search to identify eligible clinical studies up to April 15, 2024. The protocol was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews guidelines.ResultsThe initial electronic search resulted in 240 studies. The systematic application of inclusion and exclusion criteria resulted in 6 articles that met the purpose of the study. The included articles were 5 clinical case series and 1 case report, published between 2016 and 2023. Only 4 articles reported histological studies. A total of 40 sites regenerated with zirconium barriers were reported in 30 patients. Results were obtained with variability in bone gain values, between 0.9–8.0 mm horizontally and 1.4–12.0 mm vertically, in addition to a 30% complication rate.ConclusionsAlthough the results obtained in the studies included in this scoping review are favorable with respect to the amount of bone formation and the reduced surgical time required, the number of complications is considered high. Moreover, due to a limited number of patients included in the case series and the short duration of follow‐up, additional studies including a control group are required.
目的了解成人颌面骨增强术中氧化锆屏障的现状及发展。材料和方法两位独立审稿人在PubMed/MEDLINE、Web of Science、Scopus、EBSCO、Cochrane Library和LILACS数据库中进行了电子文献检索，并进行了人工检索，以确定截止到2024年4月15日的符合条件的临床研究。该方案是根据系统评价的首选报告项目和范围评价的Meta分析扩展指南设计的。结果最初的电子检索结果为240项研究。纳入和排除标准的系统应用导致6篇文章符合研究目的。纳入的文章为2016 - 2023年间发表的5篇临床病例系列和1篇病例报告。只有4篇文章报道了组织学研究。在30例患者中，共报道了用锆屏障再生的40个部位。结果显示，骨增重值存在差异，水平方向为0.9-8.0 mm，垂直方向为1.4-12.0 mm，并发症发生率为30%。结论：虽然本综述所涉及的研究结果在骨形成量和所需手术时间减少方面是有利的，但并发症的数量被认为很高。此外，由于病例系列中纳入的患者数量有限，随访时间短，需要进行包括对照组在内的额外研究。
{"title":"Zirconia Barriers in Bone Regeneration Procedures: A Scoping Review","authors":"Xavier Uriarte, Andrés Landázuri, Heloisa Fonseca Marão, Natália Lucena, Eik Schiegnitz, Leonardo Díaz","doi":"10.1111/clr.14404","DOIUrl":"https://doi.org/10.1111/clr.14404","url":null,"abstract":"PurposeTo identify the current status and development of zirconia barriers in bone augmentation procedures in the maxillofacial area of adult human patients.Materials and MethodsTwo independent reviewers conducted an electronic literature search in PubMed/MEDLINE, Web of Science, Scopus, EBSCO, the Cochrane Library, and LILACS databases, as well as a manual search to identify eligible clinical studies up to April 15, 2024. The protocol was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews guidelines.ResultsThe initial electronic search resulted in 240 studies. The systematic application of inclusion and exclusion criteria resulted in 6 articles that met the purpose of the study. The included articles were 5 clinical case series and 1 case report, published between 2016 and 2023. Only 4 articles reported histological studies. A total of 40 sites regenerated with zirconium barriers were reported in 30 patients. Results were obtained with variability in bone gain values, between 0.9–8.0 mm horizontally and 1.4–12.0 mm vertically, in addition to a 30% complication rate.ConclusionsAlthough the results obtained in the studies included in this scoping review are favorable with respect to the amount of bone formation and the reduced surgical time required, the number of complications is considered high. Moreover, due to a limited number of patients included in the case series and the short duration of follow‐up, additional studies including a control group are required.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"120 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020689","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}
Paniz Fasih, Amir Yari, Lotfollah Kamali Hakim, Nader Nasim Kashe
Objective: This study evaluated ResNet-50 and U-Net models for detecting and segmenting vertical misfit in dental implant crowns using periapical radiographic images.
Methods: Periapical radiographs of dental implant crowns were classified by two experts based on the presence of vertical misfit (reference group). The misfit area was manually annotated in images exhibiting vertical misfit. The resulting datasets were utilized to train the ResNet-50 and U-Net deep learning models. Then, 70% of the images were allocated for training, while the remaining 30% were used for validation and testing. Five general dentists categorized the testing images as "misfit" or "fit." Inter-rater reliability with Cohen's kappa index and performance metrics were calculated. The average performance metrics of dentists and artificial intelligence (AI) were compared using the paired-samples t test.
Results: A total of 638 radiographs were collected. The kappa values between dentists and AI ranged from 0.93 to 0.98, indicating perfect agreement. The ResNet-50 model achieved accuracy and precision of 92.7% and 87.5%, respectively, whereas dentists had a mean accuracy of 93.3% and precision of 89.6%. The sensitivity and specificity for AI were 90.3% and 93.8%, respectively, compared to 90.1% and 95.1% for dentists. The Dice coefficient yielded 88.9% for the ResNet-50 and 89.5% among the dentists. The U-Net algorithm produced a loss of 0.01 and an accuracy of 0.98. No significant difference was found between the average performance metrics of dentists and AI (p > 0.05).
Conclusion: AI can detect and segment vertical misfit of implant prosthetic crowns in periapical radiographs, comparable to clinician performance.
{"title":"Artificial Intelligence in Detecting and Segmenting Vertical Misfit of Prosthesis in Radiographic Images of Dental Implants: A Cross-Sectional Analysis.","authors":"Paniz Fasih, Amir Yari, Lotfollah Kamali Hakim, Nader Nasim Kashe","doi":"10.1111/clr.14406","DOIUrl":"https://doi.org/10.1111/clr.14406","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated ResNet-50 and U-Net models for detecting and segmenting vertical misfit in dental implant crowns using periapical radiographic images.</p><p><strong>Methods: </strong>Periapical radiographs of dental implant crowns were classified by two experts based on the presence of vertical misfit (reference group). The misfit area was manually annotated in images exhibiting vertical misfit. The resulting datasets were utilized to train the ResNet-50 and U-Net deep learning models. Then, 70% of the images were allocated for training, while the remaining 30% were used for validation and testing. Five general dentists categorized the testing images as \"misfit\" or \"fit.\" Inter-rater reliability with Cohen's kappa index and performance metrics were calculated. The average performance metrics of dentists and artificial intelligence (AI) were compared using the paired-samples t test.</p><p><strong>Results: </strong>A total of 638 radiographs were collected. The kappa values between dentists and AI ranged from 0.93 to 0.98, indicating perfect agreement. The ResNet-50 model achieved accuracy and precision of 92.7% and 87.5%, respectively, whereas dentists had a mean accuracy of 93.3% and precision of 89.6%. The sensitivity and specificity for AI were 90.3% and 93.8%, respectively, compared to 90.1% and 95.1% for dentists. The Dice coefficient yielded 88.9% for the ResNet-50 and 89.5% among the dentists. The U-Net algorithm produced a loss of 0.01 and an accuracy of 0.98. No significant difference was found between the average performance metrics of dentists and AI (p > 0.05).</p><p><strong>Conclusion: </strong>AI can detect and segment vertical misfit of implant prosthetic crowns in periapical radiographs, comparable to clinician performance.</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001465","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}
Joscha Gabriel Werny,Shengchi Fan,Leonardo Diaz,Bilal Al-Nawas,Keyvan Sagheb,Matthias Gielisch,Eik Schiegnitz
OBJECTIVESThis experimental study compared the accuracy of implant insertion using the free-hand (FH) technique, static computer-aided surgery (S-CAIS), or dynamic computer-assisted surgery (D-CAIS) and to evaluate the correlation of learning curves between surgeons' experience and surgical time.MATERIALS AND METHODSThirty-six models were randomly assigned to three groups (FH, n = 12; S-CAIS, n = 12; D-CAIS, n = 12). Each model was planned to receive four implants in the maxillary anterior and posterior regions. Twelve participants, six experienced surgeons, and six dental students were included in this study. The primary outcome was the deviation between the planned and final implant placement from each group. Secondary outcomes were each technique's learning curve regarding surgical time.RESULTSThe average deviation at implant platform, apex and gradual deviation with FH technique were 1.31 ± 0.88 mm, 1.75 ± 0.9 mm and 6.67° ± 3.70°, respectively. The average deviation of implant platform, apex and angular in S-CAIS were 0.67 ± 0.32 mm, 1.00 ± 0.39 and 2.66° ± 1.77°, respectively. The average deviation of implant platform, apex and angular in D-CAIS were 1.14 ± 0.70 mm, 1.23 ± 0.58 and 3.20° ± 2.16°, respectively. Significant discrepancies at the implant platform, implant apex, and angular deviation were found between all surgical methods (p < 0.016). Learning curves were evident after multiple implant insertions using both freehand and S-CAIS.CONCLUSIONThe findings indicate that computer-assisted implant insertion leads to a more precise implant alignment than implants inserted freehand in an experimental set-up.
目的比较徒手（FH）技术、静态计算机辅助手术（S-CAIS）和动态计算机辅助手术（D-CAIS）植入体的准确性，并评价外科医生经验与手术时间之间的学习曲线的相关性。材料与方法36只模型随机分为3组(FH, n = 12；S-CAIS, n = 12；D-CAIS, n = 12)。每个模型计划在上颌前、后区域植入4个种植体。本研究包括12名参与者，6名经验丰富的外科医生和6名牙科学生。主要结果是各组计划植入与最终植入之间的偏差。次要结果是每种技术与手术时间相关的学习曲线。结果FH技术种植体平台、顶端和逐渐偏差的平均偏差分别为1.31±0.88 mm、1.75±0.9 mm和6.67°±3.70°。S-CAIS种植体平台、尖端和角的平均偏差分别为0.67±0.32 mm、1.00±0.39和2.66°±1.77°。D-CAIS种植体平台、尖端和角的平均偏差分别为1.14±0.70 mm、1.23±0.58和3.20°±2.16°。两种手术方式在种植体平台、种植体顶点和角度偏差上存在显著差异（p < 0.016）。使用徒手和S-CAIS进行多次植入后，学习曲线明显。结论计算机辅助种植体置入比徒手种植体置入更精确的种植体对准。
{"title":"Evaluation of the Accuracy, Surgical Time, and Learning Curve of Freehand, Static, and Dynamic Computer-Assisted Implant Surgery in an In Vitro Study.","authors":"Joscha Gabriel Werny,Shengchi Fan,Leonardo Diaz,Bilal Al-Nawas,Keyvan Sagheb,Matthias Gielisch,Eik Schiegnitz","doi":"10.1111/clr.14403","DOIUrl":"https://doi.org/10.1111/clr.14403","url":null,"abstract":"OBJECTIVESThis experimental study compared the accuracy of implant insertion using the free-hand (FH) technique, static computer-aided surgery (S-CAIS), or dynamic computer-assisted surgery (D-CAIS) and to evaluate the correlation of learning curves between surgeons' experience and surgical time.MATERIALS AND METHODSThirty-six models were randomly assigned to three groups (FH, n = 12; S-CAIS, n = 12; D-CAIS, n = 12). Each model was planned to receive four implants in the maxillary anterior and posterior regions. Twelve participants, six experienced surgeons, and six dental students were included in this study. The primary outcome was the deviation between the planned and final implant placement from each group. Secondary outcomes were each technique's learning curve regarding surgical time.RESULTSThe average deviation at implant platform, apex and gradual deviation with FH technique were 1.31 ± 0.88 mm, 1.75 ± 0.9 mm and 6.67° ± 3.70°, respectively. The average deviation of implant platform, apex and angular in S-CAIS were 0.67 ± 0.32 mm, 1.00 ± 0.39 and 2.66° ± 1.77°, respectively. The average deviation of implant platform, apex and angular in D-CAIS were 1.14 ± 0.70 mm, 1.23 ± 0.58 and 3.20° ± 2.16°, respectively. Significant discrepancies at the implant platform, implant apex, and angular deviation were found between all surgical methods (p < 0.016). Learning curves were evident after multiple implant insertions using both freehand and S-CAIS.CONCLUSIONThe findings indicate that computer-assisted implant insertion leads to a more precise implant alignment than implants inserted freehand in an experimental set-up.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"24 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991691","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}
Mattia Severi, Franzini Chiara, Anna Simonelli, Chiara Scapoli, Leonardo Trombelli
ObjectiveTo evaluate the effectiveness of Sub‐periosteal Peri‐implant Augmented Layer (SPAL) technique performed with deproteinized bovine bone mineral (DBBM), delivered either as particulate (pDBBM) or block (bDBBM), in correcting a peri implant bone dehiscence (PIBD). Implants showing a thick (≥ 2 mm) peri‐implant buccal bone plate (PBBP) at placement were also examined.Material and MethodsPatients with a PIBD ≥ 1 mm, treated with SPAL with either pDBBM (SPALparticulate) or bDBBM (SPALblock), and patients with an implant showing a PBBP ≥ 2 mm at insertion (CONTROL) were included. Re‐entry was performed either at 6 months (SPAL groups) or 3 months (CONTROL). The rate of patients presenting no PIBD at re‐entry was the primary outcome. Bone dehiscence height (BDH) and width (BDW), thickness of buccal tissues (BTT) and marginal bone level (MBL) were secondary outcomes.ResultsThirty‐nine implants in 39 patients (14 in SPALparticulate,14 in SPALblock and 11 in CONTROL) were analyzed. No PIBD were found in SPALparticulate whereas in SPALblock one PIBD was present. Two patients in CONTROL presented a PIBD. A reduction in both BDH and BDW was observed in both SPALparticulate (2.7 ± 1.6 mm for BDH and 3.9 ± 0.2 mm for BDW) and SPALblock (2.5 ± 1.8 mm for BDH and 3.8 ± 1.1 mm for BDW). SPALblock showed a higher BTT than SPALparticulate at re‐entry (3.6 ± 1.3 mm for SPALblock and 2.6 ± 0.6 mm for SPALparticulate, p = 0.0160). All groups showed similar MBL.ConclusionSPAL performed with either a pDBBM or bDBBM is similarly effective in correcting a PIBD as well as in increasing BTT.
目的评价骨膜下种植体周围增强层（SPAL）技术与脱蛋白牛骨矿物质（DBBM）结合，以颗粒（pDBBM）或阻滞（bDBBM）的形式治疗种植体周围骨裂（PIBD）的效果。植入时显示种植体周围颊骨板（PBBP）较厚（≥2mm）。材料和方法纳入PIBD≥1mm的患者，用pDBBM （SPALparticulate）或bDBBM （SPALblock）治疗SPAL，以及植入时PBBP≥2mm的患者（CONTROL）。在6个月时（SPAL组）或3个月时（CONTROL组）重新入组。再入院时无PIBD的患者比率是主要终点。骨裂高度（BDH）和宽度（BDW）、颊组织厚度（BTT）和边缘骨水平（MBL）为次要观察指标。结果39例患者共39例种植体（SPALparticulate组14例，SPALblock组14例，CONTROL组11例）。spal颗粒中未发现PIBD，而SPALblock中存在1个PIBD。对照组2例患者出现PIBD。spal颗粒物（BDH为2.7±1.6 mm， BDW为3.9±0.2 mm）和SPALblock （BDH为2.5±1.8 mm， BDW为3.8±1.1 mm）均观察到BDH和BDW的减少。SPALblock在重新进入时的BTT高于SPALparticulate （SPALblock为3.6±1.3 mm， SPALparticulate为2.6±0.6 mm, p = 0.0160）。各组MBL表现相似。结论使用pDBBM或bDBBM进行spal在纠正PIBD和增加BTT方面同样有效。
{"title":"Correction of Peri‐Implant Buccal Bone Dehiscence Following Sub‐Periosteal Peri‐Implant Augmented Layer Technique With Either Block or Particulate Xenograft: A Retrospective Study","authors":"Mattia Severi, Franzini Chiara, Anna Simonelli, Chiara Scapoli, Leonardo Trombelli","doi":"10.1111/clr.14400","DOIUrl":"https://doi.org/10.1111/clr.14400","url":null,"abstract":"ObjectiveTo evaluate the effectiveness of Sub‐periosteal Peri‐implant Augmented Layer (SPAL) technique performed with deproteinized bovine bone mineral (DBBM), delivered either as particulate (pDBBM) or block (bDBBM), in correcting a peri implant bone dehiscence (PIBD). Implants showing a thick (≥ 2 mm) peri‐implant buccal bone plate (PBBP) at placement were also examined.Material and MethodsPatients with a PIBD ≥ 1 mm, treated with SPAL with either pDBBM (SPAL<jats:sub>particulate</jats:sub>) or bDBBM (SPAL<jats:sub>block</jats:sub>), and patients with an implant showing a PBBP ≥ 2 mm at insertion (CONTROL) were included. Re‐entry was performed either at 6 months (SPAL groups) or 3 months (CONTROL). The rate of patients presenting no PIBD at re‐entry was the primary outcome. Bone dehiscence height (BDH) and width (BDW), thickness of buccal tissues (BTT) and marginal bone level (MBL) were secondary outcomes.ResultsThirty‐nine implants in 39 patients (14 in SPAL<jats:sub>particulate</jats:sub>,14 in SPAL<jats:sub>block</jats:sub> and 11 in CONTROL) were analyzed. No PIBD were found in SPAL<jats:sub>particulate</jats:sub> whereas in SPAL<jats:sub>block</jats:sub> one PIBD was present. Two patients in CONTROL presented a PIBD. A reduction in both BDH and BDW was observed in both SPAL<jats:sub>particulate</jats:sub> (2.7 ± 1.6 mm for BDH and 3.9 ± 0.2 mm for BDW) and SPAL<jats:sub>block</jats:sub> (2.5 ± 1.8 mm for BDH and 3.8 ± 1.1 mm for BDW). SPAL<jats:sub>block</jats:sub> showed a higher BTT than SPAL<jats:sub>particulate</jats:sub> at re‐entry (3.6 ± 1.3 mm for SPAL<jats:sub>block</jats:sub> and 2.6 ± 0.6 mm for SPAL<jats:sub>particulate</jats:sub>, <jats:italic>p</jats:italic> = 0.0160). All groups showed similar MBL.ConclusionSPAL performed with either a pDBBM or bDBBM is similarly effective in correcting a PIBD as well as in increasing BTT.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"6 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989918","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}
ObjectivesWNT10A mutations are associated with tooth agenesis. This study aimed to assess the clinical outcomes of dental implants in patients carrying WNT10A mutations with different molecular statuses and phenotypes over a long‐term follow‐up period.Materials and MethodsPatients with tooth agenesis were screened by whole‐exome sequencing (WES) from January 2010 to September 2023. Carriers of pathogenic WNT10A mutations who underwent subsequent dental implant therapy were evaluated.ResultsWES identified 66 patients with tooth agenesis carrying WNT10A mutations. Of these, 27 patients (11 males/16 females; mean age 19.6 years) met the inclusion criteria. Homozygotes had significantly more missing teeth (24.4 ± 3.8) than heterozygotes (10.9 ± 5.1, p < 0.0001) and compound heterozygotes (13.8 ± 3.5, p = 0.001). A total of 160 conventional implants were placed. Seven implants were lost in four patients before final prosthesis placement, resulting in overall failure rates of 14.8% at the subject level and 4.4% at the implant level. The 5‐year cumulative survival rate (range: 0.23–12.74 years) was 85.2% and 95.6% at the subject and implant levels, respectively. The mean marginal bone loss (MBL) was 0.80 mm (95% CI: 0.59–1.02). Subgroup analysis revealed higher MBL in homozygotes (p = 0.002), sites requiring extensive bone augmentation (p = 0.016), anterior regions (p = 0.031), and full‐arch bridge cases (p < 0.0001). Patient satisfaction and OHIP‐C49 scores were favorable.ConclusionsImplant rehabilitation is predictable for patients with WNT10A mutations. However, increased MBL observed in homozygotes with severe tooth agenesis and in cases requiring extensive alveolar bone augmentation highlights the importance of genetic diagnosis prior to implant therapy in patients with severe tooth agenesis.
{"title":"Dental Implant Rehabilitation in Patients Carrying WNT10A Mutations With Different Molecular Statuses and Phenotypes: A Retrospective Cohort Study","authors":"Jiaqi Dou, Qinggang Dai, Xinbo Yu, Yining He, Yuwei Dai, Feng Wang, Yiqun Wu","doi":"10.1111/clr.14402","DOIUrl":"https://doi.org/10.1111/clr.14402","url":null,"abstract":"Objectives<jats:italic>WNT10A</jats:italic> mutations are associated with tooth agenesis. This study aimed to assess the clinical outcomes of dental implants in patients carrying <jats:italic>WNT10A</jats:italic> mutations with different molecular statuses and phenotypes over a long‐term follow‐up period.Materials and MethodsPatients with tooth agenesis were screened by whole‐exome sequencing (WES) from January 2010 to September 2023. Carriers of pathogenic <jats:italic>WNT10A</jats:italic> mutations who underwent subsequent dental implant therapy were evaluated.ResultsWES identified 66 patients with tooth agenesis carrying <jats:italic>WNT10A</jats:italic> mutations. Of these, 27 patients (11 males/16 females; mean age 19.6 years) met the inclusion criteria. Homozygotes had significantly more missing teeth (24.4 ± 3.8) than heterozygotes (10.9 ± 5.1, <jats:italic>p</jats:italic> < 0.0001) and compound heterozygotes (13.8 ± 3.5, <jats:italic>p</jats:italic> = 0.001). A total of 160 conventional implants were placed. Seven implants were lost in four patients before final prosthesis placement, resulting in overall failure rates of 14.8% at the subject level and 4.4% at the implant level. The 5‐year cumulative survival rate (range: 0.23–12.74 years) was 85.2% and 95.6% at the subject and implant levels, respectively. The mean marginal bone loss (MBL) was 0.80 mm (95% CI: 0.59–1.02). Subgroup analysis revealed higher MBL in homozygotes (<jats:italic>p</jats:italic> = 0.002), sites requiring extensive bone augmentation (<jats:italic>p</jats:italic> = 0.016), anterior regions (<jats:italic>p</jats:italic> = 0.031), and full‐arch bridge cases (<jats:italic>p</jats:italic> < 0.0001). Patient satisfaction and OHIP‐C49 scores were favorable.ConclusionsImplant rehabilitation is predictable for patients with <jats:italic>WNT10A</jats:italic> mutations. However, increased MBL observed in homozygotes with severe tooth agenesis and in cases requiring extensive alveolar bone augmentation highlights the importance of genetic diagnosis prior to implant therapy in patients with severe tooth agenesis.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"83 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988541","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}
{"title":"NOTIFICATION: Human Fetal Osteoblast Behavior on Zirconia Dental Implants and Zirconia Disks With Microstructured Surfaces. An Experimental In Vitro Study","authors":"","doi":"10.1111/clr.14395","DOIUrl":"https://doi.org/10.1111/clr.14395","url":null,"abstract":"","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"27 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974585","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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