Clinical Oral Implants Research最新文献

Objective: Abaloparatide (ABL) is a synthetic parathyroid hormone-related protein analog developed as an anabolic drug to treat osteoporosis. ABL increases bone mineral density (BMD) of the long bones and spine; however, the influence of ABL on alveolar bone regeneration remains unknown. This study assessed the effects of systemic ABL administration on tooth extraction socket healing and dental implant osseointegration in a preclinical rodent model.

Methods: Sprague-Dawley rats received daily subcutaneous injection of ABL (25 μg/kg) or vehicle (VEH) at the time of maxillary first molar (M1) extraction surgery; animals underwent either: (1) unilateral M1 extraction followed by sacrifice at 10 or 42d or (2) bilateral M1 extraction followed by staged implant placement in osteotomies with standardized defects and sacrifice at 21 or 28d.

Results: Micro-computed tomography (micro-CT) analysis demonstrated that ABL increased bone volume fraction (p = 0.004) and bone mineral density (BMD) (p = 0.006) of regenerated extraction sockets at 42d. Micro-CT of the femur validated systemic effects of ABL, showing greater trabecular BMD after 6 (p < 0.01), 9 (p < 0.001), and 14 (p < 0.001) weeks of treatment. Histomorphometry confirmed a higher mineralized bone area with ABL treatment in extraction sockets at 42d (p = 0.03) and in the regenerated peri-implant bone at 21d post-implant placement (p = 0.01) compared to control.

Conclusion: Systemic ABL administration enhances osteogenesis in extraction sockets prior to implant placement and accelerates peri-implant bone formation in the early phase of healing in the present rodent model.

The inside back cover image is based on the Original article Comparison of Different Intraoral Scanners With Prefabricated Aid on Accuracy and Framework Passive Fit of Digital Complete-Arch Implant Impression: An In Vitro Study by Xiao-Meng Zhang et al., https://doi.org/10.1111/clr.14353.

Objective: To evaluate the potential mid-term benefit of the use of a bone substitute material in the reconstructive surgical treatment of peri-implantitis.

Methods: A total of 120 subjects (127 implants) affected by peri-implantitis were followed over 3 years in a multicenter randomized clinical trial. Participants had been randomized to either control (access flap surgery) or test group (access flap surgery and bone substitute material). Clinical, radiographic, and patient-reported outcomes were assessed. The primary outcome was a composite measure including probing pocket depth ≤ 5 mm, absence of bleeding and suppuration on probing, soft tissue recession ≤ 1 mm, and implant neither reoperated nor lost. In an additional outcome (disease resolution), we allowed for one bleeding site and did not consider recession.

Results: While 14 implants (11%) were lost and a second surgical intervention had been performed at 3 implants (2.4%), pronounced improvements of clinical parameters were noted at remaining implants in both treatment groups at the 3-year follow-up. This was illustrated by a 3.2-3.5 mm reduction in probing pocket depth and a marginal bone level gain of 1.1-1.3 mm. The primary composite outcome, however, was only achieved at 14% of implants. The second composite outcome defining disease resolution was accomplished at 39% of implants. Patient-reported outcomes were generally favorable.

Conclusion: At 3 years, the use of a bone substitute material in the surgical therapy of peri-implantitis did not result in a clear benefit over access flap surgery alone.

Trial registration: ClinicalTrials.gov identifier: NCT0307706.

Objectives: To evaluate the clinical and radiographic results of transalveolar sinus floor elevation (TSFE) with grafting in cases of severely atrophic maxilla.

Materials and methods: A retrospective analysis of clinical and radiographic data was conducted. Between 2015 and 2018, a total of 105 implants were placed in 105 patients over a follow-up period of 5-8 years. Implant failures and endo-sinus bone gain (ESBG) were assessed. Statistical models were established to investigate the potential influencing factors of implant survival and ESBG.

Results: Six patients with six implants were lost, resulting in cumulative survival rates of 94% for both patient- and implant-based analyses. The 8-year cumulative survival rate was significantly lower for residual bone height (RBH) < 4 mm (88%) compared to RBH 4-6 mm (98%). ESBG ≥ 4 mm and ESBG ≥ 6 mm were observed in 89.90% and 58.59% of implant sites, respectively. According to the log-rank Mantel-Cox analysis results, none of the factors examined were significantly related to implant failure, except for RBH (p = 0.038) at baseline. The linear mixed-model regression results showed that the final ESBG was positively correlated with implant insertion site (p = 0.003), implant length (p < 0.001), sinus floor elevation (SFE) methods (p = 0.010), and RBH (p < 0.001).

Conclusions: Within the limitations of this study, it has been established that TSFE with grafting was a reliable method for implant placement in the posterior atrophic maxilla ridges with RBH ranging from 4 to 6 mm. Nevertheless, caution was advised when considering its application in cases where the initial bone height falls below 4 mm.

Background: Recently, the importance of peri-implant soft tissue integration quality has been recognised as an essential factor in the long-term success of dental implant rehabilitation.

Aim: The aim of this study was to explore the influence of three materials commonly used in implant dentistry, namely titanium (Ti), dental adhesive resin (Re) and polyetheretherketone (PEEK), on the peri-implant soft tissues.

Methods: In this clinical randomised comparative study, 37 bone-level implants were placed, and experimental transmucosal healing abutments made of different materials were randomly assigned to each implant. These abutments were removed together with the surrounding soft tissues after 8 weeks. Immunohistochemical analyses were performed to determine the presence and localisation of different immune cells. In addition, clinical and radiographic data were collected and peri-implant bone remodeling was assessed.

Results: Compared to the Ti and PEEK groups, Re abutments revealed a higher infiltration of macrophages in the connective tissue (p = 0.04) and neutrophils in the adjacent epithelium (p = 0.03). In the Re abutments, peri-implant bone remodeling was higher compared to the other groups (p = 0.01).

Conclusion: The use of resin material as a transmucosal healing abutment should be carefully considered as it was associated with a higher presence of inflammatory cells at 8 weeks post-implantation as well as superior bone remodeling compared to PEEK and Ti.

Objectives: Primary stability (PS) is a key factor for promoting osseointegration and long-term success of dental implants particularly for immediate loading protocols. Beyond the current assessments of PS, an accurate pre-operative evaluation of PS would contribute to the improvement of surgical planning and treatment outcome. This study used biomechanical testing and homogenized finite element (hFE) analysis to objectively measure PS in the laboratory, and digitally estimate PS from prior μCT reconstructions.

Material and methods: Thirty-five bone samples extracted from the jaws of two donors were examined. Twenty-two were finally evaluated for PS. After scanning of the samples with μCT, implants were inserted by two experienced surgeons, and various metrics such as μCT-based bone volume fraction (BV/TV), insertion torque (IT), and resonance frequency analysis (RFA) were assessed to determine PS. Mechanical tests were conducted to measure ultimate force (UFexp) as an objective indicator of PS while the hFE simulations were performed to estimate this same ultimate force (UFsim).

Results: Higher correlation was found between UFsim and UFexp (R² = 0.85) than between BV/TV and UFexp (R² = 0.61), IT and UFexp (R² = 0.50), and RFA and UFexp (R² = 0.38). All variables demonstrated a statistically significant linear correlation with UFexp (p < 0.01).

Conclusion: UFsim turns out to be a more reliable and objective indicator of PS than IT and RFA. The hFE analysis requires prior μCT reconstructions and is currently limited by numerical convergence problems. Despite these limitations, pre-operative hFE analysis emerges as a promising tool with a higher accuracy for estimation of PS than state of care techniques.

Purpose: To evaluate the performance and clinical outcome of vertical and horizontal bone augmentation (VHBA) in posterior maxillary regions combining lateral window sinus floor elevation (LWSFE) with a horizontal bone shell technique applying the maxillary facial sinus wall as a bone plate.

Materials and methods: In 18 patients, LWSFE was combined with a horizontal bone shield augmentation procedure utilizing the maxillary facial sinus bone wall as a lateral bone plate. Both the sinus cavity and the lateral bone box created were grafted with a mixture of autogenous bone/venous blood and bovine bone mineral. The primary aim was to assess the performance of combined techniques enabling subsequent implant placement. Using radiographic measurements (preoperative, after VHBA, at implant placement, and at follow-up), bone gain/reduction of augmented horizontal ridge width (HRW) and vertical bone height (VBH) were evaluated. Additionally, clinical outcome assessing implant survival/success rate, marginal bone loss (MBL), and implant health (mucositis/peri-implantitis) was evaluated.

Results: For the combined VHBA techniques, HRW and VBH increased significantly (p < 0.001) from preoperative 3.5 ± 1.4 mm/3.6 ± 2.1 mm to 9.7 ± 1.9 mm/18.0 ± 1.6 mm post-augmentation. However, HRW and VBH dimensions decreased up to 8.9 ± 1.8 mm/17.1 ± 1.4 mm at implant placement and 8.6 ± 1.7 mm/16.7 ± 1.3 mm at follow-up evaluation (3.8 ± 1.8 years; p < 0.001, respectively). Augmented bone reduction was significantly higher (-7.7%) between the augmentation procedure and implant placement than in the post-implant-placement period (-2.5%). All implants survived (100%) representing peri-implant MBL of -0.9 ± 0.7 mm, pocket depth of 3.4 + 1.8 mm, and prevalences of 5%/0% for peri-implant mucositis/peri-implantitis.

Conclusion: The combination of horizontal bone augmentation using local bone shield transfer from the maxillary facial sinus wall with LWSFE enables sufficient reconstruction of maxillary posterior ridge.