Objectives: This study aims to examine differences in trueness and precision between surgical guides with (S) and without sleeves (SL). A secondary aim was to assess the impact of the sleeve-to-bone distance.
Materials and methods: Mandible replicas (n = 120) were printed from an STL file obtained from a clinical CBCT. The mandibles were divided into sleeved (S, n = 60) and sleeveless (SL, n = 60) groups, each further divided into three categories (n = 20 each) with different heights from the guide to the implant platform: 2 mm (H2), 4 mm (H4), or 6 mm (H6). Digital planning and surgical guide design were done for a 4.1 × 10 mm implant for site #30. Post-op positions were captured using a scan body and lab scanner. Angular deviation was the primary outcome, with 3D and 2D deviations as secondary parameters. Statistical analysis included two-sample t-tests, and one-way and two-way ANOVA.
Results: Group S (2.41 ± 1.41°) had significantly greater angular deviation than Group SL (1.65 ± 0.93°; p = 0.0001). Angular deviation increased with sleeve-to-bone distance. H2 deviations were 1.48 ± 0.80° (S) vs. 1.02 ± 0.45° (SL; p < 0.05), H4: 2.36 ± 1.04° (S) vs. 1.48 ± 0.79° (SL; p < 0.05), H6: 3.37 ± 0.67° (S) vs. 2.46 ± 0.89° (SL; p < 0.05). 3D deviation at the implant platform was 0.36 ± 0.17 mm (S) vs. 0.30 ± 0.15 mm (SL; p < 0.05) and at the apex 0.74 ± 0.34 mm (S) vs. 0.53 ± 0.31 mm (SL; p < 0.01). Group SL at H2 had the smallest inter-implant distance (0.53 ± 0.37°), while Group S at H4 had the largest (1.20 ± 0.84°; p < 0.05).
Conclusions: Sleeveless guides are more accurate than sleeved guides, and angular deviation is influenced by the distance from the guide to the implant platform.
{"title":"Are Sleeves Necessary in Static Computer-Assisted Implant Surgery? A Comparative In Vitro Analysis.","authors":"Jenna Hang, Arndt Guentsch","doi":"10.1111/clr.14368","DOIUrl":"https://doi.org/10.1111/clr.14368","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to examine differences in trueness and precision between surgical guides with (S) and without sleeves (SL). A secondary aim was to assess the impact of the sleeve-to-bone distance.</p><p><strong>Materials and methods: </strong>Mandible replicas (n = 120) were printed from an STL file obtained from a clinical CBCT. The mandibles were divided into sleeved (S, n = 60) and sleeveless (SL, n = 60) groups, each further divided into three categories (n = 20 each) with different heights from the guide to the implant platform: 2 mm (H2), 4 mm (H4), or 6 mm (H6). Digital planning and surgical guide design were done for a 4.1 × 10 mm implant for site #30. Post-op positions were captured using a scan body and lab scanner. Angular deviation was the primary outcome, with 3D and 2D deviations as secondary parameters. Statistical analysis included two-sample t-tests, and one-way and two-way ANOVA.</p><p><strong>Results: </strong>Group S (2.41 ± 1.41°) had significantly greater angular deviation than Group SL (1.65 ± 0.93°; p = 0.0001). Angular deviation increased with sleeve-to-bone distance. H2 deviations were 1.48 ± 0.80° (S) vs. 1.02 ± 0.45° (SL; p < 0.05), H4: 2.36 ± 1.04° (S) vs. 1.48 ± 0.79° (SL; p < 0.05), H6: 3.37 ± 0.67° (S) vs. 2.46 ± 0.89° (SL; p < 0.05). 3D deviation at the implant platform was 0.36 ± 0.17 mm (S) vs. 0.30 ± 0.15 mm (SL; p < 0.05) and at the apex 0.74 ± 0.34 mm (S) vs. 0.53 ± 0.31 mm (SL; p < 0.01). Group SL at H2 had the smallest inter-implant distance (0.53 ± 0.37°), while Group S at H4 had the largest (1.20 ± 0.84°; p < 0.05).</p><p><strong>Conclusions: </strong>Sleeveless guides are more accurate than sleeved guides, and angular deviation is influenced by the distance from the guide to the implant platform.</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380197","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}
Jonas Lorenz, Shahram Ghanaati, Zoran Aleksic, Iva Milinkovic, Zoran Lazic, Marko Magić, Bastian Wessing, Ramona Schleich Grotenclos, Mauro Merli, Giorgia Mariotti, Eriberto Bressan, Luca De Stavola, Robert Sader
Objective: Assess whether horizontal ridge augmentation with guided bone regeneration (GBR) using deproteinized bovine bone mineral (DBBM), autologous bone, and a resorbable collagen membrane supports successful implant placement.
Materials and methods: This open, prospective, single-cohort, multicenter clinical study included patients with ridge defects that required GBR prior to implant insertion. The primary endpoint was radiologically assessed bone gain after 8 months post-GBR, measured at the center of planned implant sites. Secondary endpoints included implant survival and success, marginal bone levels (MBLs), MBL changes, and soft tissue health.
Results: Of 45 patients evaluated 8 months post-GBR, nine experienced dehiscence in the first 3 weeks of the healing period. GBR led to radiologically determined mean bone width gain of 4.0 ± 1.5 mm and 4.8 ± 1.7 mm, measured 1 and 3 mm from the top of the crest, respectively, allowing successful implant placement in 44 patients (97.8%). The cumulative implant survival and success rates were 98.9% and 95.5%, respectively. MBLs were stable: -1.18 ± 0.64 mm at definitive prosthesis placement (DPP) and - 1.07 ± 0.74 mm at 1 year. Soft tissue health and esthetics (plaque and bleeding indices, papilla, keratinized mucosa, and pink esthetic score) improved from DPP to 1 year. Patients were highly satisfied with implant function and esthetics, and their oral health-related quality of life improved.
Conclusions: GBR using DBBM and a collagen membrane offered a safe and effective treatment option for horizontal ridge augmentation sufficient to support implant-based tooth rehabilitation.
Trial registration: Registered at ClinicalTrials.gov NCT03028922 (registrations sites, as above listed affiliations, first posted January 23, 2017).
{"title":"Horizontal Guided Bone Regeneration of the Posterior Mandible to Allow Implant Placement: 1-Year Prospective Study Results.","authors":"Jonas Lorenz, Shahram Ghanaati, Zoran Aleksic, Iva Milinkovic, Zoran Lazic, Marko Magić, Bastian Wessing, Ramona Schleich Grotenclos, Mauro Merli, Giorgia Mariotti, Eriberto Bressan, Luca De Stavola, Robert Sader","doi":"10.1111/clr.14363","DOIUrl":"https://doi.org/10.1111/clr.14363","url":null,"abstract":"<p><strong>Objective: </strong>Assess whether horizontal ridge augmentation with guided bone regeneration (GBR) using deproteinized bovine bone mineral (DBBM), autologous bone, and a resorbable collagen membrane supports successful implant placement.</p><p><strong>Materials and methods: </strong>This open, prospective, single-cohort, multicenter clinical study included patients with ridge defects that required GBR prior to implant insertion. The primary endpoint was radiologically assessed bone gain after 8 months post-GBR, measured at the center of planned implant sites. Secondary endpoints included implant survival and success, marginal bone levels (MBLs), MBL changes, and soft tissue health.</p><p><strong>Results: </strong>Of 45 patients evaluated 8 months post-GBR, nine experienced dehiscence in the first 3 weeks of the healing period. GBR led to radiologically determined mean bone width gain of 4.0 ± 1.5 mm and 4.8 ± 1.7 mm, measured 1 and 3 mm from the top of the crest, respectively, allowing successful implant placement in 44 patients (97.8%). The cumulative implant survival and success rates were 98.9% and 95.5%, respectively. MBLs were stable: -1.18 ± 0.64 mm at definitive prosthesis placement (DPP) and - 1.07 ± 0.74 mm at 1 year. Soft tissue health and esthetics (plaque and bleeding indices, papilla, keratinized mucosa, and pink esthetic score) improved from DPP to 1 year. Patients were highly satisfied with implant function and esthetics, and their oral health-related quality of life improved.</p><p><strong>Conclusions: </strong>GBR using DBBM and a collagen membrane offered a safe and effective treatment option for horizontal ridge augmentation sufficient to support implant-based tooth rehabilitation.</p><p><strong>Trial registration: </strong>Registered at ClinicalTrials.gov NCT03028922 (registrations sites, as above listed affiliations, first posted January 23, 2017).</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342959","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}
AimPeri‐implant mucositis, a dysbiosis‐driven inflammatory disease, is a precursor to peri‐implantitis, underscoring the need for early disease management. Therefore, we investigated the efficacy of glycine powder in resolving clinical inflammation and restoring host‐microbial homeostasis.MethodsThirty subjects were randomized to receive either glycine powder air‐abrasive debridement or ultrasonic instrumentation. Clinical parameters (probe depth [PD], modified Sulcular Bleeding Index [mSBI], modified Plaque Index [mPlI]), biofilm and peri‐implant crevicular fluid were collected at baseline and at 1‐day, 1‐, 3‐, 6‐weeks and 3‐ and 6‐months post‐therapy. Microbial recolonization was examined using 16S rDNA sequencing and immune response was semi‐quantified using a bead‐based 17‐plex microarray.ResultsAt 6‐months, both groups demonstrated non‐significant reductions in mSBI when compared to baseline (p > 0.05, Wald test, mixed model for repeated measures). However, mSBI and PD decreased in the test group from week‐1 to 3‐months, while control group decreased at 1‐ and 3‐weeks only. mSBI was lower in the test group when compared to controls from Week‐1 to 3‐months, while PD differed between groups at 6 weeks and 3‐months. Glycine group demonstrated significant microbial shifts after 24‐h, increases in species richness and health‐compatible species, and loss of pathobionts (p < 0.001, Dunn test). Pro‐inflammatory cytokines decreased from 1‐ to 6‐weeks or 3‐months (p < 0.05, Wald test). Comparable results were obtained in the ultrasonic group at 3‐weeks and sustained over 6‐weeks post‐therapy.ConclusionsGlycine therapy leads to early and sustained change in host‐microbial interactions when compared to ultrasonics, however, the changes wrought by both therapies were sustained for a maximum of 3 months.Trial RegistrationClinicalTrials.gov identifier: NCT05810558
{"title":"Impact of Glycine Powder Air‐Abrasive Debridement on Peri‐Implant Mucositis: A Randomized Control Trial of Clinical, Microbial, and Immunological Changes","authors":"Brian Partido, Shweta Saraswat, Purnima S. Kumar","doi":"10.1111/clr.14361","DOIUrl":"https://doi.org/10.1111/clr.14361","url":null,"abstract":"AimPeri‐implant mucositis, a dysbiosis‐driven inflammatory disease, is a precursor to peri‐implantitis, underscoring the need for early disease management. Therefore, we investigated the efficacy of glycine powder in resolving clinical inflammation and restoring host‐microbial homeostasis.MethodsThirty subjects were randomized to receive either glycine powder air‐abrasive debridement or ultrasonic instrumentation. Clinical parameters (probe depth [PD], modified Sulcular Bleeding Index [mSBI], modified Plaque Index [mPlI]), biofilm and peri‐implant crevicular fluid were collected at baseline and at 1‐day, 1‐, 3‐, 6‐weeks and 3‐ and 6‐months post‐therapy. Microbial recolonization was examined using 16S rDNA sequencing and immune response was semi‐quantified using a bead‐based 17‐plex microarray.ResultsAt 6‐months, both groups demonstrated non‐significant reductions in mSBI when compared to baseline (<jats:italic>p</jats:italic> > 0.05, Wald test, mixed model for repeated measures). However, mSBI and PD decreased in the test group from week‐1 to 3‐months, while control group decreased at 1‐ and 3‐weeks only. mSBI was lower in the test group when compared to controls from Week‐1 to 3‐months, while PD differed between groups at 6 weeks and 3‐months. Glycine group demonstrated significant microbial shifts after 24‐h, increases in species richness and health‐compatible species, and loss of pathobionts (<jats:italic>p</jats:italic> < 0.001, Dunn test). Pro‐inflammatory cytokines decreased from 1‐ to 6‐weeks or 3‐months (<jats:italic>p</jats:italic> < 0.05, Wald test). Comparable results were obtained in the ultrasonic group at 3‐weeks and sustained over 6‐weeks post‐therapy.ConclusionsGlycine therapy leads to early and sustained change in host‐microbial interactions when compared to ultrasonics, however, the changes wrought by both therapies were sustained for a maximum of 3 months.Trial Registration<jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"http://clinicaltrials.gov\">ClinicalTrials.gov</jats:ext-link> identifier: NCT05810558","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"56 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142329196","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}
Panagiotis Ntovas,Laurent Marchand,Barmak Basir,Yukio Kudara,Marta Revilla-Leon,Wael Att
PURPOSETo evaluate the dimensional stability over time of additively manufactured surgical templates, fabricated by different resins, and stored by different methods.MATERIALS AND METHODSUsing a 3D printer with DLS technology and two different resins (Surgical Guide (SG)-WhipMix and Key Guide (KG)-KeystoneIndustries), 96 surgical guides were additively manufactured. The guides were stored in three different environments: directly exposed to sunlight (S1), in normal interior room conditions (S2), and in darkness (S3). The guides were digitally scanned immediately after fabrication and post-processing, and after 1, 3, and 6 months of storage. For each group, the mean deviation of the root mean square (RMS) between guide's intaglio surface, as well as the axial deviation between sleeves' housings were calculated.RESULTSThe mean axial variations of angular axis deviation of sleeves' housings ranged between 0.09° and 3.99°. The mean deviation of the RMS discrepancy in guide's intaglio ranged from 0.1 to 0.18 mm. Variations were significant (p < 0.001) only for the S1 group and only for SG material. After 3 months, an additional storage time of 3 months did not have any further effect on dimensional stability.CONCLUSIONSWithin the limitations of the present study, storage time of a surgical guide for up to 3 months after manufacturing, as well as printing material can significantly affect surgical guide's dimensional stability, when they are exposed to direct or indirect sunlight conditions. Storage of guides in a dark environment is recommended in order to avoid an additional source of error in computer-guided surgery workflows.
{"title":"Effect of Storage Conditions and Time on the Dimensional Stability of 3D Printed Surgical Guides: An In Vitro Study.","authors":"Panagiotis Ntovas,Laurent Marchand,Barmak Basir,Yukio Kudara,Marta Revilla-Leon,Wael Att","doi":"10.1111/clr.14362","DOIUrl":"https://doi.org/10.1111/clr.14362","url":null,"abstract":"PURPOSETo evaluate the dimensional stability over time of additively manufactured surgical templates, fabricated by different resins, and stored by different methods.MATERIALS AND METHODSUsing a 3D printer with DLS technology and two different resins (Surgical Guide (SG)-WhipMix and Key Guide (KG)-KeystoneIndustries), 96 surgical guides were additively manufactured. The guides were stored in three different environments: directly exposed to sunlight (S1), in normal interior room conditions (S2), and in darkness (S3). The guides were digitally scanned immediately after fabrication and post-processing, and after 1, 3, and 6 months of storage. For each group, the mean deviation of the root mean square (RMS) between guide's intaglio surface, as well as the axial deviation between sleeves' housings were calculated.RESULTSThe mean axial variations of angular axis deviation of sleeves' housings ranged between 0.09° and 3.99°. The mean deviation of the RMS discrepancy in guide's intaglio ranged from 0.1 to 0.18 mm. Variations were significant (p < 0.001) only for the S1 group and only for SG material. After 3 months, an additional storage time of 3 months did not have any further effect on dimensional stability.CONCLUSIONSWithin the limitations of the present study, storage time of a surgical guide for up to 3 months after manufacturing, as well as printing material can significantly affect surgical guide's dimensional stability, when they are exposed to direct or indirect sunlight conditions. Storage of guides in a dark environment is recommended in order to avoid an additional source of error in computer-guided surgery workflows.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"25 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320977","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}
Aim: To assess the feasibility of immediate (IIP), early (EIP) and delayed implant placement (DIP) for single tooth replacement in the premaxilla on the basis of the complete indication area of each approach in routine practice.
Materials and methods: Data from 100 patients (59 women, 41 men, all Caucasians) aged between 19 and 81 years old (mean age 51.71) who had been consecutively treated with a single implant in the premaxilla (13-23) in one private periodontal practice were retrospectively collected. Demographic data, diagnostic information and linear measurements were extracted from patient files and CBCTs. The feasibility of IIP, EIP and DIP was assessed for all cases by both authors, based on the following criteria: availability of apical bone, position of the tooth in relation to the morphology of the alveolar process, buccal bone morphology and presence of midfacial recession. The reasons for not being able to perform an approach, and the viable alternatives for each approach were secondary outcomes. DIP was considered to have been preceded by alveolar ridge preservation (ARP).
Results: Ninety-two patients could be treated by means of IIP, EIP or DIP. In eight patients none of these approaches were possible as they required bone augmentation prior to implant placement. Fifty-two patients (95% CI: 42%-62%) could by treated with IIP, 58 (95% CI: 48%-67%) with EIP and 88 (95% CI: 80%-93%) with DIP. The feasibility proportions of IIP and EIP were significantly lower than the one of DIP (p < 0.001). All patients who could be treated with IIP could also be treated with EIP or DIP. Lack of apical bone for implant anchorage was the main reason for not being able to perform IIP and EIP. Complete loss of the buccal bone wall and the need for bone augmentation prior to implant placement were the reasons for not being able to perform DIP.
Conclusion: From the results of this retrospective CBCT analysis, DIP is nearly always possible in contrast to IIP and EIP. Therefore, and since it is much easier than IIP and EIP, inexperienced clinicians should mainly focus on ARP and DIP in clinical practice deferring IIP and EIP until more surgical skills have been acquired.
{"title":"Feasibility of Immediate, Early and Delayed Implant Placement for Single Tooth Replacement in the Premaxilla: A Retrospective Cone-Beam Computed Tomography Study of 100 Cases.","authors":"Axelle Ickroth, Jan Cosyn","doi":"10.1111/clr.14359","DOIUrl":"10.1111/clr.14359","url":null,"abstract":"<p><strong>Aim: </strong>To assess the feasibility of immediate (IIP), early (EIP) and delayed implant placement (DIP) for single tooth replacement in the premaxilla on the basis of the complete indication area of each approach in routine practice.</p><p><strong>Materials and methods: </strong>Data from 100 patients (59 women, 41 men, all Caucasians) aged between 19 and 81 years old (mean age 51.71) who had been consecutively treated with a single implant in the premaxilla (13-23) in one private periodontal practice were retrospectively collected. Demographic data, diagnostic information and linear measurements were extracted from patient files and CBCTs. The feasibility of IIP, EIP and DIP was assessed for all cases by both authors, based on the following criteria: availability of apical bone, position of the tooth in relation to the morphology of the alveolar process, buccal bone morphology and presence of midfacial recession. The reasons for not being able to perform an approach, and the viable alternatives for each approach were secondary outcomes. DIP was considered to have been preceded by alveolar ridge preservation (ARP).</p><p><strong>Results: </strong>Ninety-two patients could be treated by means of IIP, EIP or DIP. In eight patients none of these approaches were possible as they required bone augmentation prior to implant placement. Fifty-two patients (95% CI: 42%-62%) could by treated with IIP, 58 (95% CI: 48%-67%) with EIP and 88 (95% CI: 80%-93%) with DIP. The feasibility proportions of IIP and EIP were significantly lower than the one of DIP (p < 0.001). All patients who could be treated with IIP could also be treated with EIP or DIP. Lack of apical bone for implant anchorage was the main reason for not being able to perform IIP and EIP. Complete loss of the buccal bone wall and the need for bone augmentation prior to implant placement were the reasons for not being able to perform DIP.</p><p><strong>Conclusion: </strong>From the results of this retrospective CBCT analysis, DIP is nearly always possible in contrast to IIP and EIP. Therefore, and since it is much easier than IIP and EIP, inexperienced clinicians should mainly focus on ARP and DIP in clinical practice deferring IIP and EIP until more surgical skills have been acquired.</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307261","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}
ObjectivesThis study aimed to explore multiple effects of hyperbranched poly‐l‐lysine (HBPL) titanium (Ti) surfaces on osseointegration, bacteriostasis, and anti‐inflammation across three different animal models.MethodsTi surfaces were covalently modified with HBPL, with uncoated surfaces as controls. Characterization included scanning electron microscopy (SEM) and surface chemistry and elemental analysis (EDX). Ti and Ti‐HBPL implants were placed in conventional canine edentulous sites, post‐operative infection canine edentulous sites, and diabetic rat tibias. Implants from canine edentulous models were analyzed using micro‐CT and histomorphometry to assess osseointegration at 8 weeks. Post‐operative infection beagles were used to evaluate antibacterial efficacy through clinical parameters and bacterial cultures at 1 week. In diabetic rats, micro‐CT and histomorphometry were performed at 8 weeks.ResultsHBPL was uniformly grafted on Ti‐HBPL surfaces. Ti‐HBPL surfaces showed higher bone volume/total volume (BV/TV, p < 0.001), bone‐implant contact (BIC%, p < 0.001), and trabecular number (Tb.N, p < 0.01) in beagles. Besides, it displayed higher BIC% (p < 0.001) and bone area fraction occupancy (BAFO%, p < 0.01) in hard tissue sections. In an infected model, Ti‐HBPL surfaces exhibited lower bleeding on probing (BOP, p < 0.001), and plaque index (DI, p < 0.01), with reduced bacterial colony formation (p < 0.001) compared to the control group. In diabetic rats, Ti‐HBPL surfaces showed an increase in BV/TV (p < 0.01) and Tb.N (p < 0.001), downregulated TNF‐α and IL‐1β (p < 0.01), and upregulated IL‐10 (p < 0.01) and osteocalcin (OCN) expression (p < 0.01).ConclusionsHBPL‐Ti surfaces demonstrated enhanced osseointegration, bacteriostasis, and anti‐inflammatory effects in vivo.
{"title":"Hyperbranched Poly‐l‐Lysine Modified Titanium Surface With Enhanced Osseointegration, Bacteriostasis, and Anti‐Inflammatory Properties for Implant Application: An Experimental In Vivo Study","authors":"Qifeng Jiang, Xiaoru Qin, Zhaolong Wang, Chaozhen Chen, Wei Dai, Zhikang Wang, Xiaoyan Miao, Zhiwei Jiang, Yanmin Zhang, Changyou Gao, Yue Xi, Guoli Yang","doi":"10.1111/clr.14354","DOIUrl":"https://doi.org/10.1111/clr.14354","url":null,"abstract":"ObjectivesThis study aimed to explore multiple effects of hyperbranched poly‐<jats:sc>l</jats:sc>‐lysine (HBPL) titanium (Ti) surfaces on osseointegration, bacteriostasis, and anti‐inflammation across three different animal models.MethodsTi surfaces were covalently modified with HBPL, with uncoated surfaces as controls. Characterization included scanning electron microscopy (SEM) and surface chemistry and elemental analysis (EDX). Ti and Ti‐HBPL implants were placed in conventional canine edentulous sites, post‐operative infection canine edentulous sites, and diabetic rat tibias. Implants from canine edentulous models were analyzed using micro‐CT and histomorphometry to assess osseointegration at 8 weeks. Post‐operative infection beagles were used to evaluate antibacterial efficacy through clinical parameters and bacterial cultures at 1 week. In diabetic rats, micro‐CT and histomorphometry were performed at 8 weeks.ResultsHBPL was uniformly grafted on Ti‐HBPL surfaces. Ti‐HBPL surfaces showed higher bone volume/total volume (BV/TV, <jats:italic>p</jats:italic> < 0.001), bone‐implant contact (BIC%, <jats:italic>p</jats:italic> < 0.001), and trabecular number (Tb.N, <jats:italic>p</jats:italic> < 0.01) in beagles. Besides, it displayed higher BIC% (<jats:italic>p</jats:italic> < 0.001) and bone area fraction occupancy (BAFO%, <jats:italic>p</jats:italic> < 0.01) in hard tissue sections. In an infected model, Ti‐HBPL surfaces exhibited lower bleeding on probing (BOP, <jats:italic>p</jats:italic> < 0.001), and plaque index (DI, <jats:italic>p</jats:italic> < 0.01), with reduced bacterial colony formation <jats:italic>(p</jats:italic> < 0.001) compared to the control group. In diabetic rats, Ti‐HBPL surfaces showed an increase in BV/TV (<jats:italic>p</jats:italic> < 0.01) and Tb.N (<jats:italic>p</jats:italic> < 0.001), downregulated TNF‐α and IL‐1β (<jats:italic>p</jats:italic> < 0.01), and upregulated IL‐10 (<jats:italic>p</jats:italic> < 0.01) and osteocalcin (OCN) expression (<jats:italic>p</jats:italic> < 0.01).ConclusionsHBPL‐Ti surfaces demonstrated enhanced osseointegration, bacteriostasis, and anti‐inflammatory effects in vivo.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"5 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174734","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}
OBJECTIVEComputer-assisted implant surgery (CAIS) has been introduced as a tool to aid in reaching a more accurate implant position. The aim of this network meta-analysis was to compare all the available CAIS techniques and obtain collective evidence on the method that offers the highest accuracy compared to freehand implant placement.MATERIALS AND METHODSDatabase search was done in PubMed, Scopus, and Cochrane library in addition to extensive search in the gray literature and related systematic reviews, aiming to find clinical studies that compared any CAIS technique with another, or with freehand implant placement. The outcomes evaluated were angle, platform, and apex deviation. The search process ended on March 18, 2024.RESULTSThirty-three studies were included. All CAIS techniques (static with partial or full guidance, dynamic with partial or full guidance, the combination of static and dynamic CAIS) showed significantly less deviation than freehand implant placement, except for the static CAIS with guidance for the pilot drill only. The combination of static and dynamic CAIS ranked best among all other methods. Based on the GRADE system, the certainty of evidence in the outcomes of the meta-analysis was judged as low or moderate.CONCLUSIONSThe current study demonstrates that computer-assisted implant surgery provides significantly higher accuracy in implant placement, with the combination of static and dynamic CAIS being the most precise. Nevertheless, future studies are needed, considering the different types, locations, and extents of edentulism in the analyzed investigations, as well as the necessity of obtaining stronger evidence.TRIAL REGISTRATIONPROSPERIO number: CRD42023482030.
{"title":"The Accuracy of Dental Implant Placement With Different Methods of Computer-Assisted Implant Surgery: A Network Meta-Analysis of Clinical Studies.","authors":"Basel Mahardawi,Sirimanas Jiaranuchart,Sirida Arunjaroensuk,Kanit Dhanesuan,Nikos Mattheos,Atiphan Pimkhaokham","doi":"10.1111/clr.14357","DOIUrl":"https://doi.org/10.1111/clr.14357","url":null,"abstract":"OBJECTIVEComputer-assisted implant surgery (CAIS) has been introduced as a tool to aid in reaching a more accurate implant position. The aim of this network meta-analysis was to compare all the available CAIS techniques and obtain collective evidence on the method that offers the highest accuracy compared to freehand implant placement.MATERIALS AND METHODSDatabase search was done in PubMed, Scopus, and Cochrane library in addition to extensive search in the gray literature and related systematic reviews, aiming to find clinical studies that compared any CAIS technique with another, or with freehand implant placement. The outcomes evaluated were angle, platform, and apex deviation. The search process ended on March 18, 2024.RESULTSThirty-three studies were included. All CAIS techniques (static with partial or full guidance, dynamic with partial or full guidance, the combination of static and dynamic CAIS) showed significantly less deviation than freehand implant placement, except for the static CAIS with guidance for the pilot drill only. The combination of static and dynamic CAIS ranked best among all other methods. Based on the GRADE system, the certainty of evidence in the outcomes of the meta-analysis was judged as low or moderate.CONCLUSIONSThe current study demonstrates that computer-assisted implant surgery provides significantly higher accuracy in implant placement, with the combination of static and dynamic CAIS being the most precise. Nevertheless, future studies are needed, considering the different types, locations, and extents of edentulism in the analyzed investigations, as well as the necessity of obtaining stronger evidence.TRIAL REGISTRATIONPROSPERIO number: CRD42023482030.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"15 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142165849","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}
Mandana Hosseini, Simon Storgård Jensen, Klaus Gotfredsen, Emil Hyldahl, Anne Marie Lynge Pedersen
Background: Primary Sjögren's syndrome (pSS) is a chronic systemic autoimmune disease characterized by hyposalivation. Currently, there is limited evidence for the prognosis of dental implant treatment in Sjögren's syndrome.
Aim/hypothesis: We hypothesized comparable clinical outcomes of implant-supported restorations in pSS-patients and control subjects, and improvement in oral health-related quality of life 5 years after restoration.
Material and methods: Patients with pSS and matched (age, gender, and tooth region) control group were recruited between June 2016 and March 2020. The clinical and radiological examination were performed, and patient-reported oral health impact profile (OHIP-49) questionnaire was used 2 months (baseline), 1, 3, and 5 years after prosthetic treatment.
Results: We included 23 patients with pSS and 24 matched control subjects (all women, mean age: 57.1 years). The overall DMFT (decayed-missed-filled-tooth) was significantly higher (p = 0.008), symptoms of dry mouth were more severe (p = 0.001), and unstimulated and chewing-stimulated saliva flow rates were significantly lower (p < 0.001) in pSS than in control group. All implants survived with no implant mobility. At implant sites, the plaque index and probing depths did not differ (p = 0.301 and 0.446, respectively), but the gingival index was significantly higher (p = 0.003) in pSS than control group. The mean marginal bone loss, prosthetic complications, and clinician-reported aesthetic outcomes were similar in both groups after 5 years. The OHIP scores were significantly higher in the pSS than control group (p < 0.001) but reduced significantly in both groups (p = 0.026).
Conclusion: Replacement of missing single teeth with dental implants was successful in patients with pSS 5 years after restoration.
{"title":"Prognosis of Single Implant-Supported Prosthesis in Patients With Primary Sjögren's Syndrome: A Five-Year Prospective Clinical Study.","authors":"Mandana Hosseini, Simon Storgård Jensen, Klaus Gotfredsen, Emil Hyldahl, Anne Marie Lynge Pedersen","doi":"10.1111/clr.14356","DOIUrl":"https://doi.org/10.1111/clr.14356","url":null,"abstract":"<p><strong>Background: </strong>Primary Sjögren's syndrome (pSS) is a chronic systemic autoimmune disease characterized by hyposalivation. Currently, there is limited evidence for the prognosis of dental implant treatment in Sjögren's syndrome.</p><p><strong>Aim/hypothesis: </strong>We hypothesized comparable clinical outcomes of implant-supported restorations in pSS-patients and control subjects, and improvement in oral health-related quality of life 5 years after restoration.</p><p><strong>Material and methods: </strong>Patients with pSS and matched (age, gender, and tooth region) control group were recruited between June 2016 and March 2020. The clinical and radiological examination were performed, and patient-reported oral health impact profile (OHIP-49) questionnaire was used 2 months (baseline), 1, 3, and 5 years after prosthetic treatment.</p><p><strong>Results: </strong>We included 23 patients with pSS and 24 matched control subjects (all women, mean age: 57.1 years). The overall DMFT (decayed-missed-filled-tooth) was significantly higher (p = 0.008), symptoms of dry mouth were more severe (p = 0.001), and unstimulated and chewing-stimulated saliva flow rates were significantly lower (p < 0.001) in pSS than in control group. All implants survived with no implant mobility. At implant sites, the plaque index and probing depths did not differ (p = 0.301 and 0.446, respectively), but the gingival index was significantly higher (p = 0.003) in pSS than control group. The mean marginal bone loss, prosthetic complications, and clinician-reported aesthetic outcomes were similar in both groups after 5 years. The OHIP scores were significantly higher in the pSS than control group (p < 0.001) but reduced significantly in both groups (p = 0.026).</p><p><strong>Conclusion: </strong>Replacement of missing single teeth with dental implants was successful in patients with pSS 5 years after restoration.</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132052","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}
Xiao-Jiao Fu, Min Liu, Jun-Yu Shi, Ke Deng, Hong-Chang Lai, Wen Gu, Xiao-Meng Zhang
Objectives: This study aimed to compare the accuracy of digital complete-arch implant impressions with prefabricated aids using three intraoral scanners (IOSs) and explore the correlation between virtual deviation measurement and physical framework misfit.
Materials and methods: Four edentulous maxillary master models with four and six parallel and angular implants were fabricated and scanned by a laboratory scanner as reference scans. Ten scans of each master model were acquired using three IOSs (IOS-T, IOS-M, and IOS-A) with and without prefabricated aids. Trueness and precision of root mean square (RMS) errors were measured. Ten aluminum alloy frameworks were fabricated, and the misfit was measured with a micro-computed tomography scan with one screw tightened.
Results: Trueness and precision showed significant improvement when prefabricated aids were used for all three IOSs (p < 0.010). Median (interquartile range) RMS errors of trueness reduced from 67.5 (30.4) to 61.8 (30.3) μm, from 100.6 (35.4) to 45.9 (15.1) μm, and from 52.7 (33.2) to 41.1 (22.5) μm for scanner IOS-T, IOS-M, and IOS-A, respectively (p < 0.010). The precision of IOS-A and IOS-M was significantly better than IOS-T when using prefabricated aid (p < 0.001). RMS errors and the maximum marginal misfit of the framework were significantly correlated (p < 0.001, R2 = 0.845).
Conclusions: With the prefabricated aids, the accuracy of IOSs enhanced significantly in digital complete-arch implant impressions. Three IOSs showed different levels of improvement in accuracy. Virtual RMS errors <62.2 μm could be the clinically acceptable threshold (150 μm) for framework passive fit.
{"title":"Comparison of Different Intraoral Scanners With Prefabricated Aid on Accuracy and Framework Passive Fit of Digital Complete-Arch Implant Impression: An In Vitro Study.","authors":"Xiao-Jiao Fu, Min Liu, Jun-Yu Shi, Ke Deng, Hong-Chang Lai, Wen Gu, Xiao-Meng Zhang","doi":"10.1111/clr.14353","DOIUrl":"https://doi.org/10.1111/clr.14353","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the accuracy of digital complete-arch implant impressions with prefabricated aids using three intraoral scanners (IOSs) and explore the correlation between virtual deviation measurement and physical framework misfit.</p><p><strong>Materials and methods: </strong>Four edentulous maxillary master models with four and six parallel and angular implants were fabricated and scanned by a laboratory scanner as reference scans. Ten scans of each master model were acquired using three IOSs (IOS-T, IOS-M, and IOS-A) with and without prefabricated aids. Trueness and precision of root mean square (RMS) errors were measured. Ten aluminum alloy frameworks were fabricated, and the misfit was measured with a micro-computed tomography scan with one screw tightened.</p><p><strong>Results: </strong>Trueness and precision showed significant improvement when prefabricated aids were used for all three IOSs (p < 0.010). Median (interquartile range) RMS errors of trueness reduced from 67.5 (30.4) to 61.8 (30.3) μm, from 100.6 (35.4) to 45.9 (15.1) μm, and from 52.7 (33.2) to 41.1 (22.5) μm for scanner IOS-T, IOS-M, and IOS-A, respectively (p < 0.010). The precision of IOS-A and IOS-M was significantly better than IOS-T when using prefabricated aid (p < 0.001). RMS errors and the maximum marginal misfit of the framework were significantly correlated (p < 0.001, R<sup>2</sup> = 0.845).</p><p><strong>Conclusions: </strong>With the prefabricated aids, the accuracy of IOSs enhanced significantly in digital complete-arch implant impressions. Three IOSs showed different levels of improvement in accuracy. Virtual RMS errors <62.2 μm could be the clinically acceptable threshold (150 μm) for framework passive fit.</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132051","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}
Shaza Bishti, Martin Homa, Stefan Wolfart, Taskin Tuna
ObjectiveTo investigate the pull‐off forces on implant‐supported restorations caused by sticky food, to understand how much retention force cemented restorations must have to withstand chewing forces without unintentional retention loss. The influence of food type, restoration design, and surface treatment were investigated.Material and MethodsMonolithic implant‐supported CAD/CAM zirconia crowns were fabricated and divided into groups according to their design: no (NC), flat (FC) and high cusps (HC) and subdivided according to surface roughness: rough (r) and smooth (s) (n = 10/group). NC represented the control group. The crowns were fixed in a universal testing machine opposite to each other. Four sticky foods (caramel, fruit jelly, candy strips and licorice) and a resin crown remover were tested. These were heated (36.4°C), placed between the crowns and compressed, then tensile strength tests were performed. The maximum pull‐off force was recorded (Newton [N]). Statistical analysis was performed using 3‐way ANOVA.ResultsThe highest mean pull‐off force among food samples was with caramel_HC_r (12.09 ± 1.26 N), whereas the lowest was with licorice_FC_s (3.21 ± 0.15 N). For the resin crown remover, a mean pull‐off force of 55.41 ± 3.87 N was measured in the HC_r group. Both food type and crown design showed a significant influence on pull‐off force (p < 0.001), whereas no significant effect was reported with different surface roughnesses (p = 0.344).ConclusionThis study reported pull‐off forces of up to 20 N between all‐ceramic restorations caused by sticky food. The clinical implication of these findings is that a cemented implant‐restoration must have a minimum retention force of 20 N to withstand unintentional displacement during function.
{"title":"Pull‐Off Forces on Implant‐Supported Single Restorations by Sticky Food: An In Vitro Study","authors":"Shaza Bishti, Martin Homa, Stefan Wolfart, Taskin Tuna","doi":"10.1111/clr.14355","DOIUrl":"https://doi.org/10.1111/clr.14355","url":null,"abstract":"ObjectiveTo investigate the pull‐off forces on implant‐supported restorations caused by sticky food, to understand how much retention force cemented restorations must have to withstand chewing forces without unintentional retention loss. The influence of food type, restoration design, and surface treatment were investigated.Material and MethodsMonolithic implant‐supported CAD/CAM zirconia crowns were fabricated and divided into groups according to their design: no (NC), flat (FC) and high cusps (HC) and subdivided according to surface roughness: rough (r) and smooth (s) (<jats:italic>n</jats:italic> = 10/group). NC represented the control group. The crowns were fixed in a universal testing machine opposite to each other. Four sticky foods (caramel, fruit jelly, candy strips and licorice) and a resin crown remover were tested. These were heated (36.4°C), placed between the crowns and compressed, then tensile strength tests were performed. The maximum pull‐off force was recorded (Newton [N]). Statistical analysis was performed using 3‐way ANOVA.ResultsThe highest mean pull‐off force among food samples was with caramel_HC_r (12.09 ± 1.26 N), whereas the lowest was with licorice_FC_s (3.21 ± 0.15 N). For the resin crown remover, a mean pull‐off force of 55.41 ± 3.87 N was measured in the HC_r group. Both food type and crown design showed a significant influence on pull‐off force (<jats:italic>p</jats:italic> < 0.001), whereas no significant effect was reported with different surface roughnesses (<jats:italic>p</jats:italic> = 0.344).ConclusionThis study reported pull‐off forces of up to 20 N between all‐ceramic restorations caused by sticky food. The clinical implication of these findings is that a cemented implant‐restoration must have a minimum retention force of 20 N to withstand unintentional displacement during function.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"20 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100675","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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