{"title":"Preface.","authors":"Gil Alcoforado, Frank Schwarz, Ronald E Jung","doi":"10.1111/clr.70076","DOIUrl":"https://doi.org/10.1111/clr.70076","url":null,"abstract":"","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"37 Suppl 30 ","pages":"S5-S6"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275763","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}
Franz J Strauss, Giulia Brunello, Daniel S Thoma, Ina Kopp, Charlotte Stilwell, Ronald E Jung, Hom-Lay Wang, Frank Schwarz
Objectives: To gather expert opinions on the use of standard, short, and/or zygomatic implants supporting fixed and removable prostheses in the edentulous maxilla. The aim of this survey was to inform a consensus development process for the subsequent establishment of a clinical practice guideline for the treatment of the edentulous maxilla.
Materials and methods: A questionnaire was developed in preparation for the 1st Global Consensus for Clinical Guidelines for the rehabilitation of the edentulous maxilla. The survey was conducted in a single round using an anonymous questionnaire. The survey included 19 multiple-choice questions and 110 statements, where respondents were asked to rank their agreement for each option provided using a 7-point Likert scale. Consensus was defined as > 75% and ≤ 95% agreement or disagreement, and strong consensus as > 95% agreement or disagreement.
Results: A total of 199 experts, including prosthodontists, oral surgeons, periodontists, and general practitioners from 37 countries were invited to participate. Of these, 118 completed the questionnaire, yielding a response rate of 59.3%. Of the 110 Likert-scale statements, consensus was reached for 68 (61%) while strong consensus was reached for 5 (4.5%). The statements that achieved strong consensus (> 95%) were: (1) the need for specialized training in the placement of zygomatic implants, (2) the routine use of CT/CBCT imaging for implant planning, (3) the necessity of evaluating maxillary sinus status before performing a lateral sinus lift or (4) when sinus pathology is suspected, and (5) the inclusion of surgical complications as a clinician-reported outcome in future studies.
Conclusion: The expert survey evaluated treatment approaches for rehabilitation of the edentulous maxilla using standard, short, and/or zygomatic implants to inform a consensus development process and support the establishment of a clinical practice guideline for managing edentulous maxilla.
{"title":"1st Global Consensus for Clinical Guidelines for the Rehabilitation of the Edentulous Maxilla: A Single-Round Survey on Standard, Short, and Zygomatic Implant-Supported Prostheses.","authors":"Franz J Strauss, Giulia Brunello, Daniel S Thoma, Ina Kopp, Charlotte Stilwell, Ronald E Jung, Hom-Lay Wang, Frank Schwarz","doi":"10.1111/clr.70015","DOIUrl":"10.1111/clr.70015","url":null,"abstract":"<p><strong>Objectives: </strong>To gather expert opinions on the use of standard, short, and/or zygomatic implants supporting fixed and removable prostheses in the edentulous maxilla. The aim of this survey was to inform a consensus development process for the subsequent establishment of a clinical practice guideline for the treatment of the edentulous maxilla.</p><p><strong>Materials and methods: </strong>A questionnaire was developed in preparation for the 1st Global Consensus for Clinical Guidelines for the rehabilitation of the edentulous maxilla. The survey was conducted in a single round using an anonymous questionnaire. The survey included 19 multiple-choice questions and 110 statements, where respondents were asked to rank their agreement for each option provided using a 7-point Likert scale. Consensus was defined as > 75% and ≤ 95% agreement or disagreement, and strong consensus as > 95% agreement or disagreement.</p><p><strong>Results: </strong>A total of 199 experts, including prosthodontists, oral surgeons, periodontists, and general practitioners from 37 countries were invited to participate. Of these, 118 completed the questionnaire, yielding a response rate of 59.3%. Of the 110 Likert-scale statements, consensus was reached for 68 (61%) while strong consensus was reached for 5 (4.5%). The statements that achieved strong consensus (> 95%) were: (1) the need for specialized training in the placement of zygomatic implants, (2) the routine use of CT/CBCT imaging for implant planning, (3) the necessity of evaluating maxillary sinus status before performing a lateral sinus lift or (4) when sinus pathology is suspected, and (5) the inclusion of surgical complications as a clinician-reported outcome in future studies.</p><p><strong>Conclusion: </strong>The expert survey evaluated treatment approaches for rehabilitation of the edentulous maxilla using standard, short, and/or zygomatic implants to inform a consensus development process and support the establishment of a clinical practice guideline for managing edentulous maxilla.</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"37 Suppl 30 ","pages":"S135-S154"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad H A Saleh, Hamoun Sabri, Parham Hazrati, Hom-Lay Wang
Objectives: This systematic review evaluated the current outcome measures following alveolar ridge augmentation (ARA) in the edentulous maxilla. The secondary objective was to determine the validity of the identified patient-reported outcome measures (PROMs) through standard analysis and methodology.
Materials and methods: A systematic review was conducted. Databases including MEDLINE, Embase, Scopus, and Cochrane Central were searched in April 2024, limited to studies published in the last 10 years. Inclusion criteria were prospective clinical studies with at least 10 patients per treatment arm, edentulous maxilla, and ARA procedures. The quality and validity of patient-reported outcomes (PROs) were assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, which systematically evaluates their reliability, validity, and responsiveness.
Results: Of 1426 articles, 14 studies were included, with 11 unique study cohorts. Only 45.45% of the studies reported PROMs. The COSMIN analysis indicated that the Dutch version of the Oral Health Impact Profile (OHIP-49NL) and the Denture Satisfaction Questionnaire showed strong psychometric properties. However, the Patient Satisfaction and the Change in Psychology Questionnaire and Patient's Overall Satisfaction with Denture Questionnaire exhibited significant shortcomings.
Conclusion: Future research should focus on improving the validity of PROMs incorporating ARA-specific outcome measures and adopting a dual-phase approach for assessing early healing and long-term PROMs to enhance study consistency and reliability.
{"title":"Outcome Measures in Alveolar Ridge Augmentation in the Edentulous Maxilla: A Systematic Review and COSMIN Analysis.","authors":"Muhammad H A Saleh, Hamoun Sabri, Parham Hazrati, Hom-Lay Wang","doi":"10.1111/clr.70060","DOIUrl":"10.1111/clr.70060","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review evaluated the current outcome measures following alveolar ridge augmentation (ARA) in the edentulous maxilla. The secondary objective was to determine the validity of the identified patient-reported outcome measures (PROMs) through standard analysis and methodology.</p><p><strong>Materials and methods: </strong>A systematic review was conducted. Databases including MEDLINE, Embase, Scopus, and Cochrane Central were searched in April 2024, limited to studies published in the last 10 years. Inclusion criteria were prospective clinical studies with at least 10 patients per treatment arm, edentulous maxilla, and ARA procedures. The quality and validity of patient-reported outcomes (PROs) were assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, which systematically evaluates their reliability, validity, and responsiveness.</p><p><strong>Results: </strong>Of 1426 articles, 14 studies were included, with 11 unique study cohorts. Only 45.45% of the studies reported PROMs. The COSMIN analysis indicated that the Dutch version of the Oral Health Impact Profile (OHIP-49NL) and the Denture Satisfaction Questionnaire showed strong psychometric properties. However, the Patient Satisfaction and the Change in Psychology Questionnaire and Patient's Overall Satisfaction with Denture Questionnaire exhibited significant shortcomings.</p><p><strong>Conclusion: </strong>Future research should focus on improving the validity of PROMs incorporating ARA-specific outcome measures and adopting a dual-phase approach for assessing early healing and long-term PROMs to enhance study consistency and reliability.</p>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"37 Suppl 30 ","pages":"S372-S394"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giulia Brunello, Guo-Hao Lin, Ina Kopp, Alonso Carrasco-Labra, Ronald E Jung, Hom-Lay Wang, Frank Schwarz, Franz J Strauss
<p><strong>Objectives: </strong>To identify a core outcome set (COS) to standardize outcome measures for studies on the rehabilitation of the edentulous maxilla in implant dentistry. This work was conducted in preparation for the 1st Global Consensus for Clinical Guidelines (GCCG) for the Rehabilitation of the Edentulous Maxilla.</p><p><strong>Materials and methods: </strong>The COS was developed using a standardized and validated methodology, following the Core Outcome Measures in Effectiveness Trials (COMET) initiative. Outcomes were first identified through eight systematic reviews covering surgical and prosthetic aspects of edentulous maxilla rehabilitation. This preliminary list was expanded by input from clinical and cross-disciplinary experts as well as patient surveys to capture additional relevant outcomes that were not represented in the literature. A 3-round Delphi survey was conducted. The first round was conducted prior to the meeting and the second and third round took place during the in-person consensus meeting. In the first round, participants could propose new outcomes and rated each item using a 9-point Likert scale, from 1 (not important) to 9 (critical), with scores of 7-9 denoting critical importance, 4-6 importance, and 1-3 low importance for decision making. In the second round, participants re-scored a revised outcome list incorporating written suggestions and consolidated overlapping items from the first round. Outcomes rated 7-9 by at least 75% of participants in the second round constituted the final COS selection. In the third round, these selected outcomes were evaluated for their relevance across the different stages of the GCCG workflow: patient selection, diagnostic tools, treatment planning, treatment procedure, management of complications during the treatment procedure, maintenance, and management of complications during maintenance.</p><p><strong>Results: </strong>Of the 105 experts invited, response rates for the three Delphi rounds were 87.6%, 95.2%, and 92.4%, respectively. An initial list of 119 outcomes was generated from systematic reviews and surveys and subsequently refined after the first round based on participant feedback. In the second round, 34 outcomes were rated as critical and included in the final COS. These comprised 10 patient-reported outcomes (PROs): aesthetic satisfaction; chewing function/comfort/discomfort; complications during treatment/maintenance; ease of cleaning/oral hygiene efficacy; pain; patient overall satisfaction with treatment; patient-reported complaints; prosthesis retention/stability; quality of life; speech/phonetics/pronunciation function, 22 objective clinician-reported outcomes (ClinROs): biological complications; history of patient compliance; implant failure; implant primary stability; implant success; implant survival; mechanical/technical complications; peri-implant health (implant level); peri-implant health (patient level); peri-implant mucositis; peri-implant su
{"title":"1st Global Consensus for Clinical Guidelines: Identifying a Core Outcome Set for Implant Dentistry in Edentulous Maxilla Rehabilitation.","authors":"Giulia Brunello, Guo-Hao Lin, Ina Kopp, Alonso Carrasco-Labra, Ronald E Jung, Hom-Lay Wang, Frank Schwarz, Franz J Strauss","doi":"10.1111/clr.70075","DOIUrl":"10.1111/clr.70075","url":null,"abstract":"<p><strong>Objectives: </strong>To identify a core outcome set (COS) to standardize outcome measures for studies on the rehabilitation of the edentulous maxilla in implant dentistry. This work was conducted in preparation for the 1st Global Consensus for Clinical Guidelines (GCCG) for the Rehabilitation of the Edentulous Maxilla.</p><p><strong>Materials and methods: </strong>The COS was developed using a standardized and validated methodology, following the Core Outcome Measures in Effectiveness Trials (COMET) initiative. Outcomes were first identified through eight systematic reviews covering surgical and prosthetic aspects of edentulous maxilla rehabilitation. This preliminary list was expanded by input from clinical and cross-disciplinary experts as well as patient surveys to capture additional relevant outcomes that were not represented in the literature. A 3-round Delphi survey was conducted. The first round was conducted prior to the meeting and the second and third round took place during the in-person consensus meeting. In the first round, participants could propose new outcomes and rated each item using a 9-point Likert scale, from 1 (not important) to 9 (critical), with scores of 7-9 denoting critical importance, 4-6 importance, and 1-3 low importance for decision making. In the second round, participants re-scored a revised outcome list incorporating written suggestions and consolidated overlapping items from the first round. Outcomes rated 7-9 by at least 75% of participants in the second round constituted the final COS selection. In the third round, these selected outcomes were evaluated for their relevance across the different stages of the GCCG workflow: patient selection, diagnostic tools, treatment planning, treatment procedure, management of complications during the treatment procedure, maintenance, and management of complications during maintenance.</p><p><strong>Results: </strong>Of the 105 experts invited, response rates for the three Delphi rounds were 87.6%, 95.2%, and 92.4%, respectively. An initial list of 119 outcomes was generated from systematic reviews and surveys and subsequently refined after the first round based on participant feedback. In the second round, 34 outcomes were rated as critical and included in the final COS. These comprised 10 patient-reported outcomes (PROs): aesthetic satisfaction; chewing function/comfort/discomfort; complications during treatment/maintenance; ease of cleaning/oral hygiene efficacy; pain; patient overall satisfaction with treatment; patient-reported complaints; prosthesis retention/stability; quality of life; speech/phonetics/pronunciation function, 22 objective clinician-reported outcomes (ClinROs): biological complications; history of patient compliance; implant failure; implant primary stability; implant success; implant survival; mechanical/technical complications; peri-implant health (implant level); peri-implant health (patient level); peri-implant mucositis; peri-implant su","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"37 Suppl 30 ","pages":"S108-S120"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVESTo evaluate whether adding a connective tissue graft (CTG) to guided bone regeneration (GBR) improves clinical and radiographic outcomes in surgical peri-implantitis treatment.MATERIALS AND METHODSThirty-two patients with peri-implantitis were randomly assigned to receive GBR and CTG (test group, TG) or GBR alone (control group, CG). Clinical and radiographic parameters were recorded at baseline, 6, and 12 months. The primary outcome was the change in clinical attachment level (CAL), while secondary outcomes included pocket probing depth (PPD), bleeding on probing (BoP), plaque index (PI), keratinized mucosa width (KMW), mucosal thickness (MT), recession (REC), suppuration (SUP), marginal bone levels (MBL), bone defect morphology, and disease resolution (DR).RESULTSAt 12 months, CAL gain was significantly higher in TG compared with CG (3.21 ± 1.57 mm vs. 1.65 ± 1.28 mm; p = 0.022), and TG achieved significantly greater increase in KMW (2.25 ± 2.89 mm vs. 0.26 ± 1.49 mm; p = 0.010). Both groups showed significant PPD reduction, with a greater, though not statistically significant, improvement comparing TG with CG (3.25 ± 1.59 mm vs. 1.97 ± 1.23 mm; p = 0.052). Additionally, MBL improved significantly in both groups (p < 0.001), with higher gains in TG (p < 0.001). However, DR was comparable between the two groups.CONCLUSIONSGBR effectively improves peri-implant parameters after 1 year. Adding a CTG enhances CAL and KMW gains and may promote more favorable bone levels, although the impact on DR remains inconclusive. Long-term studies are warranted to confirm these findings.TRIAL REGISTRATIONClinicalTrials.gov NCT04323540.
目的评价在引导骨再生（GBR）中加入结缔组织移植物（CTG）是否能改善手术治疗种植体周围炎的临床和影像学结果。材料与方法32例种植体周围炎患者随机分为GBR联合CTG组（试验组，TG）和GBR组（对照组，CG）。在基线、6个月和12个月记录临床和影像学参数。主要结果是临床附着水平（CAL）的变化，次要结果包括口袋探测深度（PPD）、探测出血（BoP）、斑块指数（PI）、角化粘膜宽度（KMW）、粘膜厚度（MT）、萎缩（REC）、化脓（SUP）、边缘骨水平（MBL）、骨缺损形态和疾病缓解（DR）。结果12个月后，TG组CAL增益显著高于CG组（3.21±1.57 mm vs. 1.65±1.28 mm, p = 0.022）， TG组KMW组CAL增益显著高于CG组（2.25±2.89 mm vs. 0.26±1.49 mm, p = 0.010）。两组均显示PPD显著降低，TG与CG相比改善更大（3.25±1.59 mm vs. 1.97±1.23 mm; p = 0.052），但无统计学意义。此外，两组MBL均有显著改善（p < 0.001）， TG的改善更高（p < 0.001）。然而，两组之间的DR具有可比性。结论sgbr术后1年可有效改善种植体周围参数。添加CTG可提高CAL和KMW的增加，并可能促进更有利的骨水平，尽管对DR的影响尚不确定。有必要进行长期研究来证实这些发现。临床试验注册。gov NCT04323540。
{"title":"Effect of Connective Tissue Graft as an Adjunct to Guided Bone Regeneration in the Surgical Treatment of Peri-Implantitis: A Dual-Center Randomized Controlled Trial.","authors":"Lucrezia Paterno Holtzman,Iva Milinkovic,Marija Vuckovic,Chiara Malpassi,Marla Cuppini,Alex Solderer,Zoran Aleksic,Luca Cordaro","doi":"10.1111/clr.70093","DOIUrl":"https://doi.org/10.1111/clr.70093","url":null,"abstract":"OBJECTIVESTo evaluate whether adding a connective tissue graft (CTG) to guided bone regeneration (GBR) improves clinical and radiographic outcomes in surgical peri-implantitis treatment.MATERIALS AND METHODSThirty-two patients with peri-implantitis were randomly assigned to receive GBR and CTG (test group, TG) or GBR alone (control group, CG). Clinical and radiographic parameters were recorded at baseline, 6, and 12 months. The primary outcome was the change in clinical attachment level (CAL), while secondary outcomes included pocket probing depth (PPD), bleeding on probing (BoP), plaque index (PI), keratinized mucosa width (KMW), mucosal thickness (MT), recession (REC), suppuration (SUP), marginal bone levels (MBL), bone defect morphology, and disease resolution (DR).RESULTSAt 12 months, CAL gain was significantly higher in TG compared with CG (3.21 ± 1.57 mm vs. 1.65 ± 1.28 mm; p = 0.022), and TG achieved significantly greater increase in KMW (2.25 ± 2.89 mm vs. 0.26 ± 1.49 mm; p = 0.010). Both groups showed significant PPD reduction, with a greater, though not statistically significant, improvement comparing TG with CG (3.25 ± 1.59 mm vs. 1.97 ± 1.23 mm; p = 0.052). Additionally, MBL improved significantly in both groups (p < 0.001), with higher gains in TG (p < 0.001). However, DR was comparable between the two groups.CONCLUSIONSGBR effectively improves peri-implant parameters after 1 year. Adding a CTG enhances CAL and KMW gains and may promote more favorable bone levels, although the impact on DR remains inconclusive. Long-term studies are warranted to confirm these findings.TRIAL REGISTRATIONClinicalTrials.gov NCT04323540.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"82 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146089133","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}
F R S Michallek,M Sluka,V C Landwehr,K Vach,L Larsson,K Nelson,S Nahles,F Kernen,G Iglhaut,T Fretwurst
INTRODUCTIONThe aim was the immunohistological evaluation of a porcine dermal matrix (PDM) in comparison to a non-augmented control group for peri-implant tissue thickening.MATERIALS AND METHODSThis human histological study involved the placement of PDM in the test group (20 patients) during implant placement, while the control group underwent implant placement without grafting (20 patients). Postoperative clinical evaluations were conducted, and biopsies were obtained after 3 months. Histomorphometric evaluation utilized H&E staining. Immunohistological analysis included CD31, PSR, TE-7, CD3, CD20, CD138, and CD68.RESULTSA total of 40 patients (17 females, 23 males; 60.62 years) were included. Though more frequent gingival redness occurred during wound healing in the PDM, the groups showed no significant differences in epithelial thickness (p = 0.63), rete ridges (p = 0.53), papilla density (p = 0.626), papilla complexity (p = 0.053), vascularization (p = 0.052), connective tissue morphology (p = 0.127), collagen differentiation (p = 0.41), and CD3+ (p = 0.85) and CD138+ cells (p = 0.33). The PDM group showed significantly more CD68+ cells (p = 0.049) and CD20+ cells (p = 0.046), which correlates with a potentially distinct immune response caused by the PDM.CONCLUSIONThe PDM used in this study exhibited no significant differences regarding epithelial changes, vascularization, tissue morphology, and collagen differentiation compared to a healthy control sample 3 months after grafting. The PDM group demonstrated a significantly higher frequency of CD68+ and CD20+ cells. The noticeable interindividual variation in immunoprofiles and clinical relevance of these findings should be investigated in future research.
{"title":"Immunohistological Evaluation of Peri-Implant Soft Tissue Grafting Using a Porcine Dermal Matrix-A Human Histological Study.","authors":"F R S Michallek,M Sluka,V C Landwehr,K Vach,L Larsson,K Nelson,S Nahles,F Kernen,G Iglhaut,T Fretwurst","doi":"10.1111/clr.70088","DOIUrl":"https://doi.org/10.1111/clr.70088","url":null,"abstract":"INTRODUCTIONThe aim was the immunohistological evaluation of a porcine dermal matrix (PDM) in comparison to a non-augmented control group for peri-implant tissue thickening.MATERIALS AND METHODSThis human histological study involved the placement of PDM in the test group (20 patients) during implant placement, while the control group underwent implant placement without grafting (20 patients). Postoperative clinical evaluations were conducted, and biopsies were obtained after 3 months. Histomorphometric evaluation utilized H&E staining. Immunohistological analysis included CD31, PSR, TE-7, CD3, CD20, CD138, and CD68.RESULTSA total of 40 patients (17 females, 23 males; 60.62 years) were included. Though more frequent gingival redness occurred during wound healing in the PDM, the groups showed no significant differences in epithelial thickness (p = 0.63), rete ridges (p = 0.53), papilla density (p = 0.626), papilla complexity (p = 0.053), vascularization (p = 0.052), connective tissue morphology (p = 0.127), collagen differentiation (p = 0.41), and CD3+ (p = 0.85) and CD138+ cells (p = 0.33). The PDM group showed significantly more CD68+ cells (p = 0.049) and CD20+ cells (p = 0.046), which correlates with a potentially distinct immune response caused by the PDM.CONCLUSIONThe PDM used in this study exhibited no significant differences regarding epithelial changes, vascularization, tissue morphology, and collagen differentiation compared to a healthy control sample 3 months after grafting. The PDM group demonstrated a significantly higher frequency of CD68+ and CD20+ cells. The noticeable interindividual variation in immunoprofiles and clinical relevance of these findings should be investigated in future research.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"3 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073326","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}
Francisco Maligno,Ricardo N M J Páscoa,Pedro S Gomes
OBJECTIVESThis study aimed to assess biochemical differences in peri-implant crevicular fluid (PICF) using ATR-FTIR spectroscopy and multivariate analysis, through a between-participant comparison of healthy and peri-implantitis (PI) sites, and a within-participant comparison of PI-PICF and GCF from contralateral periodontal healthy teeth.MATERIALS AND METHODSSamples were categorized into three groups based on peri-implant status and sampling site: PICF from peri-implant healthy sites, PICF from PI-affected sites, and GCF from contralateral healthy teeth in PI patients, with n = 20/group. Samples were collected and analyzed through ATR-FTIR spectroscopy. Chemometric models were applied for cluster/outlier identification and discrimination. Regression coefficient vectors of PLS-DA models identified key spectral differences between groups.RESULTSA total of 40 implants were analyzed; participants had a mean age of 62 years, predominantly female (59%), non-smokers (88%), and most received regular maintenance therapy (82%). PCA revealed subtle cluster formations without clear group separation. Comparing PICF from patients with and without PI, the most important wavenumbers for the PLS-DA model were within 1700-1680 cm-1, 1190-1130 cm-1, and 1050-980 cm-1, associated with protein-related signals and nucleic-acid content. Comparing the GCF and PICF from PI patients, using a split-mouth design, the most important wavenumbers were 3006 cm-1, 2982 cm-1, and 2900 cm-1, related to lipid structures. In terms of accuracy, between-participant assessment achieved 75%, whereas the split-mouth assessment reached 83.4%.CONCLUSIONSFTIR-spectroscopy combined with chemometric modeling effectively discriminates peri-implant health and PI in both inter- and intra-subject comparisons. Higher within-subject accuracy supports FTIR's potential as a site-specific, non-invasive diagnostic tool for peri-implantitis.
{"title":"Peri-Implant Crevicular Fluid Analysis by Mid-Infrared Spectroscopy in Peri-Implantitis-A Pilot Study.","authors":"Francisco Maligno,Ricardo N M J Páscoa,Pedro S Gomes","doi":"10.1111/clr.70091","DOIUrl":"https://doi.org/10.1111/clr.70091","url":null,"abstract":"OBJECTIVESThis study aimed to assess biochemical differences in peri-implant crevicular fluid (PICF) using ATR-FTIR spectroscopy and multivariate analysis, through a between-participant comparison of healthy and peri-implantitis (PI) sites, and a within-participant comparison of PI-PICF and GCF from contralateral periodontal healthy teeth.MATERIALS AND METHODSSamples were categorized into three groups based on peri-implant status and sampling site: PICF from peri-implant healthy sites, PICF from PI-affected sites, and GCF from contralateral healthy teeth in PI patients, with n = 20/group. Samples were collected and analyzed through ATR-FTIR spectroscopy. Chemometric models were applied for cluster/outlier identification and discrimination. Regression coefficient vectors of PLS-DA models identified key spectral differences between groups.RESULTSA total of 40 implants were analyzed; participants had a mean age of 62 years, predominantly female (59%), non-smokers (88%), and most received regular maintenance therapy (82%). PCA revealed subtle cluster formations without clear group separation. Comparing PICF from patients with and without PI, the most important wavenumbers for the PLS-DA model were within 1700-1680 cm-1, 1190-1130 cm-1, and 1050-980 cm-1, associated with protein-related signals and nucleic-acid content. Comparing the GCF and PICF from PI patients, using a split-mouth design, the most important wavenumbers were 3006 cm-1, 2982 cm-1, and 2900 cm-1, related to lipid structures. In terms of accuracy, between-participant assessment achieved 75%, whereas the split-mouth assessment reached 83.4%.CONCLUSIONSFTIR-spectroscopy combined with chemometric modeling effectively discriminates peri-implant health and PI in both inter- and intra-subject comparisons. Higher within-subject accuracy supports FTIR's potential as a site-specific, non-invasive diagnostic tool for peri-implantitis.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"103 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021338","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}
Marc Balmer,Michael Payer,Anke Steinwender,Valentin Herber,Ronald E Jung,Sebastian Kühl
OBJECTIVESTo evaluate the clinical performance of two-piece zirconia implants with screw-retained abutments compared to titanium implants after 1 year of loading.MATERIALS AND METHODSIn this multicenter, prospective, randomized clinical trial, 61 two-piece zirconia and 61 titanium implants were placed and restored with single crowns. Evaluations were performed at implant placement, crown delivery, and 1-year post-loading. Peri-implant Marginal Bone Loss (MBL), survival rate, early wound healing index, and soft tissue parameters were assessed. Intergroup comparisons of continuous outcomes were performed using Linear Mixed-Effects Models accounting for center and potential confounders. Categorical variables were analyzed using the chi-square or Fisher's exact test. Survival was analyzed using Kaplan-Meier estimates. Significance was set at p < 0.05.RESULTSNo significant differences were found between the two implant types. Mean MBL from implantation to crown insertion was 1.10 ± 0.78 mm for titanium and 0.94 ± 0.67 mm for zirconia implants. No significant additional bone loss occurred over the subsequent year, with changes of 0.07 ± 0.55 mm and 0.08 ± 0.51 mm for titanium and zirconia, respectively. After 1 year, zirconia implants showed a 100% survival rate, while titanium implants showed 96.5% with two failures. At 1 year, differences in probing depths, plaque accumulation, and Papilla Bleeding Index were not statistically significant.CONCLUSIONAfter 1 year of loading, no statistically significant differences in MBL, implant survival, or peri-implant health were found between zirconia and titanium implants, indicating no clinical superiority. Zirconia implants may therefore be considered a viable alternative in single-tooth implant restorations.TRIAL REGISTRATIONThe study is registered at the German Clinical Trial Register (No. DRKS 00013209) as well as at the Federal Office of Public Health's (FOPH) portal for human research in Switzerland (kofam.ch).
{"title":"One-Year Analysis of Clinical and Radiological Outcomes of Two-Piece Zirconia Compared to Titanium Implants: A Multicenter Prospective Randomized Clinical Trial.","authors":"Marc Balmer,Michael Payer,Anke Steinwender,Valentin Herber,Ronald E Jung,Sebastian Kühl","doi":"10.1111/clr.70094","DOIUrl":"https://doi.org/10.1111/clr.70094","url":null,"abstract":"OBJECTIVESTo evaluate the clinical performance of two-piece zirconia implants with screw-retained abutments compared to titanium implants after 1 year of loading.MATERIALS AND METHODSIn this multicenter, prospective, randomized clinical trial, 61 two-piece zirconia and 61 titanium implants were placed and restored with single crowns. Evaluations were performed at implant placement, crown delivery, and 1-year post-loading. Peri-implant Marginal Bone Loss (MBL), survival rate, early wound healing index, and soft tissue parameters were assessed. Intergroup comparisons of continuous outcomes were performed using Linear Mixed-Effects Models accounting for center and potential confounders. Categorical variables were analyzed using the chi-square or Fisher's exact test. Survival was analyzed using Kaplan-Meier estimates. Significance was set at p < 0.05.RESULTSNo significant differences were found between the two implant types. Mean MBL from implantation to crown insertion was 1.10 ± 0.78 mm for titanium and 0.94 ± 0.67 mm for zirconia implants. No significant additional bone loss occurred over the subsequent year, with changes of 0.07 ± 0.55 mm and 0.08 ± 0.51 mm for titanium and zirconia, respectively. After 1 year, zirconia implants showed a 100% survival rate, while titanium implants showed 96.5% with two failures. At 1 year, differences in probing depths, plaque accumulation, and Papilla Bleeding Index were not statistically significant.CONCLUSIONAfter 1 year of loading, no statistically significant differences in MBL, implant survival, or peri-implant health were found between zirconia and titanium implants, indicating no clinical superiority. Zirconia implants may therefore be considered a viable alternative in single-tooth implant restorations.TRIAL REGISTRATIONThe study is registered at the German Clinical Trial Register (No. DRKS 00013209) as well as at the Federal Office of Public Health's (FOPH) portal for human research in Switzerland (kofam.ch).","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"42 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021339","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}
S Roehling,K H Bormann,M M Bornstein,S Laval,F Thieringer,M Gahlert
OBJECTIVESThis study aimed to prospectively investigate the long-term clinical performance of a commercially available one-piece zirconia dental implant system over 10 years.MATERIAL AND METHODSA multicenter, open-label study was conducted at three clinical centers in Germany. Forty-four patients with single-tooth gaps meeting specific inclusion criteria received 44 yttria-stabilized zirconia (Y-TZP) implants featuring a sandblasted and acid-etched (ZLA) surface. Clinical and radiographic follow-ups were performed at 1, 3, 5, and 10 years to assess implant survival, success, peri-implant bone levels, and esthetic outcomes using Pink Esthetic Score (PES) and White Esthetic Score (WES).RESULTSAt the 10-year follow-up, 35 patients with 35 implants were available for evaluation. The estimated 10-year survival rate was 97.7% (95% CI: 97.27-98.13). Three implants (8.6%) showed biological complications, including peri-implant mucositis in 2 implants (5.7%) and peri-implantitis in 1 implant (2.9%), leading to a success rate of 91.4% (95% CI: 76.9-97.8). Peri-implant bone loss was moderate, averaging 1.20 (±0.61) mm over 10 years, with stable bone levels observed after the initial remodeling phase. Esthetic outcomes revealed a slight increase in PES (7.4 to 7.8) and a minor decrease in WES (7.0 to 6.7) between years 5 and 10.CONCLUSIONSZirconia implants demonstrated high long-term survival and success rates, moderate bone loss, and favorable esthetic outcomes. These findings support their use as a clinically reliable and esthetically acceptable long-term alternative to titanium implants. However, the limited sample size highlights the need for further confirmation in larger cohorts.
{"title":"Long-Term Clinical, Radiographic and Esthetic Outcomes of Zirconia Dental Implants: A 10-Year Prospective Multicenter Study.","authors":"S Roehling,K H Bormann,M M Bornstein,S Laval,F Thieringer,M Gahlert","doi":"10.1111/clr.70089","DOIUrl":"https://doi.org/10.1111/clr.70089","url":null,"abstract":"OBJECTIVESThis study aimed to prospectively investigate the long-term clinical performance of a commercially available one-piece zirconia dental implant system over 10 years.MATERIAL AND METHODSA multicenter, open-label study was conducted at three clinical centers in Germany. Forty-four patients with single-tooth gaps meeting specific inclusion criteria received 44 yttria-stabilized zirconia (Y-TZP) implants featuring a sandblasted and acid-etched (ZLA) surface. Clinical and radiographic follow-ups were performed at 1, 3, 5, and 10 years to assess implant survival, success, peri-implant bone levels, and esthetic outcomes using Pink Esthetic Score (PES) and White Esthetic Score (WES).RESULTSAt the 10-year follow-up, 35 patients with 35 implants were available for evaluation. The estimated 10-year survival rate was 97.7% (95% CI: 97.27-98.13). Three implants (8.6%) showed biological complications, including peri-implant mucositis in 2 implants (5.7%) and peri-implantitis in 1 implant (2.9%), leading to a success rate of 91.4% (95% CI: 76.9-97.8). Peri-implant bone loss was moderate, averaging 1.20 (±0.61) mm over 10 years, with stable bone levels observed after the initial remodeling phase. Esthetic outcomes revealed a slight increase in PES (7.4 to 7.8) and a minor decrease in WES (7.0 to 6.7) between years 5 and 10.CONCLUSIONSZirconia implants demonstrated high long-term survival and success rates, moderate bone loss, and favorable esthetic outcomes. These findings support their use as a clinically reliable and esthetically acceptable long-term alternative to titanium implants. However, the limited sample size highlights the need for further confirmation in larger cohorts.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"47 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014935","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}
Momen A Atieh,Maanas Shah,Abeer Hakam,Fawaghi AlAli,Samhar AlSayed,Andrew Tawse-Smith,Nabeel H M Alsabeeha
BACKGROUNDPeri-implantitis is a common implant complication requiring early detection to prevent bone loss and implant failure. Deep learning models show promise for enhancing radiographic diagnosis.OBJECTIVESThis review systematically evaluated the diagnostic performance of deep learning models in detecting peri-implant marginal bone loss on radiographic images.MATERIALS AND METHODSA comprehensive search of PubMed, EMBASE, CENTRAL, ClinicalTrials.gov, and ProQuest identified studies published between 2010 and July 2025. Two reviewers independently screened studies, extracted data, and assessed methodological quality using QUADAS-2. Diagnostic metrics, including sensitivity, specificity, F1-score, area under the curve (AUC), were synthesized using random-effects meta-analysis. Heterogeneity and publication bias were evaluated using I2 statistics, meta-regression, and funnel plots.RESULTSFive studies comprising 12,545 periapical and panoramic radiographs met inclusion criteria. Deep learning models achieved pooled sensitivity of 88%, specificity of 91%, and AUC of 0.95, indicating high diagnostic performance. Positive and negative likelihood ratios suggested strong clinical utility. Quality was generally good, though reporting of implant characteristics and data augmentation was inconsistent. Meta-regression revealed that dataset size and unit of analysis influenced accuracy, whereas imaging type did not. No publication bias was found.CONCLUSIONDeep learning models demonstrate high accuracy in detecting radiographic marginal bone loss, potentially indicating peri-implantitis but cannot substitute for comprehensive clinical assessment.CLINICAL RELEVANCEThese models offer a promising adjunct for radiographic detection of marginal bone loss, supporting clinicians in early diagnosis and timely interventions.
{"title":"Diagnostic Accuracy of Deep Learning Models in Detecting Peri-Implant Marginal Bone Loss: A Systematic Review and Meta-Analysis.","authors":"Momen A Atieh,Maanas Shah,Abeer Hakam,Fawaghi AlAli,Samhar AlSayed,Andrew Tawse-Smith,Nabeel H M Alsabeeha","doi":"10.1111/clr.70090","DOIUrl":"https://doi.org/10.1111/clr.70090","url":null,"abstract":"BACKGROUNDPeri-implantitis is a common implant complication requiring early detection to prevent bone loss and implant failure. Deep learning models show promise for enhancing radiographic diagnosis.OBJECTIVESThis review systematically evaluated the diagnostic performance of deep learning models in detecting peri-implant marginal bone loss on radiographic images.MATERIALS AND METHODSA comprehensive search of PubMed, EMBASE, CENTRAL, ClinicalTrials.gov, and ProQuest identified studies published between 2010 and July 2025. Two reviewers independently screened studies, extracted data, and assessed methodological quality using QUADAS-2. Diagnostic metrics, including sensitivity, specificity, F1-score, area under the curve (AUC), were synthesized using random-effects meta-analysis. Heterogeneity and publication bias were evaluated using I2 statistics, meta-regression, and funnel plots.RESULTSFive studies comprising 12,545 periapical and panoramic radiographs met inclusion criteria. Deep learning models achieved pooled sensitivity of 88%, specificity of 91%, and AUC of 0.95, indicating high diagnostic performance. Positive and negative likelihood ratios suggested strong clinical utility. Quality was generally good, though reporting of implant characteristics and data augmentation was inconsistent. Meta-regression revealed that dataset size and unit of analysis influenced accuracy, whereas imaging type did not. No publication bias was found.CONCLUSIONDeep learning models demonstrate high accuracy in detecting radiographic marginal bone loss, potentially indicating peri-implantitis but cannot substitute for comprehensive clinical assessment.CLINICAL RELEVANCEThese models offer a promising adjunct for radiographic detection of marginal bone loss, supporting clinicians in early diagnosis and timely interventions.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"29 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005337","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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