Clinical Oral Implants Research最新文献

Aim

To assess the factors influencing the survival and success rates of narrow diameter implants (NDIs) placed in the posterior area; additionally, the study evaluated marginal bone changes, along with biological and prosthetic complications.

Materials and Methods

This retrospective single-center study investigated the clinical and radiographic outcomes of 227 NDIs placed in the premolar and molar regions of 119 patients. The analysis focused on implant survival and success rates, marginal bone levels (MBL), and the incidence of biological and mechanical complications. Generalized estimating equations (GEE) were employed to assess the impact of patient- and implant-related characteristics on these outcomes.

Results

Over a mean follow-up period of 11.51 years (SD: 4.03) the study recorded the loss of 12 NDIs in seven patients. The Kaplan–Meier survival rates were 90.3% (95% CI: 85.4%–95.4%) and 85.7% (95% CI: 77.2%–95.0%) respectively. The average marginal bone loss (MBL) was estimated at −0.75 (SD 1.34) mm. Mucositis was observed in 33.18% of the implants and peri-implantitis in 9.86% of the sample.

Conclusion

This study offers valuable understanding of NDIs as a predictable option in implant dentistry, particularly for patients with challenging anatomical conditions. However, careful case selection and comprehensive treatment planning are crucial to minimize the risk of implant fractures.

Objective and Aim

A retrospective study to evaluate the clinical and radiological outcomes of dental implants placed in compromised patients who have undergone antiresorptive therapy (AR) or head and neck radiotherapy (IR).

Material and Methods

Dental implant placement was evaluated in compromised patients undergoing or after receiving AR/IR therapy following specific preventive measures: antibiotic prophylaxis (2 days before and 5 days after surgery) and primary wound closure with submerged healing for 4 months. The primary outcome was implant survival during the observation period. Secondary outcomes included marginal bone loss, occurrence of osteonecrosis, and factors influencing implant survival.

Results

A total of 92 patients (59 IR, 32 AR) with 369 dental implants were included in the study. During a mean follow-up period of 25 months (SD: 16), 23 implants were lost (IR: 21, AR: 2). Implant survival rates were 92% and 98% for IR and AR, respectively. Identified risk factors for implant failure included placement in neomandibular/−maxillary sites, maxillary implantation, implant diameter < 4.2 mm, active smoking, and diabetes mellitus. The mean marginal bone loss was 0.57 mm (SD: 1.51) in the IR group and −0.09 mm (SD: 1.17) in the AR group.

Conclusion

With comprehensive risk assessment and careful evaluation of implant indications, dental implants can serve as an effective dental rehabilitation option for patients undergoing or after receiving AR/IR therapy, provided strict adherence to preventive measures is maintained. Implants placed following AR therapy demonstrate higher survival rates and reduced marginal bone loss compared to those placed after IR therapy.

Aim

To assess peri-implant conditions in a cohort of patients previously treated for periodontitis undergoing supportive periodontal care (SPC).

Materials and Methods

A prospective observational study was carried out on previously treated periodontitis patients followed for 5 years in SPC. Peri-implant diagnosis at baseline and the end of the 5-year period was assessed.

Results

Two hundred patients were included in the study. A total of 88 implants were present at baseline in 31 of those patients. A total of 55 (62.5%) implants were diagnosed as having healthy peri-implant tissues, while 22 (25%) were diagnosed with peri-implant mucositis and 11 (12.5%) with peri-implantitis. Five-year data are available for 68 implants in 23 patients. None of these implants was lost during the 5 years follow-up. An additional 20 implants were placed during the study period, resulting in a total of 88 implants reassessed at the last study follow-up, with peri-implant diagnosis almost unchanged compared with baseline. None of the studied patient and implant factors were associated with implant diagnosis in a multilevel model with logistic regression target distribution.

Conclusions

A small percentage of implants in a population undergoing SPC were diagnosed with peri-implantitis, and peri-implant conditions were maintained almost unchanged during 5 years of SPC.

Objective

To assess clinical trends to prevent peri-implantitis in applying a two-step survey based on the Delphi method.

Material and Methods

A panel of participants aged < 45 years old selected by the Spanish Society of Periodontology (SEPA) was asked to answer a survey with 75 statements prepared by a steering committee. Items were divided into 5 major areas: etiopathogenesis and epidemiology, surgical, implant, and prosthetic-related factors on the onset/progression of peri-implantitis, and self- and professional-administered oral hygiene. Degree of agreement or disagreement among participants was reported.

Results

In total, 44 participants responded favorably to participate in the survey. From the 75 statements formulated, 35 were agreed on in a first round (46.7%). From the 40 statements that did not reach consensus, 16 were agreed on in a second round (40.0%). Overall, 51 out of 75 statements (68.0%) achieved consensus in a second round. From these, 36 (48.0%) were in agreement, while 15 (20.0%) were in disagreement. The sections that explored surgical-related factors and prosthesis-related factors of peri-implantitis yielded the highest level of conflict (9/18 and 8/14 statements demonstrated indeterminate agreement, respectively). In the sections on the etiopathogenesis and epidemiology of peri-implantitis and implant-related factors, most items reached consensus (14/17 and 10/13 items, respectively). The section on self- and professional-administered oral hygiene obtained the highest level of consensus, with only 1/13 items showing dissent among the participants.

Conclusion

The results of this study on the clinical trends in the prevention of peri-implantitis showed consensus agreement for ∼70% of the statements evaluated.

Objective

To investigate the impact of the restorative emergence angle and splinting configurations on peri-implant soft and hard tissues.

Materials and Methods

Thirty implants were placed in the mandibular premolars (P2, P3, P4) of five beagle dogs. In a split-mouth design, each animal received both narrow (NE) (emergence angle = 30°) and wide (WE) (emergence angle = 60°) abutments on each side of the mandible. The implants were subsequently splinted. Radiographic images were captured at 0, 4, 12, and 24 weeks post-restoration. Biopsy samples were then collected for histomorphometric analysis and circularly polarized light examination. All analyses were performed based on the splinted positions: either the mesial or distal end of the terminal implant, the splinted zone of the terminal implant, or the splinted zone of the middle implant.

Results

Radiographic evaluation showed more pronounced bone remodeling in the WE group. In histomorphometric analysis, both the vertical distance from the implant shoulder to the alveolar bone crest and the infiltrated connective tissue areas were significantly larger in the WE group. Conversely, the NE group exhibited a longer connective tissue attachment. Analysis using circularly polarized light indicated a significantly reduced area fraction of collagen fibers in the peri-implant epithelium of the WE group, as well as in the oral epithelium of the splinted zone.

Conclusion

A wide emergence angle of implant prostheses can compromise connective tissue attachment, hinder the formation of an adequate soft tissue seal, and potentially lead to marked bone remodeling.

Purpose

To evaluate the short-term success and survival rates of immediately restored surface modified two-piece zirconia implants (CL).

Material and Methods

A total of 23 patients had received CL implants (n = 26) for single-tooth replacements in the anterior and posterior maxilla and mandible at healed extraction sites. Immediate implant restoration was accomplished if an insertion torque ≥ 30 Ncm was reached (Type 3–4 A protocol). Final occlusally screw-retained crowns were provided after 3 months of healing.

Implant survival and success (i.e., bleeding on probing—BOP, probing pocket depth—PD, mucosal recession—MR) were assessed at 6 and 12 months following final restoration.

Patient-reported outcomes were evaluated at 6 and 12 months.

Results

Five implants (n = 5 patients) could not be immediately restored, and four implants were lost during follow-up. The survival rates amounted to 80%. For the final analysis, 16 patients with a total of 16 implants were evaluated. Minor changes to baseline (final restoration) were noted at 6 and 12 months for mean BOP (−3.3% ± 13.14%; 8.3% ± 16.9%), PD (−0.15 ± 0.48 mm; 0.08 ± 0.48 mm), and MR (0.0 ± 0.0 mm; 0.0 ± 0.0 mm) values. Mechanical and technical complications were not observed. Patients expressed an overall high satisfaction at 6 and 12 months.

Conclusions

The presented immediate restoration protocol may be associated with an increased risk for early implant losses.

Objective

This study aimed to evaluate the effectiveness of auxiliary occlusal devices (AODs) in improving occlusal accuracy and reducing clinical adjustments in a fully digital workflow for multiple (3 or more) implant-supported single crowns.

Materials and Methods

Twenty-nine patients with a total of 106 implant-supported single crowns were enrolled. Participants were randomly assigned to either the test group (with AODs) or the control group (without AODs). Both groups underwent a digital workflow, and the morphology of restorations was recorded before and after occlusal adjustment using an intra-oral scanner. Quantitative occlusal modifications, including grinding and porcelain additions, were calculated by 3D analysis software, and crown remake (occlusal deficiency > 0.5 mm) was documented. Statistical analysis included the Mann–Whitney U test, Fisher's exact test, and generalized linear mixed model to assess the effects of group assignment, edentulous position, and their interaction on the amount of occlusal adjustment.

Results

The test group exhibited significantly lower rates of porcelain addition (16.4% vs. 26.3%, p = 0.051) and crown remake (3.8% vs. 20.4%, p = 0.015) compared to the control group. The absolute amount of occlusal modification was significantly reduced in the AOD group (median 0.3290 mm) compared to the control (median 0.5273 mm, p = 0.001). Notably, free-end saddle crowns showed a higher incidence of occlusal porcelain addition (p = 0.022), but the use of AODs in these cases significantly mitigated the need for adjustments (p = 0.007).

Conclusion

The incorporation of AODs in a digital workflow significantly improves the precision of occlusal registration and reduces chairside modifications and remakes. AODs are especially beneficial in complex cases such as free-end saddles and should be considered a valuable adjunct in digital implant prosthodontics.

Trial Registration

This study was registered on the Chinese Clinical Trial Registry (https://www.chictr.org.cn/; ChiCTR2200064819)

Objectives

Proton pump inhibitors (PPIs) have been suggested to influence bone metabolism and osseointegration. This study aimed to assess the long-term effects of PPI usage on trabecular bone patterns around dental implants through fractal analysis of periapical radiographs.

Material and Methods

This retrospective, matched case–control study analyzed a database of 27 PPI users (87 dental implants) and established a control group of 27 nonusers (88 dental implants), matching them by age, sex, smoking status, total follow-up duration, and history of augmentation procedures. The final study population included 54 patients with a total of 175 dental implants, all of which were from the same brand and identical in composition and surface treatment. The primary predictor variable was PPI use, while the outcome measures included implant survival rate, crestal bone loss (CBL), and fractal dimension (FD) values assessed on periapical radiographs.

Results

Three PPI users experienced implant failure during a mean follow-up period of 76.9 months, whereas no failures occurred in the nonuser group (p > 0.05). Similarly, no significant differences were observed in CBL values between the two groups (p > 0.05). However, the mean (standard deviation) FD values at the final follow-up were 1.14 (0.07) for PPI users and 1.19 (0.05) for nonusers, showing a significant difference (p < 0.01).

Conclusions

The findings of this study suggest that PPI use may have a detrimental impact on bone metabolism surrounding dental implants. Clinicians should be vigilant regarding possible trabecular alterations in the jawbones of patients undergoing PPI therapy.

Background and Objectives

Peri-implantitis, a significant complication resulting from bacterial colonization on dental implants, presents a challenge in oral healthcare. Developing surfaces that inhibit bacterial adhesion while promoting tissue integration is crucial for improving implant outcomes. This study aims to evaluate bacterial colonization on a novel passivated surface for dental implants using an in vitro multispecies biofilm model.

Materials and Methods

Three types of titanium implants (standard, citric acid-passivated, and piranha-passivated) were characterized by analyzing roughness, contact angle values, and surface energy after the passivation treatments. The capacity for biofilm formation on these implants was evaluated using quantitative polymerase chain reaction (qPCR), scanning electron microscopy (SEM), and confocal laser scanning microscopy (CLSM). Bacterial colonization and viability were assessed at 6, 12, and 24 h. In addition, the protein adsorption capacity of these surfaces was determined.

Results

Treatments increased hydrophilicity and polar surface energy, with no change in roughness. Although no statistically significant differences were found, a slightly lower concentration of primary and intermediate colonizers was observed on piranha-treated surfaces compared to citric acid implants, particularly during the 24-h incubation period. CLSM analyses revealed a higher percentage of dead bacteria on piranha-passivated implants over time. Piranha passivation also resulted in the lowest fibrinogen adsorption.

Conclusion

These findings suggest that piranha passivation may be a promising treatment for dental implant surfaces, potentially reducing the risk of peri-implantitis. However, the inherent limitations of the in vitro approach necessitate further clinical trials to validate the efficacy of this surface modification in real-world clinical settings.