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Bone Augmentation of Atrophic Alveolar Ridges Using a Synthetic Bone Substitute With Mesenchymal Stem Cells: A Randomized, Controlled Clinical Trial 间充质干细胞合成骨替代物用于萎缩牙槽嵴骨增强:一项随机对照临床试验
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-08-22 DOI: 10.1111/clr.70025
Mariano Sanz, Cecilie Gjerde, Bjørn Tore Gjertsen, Alberto Ortiz-Vigón, Nerea Sanchez, Alain Hoornaert, Jordi Caballe-Serrano, Maria Giralt-Hernando, Frederick Gaultier, Nicoleta Reinald, Else Marie Pinholt, Markus Rojewski, Helen Rouard, Nathalie Chevallier, Samih Mohamed-Ahmed, Xieqi Shi, Tie-Jun Shi, Hubert Schrezenmeier, Pierre Layrolle, Kamal Mustafa

Objectives

To assess the efficacy and safety of a cell-based therapy for 3D bone augmentation of severe alveolar bone defects prior to dental implant placement.

Materials and Methods

A Phase 2 randomized controlled clinical trial evaluated the safety and efficacy of a cell therapy using expanded autologous iliac crest-derived mesenchymal cells seeded on a synthetic bioabsorbable bone substitute covered with a non-resorbable membrane. The control group received an autogenous bone block graft. After 5 months, CBCT scans were compared to measure the bone volume changes achieved after the regenerative surgery. Subsequently, dental implants were placed in the regenerated areas.

Results

A total of 48 patients were included and randomized (36 patients in the test group and 12 in the control group). However, seven patients did not reach the minimum required number of expanded MSCs and were therefore unable to be treated. The tested intervention demonstrated significantly greater gains in bone volume, with a mean difference of 480.01 mm3 (p = 0.032). Similarly, the mean change in bone crest volume from baseline to 5 months was notably higher in the test group (1066.91 mm3) compared to the control group (586.9 mm3). Adverse reactions and patient morbidity were minor in both groups. Implants were placed on the regenerated bone, and all were integrated successfully in both groups.

Conclusions

The cell-based therapy resulted in significant changes in bone volume compared to the control treatment, enabling dental implants in all patients. The procedure was associated with minimal adverse effects and patient morbidity.

Trial Registration

ClinicalTrials.gov: NCT03373052, NCT04297813

目的评价基于细胞的三维骨增强治疗重度牙槽骨缺损的有效性和安全性。材料和方法一项2期随机对照临床试验评估了细胞疗法的安全性和有效性,该疗法将自体髂骨源性间充质细胞植入覆盖有不可吸收膜的合成生物可吸收骨替代物上。对照组采用自体骨块移植。5个月后,比较CBCT扫描来测量再生手术后骨体积的变化。随后,在再生区域放置牙种植体。结果共纳入48例患者,随机分组,其中试验组36例,对照组12例。然而,7名患者没有达到所需的最小增殖MSCs数量,因此无法接受治疗。经测试的干预显示骨体积显著增加,平均差异为480.01 mm3 (p = 0.032)。同样,试验组从基线到5个月的平均骨嵴体积变化(1066.91 mm3)明显高于对照组(586.9 mm3)。两组患者的不良反应和发病率均较轻。在再生骨上放置种植体,两组均成功整合。结论与对照治疗相比,细胞为基础的治疗导致骨体积的显著变化,所有患者都可以种植牙。该手术与最小的不良反应和患者发病率相关。临床试验注册网站:NCT03373052, NCT04297813
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引用次数: 0
Patient-Reported and Clinician-Reported Esthetic Outcomes at Implant Sites Are Not Associated: A Systematic Review With Individual Participant Data Meta-Analysis 患者报告和临床医生报告的种植体部位的美学结果不相关:一项系统评价与个体参与者数据荟萃分析
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-08-20 DOI: 10.1111/clr.70019
Sofya Sadilina, Nicolas P. A. Müller, Franz J. Strauss, Ronald E. Jung, Daniel S. Thoma, Stefan P. Bienz

Objectives

This systematic review aimed to determine whether patient-reported outcomes (PROs) are associated with clinician-reported outcomes (ClinROs) in terms of esthetics in patients with single implant-supported crowns in the esthetic region.

Methods

A systematic electronic search was conducted following a pre-established protocol to identify randomized controlled trials (RCT) involving patients with single implant-supported crowns in the esthetic region. Studies had to assess both patient- and clinician-reported outcomes. A two-stage individual participant data (IPD) meta-analysis was conducted. First, each study was analyzed separately to obtain correlation coefficients. Second, these estimates were pooled using a random-effects restricted maximum likelihood (REML) model.

Results

A total of 29 RCTs evaluating 1414 implant-supported crowns were included, with IPD available for 14 trials evaluating 675 patients. At crown insertion, IPD meta-analysis from 171 patients across four RCTs showed no significant correlations (r = 0.11, 95% CI [−0.04; 0.27], p = 0.16) between pink esthetic score (PES) and patient satisfaction with esthetics assessed with visual analogue scale (VAS). At the 1-year follow-up, IPD from 502 patients in 11 studies showed a negligible positive correlation (r = 0.09, 95% CI [−0.00; 0.18], p = 0.06) between PES or modified PES and VAS esthetic satisfaction. At 10-year follow-up, data from 80 patients in two studies showed no correlation between modified PES and VAS patient satisfaction (r = −0.05, 95% CI [−0.37; 0.27], p = 0.75). Regarding white esthetic score (WES) and VAS satisfaction, data from 376 patients in seven studies showed no significant correlations at the 1-year follow-up (r = 0.03, 95% CI [−0.08; 0.13], p = 0.60).

Conclusion

Clinician-reported outcomes, using PES and WES, showed no correlation with patient-reported esthetic satisfaction, regardless of the follow-up duration.

Trial Registration

PROSPERO number CRD42023394920

目的:本系统综述旨在确定患者报告的结果(PROs)与临床医生报告的结果(ClinROs)在美观区使用单种植体支撑冠的患者的美学方面是否相关。方法根据预先制定的方案进行系统的电子检索,以确定涉及美学区单种植体支撑冠患者的随机对照试验(RCT)。研究必须评估患者和临床医生报告的结果。进行了两阶段个体参与者数据(IPD)荟萃分析。首先,对每项研究分别进行分析,得到相关系数。其次,使用随机效应限制最大似然(REML)模型汇总这些估计值。结果共纳入了29项随机对照试验,评估了1414个种植体支撑冠,其中14项试验评估了675名患者。在冠插入时,来自4个随机对照试验的171例患者的IPD荟萃分析显示,粉红色美学评分(PES)与视觉模拟量表(VAS)评估的患者美学满意度之间没有显著相关性(r = 0.11, 95% CI [- 0.04; 0.27], p = 0.16)。在1年的随访中,11项研究中502例患者的IPD显示PES或改良PES与VAS审美满意度之间存在可忽略的正相关(r = 0.09, 95% CI [- 0.00; 0.18], p = 0.06)。在10年的随访中,两项研究中80例患者的数据显示改良PES和VAS患者满意度之间没有相关性(r = - 0.05, 95% CI [- 0.37; 0.27], p = 0.75)。关于白色审美评分(WES)和VAS满意度,7项研究中376例患者的数据显示1年随访无显著相关性(r = 0.03, 95% CI [- 0.08; 0.13], p = 0.60)。结论无论随访时间如何,临床医生报告的PES和WES结果与患者报告的审美满意度没有相关性。试验注册号CRD42023394920
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引用次数: 0
Evaluation of a Gel Loaded With M101 on Bone and Peri-Implantitis Healing: An Experimental In Vivo Study 负载M101凝胶对骨和种植体周围炎愈合的评价:一项实验体内研究
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-08-20 DOI: 10.1111/clr.70022
Céline Stutz, Catherine Petit, Pierre-Yves Gegout, Camille Le Gall, Maria Permuy, Mónica López-Peña, Fernando Muñoz, Mario García González, Bénédicte Puissant, Yves Renaudineau, Franck Zal, Elisabeth Leize-Zal, Olivier Huck

Objectives

The aim of this study was to evaluate the effect of M101 gel in bone and peri-implantitis healing and its safety of use.

Materials and Methods

M101 gel and solution (1 g/L) were evaluated in four different models: (i) human osteoblast culture; (ii) mouse calvarial defect; (iii) extraction model in dogs; (iv) peri-implantitis model in dogs. M101 cytocompatibility was evaluated in osteoblasts, and expression of ALP, Runx2, and BMP-2 was determined. Calvarial defect was induced in mice by bone drilling, and healing was evaluated after 5 weeks. In dogs, peri-implantitis was treated by non-surgical and surgical approaches with or without M101 gel application. Analyses were performed after 2 months. Socket healing was evaluated by micro-CT after tooth extraction. Local and systemic responses were evaluated after gel administration and intravenous injection.

Results

The cytocompatibility of M101 was confirmed in osteoblasts, and ALP, Runx2, and BMP-2 gene expression was increased after exposure (p < 0.05). In mice, calvarial bone defect healing was 1.6 folds more in the M101 gel treated group than in the untreated group (p < 0.001). In the extraction model, the local M101 gel application and systemic M101 administration did not induce an immunological response. In the peri-implantitis dog model, M101 gel as an adjuvant to non-surgical treatment led to improved PiPD reduction (p < 0.05) when compared to non-surgical treatment without M101 gel. No difference was observed when used as an adjunct to surgical treatment.

Conclusion

M101 may be a safe and interesting candidate as an adjuvant to improve bone healing and non-surgical treatment in peri-implantitis.

目的评价M101凝胶在骨和种植体周围炎愈合中的作用及其使用安全性。材料和方法sm101凝胶和溶液(1 g/L)在四种不同的模型中进行评估:(i)人成骨细胞培养;(ii)小鼠颅骨缺损;(iii)犬类提取模型;(iv)犬种周围炎模型。在成骨细胞中评估M101的细胞相容性,并检测ALP、Runx2和BMP‐2的表达。采用骨钻孔法诱导小鼠颅骨缺损,5周后观察愈合情况。在犬中,种植体周围炎通过非手术和手术途径治疗,有或没有使用M101凝胶。2个月后进行分析。拔牙后用micro - CT评估牙槽愈合情况。凝胶给药和静脉注射后评估局部和全身反应。结果M101在成骨细胞中具有细胞相容性,暴露后ALP、Runx2、BMP‐2基因表达增加(p < 0.05)。在小鼠中,M101凝胶处理组颅骨骨缺损愈合比未处理组多1.6倍(p < 0.001)。在提取模型中,局部应用M101凝胶和全身给药均未引起免疫反应。在犬种植体周围炎模型中,与不使用M101凝胶的非手术治疗相比,M101凝胶作为辅助治疗的非手术治疗可改善PiPD降低(p < 0.05)。当作为手术治疗的辅助手段时,没有观察到差异。结论m101可能是一种安全而有趣的佐剂,可促进种植体周围炎的骨愈合和非手术治疗。
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引用次数: 0
The Accuracy of Autonomous Robotic Surgery vs. Dynamic Navigation in Implant Placement: An Open-Label, Double-Arm, Randomized Controlled Clinical Trial 自主机器人手术与动态导航在种植体植入中的准确性:一项开放标签、双臂、随机对照临床试验
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-08-20 DOI: 10.1111/clr.70024
Hongbo Wei, Zhiyuan Shu, Miaomiao Tian, Yufang Ge, Dehua Li

Objectives

This study aimed to compare the accuracy and clinical outcomes of an autonomous robot with dynamic navigation in implant placement under standardized conditions, with the same optical tracking system.

Methods

A prospective open-label randomized controlled trial with two parallel arms enrolled 40 patients with a single tooth missing. Participants were randomly allocated to either the autonomous robot group (AR group, n = 20) or the dynamic navigation group (DN group, n = 20) for implant placement. The surgical systems of these two groups utilized the same optical tracking technology. The primary parameters for accuracy analysis were angular, coronal, and apical deviations between planned and actual implant positions. Secondary outcomes included surgical time, patient-reported pain, edema, complications, and early implant success rate.

Results

The AR group demonstrated significantly lower angular deviation of implants (1.01° ± 0.65°) compared to the DN group (1.78° ± 1.15°, p < 0.01). There was no statistically significant difference found in coronal and apical implant deviations. Surgical time was longer for robotic procedures (21.52 ± 9.81 min vs. 14.27 ± 3.57 min, p < 0.01). Postoperative pain, edema, complications, and early implant success rate were comparable between the two groups.

Conclusion

Within the limitations of this study, the autonomous robot achieved superior angular accuracy of implant placement compared to dynamic navigation; however, there was no statistically significant difference in relation to linear deviations.

Trial Registration

Chinese Clinical Trial Registry number: ChiCTR2400085659

目的比较在同一光学跟踪系统下,在标准化条件下,自主机器人动态导航在种植体植入中的准确性和临床效果。方法一项前瞻性开放标签随机对照试验,双平行臂,纳入40例单颗缺牙患者。参与者被随机分配到自主机器人组(AR组,n = 20)或动态导航组(DN组,n = 20)进行种植。两组手术系统采用相同的光学跟踪技术。准确性分析的主要参数是计划种植体位置与实际种植体位置之间的角度、冠状和根尖偏差。次要结局包括手术时间、患者报告的疼痛、水肿、并发症和早期种植成功率。结果AR组种植体的角度偏差(1.01°±0.65°)明显低于DN组(1.78°±1.15°,p < 0.01)。冠状和根尖种植体偏差无统计学差异。机器人手术时间更长(21.52±9.81 min vs. 14.27±3.57 min, p < 0.01)。两组术后疼痛、水肿、并发症和早期种植成功率比较。结论在本研究的局限性下,与动态导航相比,自主机器人获得了更好的种植体放置角度精度;然而,与线性偏差相关,没有统计学上的显著差异。中国临床试验注册号:ChiCTR2400085659
{"title":"The Accuracy of Autonomous Robotic Surgery vs. Dynamic Navigation in Implant Placement: An Open-Label, Double-Arm, Randomized Controlled Clinical Trial","authors":"Hongbo Wei,&nbsp;Zhiyuan Shu,&nbsp;Miaomiao Tian,&nbsp;Yufang Ge,&nbsp;Dehua Li","doi":"10.1111/clr.70024","DOIUrl":"10.1111/clr.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to compare the accuracy and clinical outcomes of an autonomous robot with dynamic navigation in implant placement under standardized conditions, with the same optical tracking system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective open-label randomized controlled trial with two parallel arms enrolled 40 patients with a single tooth missing. Participants were randomly allocated to either the autonomous robot group (AR group, <i>n</i> = 20) or the dynamic navigation group (DN group, <i>n</i> = 20) for implant placement. The surgical systems of these two groups utilized the same optical tracking technology. The primary parameters for accuracy analysis were angular, coronal, and apical deviations between planned and actual implant positions. Secondary outcomes included surgical time, patient-reported pain, edema, complications, and early implant success rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The AR group demonstrated significantly lower angular deviation of implants (1.01° ± 0.65°) compared to the DN group (1.78° ± 1.15°, <i>p</i> &lt; 0.01). There was no statistically significant difference found in coronal and apical implant deviations. Surgical time was longer for robotic procedures (21.52 ± 9.81 min vs. 14.27 ± 3.57 min, <i>p</i> &lt; 0.01). Postoperative pain, edema, complications, and early implant success rate were comparable between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Within the limitations of this study, the autonomous robot achieved superior angular accuracy of implant placement compared to dynamic navigation; however, there was no statistically significant difference in relation to linear deviations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trial Registry number: ChiCTR2400085659</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 11","pages":"1486-1497"},"PeriodicalIF":5.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899343","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}
引用次数: 0
Antibacterial Effect of Combined Electrolytic and Chemical Decontamination Methods on Dental Implant Surfaces: In Vitro Study 电解与化学联合消毒对种植体表面抗菌效果的体外研究。
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-08-07 DOI: 10.1111/clr.70012
Verónica Odeh, Leire Virto, Enrique Garcia-Quismondo, David Herrera, Jesús Palma, Mariano Sanz

Objectives

To evaluate the combined effect of direct electrical current and chlorhexidine digluconate (CHX) for decontaminating titanium implant surfaces, using a validated in vitro oral multispecies biofilm model.

Material and Methods

Contaminated implant surfaces were tested using an electrochemical cell consisting of a three-electrode system immersed in a KI-AL electrolyte, the biofilm-coated implant being the working electrode, a platinum mesh the counter electrode, and an Ag/AgCl electrode the reference. Direct electrical currents (DC) were applied at two voltage levels (-3 V and−0.75 V) for 5 min, followed by a 1-min rinse in 0.12% CHX. The results were compared to 0.12% CHX alone. Untreated contaminated implants served as negative controls. The antibiofilm effect was evaluated by quantitative polymerase chain reaction with propidium monoazide and by scanning electron microscopy in three different implant zones (threads, valleys and transmucosal machined neck). The area of residual bacteria was also calculated by image analysis.

Results

The combined treatment significantly reduced the viable total bacterial counts ([-3 V + CHX] = 4.6 and [−0.75 V + CHX] = 4.9 logarithm colony forming units-LogCFU/mL), compared to the negative control group (6.1 LogCFU/mL) and 0.12% CHX alone (6.3 LogCFU/mL). The area of residual bacteria was also significantly reduced, removing over 95% of the biofilm in combined treatment groups, with slightly higher efficiency at -3 V. Electrolytic cleaning was able to reach all implant zones and no significant differences were found between [-3 V + CHX] and [−0.75 V + CHX] for any parameter.

Conclusion

The proposed combined treatments were more effective in reducing the vitality of multispecies biofilms on implant surfaces compared to CHX alone.

目的采用体外口腔多物种生物膜模型,评价直流电流联合二光酸氯己定(CHX)对钛种植体表面去污的效果。材料和方法使用浸在KI-AL电解质中的三电极系统组成的电化学电池对受污染的植入物表面进行测试,生物膜覆盖的植入物为工作电极,铂网为反电极,Ag/AgCl电极为参比电极。在两个电压水平(-3 V和0.75 V)下施加直流电流(DC) 5分钟,然后在0.12% CHX中冲洗1分钟。结果与单独使用0.12% CHX进行比较。未处理的污染植入物作为阴性对照。采用单叠氮丙啶定量聚合酶链反应和扫描电镜对三个不同种植区域(螺纹区、谷区和经黏膜加工颈部)的抗菌膜效果进行评价。并通过图像分析计算出残留细菌的面积。结果与阴性对照组(6.1 LogCFU/mL)和单独使用0.12% CHX组(6.3 LogCFU/mL)相比,联合处理显著降低了活菌总数([-3 V + CHX] = 4.6和[-0.75 V + CHX] = 4.9对数菌落形成单位-LogCFU/mL)。残余细菌的面积也显著减少,联合处理组的生物膜去除率超过95%,在-3 V时效率略高。电解清洗能够到达种植体的所有区域,在[-3 V + CHX]和[-0.75 V + CHX]之间没有发现任何参数的显着差异。结论与单纯CHX治疗相比,联合治疗可有效降低种植体表面多物种生物膜的活性。
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引用次数: 0
Flapless Mini Implants Immediately Loaded for Full-Arch Overdenture Rehabilitation: An Up-To-15-Year Retrospective Study 即刻加载无瓣微型种植体用于全弓覆盖义齿修复:一项长达15年的回顾性研究。
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-08-07 DOI: 10.1111/clr.70017
Gerardo Pellegrino, Zoran Zaccheroni, Subhi Tayeb, Andrea Oliverio, Edoardo Mancuso, Lorenzo Bonifazi, Amerigo Giudice, Carlo Barausse, Pietro Felice

Objectives

This study aimed to evaluate the survival rates of Mini Dental Implants (MDIs) placed in both the maxilla and the mandible, and their associated overdenture prostheses in edentulous patients over short-, medium-, and long-term follow-up periods.

Materials and Methods

Patients rehabilitated with Mini Dental Implants (diameter ≤ 2.9 mm) as support for overdenture prostheses with a minimum follow-up period of 3 years were included in the study. Data from eligible patients were collected, and marginal bone loss (MBL) was assessed for each implant. The primary outcomes for the prostheses and implants included failure rates, complications, and implant-related MBL.

Results

The study analyzed 83 patients and 334 implants over an 8.09 ± 3.96-year mean follow-up. The cumulative implant survival rate at 15 years was 86.3% (95% CI: 79.5%–91.0%). Mean MBL increased from 0.09 ± 0.44 mm at implant placement to 1.79 ± 0.82 mm at 15 years, with Lodi Biomax implants exhibiting significantly lower annual bone loss compared to Dentatus Atlas implants (p < 0.001). The prosthetic survival rate was 95.45% (95% CI: 91.1–99.81). Longer follow-up (p = 0.018) and fewer adjustments (p < 0.001) reduced risks of complication occurrence. Additionally, Lodi Biomax implants had fewer complications compared to Dentatus Atlas (p = 0.039).

Conclusion

Mini Dental Implants with a diameter between 2.4 and 3 mm showed high survival rates over follow-ups of up to 15 years. Their use offers a viable prosthetic solution for edentulous patients, minimizing surgical invasiveness, rehabilitation time, and costs, particularly when a fixed prosthesis is either not feasible or not requested by the patient.

目的本研究旨在通过短期、中期和长期随访评估无牙患者在上颌和下颌骨放置微型牙种植体(mdi)及其相关覆盖义齿的生存率。材料与方法采用微型种植体(直径≤2.9 mm)作为覆盖义齿支撑的患者,随访时间至少为3年。收集符合条件的患者的数据,并评估每个种植体的边际骨损失(MBL)。假体和种植体的主要结局包括失败率、并发症和种植体相关的MBL。结果在8.09±3.96年的平均随访期间,研究分析了83例患者和334个种植体。15年累积种植体存活率为86.3% (95% CI: 79.5%-91.0%)。平均MBL从植入时的0.09±0.44 mm增加到15年时的1.79±0.82 mm, Lodi Biomax种植体的年骨损失明显低于Dentatus Atlas种植体(p < 0.001)。假体存活率为95.45% (95% CI: 91.1-99.81)。较长的随访时间(p = 0.018)和较少的调整(p < 0.001)降低了并发症发生的风险。此外,Lodi Biomax种植体与Dentatus Atlas相比并发症较少(p = 0.039)。结论直径为2.4 ~ 3mm的微型种植体术后随访15年生存率较高。它们的使用为无牙患者提供了一种可行的假体解决方案,最大限度地减少了手术侵入性、康复时间和成本,特别是当固定假体不可行或患者不要求固定假体时。
{"title":"Flapless Mini Implants Immediately Loaded for Full-Arch Overdenture Rehabilitation: An Up-To-15-Year Retrospective Study","authors":"Gerardo Pellegrino,&nbsp;Zoran Zaccheroni,&nbsp;Subhi Tayeb,&nbsp;Andrea Oliverio,&nbsp;Edoardo Mancuso,&nbsp;Lorenzo Bonifazi,&nbsp;Amerigo Giudice,&nbsp;Carlo Barausse,&nbsp;Pietro Felice","doi":"10.1111/clr.70017","DOIUrl":"10.1111/clr.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the survival rates of Mini Dental Implants (MDIs) placed in both the maxilla and the mandible, and their associated overdenture prostheses in edentulous patients over short-, medium-, and long-term follow-up periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients rehabilitated with Mini Dental Implants (diameter ≤ 2.9 mm) as support for overdenture prostheses with a minimum follow-up period of 3 years were included in the study. Data from eligible patients were collected, and marginal bone loss (MBL) was assessed for each implant. The primary outcomes for the prostheses and implants included failure rates, complications, and implant-related MBL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study analyzed 83 patients and 334 implants over an 8.09 ± 3.96-year mean follow-up. The cumulative implant survival rate at 15 years was 86.3% (95% CI: 79.5%–91.0%). Mean MBL increased from 0.09 ± 0.44 mm at implant placement to 1.79 ± 0.82 mm at 15 years, with Lodi Biomax implants exhibiting significantly lower annual bone loss compared to Dentatus Atlas implants (<i>p</i> &lt; 0.001). The prosthetic survival rate was 95.45% (95% CI: 91.1–99.81). Longer follow-up (<i>p</i> = 0.018) and fewer adjustments (<i>p</i> &lt; 0.001) reduced risks of complication occurrence. Additionally, Lodi Biomax implants had fewer complications compared to Dentatus Atlas (<i>p</i> = 0.039).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Mini Dental Implants with a diameter between 2.4 and 3 mm showed high survival rates over follow-ups of up to 15 years. Their use offers a viable prosthetic solution for edentulous patients, minimizing surgical invasiveness, rehabilitation time, and costs, particularly when a fixed prosthesis is either not feasible or not requested by the patient.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 11","pages":"1445-1457"},"PeriodicalIF":5.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792119","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}
引用次数: 0
Marginal Bone Changes at Bone-Level Implants With Narrow or Standard Diameter Abutments: 1-Year Results of a Randomised Controlled Trial 狭窄或标准直径基牙的骨水平种植体的边缘骨改变:1年的随机对照试验结果
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-07-31 DOI: 10.1111/clr.70005
Antonio Liñares, Lucía Maceiras, Lourdes Nóvoa, Alejandro González, Borja Rodríguez, Pilar Batalla, Yago Leira, Juan Blanco

Aim

To evaluate changes in the peri-implant marginal bone level at implants restored with narrow or standard-diameter abutments after 12 months.

Material & Methods

Twenty-eight partially edentulous patients were randomly allocated to two groups. The test group consisted of 14 patients restored with a 2.9 mm diameter abutment (21 implants), while the control group included 14 patients restored with a 4.1 mm diameter abutment (17 implants). The primary outcome variable was the radiographic change in the peri-implant marginal bone level at 12 months, measured as the distance from the implant shoulder to the first bone-to-implant contact (fBIC). Secondary outcome variables included clinical peri-implant parameters, the papilla index, biological and mechanical complications, patient-reported outcomes (PROs) and professional aesthetic assessment.

Results

A per-protocol analysis was conducted on the 22 patients who completed all scheduled follow-up visits. At the patient level, the change in mean radiographic bone level from definitive prosthesis placement to 12 months showed a reduction in the distance from the implant shoulder to the fBIC of 0.16 ± 0.31 mm in the test group and 0.21 ± 0.34 mm in the control group, with no statistically significant differences between the groups. No statistically significant differences were observed between the two groups for any of the secondary outcomes.

Conclusions

Considering the limitations of this study, no significant differences in peri-implant marginal bone levels were found between bone-level implants restored with narrow and standard diameter abutments after 12-month follow-up. Additionally, no differences were observed in clinical variables, patient-reported outcomes, or complications.

目的评价采用窄基牙或标准基牙修复种植体12个月后种植体周围边缘骨水平的变化。材料,方法将28例部分无牙患者随机分为两组。试验组14例患者修复2.9 mm基牙(21颗种植体),对照组14例患者修复4.1 mm基牙(17颗种植体)。主要结局变量是12个月时种植体周围边缘骨水平的x线片变化,以从种植体肩部到第一次骨与种植体接触(fBIC)的距离来测量。次要结果变量包括临床种植体周围参数、乳头指数、生物和机械并发症、患者报告的结果(PROs)和专业美学评估。结果对22例完成所有预定随访的患者进行了方案分析。在患者水平上,从最终假体放置到12个月的平均x线骨水平变化显示,试验组从假体肩关节到fBIC的距离减少了0.16±0.31 mm,对照组减少了0.21±0.34 mm,组间差异无统计学意义。两组间的任何次要结果均无统计学显著差异。结论考虑到本研究的局限性,经过12个月的随访,窄基牙和标准基牙修复的骨水平种植体在种植体周围边缘骨水平上没有显著差异。此外,在临床变量、患者报告的结果或并发症方面没有观察到差异。
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引用次数: 0
Five Year Clinical, Radiographic and Soft Tissue Profilometric Outcomes at Two Narrow-Diameter Implants to Replace Missing Maxillary Lateral Incisors 两颗窄径种植体替代缺失上颌侧切牙的5年临床、影像学和软组织测量结果
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-07-27 DOI: 10.1111/clr.70010
Andrea Roccuzzo, Jean-Claude Imber, Jakob Lempert, Leonardo Mancini, Simon Storgård Jensen

Objectives

To compare the 5-year outcomes in patients with congenitally missing maxillary lateral incisors (MLIs) rehabilitated with two different narrow-diameter implants (NDIs).

Materials and Methods

One-hundred patients rehabilitated with a cement-retained bi-layered zirconia single-unit crown on either a Ø2.9 mm (Test) (n = 50) or a Ø3.3 mm (Control) (n = 50) (T1) were assessed at 1-, 3-, and 5-year follow-up (T2, T3, T4). Clinical, radiographic, patient-reported outcome measures (PROMs), biological/technical complications, and esthetic ones were recorded. After the acquisition of intraoral optical scans (IOS) (T4), three different soft tissue profilometric profiles (linear, concave, and convex) were identified.

Results

At T4, 66 patients (n = 33 per group; drop-outs n = 33; implant survival rate: 99%; early implant loss n = 1) were evaluated. Between T1 and T4, crestal bone level (CBL) changes at Ø3.3 and at Ø2.9 mm implants were comparable (difference: 0.24 mm; p > 0.05). Despite the positive recorded esthetic scores (i.e., Score 1–2), at T4, 9.1% of Ø2.9 mm versus 18.2% of Ø3.3 mm implants displayed alveolar process deficiency (Score 3). The frequency of soft tissue profilometric profiles was linear (21.2% vs. 40.6%), concave (72.7% vs. 37.5%) and convex (6.1% vs. 21.9%) (Ø2.9 mm vs. Ø3.3 mm group [p > 0.01]). Complications included decementation, ceramic chipping of the incisal edge (3× each), abutment loosening (1×) and a buccal fistula (3×). The statistically significant improved PROMs values at T1 remained stable up to T4 for both groups (p > 0.05).

Conclusion

The use of Ø2.9 or Ø3.3 mm implants showed comparable positive long-term results. Clinicians can rely on both implant types to replace congenitally missing MLIs.

目的比较两种不同窄径种植体(ndi)修复先天性上颌侧切牙(MLIs)患者的5年疗效。材料和方法100例患者在Ø2.9 mm(试验组)(n = 50)或Ø3.3 mm(对照组)(n = 50) (T1)上使用水泥保留的双层氧化锆单单元冠(T1)康复,随访1年、3年和5年(T2、T3、T4)。记录临床、放射学、患者报告的结果测量(PROMs)、生物/技术并发症和美学并发症。在获得口腔内光学扫描(IOS) (T4)后,识别出三种不同的软组织轮廓(线性,凹形和凸形)。结果T4组66例,每组33例;退出组n = 33;种植体成活率:99%;评估早期种植体丢失(n = 1)。T1和T4期间,Ø3.3和Ø2.9 mm种植体的冠骨水平(CBL)变化具有可比性(差异:0.24 mm;p比;0.05)。尽管记录的美观评分为阳性(即得分1-2),但在T4时,9.1%的Ø2.9 mm与18.2%的Ø3.3 mm种植体显示牙槽突缺陷(得分3)。软组织轮廓的频率为线性(21.2% vs. 40.6%)、凹形(72.7% vs. 37.5%)和凸形(6.1% vs. 21.9%) (Ø2.9 mm vs. Ø3.3 mm组;0.01])。并发症包括切牙、切牙边缘陶瓷碎裂(各3例)、基牙松动(1例)和颊瘘(3例)。两组在T1时显著改善的PROMs值保持稳定直至T4 (p >;0.05)。结论使用Ø2.9或Ø3.3 mm种植体具有相当的长期阳性结果。临床医生可以依靠这两种种植体来替代先天缺失的mli。
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引用次数: 0
Influence of Clinician's Experience on the Accuracy of Dental Implant Placement by Dynamic Computer-Assisted Surgery Systems: A Systematic Review and Meta-Analysis 临床医生的经验对动态计算机辅助手术系统植入牙体准确性的影响:系统回顾和Meta分析
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-07-27 DOI: 10.1111/clr.70009
Lata Goyal, Komal Kaur Saroya, Hariram Sankar, Meghna Dewan, Kirti Chawla, Gunjan Pruthi

Aim

To synthesize evidence on the effect of clinicians' experience on the accuracy of implants placed using Dynamic Computer-Assisted Surgery systems (dCAIS).

Methods

PubMed, Scopus, EMBASE, and Cochrane Library were searched till April 19, 2025, for research reporting implant accuracy with dCAIS along with the influence of the operator's experience. Clinicians who had placed implants with dCAIS (dCAIS-Ex) were compared with those without any prior experience with dCAIS (dCAIS-IEx), irrespective of their experience with implant surgery; clinicians placing implants with dCAIS with or without prior experience in implant surgeries were also compared (IEx vs. I-InEx). The risk of bias was assessed with ROBINS-I for in vivo and QUIN tool for in vitro studies. Meta-analyses were performed to evaluate implant accuracy (coronal, apical, and angular deviations) and operating time.

Results

4 in vivo and 10 in vitro studies were included. Pooled analysis of in vivo and in vitro studies showed significant differences in angular deviation [SMD = −0.35 (−0.69, −0.01), p = 0.04; SMD = −0.39 (−0.62, −0.17), p = 0.0007], where dCAIS-Ex clinicians showed lower deviations than dCAIS-IEx clinicians. No statistical difference was observed in implant accuracy between I-Ex versus I-IEx clinicians. Data was highly heterogeneous to report conclusive evidence on operating time with dCAIS between respective groups.

Conclusions

The influence of clinicians' experience was significant only on angular deviation when implants were placed by dCAIS-Ex vs. dCAIS-InEx clinicians. However, the small magnitude of difference might not be clinically perceptible. More randomized clinical trials with high quality and standardized methodology are required to synthesize meaningful evidence.

目的综合临床医生经验对动态计算机辅助手术系统(dCAIS)植入物准确性影响的证据。方法检索spubmed、Scopus、EMBASE和Cochrane图书馆,截止到2025年4月19日,研究报告使用dCAIS植入物的准确性以及操作人员经验的影响。将使用dCAIS (dCAIS‐Ex)放置种植体的临床医生与没有使用dCAIS (dCAIS‐IEx)的临床医生进行比较,无论他们是否有种植体手术经验;还比较了有或没有种植体手术经验的使用dCAIS放置种植体的临床医生(IEx vs. I‐InEx)。在体内研究中使用ROBINS‐I评估偏倚风险,体外研究使用QUIN工具评估偏倚风险。Meta分析评估种植体的准确性(冠状、根尖和角度偏差)和手术时间。结果共纳入4项体内研究和10项体外研究。体内和体外研究的汇总分析显示,角偏差有显著差异[SMD = - 0.35 (- 0.69, - 0.01), p = 0.04;SMD = - 0.39 (- 0.62, - 0.17), p = 0.0007],其中dCAIS‐Ex临床医生的偏差低于dCAIS‐IEx临床医生。I‐Ex和I‐IEx临床医生在种植体准确性方面没有统计学差异。不同组间dCAIS手术时间的数据差异很大。结论dCAIS‐Ex与dCAIS‐InEx临床医生放置种植体时,临床医生的经验仅对种植体的角度偏差有显著影响。然而,这种微小的差异可能在临床上无法察觉。需要更多具有高质量和标准化方法的随机临床试验来合成有意义的证据。
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引用次数: 0
Anatomically Based Multitask Deep Learning Radiomics Nomogram Predicts the Implant Failure Risk in Sinus Floor Elevation 基于解剖学的多任务深度学习放射组学图预测窦底抬高的种植失败风险。
IF 5.3 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-07-23 DOI: 10.1111/clr.70011
Yujie Zhu, Yang Liu, Yue Zhao, Qinyi Lu, Wendi Wang, Yuan Chen, Ping Ji, Tao Chen

Objectives

To develop and assess the performance of an anatomically based multitask deep learning radiomics nomogram (AMDRN) system to predict implant failure risk before maxillary sinus floor elevation (MSFE) while incorporating automated segmentation of key anatomical structures.

Materials and Methods

We retrospectively collected patients' preoperative cone beam computed tomography (CBCT) images and electronic medical records (EMRs). First, the nn-UNet v2 model was optimized to segment the maxillary sinus (MS), Schneiderian membrane (SM), and residual alveolar bone (RAB). Based on the segmentation mask, a deep learning model (3D-Attention-ResNet) and a radiomics model were developed to extract 3D features from CBCT scans, generating the DL Score, and Rad Score. Significant clinical features were also extracted from EMRs to build a clinical model. These components were then integrated using logistic regression (LR) to create the AMDRN model, which includes a visualization module to support clinical decision-making.

Results

Segmentation results for MS, RAB, and SM achieved high DICE coefficients on the test set, with values of 99.50% ± 0.84%, 92.53% ± 3.78%, and 91.58% ± 7.16%, respectively. On an independent test set, the Clinical model, Radiomics model, 3D-DL model, and AMDRN model achieved prediction accuracies of 60%, 76%, 82%, and 90%, respectively, with AMDRN achieving the highest AUC of 93%.

Conclusion

The AMDRN system enables efficient preoperative prediction of implant failure risk in MSFE and accurate segmentation of critical anatomical structures, supporting personalized treatment planning and clinical risk management.

目的:开发并评估基于解剖学的多任务深度学习放射组学(AMDRN)系统的性能,该系统在颌骨窦底抬高(MSFE)前预测种植体失败风险,同时结合关键解剖结构的自动分割。材料与方法回顾性收集患者术前锥形束计算机断层扫描(CBCT)图像和电子病历(emr)。首先,优化nn-UNet v2模型,分割上颌窦(MS)、施耐德膜(SM)和残余牙槽骨(RAB)。基于分割掩码,开发了深度学习模型(3D- attention - resnet)和放射组学模型,从CBCT扫描中提取3D特征,生成DL评分和Rad评分。从emr中提取重要的临床特征,建立临床模型。然后使用逻辑回归(LR)将这些组件集成以创建AMDRN模型,该模型包括支持临床决策的可视化模块。结果MS、RAB和SM的分割结果在测试集上获得了较高的DICE系数,分别为99.50%±0.84%、92.53%±3.78%和91.58%±7.16%。在独立测试集上,临床模型、放射组学模型、3D-DL模型和AMDRN模型的预测准确率分别为60%、76%、82%和90%,其中AMDRN模型的AUC最高,为93%。结论AMDRN系统能够有效预测MSFE种植体失效风险,准确分割关键解剖结构,支持个性化治疗计划和临床风险管理。
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引用次数: 0
期刊
Clinical Oral Implants Research
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