Clinical Oral Implants Research最新文献

Objective

A cross-sectional study was made to evaluate the role of local factors, including surgical, implant, and prosthesis-related parameters, in the presence of peri-implantitis.

Methods

Consecutive partially edentulous patients with ≥ 1 implant presenting peri-implantitis were included. Clinical and radiographic data were collected to characterize local factors. Overall, 28 site-specific variables were analyzed for peri-implantitis and non-peri-implantitis implants. Simple and multiple logistic regression analyses were performed to explore potential associations. The diagnostic accuracy of those variables that demonstrated statistical significance in the multiple logistic regression analysis was further tested.

Results

In total, 100 patients with 452 implants met the inclusion criteria. Of these, 227 implants (50.2%) were diagnosed with peri-implantitis, while 225 (49.8%) did not present peri-implantitis. The multiple logistic regression analysis demonstrated statistical significance for the following factors: (1) medial implant position within the prosthesis (OR = 3.9) was more prone to develop peri-implantitis; (2) internal Morse taper implant connection was the least likely to develop peri-implantitis (OR = 0.43); (3) mesio-distally centered implants were less prone to exhibit peri-implantitis (OR = 0.46); (4) bucco-lingual centered implants were less prone to exhibit peri-implantitis (OR = 0.29); (5) implants positioned inside (≥ 2 mm) the bony housing were less prone to exhibit peri-implantitis (OR = 0.13); and (6) implants tilted 10°–30° (OR = 5.84) and ≥ 30° (OR = 7.43) were more prone to exhibit peri-implantitis. Moreover, a prediction model based on the aforementioned factors yielded a high level of accuracy.

Conclusions

Implant malpositioning is a critical factor associated with peri-implantitis.

Objective

Statistics is fundamental in implant dentistry research, playing a crucial role in study design, data analysis, and interpretation of findings. This editorial, authored by members of the Statistical Advisory Board of Clinical Oral Implants Research, aims to highlight common statistical pitfalls encountered in submitted manuscripts and provide practical recommendations to enhance the quality of statistical reporting.

Materials and Methods

In this editorial, study design considerations, sample size calculation, appropriate selection of statistical tests, multiplicity issues, handling hierarchical data structures, and best practices for data presentation are discussed. The importance of pre-registering research protocols, adhering to pre-specified analyses, and reporting effect sizes alongside p-values is emphasised. Additionally, common misinterpretations of statistical significance and the risks of extrapolating findings beyond their intended scope are addressed.

Results

Statistical errors remain prevalent in the scientific literature, affecting the validity of results and evidence-based decision making.

Conclusions

By following guidelines, authors can improve the robustness and reproducibility of their research, ultimately contributing to higher-quality evidence in implant dentistry. Guidance for researchers, reviewers, and readers in handling statistical challenges is presented aiming to ensure that studies published in Clinical Oral Implants Research meet the highest methodological standards.

Introduction

Odanacatib (ODN), a cathepsin K inhibitor, is a drug that reduces bone resorption while preserving bone formation. ODN was initially developed for the treatment of postmenopausal osteoporosis, but further development as a systemic medication has been discontinued. Here, we propose ODN as a topical treatment, the coating of dental implants, to achieve an anabolic shift of early osseointegration.

Material and Methods

To this aim, we have coated double acid etching titanium implants (SLA) with and without ODN dispersed in a simulated body fluid (SBF). The implants were inserted into the tibia of 72 male Wistar rats and osseointegration was studied on Days 15 and 40. Biomechanical testing, micro-computed microtomography, and histomorphometric analyses were performed.

Results

Biomechanical testing reveals that after 15 days of healing, removal torque increased from 2.5 Ncm (1.5–4.4) to 3.9 Ncm (1.7–7.6) when comparing SBF alone with SBF containing ODN, respectively (p = 0.017). Consistently, micro-computed microtomography indicated that local bone volume increased from 24.4% (13.86–32.45) to 32.8% (19.7–39.4), respectively (p = 0.003). The same was true for presumed bone-to-implant contact, which was 34.38% (27.0–50.0) and 43.33% (31.6–54.2), respectively (p = 0.035). Histomorphometric analyses confirmed that the new bone area per total area increased from 34.78% (18.9–43.7) to 41.10% (23.5–54.0), respectively (p = 0.102). This trend proceeds after 40 days of osseointegration.

Discussion

These findings suggest that topical delivery of a cathepsin K inhibitor can support the early osseointegration phase in an ectopic rodent implantation model.

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.