Clinical Oral Implants Research最新文献_第7页

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

Clinical Oral Implants Research

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

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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

Clinical Oral Implants Research

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

Clinical Oral Implants Research

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。

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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

Clinical Oral Implants Research

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。

{"title":"Marginal Bone Changes at Bone-Level Implants With Narrow or Standard Diameter Abutments: 1-Year Results of a Randomised Controlled Trial","authors":"Antonio Liñares, Lucía Maceiras, Lourdes Nóvoa, Alejandro González, Borja Rodríguez, Pilar Batalla, Yago Leira, Juan Blanco","doi":"10.1111/clr.70005","DOIUrl":"10.1111/clr.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate changes in the peri-implant marginal bone level at implants restored with narrow or standard-diameter abutments after 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material & Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 10","pages":"1335-1345"},"PeriodicalIF":5.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747240","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

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

Clinical Oral Implants Research

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

Clinical Oral Implants Research

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

Clinical Oral Implants Research

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

Osseointegration in the Absence of Primary Stability: An Experimental Preclinical Mandibular Minipig Overpreparation In Vivo Model 缺乏初级稳定性的骨整合：实验性临床前下颌迷你猪体内过度制备模型。

IF 5.3 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2025-07-23 DOI: 10.1111/clr.70006

Thomas Gill, Hansley Ooi, Emre Tezulas, Aviva Petrie, Simon Rawlinson, Mario Roccuzzo, Shakeel Shahdad

Objectives

The effect of osteotomy overpreparation, and thus lack of primary stability, on implant osseointegration and crestal bone volume maintenance was investigated by comparing placement of dental implants with either a standard osteotomy preparation (NP) or an overprepared osteotomy (OP) where the final osteotomy drill was larger in diameter than the implant placed.

Methods

Bone-level implants (Ø3.3 mm diameter) were placed in the mandible of minipigs with two preparation techniques: an NP (Group 1) and an OP to a final osteotomy of 3.5 mm in diameter (Group 2) and submerged for 2 and 8 weeks. An Implant Stability Quotient (ISQ) was measured for each implant at placement. Implant survival, defined histologically as the absence of fibrous encapsulation and the presence of direct bone-to-implant contact, osseointegration and crestal bone formation were analysed histologically and histomorphometrically to compare the preparation techniques.

Results

A 100% survival for both preparation types was observed. The mean ISQ at insertion for Groups 1 and 2 was 69.35 a.u. (95% CI: 68.02–70.68) and 11.95 a.u. (95% CI: 10.53–13.37) respectively (p < 0.001). At 2 and 8 weeks, there was no difference between the two groups for total bone-to-implant contact (tBIC) (p > 0.05). Group 2 demonstrated significantly higher mean first bone-to-implant contact (fBIC), coronal bone-to-implant contact (cBIC) and bone-area-to-total-area (BATA) at 2 and 8 weeks compared to Group 1 (p < 0.05).

Conclusion

Implants inserted into an overprepared osteotomy with no primary stability successfully osseointegrated. At 2 and 8 weeks, OP resulted in significantly more coronal bone apposition and maintenance of coronal bone volume as measured by fBIC, cBIC and BATA.

目的通过比较标准截骨准备（NP）和过度截骨准备（OP）（最终截骨钻直径大于所放置的种植体）对种植体骨整合和嵴骨体积维持的影响，研究截骨过度准备（因此缺乏初级稳定性）对种植体骨整合和嵴骨体积维持的影响。方法采用NP（1组）和OP（2组）两种制备方法，将直径为Ø3.3 mm的骨水平种植体放置于小型猪下颌骨，最终截骨直径为3.5 mm（2组），浸泡2周和8周。在放置时测量每个种植体的种植体稳定商（ISQ）。种植体存活，在组织学上定义为纤维包被的缺失和骨与种植体直接接触的存在，骨整合和嵴骨形成在组织学和组织形态学上进行了分析，以比较制备技术。结果两种制剂的存活率均为100%。第1组和第2组的平均ISQ为69.35 a.u。（95% CI: 68.02-70.68）和11.95 a.u。（95% CI: 10.53 ~ 13.37），差异有统计学意义（p 0.05）。2组在第2周和第8周的平均首次骨与种植体接触（fBIC）、冠状骨与种植体接触（cBIC）和骨面积与总面积（BATA）均显著高于1组（p < 0.05）。结论种植体置入预备过度的截骨术中，在无初始稳定性的情况下成功实现骨整合。在第2周和第8周，通过fBIC、cBIC和BATA测量，OP显著增加了冠状骨的附着和冠状骨体积的维持。

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引用次数: 0

Clinical and Radiographic Changes at Implants Supporting Fixed Partial Dental Prostheses With Cantilever Extensions. A Retrospective Study After at Least 10 Years of Loading 悬臂延伸固定部分义齿种植体的临床和影像学变化。至少10年负荷后的回顾性研究

IF 5.3 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2025-07-22 DOI: 10.1111/clr.70000

Alexios Bakopoulos, Haralampos Petridis, Konstantinos Michalakis, Lazaros Tsalikis, Ioannis Vouros

Aim

To report clinical and radiographic changes at implants supporting Fixed Partial Dental Prostheses with Cantilever extensions (FPDPC's) after a loading time exceeding 10 years.

Materials and Methods

Patients with FPDPC's were reevaluated after a loading time of 10–21 years. A clinical and radiographic examination was conducted to assess Marginal bone level change (MBLc), biological, and prosthetic parameters. Pocket depth (PD), Attachment Level (CAL), Bleeding on Probing (BOP), and Presence of Plaque (PL) were also recorded.

Results

Nineteen patients with 21 FPDPC's supported by 47 implants were re-evaluated after a mean loading time of 13.3 ± 2.9 years (range: 10–21 years). Implant survival rate was 100% and implant success rate was 91.5%, accounting for 4 implants (8.5%) that presented with peri-implantitis. Twelve implants (25.5%) exhibited peri-implant mucositis. Three of the FPDPC's had to be replaced due to fracture of the cantilever teeth and one other FPDPC had abutment screw fracture which was corrected, leading to prosthetic survival and success rates of 86% and 81%, respectively. Mean MBLc from implant placement to time of re-evaluation was 0.99 ± 1.11 mm (95% CI: 0.67, 1.31, p-value < 0.001). Mean PD at re-evaluation was 3.9 ± 1.6 mm, mean CAL was 1.2 ± 1.6 mm. Percentages of BOP and PL were 14.89% ± 23.11% and 26.6% ± 30.625 respectively.

Conclusion

Fixed partial dental prostheses with cantilever extensions are a reliable option if extensive bone grafting or sinus lifts are to be avoided, with 10-year results showing 100% implant survival, 90% implant success, and 86% and 81% prosthetic survival and success rates, respectively.

目的报告悬臂式部分固定牙种植体（FPDPC’s）在加载时间超过10年后的临床和放射学变化。材料和方法在10-21年的加载时间后对FPDPC患者进行重新评估。进行临床和影像学检查以评估边缘骨水平变化（MBLc），生物学和假体参数。同时记录袋深（PD）、附着水平（CAL）、探查出血（BOP）和斑块存在情况（PL）。结果19例患者共21颗FPDPC，共47颗种植体，平均加载时间为13.3±2.9年（范围：10-21年）。种植体成活率为100%，种植体成功率为91.5%，其中4例（8.5%）种植体出现种植体周围炎。12个种植体（25.5%）出现种植体周围粘膜炎。由于悬臂牙断裂，三颗FPDPC必须更换，另一颗FPDPC的基牙螺钉断裂被纠正，导致假体的存活率和成功率分别为86%和81%。从种植体植入到重新评估时间的平均MBLc为0.99±1.11 mm (95% CI: 0.67, 1.31, p‐value <；0.001)。重新评估时的平均PD为3.9±1.6 mm，平均CAL为1.2±1.6 mm。BOP和PL分别为14.89%±23.11%和26.6%±30.625。结论在避免广泛植骨或窦提升的情况下，悬臂式固定部分义齿是一种可靠的选择，10年的结果显示种植体成活率为100%，种植体成功率为90%，假体成活率和成功率分别为86%和81%。

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引用次数: 0

Neutrophil Extracellular Traps Induce Pyroptosis of Gingival Fibroblasts in Peri-Implantitis 中性粒细胞胞外诱捕诱导种植体周围炎牙龈成纤维细胞焦亡。

IF 5.3 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2025-07-21 DOI: 10.1111/clr.70002

Jiangbo Li, Zhixin Li, Kailibinuer Abuduwaili, Jiaying Song, Yue Sun, Zhuofan Chen, Danying Chen, Baoxin Huang

Objectives

This study aimed to verify the release of neutrophil extracellular traps (NETs) in peri-implantitis and explore whether NETs induce pyroptosis and inflammatory responses in human gingival fibroblasts (HGFs).

Materials and Methods

Peri-implant soft tissue samples were collected from healthy individuals and patients with peri-implantitis. NETs and the expression of pyroptosis-related factors including NLRP3, Caspase1, GSDMD, and IL-1β were detected. In vitro, NETs induced from differentiated HL60 (dHL60) cells and human neutrophils were used to stimulate HGFs. Transcriptome sequencing analysis and functional enrichment analysis were performed to analyze the influence of NETs on programmed cell death and inflammatory-related signaling pathways in HGFs. Further investigations were conducted to explore the changes in cell viability, cell membrane permeability, and the expression levels of inflammatory factors and pyroptosis-related markers in HGFs treated with NETs in the presence or absence of DNase I.

Results

Compared to healthy samples, the release of NETs was significantly elevated in soft tissues with peri-implantitis, accompanied by increased expression of NLRP3, Caspase1, GSDMD, and IL-1β. Functional enrichment analyses revealed that NETs activated signaling pathways related to pyroptosis and inflammatory responses of HGFs. Meanwhile, the results of the in vitro study revealed that NETs reduced cell viability, increased cell membrane permeability, and upregulated expression of inflammatory cytokines and pyroptosis markers in HGFs, which were partially reversed by DNase I treatment.

Conclusion

NETs may exacerbate the pathological progression of peri-implantitis by inducing pyroptosis and inflammatory responses in HGFs. Targeting NETs may offer a potential therapeutic strategy to mitigate the inflammation in peri-implantitis.

目的本研究旨在验证中性粒细胞胞外陷阱（NETs）在种植体周围炎中的释放，并探讨NETs是否会诱导人牙龈成纤维细胞（HGFs）的热凋亡和炎症反应。材料与方法采集健康个体和种植体周围炎患者的speri -implant软组织标本。检测NETs及NLRP3、Caspase1、GSDMD、IL-1β等焦解热相关因子的表达。体外，用分化的HL60 （dHL60）细胞和人中性粒细胞诱导的NETs刺激HGFs。通过转录组测序分析和功能富集分析来分析NETs对hgf中程序性细胞死亡和炎症相关信号通路的影响。进一步研究在DNase i存在或不存在的情况下，NETs处理的hgf细胞活力、细胞膜通透性、炎症因子和热降解相关标志物的表达水平的变化。结果与健康样品相比，种植体周围软组织中NETs的释放显著升高，NLRP3、Caspase1、GSDMD和IL-1β的表达增加。功能富集分析显示，NETs激活了与HGFs焦亡和炎症反应相关的信号通路。同时，体外研究结果显示，NETs降低了HGFs的细胞活力，增加了细胞膜通透性，上调了炎症因子和焦亡标志物的表达，而DNase I处理可部分逆转这一现象。结论nets可能通过诱导HGFs的焦亡和炎症反应而加速种植体周围炎的病理进展。靶向NETs可能提供一种潜在的治疗策略，以减轻种植体周围炎的炎症。

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引用次数: 0