Clinical Oral Implants Research最新文献_第8页

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。

{"title":"Osseointegration in the Absence of Primary Stability: An Experimental Preclinical Mandibular Minipig Overpreparation In Vivo Model","authors":"Thomas Gill, Hansley Ooi, Emre Tezulas, Aviva Petrie, Simon Rawlinson, Mario Roccuzzo, Shakeel Shahdad","doi":"10.1111/clr.70006","DOIUrl":"10.1111/clr.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> < 0.001). At 2 and 8 weeks, there was no difference between the two groups for total bone-to-implant contact (tBIC) (<i>p</i> > 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 (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 10","pages":"1346-1359"},"PeriodicalIF":5.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684290","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

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

Influence of Horizontal Intraoral Scan Bodies on the Trueness of Digital Impressions for Complete-Arch Prostheses on Four Implants: An In Vitro Evaluation 水平口内扫描体对四种种植体全弓修复体数字印象真实性的影响：体外评估。

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

Clinical Oral Implants Research

Pub Date : 2025-07-18 DOI: 10.1111/clr.70001

Andrea Laureti, Tiago Marques, João Pitta, Vincent Fehmer, Irena Sailer, Alessandro Pozzi, Luís Azevedo

Objective

To assess the impact of horizontal intraoral scan bodies (H-ISBs) on the trueness of complete-arch digital impressions compared to vertical ISBs (V-ISBs). To evaluate trueness among four intraoral scanners (IOS) and inter-operator variability across different ISB × IOS combinations.

Materials and Methods

Digital impressions were made from a dental cast with four multi-unit analogs using four H-ISBs: H-NB, H-NS, H-M6, H-SF, and a V-ISB (V-EA) as a comparison. Two operators performed 10 scans per ISB with four IOS devices (i5D, PS, T3, T4), generating 400 impressions. Reference scans were obtained with a desktop scanner, and trueness was analyzed using root-mean-square (RMS) error calculations (α = 0.05).

Results

H-NS and H-SF exhibited the highest trueness across IOSs, whereas H-NB and H-M6 showed lower trueness. V-EA outperformed H-NB and H-M6 but not H-NS and H-SF. Significant IOS-ISB interaction effects (p < 0.01) indicated H-SF as the most accurate, especially with PS. T4 and i5D displayed greater variability, particularly with H-NB. V-ISBs exhibited higher inter-operator variability compared to H-ISBs.

Conclusions

H-ISBs did not perform better than V-ISBs in all scenarios. The interactions among ISB design, IOS type, and operator significantly affect the digital impression trueness. The discrepancies measured among the systems remain well below the currently accepted threshold for clinically relevant misfit, supporting the suitability of the horizontal configuration for complete-arch impressions.

目的评价水平口内扫描体（H-ISBs）与垂直口内扫描体（V-ISBs）对全弓数字印模准确性的影响。评估四种口腔内扫描仪（IOS）的准确性和不同ISB × IOS组合的操作者之间的差异。材料和方法采用四种h - isb: H-NB， H-NS, H-M6， H-SF和V-ISB （V-EA）作为比较，用四种多单元类似物的牙模制作数字印模。两名操作人员使用4台IOS设备（i5D、PS、T3、T4）对每个ISB进行了10次扫描，产生了400次印象。使用台式扫描仪获得参考扫描结果，采用均方根误差（RMS）计算分析准确率（α = 0.05）。结果H-NB和H-M6的准确率较低，h - ns和H-SF的准确率最高。V-EA优于H-NB和H-M6，但优于H-NS和H-SF。显著的IOS-ISB相互作用效应（p < 0.01）表明H-SF最准确，特别是PS。T4和i5D表现出更大的变异性，特别是H-NB。与H-ISBs相比，V-ISBs表现出更高的操作员间变异性。结论sh - isbs在所有情况下的表现均不优于V-ISBs。ISB设计、IOS类型和操作人员之间的交互作用显著影响数字印象的真实性。系统之间测量的差异仍然远远低于目前临床相关不匹配的可接受阈值，支持水平配置对完全弓印模的适用性。

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引用次数: 0

Accuracy and Time Efficiency of Artificial Intelligence-Driven Tooth Segmentation on CBCT Images: A Validation Study Using Two Implant Planning Software Programs 人工智能驱动的CBCT图像牙齿分割的准确性和时效性：两种种植规划软件的验证研究。

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

Clinical Oral Implants Research

Pub Date : 2025-07-18 DOI: 10.1111/clr.70003

Panagiotis Ntovas, Piyarat Sirirattanagool, Praewvanit Asavanamuang, Shruti Jain, Lorenzo Tavelli, Marta Revilla-León, Maria Eliza Galarraga-Vinueza

Objectives

To assess the accuracy and time efficiency of manual versus artificial intelligence (AI)-driven tooth segmentation on cone-beam computed tomography (CBCT) images, using AI tools integrated within implant planning software, and to evaluate the impact of artifacts, dental arch, tooth type, and region.

Materials and Methods

Fourteen patients who underwent CBCT scans were randomly selected for this study. Using the acquired datasets, 67 extracted teeth were segmented using one manual and two AI-driven tools. The segmentation time for each method was recorded. The extracted teeth were scanned with an intraoral scanner to serve as the reference. The virtual models generated by each segmentation method were superimposed with the surface scan models to calculate volumetric discrepancies.

Results

The discrepancy between the evaluated AI-driven and manual segmentation methods ranged from 0.10 to 0.98 mm, with a mean RMS of 0.27 (0.11) mm. Manual segmentation resulted in less RMS deviation compared to both AI-driven methods (CDX; BSB) (p < 0.05). Significant differences were observed between all investigated segmentation methods, both for the overall tooth area and each region, with the apical portion of the root showing the lowest accuracy (p < 0.05). Tooth type did not have a significant effect on segmentation (p > 0.05). Both AI-driven segmentation methods reduced segmentation time compared to manual segmentation (p < 0.05).

Conclusions

AI-driven segmentation can generate reliable virtual 3D tooth models, with accuracy comparable to that of manual segmentation performed by experienced clinicians, while also significantly improving time efficiency. To further enhance accuracy in cases involving restoration artifacts, continued development and optimization of AI-driven tooth segmentation models are necessary.

目的评估人工与人工智能（AI）驱动的锥形束计算机断层扫描（CBCT）图像分割的准确性和时间效率，使用人工智能工具集成在种植体计划软件中，并评估伪影、牙弓、牙齿类型和区域的影响。材料与方法本研究随机选择14例接受CBCT扫描的患者。利用采集到的数据集，使用一种人工工具和两种人工智能驱动工具对67颗提取的牙齿进行分割。记录每种方法的分割时间。拔牙后用口腔内扫描仪扫描作为参考。将每种分割方法生成的虚拟模型与表面扫描模型叠加，计算体积差异。结果人工智能与人工分割方法的差异范围为0.10 ~ 0.98 mm，平均RMS为0.27 (0.11)mm。人工分割方法的RMS偏差小于人工智能和人工智能分割方法(CDX；BSB) （p 0.05）。与人工分割相比，两种人工智能驱动的分割方法都缩短了分割时间（p < 0.05）。结论ai驱动的牙体分割可以生成可靠的虚拟三维牙体模型，其精度可与临床经验丰富的临床医生手工分割相媲美，同时显著提高了时间效率。为了进一步提高涉及修复工件的情况下的准确性，需要继续开发和优化人工智能驱动的牙齿分割模型。

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引用次数: 0

Assessment of Residual Bone Level Around Explanted Implants and Description of the Systemic and Local Characteristics. A Retrospective Study 外植体周围残骨水平评估及系统和局部特征描述。回顾性研究。

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

Clinical Oral Implants Research

Pub Date : 2025-07-16 DOI: 10.1111/clr.70004

Rodrigo Martin-Cabezas, Norbert Cionca, Catherine Giannopoulou

Objectives

The study aimed to evaluate the residual bone level of explanted implants and to report local and systemic characteristics observed in patients who underwent implant explantation.

Material and Methods

A total of 494 administrative records were initially retrieved from the database. After elimination of duplicates, 464 medical records of patients who underwent implant explantation between 2005 and 2021 in thirteen private clinics in Switzerland were screened. Information regarding implant history, local (oral health, periodontal and prosthetic status) and systemic (systemic diseases, medication, and smoking) characteristics was assessed through the medical records and the radiographic data. ISRCTN registry (ISRCTN10631004).

Results

In total, 399 patients and 521 implants were included in the analysis. Peri-implantitis was the most frequent reason for explantation (62%). Explantation was mainly performed in cases of advanced peri-implantitis with a mean bone loss of 62.92% of the implant length. Most patients had radiographic bone loss around the remaining dentition with a bone loss/age ratio of 0.74, presented compromised oral health, and 47.80% of them were smokers. Moreover, only 56.12% of patients reported being in good systemic health.

Conclusion

Implant explantations were typically performed once bone loss reached approximately 60% of the implant length. They were most often observed in advanced cases of peri-implantitis and in patients with high-risk profiles for periodontal breakdown, such as a history of periodontal disease or heavy smoking habits.

目的本研究旨在评估植体移植后的残骨水平，并报告植体移植患者的局部和全身特征。材料和方法最初从数据库中检索到总共494份行政记录。在消除重复后，对2005年至2021年期间在瑞士13家私人诊所接受植入物移植的464名患者的医疗记录进行了筛选。通过医疗记录和放射学数据评估种植史、局部（口腔健康、牙周和假体状态）和全身（全身性疾病、用药和吸烟）特征。ISRCTN注册表（ISRCTN10631004）。结果共纳入399例患者，521颗种植体。种植体周围炎是最常见的原因（62%）。植体移植主要发生在晚期种植体周围炎患者，平均骨损失为种植体长度的62.92%。大多数患者在剩余牙列周围有影像学骨质流失，骨质流失/年龄比为0.74，口腔健康受损，其中47.80%为吸烟者。此外，只有56.12%的患者报告全身健康状况良好。结论当骨损失达到种植体长度的60%左右时，通常进行种植体移植。它们最常见于晚期种植体周围炎病例和牙周破裂高危人群，如有牙周病史或重度吸烟习惯。

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引用次数: 0

Functional, Patient-Centered and Bone Remodeling Outcomes in Two Narrow-Diameter Implant Retained Mandibular Overdenture Wearers After 5 Years of Follow-Up: A Prospective Case Series 两名窄直径种植保留下颌覆盖义齿佩戴者5年随访后的功能、以患者为中心和骨重塑结果：一项前瞻性病例系列研究

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

Clinical Oral Implants Research

Pub Date : 2025-07-11 DOI: 10.1111/clr.14471

Anna Paula Da Rosa Possebon, Fernando Antônio Vargas Júnior, Fernanda Isabel Román Ramos, Otacílio Luiz Chagas-Júnior, Luciana de Rezende Pinto, Fernanda Faot

Objectives

This prospective longitudinal case series investigated changes in functional, radiographic, and patient-centered outcomes in users of two narrow-diameter implant-retained mandibular overdentures (IMO) over a 5-year follow-up.

Materials and Methods

Twenty-four patients from a previous 3-year study (8 man, 16 women, 71.58 ± 7.03 years, mean mandibular edentulism duration 23.9 ± 14.4 years) were invited for a 5-year follow-up evaluation of radiographic and functional parameters. Masticatory function (MF) was assessed using the Swallowing Threshold Test (ST), with X50 and B cut-off values indicating satisfactory performance. Oral health-related quality of life (OHRQoL) was evaluated using the OHIP-Edent questionnaire. The Posterior Mandibular Area Index (PAI) was analyzed using digital panoramic radiographs. Data was analyzed using multilevel mixed-effects linear regression.

Results

Twenty participants completed the 5-year follow-up evaluation. ST_X50 (4.00–3.70; p ≤ 0.01; 95% CI: 0.47–1.82) reached a significant reduction along with an increased number of masticatory cycles (59.33–65.60; p ≤ 0.01; 95% CI: 0.32–1.11) between years. The number of IMO wearers presenting satisfactory mastication increased but persisted as unsatisfactory in nine participants by year 5. Declines in the Functional Limitation and Physical Disability domains of OHRQoL were noted, with unsatisfactory mastication correlating with higher pain (coef: 2.5; p: 0.03; 95% CI: 0.25–4.74) and psychological disability scores (coef: 0.94; p ≤ 0.01; 95% CI: 0.19–1.68). PAI increased significantly (1.13–1.68; p ≤ 0.01; 95% CI: 0.24–0.56), indicating ongoing bone remodeling.

Conclusions

Although MF and bone parameters improved over 5 years, persistent unsatisfactory mastication continued to negatively affect quality of life. These findings underscore the interdependence between functional and patient-centered outcomes in IMO users.

Trial Registration

The Brazilian Registry of Clinical Trials (ReBEC), Trial identification: UTN code: U1111-1259-4127

目的：本前瞻性纵向病例系列研究了两个窄直径种植下颌覆盖义齿（IMO）使用者在5年随访期间功能、影像学和以患者为中心的结果的变化。材料与方法从先前3年的研究中选取24例患者（男性8例，女性16例，71.58±7.03岁，平均下颌义齿持续时间23.9±14.4年）进行5年的影像学和功能参数随访评估。吞咽阈值测试（ST）评估咀嚼功能（MF）， X50和B截断值表明表现满意。口腔健康相关生活质量（OHRQoL）采用OHIP -事件问卷进行评估。采用数字全景x线片分析后下颌面积指数（PAI）。数据分析采用多水平混合效应线性回归。结果20例患者完成了5年随访评估。ST_X50 (4.00 - -3.70;P≤0.01；95% CI: 0.47-1.82)随着咀嚼循环次数的增加(59.33-65.60；P≤0.01；95% CI: 0.32-1.11)。在第5年，表现出满意咀嚼的IMO佩戴者人数有所增加，但仍有9名参与者表现不满意。OHRQoL的功能限制和身体残疾领域的下降被注意到，咀嚼不满意与更高的疼痛相关(系数：2.5；p: 0.03;95% CI: 0.25-4.74)和心理残疾评分(coef: 0.94；P≤0.01；95% ci: 0.19-1.68)。PAI显著升高(1.13-1.68；P≤0.01；95% CI: 0.24-0.56)，表明正在进行骨重塑。结论虽然5年内MF和骨参数得到改善，但持续咀嚼不良仍对生活质量产生负面影响。这些发现强调了IMO使用者的功能和以患者为中心的结果之间的相互依赖性。试验注册巴西临床试验注册中心（ReBEC），试验标识：UTN代码：U1111‐1259‐4127

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引用次数: 0