Clinical Oral Implants Research最新文献_第8页

Clinical and radiographic outcomes of implant-supported fixed prostheses with cantilever extension in anterior mandible: A retrospective study 下颌前部悬臂延伸种植体支撑固定义齿的临床和放射学效果：回顾性研究。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-11 DOI: 10.1111/clr.14310

Siyuan Wang, Xiaoyu Chen, Zhaoting Ling, Yiwen Xie, Cong Chen, Xiaoting Shen, Fuming He

Objectives

The objective of this study is to analyze the clinical and radiographic outcomes of implant-supported fixed protheses with cantilever extensions (ISFPCs) in the partially edentulous anterior mandible.

Materials and Methods

Patients who received anterior mandible implant restoration between January 2016 and December 2021 were included. Patients with two, three, or four continuous missing teeth receiving adjacent implant supported single-unit crowns (ISSCs), ISFPCs, implant-supported fixed protheses without cantilever extensions (ISFPNs) were divided into groups: ISSC+ISSC, ISFPC, ISSC+ISFPC, three-unit ISFPN, ISFPC+ISFPC, or four-unit ISFPN, respectively. We recorded and evaluated survival rates, mechanical and biological complications, peri-implant marginal bone loss (MBL), esthetic outcomes, and patient perceptions. Statistical analysis was performed using linear mixed models (LMM).

Results

The study included 87 patients and 152 implants. No implant loss occurred during an average follow-up of 3.48 ± 1.85 years (range: 1–7 years). According to LMM models, prosthetic type had a statistically significant impact on MBL during follow-up periods, in favor of the ISFPC and ISFPC+ISFPC groups (0.16 ± 0.48 mm vs. 0.51 ± 0.49 mm, p = .034; 0.22 ± 0.49 mm vs. 0.60 ± 0.62 mm, p = .043, respectively). Mechanical and biological complications were relatively low and comparable. The four-unit ISFPC group had higher subjective esthetic scores compared with the ISSC+ISSC group (98.6 vs. 83.8, p < .05), and patients in the ISFPC+ISFPC group expressed greater satisfaction with cleanability than the ISFPN group (98.8 vs. 80.6).

Conclusion

ISFPCs offer a highly predictable treatment option in the anterior mandible, characterized by high survival rates, and comparable complication rates, peri-implant bone stability and esthetics to adjacent ISSCs or ISFPNs.

研究目的本研究的目的是分析部分缺牙的前下颌种植体支撑悬臂延伸固定义齿（ISFPCs）的临床和影像学效果：纳入2016年1月至2021年12月期间接受前下颌骨种植修复的患者。将接受相邻种植体支持单体冠（ISSC）、ISFPC、无悬臂延伸种植体支持固定义齿（ISFPN）修复的两颗、三颗或四颗连续缺失牙患者分为几组：分别为 ISSC+ISSC、ISFPC、ISSC+ISFPC、三单位 ISFPN、ISFPC+ISFPC 或四单位 ISFPN。我们记录并评估了存活率、机械和生物并发症、种植体周围边缘骨质流失（MBL）、美学效果和患者感受。统计分析采用线性混合模型（LMM）进行：研究包括 87 名患者和 152 个种植体。在平均 3.48 ± 1.85 年（范围：1-7 年）的随访期间，没有发生种植体脱落的情况。根据 LMM 模型，修复体类型对随访期间的 MBL 有显著的统计学影响，ISFPC 组和 ISFPC+ISFPC 组更有利（分别为 0.16 ± 0.48 mm vs. 0.51 ± 0.49 mm，p = .034；0.22 ± 0.49 mm vs. 0.60 ± 0.62 mm，p = .043）。机械并发症和生物并发症相对较低，且具有可比性。与 ISSC+ISSC 组相比，四单位 ISFPC 组的主观美学评分更高（98.6 分 vs. 83.8 分，p 结论：ISFPC 具有高度可预测性：ISFPC为下颌骨前部提供了一种可预测性很高的治疗方案，其特点是存活率高，并发症发生率、种植体周围骨稳定性和美观度与邻近的ISSC或ISFPN相当。

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引用次数: 0

Periodontal conditions of teeth adjacent to dental implants with or without peri-implantitis after non-surgical therapy in patients treated for periodontitis: A retrospective study 牙周炎患者在接受非手术治疗后，牙种植体邻近牙齿的牙周状况（有无种植体周围炎）：回顾性研究。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-11 DOI: 10.1111/clr.14316

Cheng-En Sung, Kwok-Hung Chung, Fu-Gong Lin, Ren-Yeong Huang, Wan-Chien Cheng, Wei-Liang Chen

Objectives

To retrospectively assess the periodontal conditions of teeth adjacent to and contralateral to implants presenting with or without peri-implantitis, following non-surgical periodontal and peri-implant mechanical therapy.

Materials and Methods

One hundred and one patients with existing dental implants and chronic periodontitis, who underwent non-surgical periodontal and peri-implant mechanical therapy, were included. The periodontal clinical probing depth (PPD), gingival recession (GR), and bleeding on probing (BOP) were recorded at six sites around the adjacent (Adj-) teeth and the contralateral (CL-) teeth relative to the implant. The potential factors influencing the periodontal conditions of 316 teeth were analyzed by multivariate linear regression models with generalized estimating equation methods and α = .05.

Results

The PPD of Adj-teeth was significantly different from that of CL-teeth before and after non-surgical therapy when the implant was diagnosed with peri-implantitis (PI) (p < .05). The PPD of teeth was shown to be affected by neighboring implants diagnosed with peri-implantitis (β = .825 mm, p < .001), teeth adjacent to implants (β = .245 mm, p = .004), a molar tooth type (β = .435 mm, p = .019), and non-surgical therapy (β = −.522 mm, p < .001).

Conclusions

Relatively compromised periodontal conditions at Adj-teeth after non-surgical PI therapy were detected. Therefore, clinicians should be aware that non-surgical therapy may be less successful at teeth adjacent to implants with PI.

目的回顾性评估接受非手术牙周和种植体周围机械治疗后，出现或不出现种植体周围炎的种植体邻近牙齿和对侧牙齿的牙周状况：材料和方法：纳入 101 名接受非手术牙周和种植体周围机械治疗的现有牙科种植体和慢性牙周炎患者。在与种植体相对的邻牙（Adj-）和对侧牙（CL-）周围的六个部位记录牙周临床探诊深度（PPD）、牙龈退缩（GR）和探诊出血（BOP）。采用广义估计方程法和α = .05的多变量线性回归模型分析了影响316颗牙齿牙周状况的潜在因素：结果：当种植体被诊断为种植体周围炎（PI）时，Adj牙的PPD与CL牙的PPD在非手术治疗前后有显著差异（p 结论：当种植体被诊断为种植体周围炎（PI）时，Adj牙的PPD与CL牙的PPD在非手术治疗前后有显著差异：非手术 PI 治疗后发现 Adj 牙的牙周状况相对较差。因此，临床医生应该意识到，非手术疗法在患有 PI 的种植体邻近牙齿上可能不太成功。

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引用次数: 0

Accuracy of manual and artificial intelligence-based superimposition of cone-beam computed tomography with digital scan data, utilizing an implant planning software: A randomized clinical study 利用种植规划软件对锥形束计算机断层扫描与数字扫描数据进行人工叠加和人工智能叠加的准确性：随机临床研究。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-10 DOI: 10.1111/clr.14313

Panagiotis Ntovas, Laurent Marchand, Matthew Finkelman, Marta Revilla-León, Wael Att

Objectives

To investigate the accuracy of conventional and automatic artificial intelligence (AI)-based registration of cone-beam computed tomography (CBCT) with intraoral scans and to evaluate the impact of user's experience, restoration artifact, number of missing teeth, and free-ended edentulous area.

Materials and Methods

Three initial registrations were performed for each of the 150 randomly selected patients, in an implant planning software: one from an experienced user, one from an inexperienced operator, and one from a randomly selected post-graduate student of implant dentistry. Six more registrations were performed for each dataset by the experienced clinician: implementing a manual or an automatic refinement, selecting 3 small or 3 large in-diameter surface areas and using multiple small or multiple large in-diameter surface areas. Finally, an automatic AI-driven registration was performed, using the AI tools that were integrated into the utilized implant planning software. The accuracy between each type of registration was measured using linear measurements between anatomical landmarks in metrology software.

Results

Fully automatic-based AI registration was not significantly different from the conventional methods tested for patients without restorations. In the presence of multiple restoration artifacts, user's experience was important for an accurate registration. Registrations' accuracy was affected by the number of free-ended edentulous areas, but not by the absolute number of missing teeth (p < .0083).

Conclusions

In the absence of imaging artifacts, automated AI-based registration of CBCT data and model scan data can be as accurate as conventional superimposition methods. The number and size of selected superimposition areas should be individually chosen depending on each clinical situation.

研究目的研究传统和基于人工智能（AI）的锥束计算机断层扫描（CBCT）与口内扫描配准的准确性，并评估用户经验、修复假象、缺失牙数量和自由缺牙面积的影响：对随机抽取的 150 名患者分别在种植规划软件中进行了三次初始注册：一次来自经验丰富的用户，一次来自经验不足的操作者，还有一次来自随机抽取的种植牙研究生。经验丰富的临床医生对每个数据集又进行了六次注册：实施手动或自动细化，选择 3 个小直径或 3 个大直径表面区域，使用多个小直径或多个大直径表面区域。最后，使用集成在所使用的种植规划软件中的人工智能工具，进行人工智能驱动的自动配准。每种配准方式的精确度都是通过计量软件中解剖地标之间的线性测量来衡量的：结果：对于没有修复体的患者，全自动人工智能配准与传统方法的差异不大。在存在多种修复假象的情况下，用户的经验对准确套准非常重要。注册的准确性受缺牙区数量的影响，但不受缺牙绝对数量的影响（p 结论）：在没有成像伪影的情况下，基于人工智能的 CBCT 数据和模型扫描数据的自动配准与传统的叠加方法一样准确。所选叠加区域的数量和大小应根据不同的临床情况单独选择。

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引用次数: 0

Alveolar ridge preservation versus early implant placement in single non-molar sites: A systematic review and meta-analysis 单颗非磨牙部位牙槽嵴保留与早期种植体植入的比较：系统回顾和荟萃分析。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-08 DOI: 10.1111/clr.14314

Momen A. Atieh, Maanas Shah, Abeer Hakam, Fawaghi AlAli, Ibrahim Aboushakra, Nabeel H. M. Alsabeeha

Objectives

The aim of this systematic review and meta-analyses was to evaluate the outcomes of alveolar ridge preservation (ARP) following extraction of non-molar teeth in comparison to early implant placement (EIP) in terms of clinical and radiographic changes, need for additional augmentation at the time of implant placement, patient-reported outcomes, and implant failure rate.

Methods

Electronic databases were searched to identify randomized and non-randomized studies that compared ARP to EIP. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program.

Results

A total of 106 studies were identified, of which five studies with 198 non-molar extraction sockets in 198 participants were included. Overall meta-analysis showed significant differences in changes in midfacial mucosal margin (mean difference (MD) −0.09; 95% confidence interval (CI) −0.17 to −0.01; p = .03) and ridge width (MD −1.70; 95% CI −3.19 to −0.20; p = .03) in favor of ARP. The use of ARP was also associated with less need for additional augmentation at implant placement, but the difference was not statistically significant.

Conclusions

Within the limitation of this review, ARP following extraction of non-molar teeth has short-term positive effects on soft tissue contour, mucosal margin and thickness, and alveolar ridge width and height. It can also simplify future implant treatment by minimizing the need for additional augmentation.

研究目的本系统综述和荟萃分析旨在评估拔除非磨牙后牙槽骨嵴保留（ARP）与早期种植体植入（EIP）在临床和影像学变化、种植体植入时的额外增量需求、患者报告结果和种植体失败率方面的比较结果：对电子数据库进行检索，以确定将 ARP 与 EIP 进行比较的随机和非随机研究。使用 Cochrane 协作组织的偏倚风险工具评估了偏倚风险。使用统计软件程序对数据进行分析：共确定了 106 项研究，其中有 5 项研究纳入了 198 名参与者的 198 个非磨牙拔牙窝。总体荟萃分析表明，在中面部粘膜边缘（平均差（MD）-0.09；95% 置信区间（CI）-0.17 至 -0.01；P = .03）和牙脊宽度（MD -1.70；95% CI -3.19 至 -0.20；P = .03）的变化方面，ARP 有显著差异。ARP的使用还与种植体植入时的额外增量需求较少有关，但差异无统计学意义：在本综述的限制范围内，非磨牙拔除后的 ARP 对软组织轮廓、粘膜边缘和厚度、牙槽嵴宽度和高度有短期的积极影响。它还可以简化未来的种植治疗，最大限度地减少额外增量的需要。

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引用次数: 0

Vitality of autologous retromolar bone grafts for alveolar ridge augmentation after a 3-months healing period: A prospective histomorphometrical analysis 用于牙槽嵴增高的自体反磨骨移植物在 3 个月愈合期后的活力：前瞻性组织形态学分析。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-07 DOI: 10.1111/clr.14306

Andres Stricker, Tobias Fretwurst, Arzu Abdullayeva, Dieter Bosshardt, Tara Aghaloo, Fabian Duttenhöfer, Luca Cordaro, Katja Nelson, Christian Gross

Objectives

The incorporation of retromolar bone grafts used for alveolar ridge augmentation is not well understood. This prospective observational study aims to supply histomorphometrical data from bone graft biopsies taken at the time of retrieval and after a 3-month healing period using patient-matched biopsies.

Materials and Methods

In 17 patients, trephine biopsies of the graft were acquired at the time of graft retrieval and after a 3-month healing period. The biopsies were compared histomorphometrically regarding the number of osteocytes, appearance of osteocyte lacunae, quantity, surface area, and activity of the Haversian canals.

Results

All grafts appeared clinically stable after screw removal and 17 implants were placed. Histomorphometric analysis revealed no significant difference in the number of osteocytes (p = .413), osteocyte lacunae (p = .611), the ratio of filled/empty osteocyte lacunae (p = .467) and active Haversian canals (p = .495) between the biopsies retrieved after a 3-months healing period with those at the time of grafting. The only significant difference was noted in the mean surface area of the Haversian canals (p = .002). Specifically, the grafts post 3-month healing showed a significantly larger mean area (0.069 mm²) compared to the time of grafting (0.029 mm²).

Conclusion

This study demonstrates, compared to other data, a high rate of vital structures in retromolar bone block grafts after 3 months of healing, exhibiting the same histological features in comparison to the biopsies from the native alveolar ridge. Standard histomorphometrical parameters, e.g., the amount of filled or empty osteocyte lacunae for the description of the vitality of the graft need to be reappraised.

目的：目前对用于牙槽嵴增高的反磨骨移植物的结合情况还不甚了解。这项前瞻性观察研究旨在利用与患者匹配的活组织切片，提供骨移植物取回时和3个月愈合期后的组织形态学数据：在 17 例患者中，分别在取骨时和 3 个月愈合期后对移植骨进行了穿刺活检。活检组织形态学比较了骨细胞的数量、骨细胞裂隙的外观、数量、表面积和哈弗氏管的活性：所有移植物在取出螺钉后临床表现稳定，并植入了 17 个种植体。组织形态计量分析表明，3 个月愈合期后取回的活检组织与移植时的活检组织在骨细胞数量（p = .413）、骨细胞裂隙（p = .611）、骨细胞裂隙填充/空隙比率（p = .467）和活跃的哈弗氏管（p = .495）方面均无明显差异。唯一明显的差异是哈弗氏管的平均表面积（p = .002）。具体来说，愈合 3 个月后的移植物平均面积（0.069 平方毫米）明显大于移植时的平均面积（0.029 平方毫米）：本研究表明，与其他数据相比，愈合 3 个月后的后牙槽骨块移植物中的重要结构比例较高，与原生牙槽嵴活检组织学特征相同。标准的组织形态学参数，如用于描述移植物活力的骨细胞填充或空洞的数量，需要重新评估。

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引用次数: 0

Accuracy of artificial intelligence-based segmentation of the mandibular canal in CBCT 基于人工智能的 CBCT 下颌管分割的准确性。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-07 DOI: 10.1111/clr.14307

Panagiotis Ntovas, Laurent Marchand, Matthew Finkelman, Marta Revilla-León, Wael Att

Objectives

To investigate the accuracy of artificial intelligence (AI)-based segmentation of the mandibular canal, compared to the conventional manual tracing, implementing implant planning software.

Materials and methods

Localization of the mandibular canals was performed for 104 randomly selected patients. A localization was performed by three experienced clinicians in order to serve as control. Five tracings were performed: One from a clinician with a moderate experience with a manual tracing (I₁), followed by the implementation of an automatic refinement (I₂), one manual from a dental student (S₁), and one from the experienced clinician, followed by an automatic refinement (E). Subsequently, two fully automatic AI-driven segmentations were performed (A₁,A₂). The accuracy between each method was measured using root mean square error calculation.

Results

The discrepancy among the models of the mandibular canals, between the experienced clinicians and each investigated method ranged from 0.21 to 7.65 mm with a mean of 3.5 mm RMS error. The analysis of each separate mandibular canal's section revealed that mean RMS error was higher in the posterior and anterior loop compared to the middle section. Regarding time efficiency, tracing by experienced users required more time compared to AI-driven segmentation.

Conclusions

The experience of the clinician had a significant influence on the accuracy of mandibular canal's localization. An AI-driven segmentation of the mandibular canal constitutes a time-efficient and reliable procedure for pre-operative implant planning. Nevertheless, AI-based segmentation results should always be verified, as a subsequent manual refinement of the initial segmentation may be required to avoid clinical significant errors.

目的研究基于人工智能（AI）的下颌管分割的准确性，与传统的手动描记相比：随机选取 104 名患者进行下颌管定位。由三位经验丰富的临床医生进行定位，作为对照。共进行了五次追踪：一名经验丰富的临床医师进行了手动描记（I1），随后进行了自动改进（I2）；一名牙科学生进行了手动描记（S1）；一名经验丰富的临床医师进行了自动改进（E）。随后，进行了两次人工智能驱动的全自动分割（A1,A2）。使用均方根误差计算方法测量了每种方法之间的准确性：结果：经验丰富的临床医生与每种研究方法之间的下颌管模型差异在 0.21 至 7.65 毫米之间，平均均方根误差为 3.5 毫米。对下颌管各部分的分析表明，与中段相比，后环和前环的平均有效值误差更大。在时间效率方面，与人工智能驱动的分段相比，有经验的用户追踪需要更多时间：结论：临床医生的经验对下颌管定位的准确性有很大影响。人工智能驱动的下颌管分割是一种省时、可靠的术前种植规划程序。不过，人工智能分割结果应始终经过验证，因为随后可能需要对初始分割结果进行人工改进，以避免出现重大临床误差。

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引用次数: 0

Mechanical performance of patient-specific prefabricated temporary shell versus laboratory-fabricated CAD/CAM provisional implant-supported single-tooth restorations: A laboratory study 患者专用预制临时外壳与实验室制造的 CAD/CAM 临时种植体支持单牙修复体的机械性能对比：实验室研究。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-05 DOI: 10.1111/clr.14308

Vincent J. J. Donker, Paulien E. A. Janss, Christiaan W. P. Pol, Gerry M. Raghoebar, Arjan Vissink, Henny J. A. Meijer

Objective

To evaluate the mechanical performance of patient-specific prefabricated temporary shell versus laboratory-fabricated CAD/CAM provisional restorations on titanium temporary abutments, with and without thermo-mechanical ageing.

Materials and Methods

Implants with a conical connection were divided into four groups (n = 24) and restored with temporary shell or laboratory-fabricated central or lateral incisor PMMA restorations that were relined or bonded on titanium temporary abutments. The diameter of the central and lateral incisor groups' implants was regular (ϕ 4.3 mm) or narrow (ϕ 3.5 mm), respectively. Half of each group's specimens were subjected to ageing, simultaneous thermocycling (5–55°C) and chewing simulation (120,000 cycles, 50 N, 1.7 Hz) resulting in eight groups in total (n = 12). The aged specimens were evaluated with optical microscopy, and survival and complication rates were determined according to modified USPHS criteria. The non-aged specimens and those that had survived ageing were loaded until failure, whereupon bending moments were calculated.

Results

Survival rates after ageing were 100% for all groups. Apart from wear facets (ϕ 2–3 mm) on the palatal restoration surface, no complications were observed. The mean fracture load and bending moments ranged between 597.6–847.1 N and 433.3–550.6 Ncm, respectively, with no significant differences between the eight groups (p = .25; p = .20).

Conclusions

As patient-specific temporary shell central and lateral incisor provisional implant-supported restorations are mechanically stable enough to withstand clinical bite forces, even after thermo-mechanical ageing, they may serve as an alternative to laboratory-fabricated provisional restorations.

目的评估钛临时基台上患者特制的预制临时外壳与实验室制作的CAD/CAM临时修复体的机械性能，包括热机械老化和非热机械老化：将锥形连接的种植体分为四组（n = 24），使用临时外壳或实验室制作的中切牙或侧切牙 PMMA 修复体进行修复，并在钛临时基台上重新衬垫或粘结。中切牙组和侧切牙组的种植体直径分别为规则（ϕ 4.3 毫米）或狭窄（ϕ 3.5 毫米）。每组一半的试样进行老化，同时进行热循环（5-55°C）和咀嚼模拟（120,000 次，50 N，1.7 Hz），共分为八组（n = 12）。老化标本采用光学显微镜进行评估，存活率和并发症发生率根据修改后的 USPHS 标准确定。对未老化试样和老化后存活的试样进行加载直至失效，然后计算弯矩：结果：各组老化后的存活率均为 100%。除了腭修复体表面的磨损面（ϕ 2-3 mm）外，没有发现其他并发症。平均折断载荷和弯曲力矩分别为 597.6-847.1 N 和 433.3-550.6 Ncm，八组之间无明显差异（p = .25; p = .20）：由于患者特制的临时中切牙和侧切牙临时种植体支持修复体具有足够的机械稳定性，即使在热机械老化后也能承受临床咬合力，因此可以作为技工室制作的临时修复体的替代物。

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引用次数: 0

Enhancing guided bone regeneration with cross-linked collagen-conjugated xenogeneic bone blocks and membrane fixation: A preclinical in vivo study 利用交联胶原共轭异种骨块和膜固定增强引导性骨再生：临床前体内研究。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-05 DOI: 10.1111/clr.14309

Yin-Zhe An, Young Woo Song, Daniel S. Thoma, Franz J. Strauss, Jung-Seok Lee

Objective

To determine whether combining cross-linked (CL) collagen-integrated xenogeneic bone blocks stabilized with the fixation of resorbable collagen membranes (CM) can enhance guided bone regeneration (GBR) in the overaugmented calvarial defect model.

Materials and Methods

Four circular defects with a diameter of 8 mm were prepared in the calvarium of 13 rabbits. Defects were randomly assigned to receive one of the following treatments: (i) non-cross-linked (NCL) porcine-derived collagen-embedded bone block covered by a CM without fixation (NCL + unfix group); (ii) NCL bone block covered by CM with fixation using bone-tack (NCL + fix group); (iii) cross-linked (CL) porcine-derived collagen-embedded bone block covered by CM without fixation (CL + unfix group); and (iv) CL bone block covered by CM with fixation using bone-tack fixation (CL + fix group). The efficacy of GBR was assessed through histological and molecular analyses after 2 and 8 weeks.

Results

At 2 weeks, there were no significant differences in histologically measured areas of newly formed bone among the groups. At 8 weeks, however, the CL + fix group exhibited a larger area of new bone (5.08 ± 1.09 mm², mean ± standard deviation) compared to the NCL + unfix (1.62 ± 0.42 mm²; p < .0083), NCL + fix (3.97 ± 1.39 mm²) and CL + unfix (2.55 ± 1.04 mm²) groups. Additionally, the expression levels of tumour necrosis factor-alpha, fibroblast growth factor-2, vascular endothelial growth factor, osteocalcin and calcitonin receptor were significantly higher in the CL + fix group compared to the other three groups (p < .0083).

Conclusion

Cross-linked bone blocks stabilized with collagen membrane fixation can significantly enhance GBR.

目的确定结合交联（CL）胶原整合异种骨块与可吸收胶原膜（CM）固定是否能在过度增大的腓骨缺损模型中增强引导骨再生（GBR）：在 13 只兔子的腓骨上制备了四个直径为 8 毫米的圆形缺损。缺损处被随机分配接受以下处理之一：(i) 非交联（NCL）孔源胶原嵌入骨块，由 CM 覆盖，无固定（NCL + unfix 组）；(ii) NCL 骨块，由 CM 覆盖，使用骨钉固定（NCL + fix 组）；(iii)交联（CL）孔源胶原嵌入骨块，由 CM 覆盖，无固定（CL + unfix 组）；(iv)CL 骨块，由 CM 覆盖，使用骨钉固定（CL + fix 组）。2 周和 8 周后，通过组织学和分子分析评估 GBR 的疗效：结果：2 周后，经组织学测量，各组新形成骨的面积无明显差异。但在 8 周时，与 NCL + 未固定组（1.62 ± 0.42 mm2; p 2）和 CL + 未固定组（2.55 ± 1.04 mm2）相比，CL + 固定组的新骨面积更大（5.08 ± 1.09 mm2，平均值 ± 标准差）。此外，与其他三组相比，CL + 固定组的肿瘤坏死因子-α、成纤维细胞生长因子-2、血管内皮生长因子、骨钙素和降钙素受体的表达水平显著较高（p 结论通过胶原膜固定稳定的交联骨块可显著提高 GBR。

{"title":"Enhancing guided bone regeneration with cross-linked collagen-conjugated xenogeneic bone blocks and membrane fixation: A preclinical in vivo study","authors":"Yin-Zhe An, Young Woo Song, Daniel S. Thoma, Franz J. Strauss, Jung-Seok Lee","doi":"10.1111/clr.14309","DOIUrl":"10.1111/clr.14309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether combining cross-linked (CL) collagen-integrated xenogeneic bone blocks stabilized with the fixation of resorbable collagen membranes (CM) can enhance guided bone regeneration (GBR) in the overaugmented calvarial defect model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Four circular defects with a diameter of 8 mm were prepared in the calvarium of 13 rabbits. Defects were randomly assigned to receive one of the following treatments: (i) non-cross-linked (NCL) porcine-derived collagen-embedded bone block covered by a CM without fixation (NCL + unfix group); (ii) NCL bone block covered by CM with fixation using bone-tack (NCL + fix group); (iii) cross-linked (CL) porcine-derived collagen-embedded bone block covered by CM without fixation (CL + unfix group); and (iv) CL bone block covered by CM with fixation using bone-tack fixation (CL + fix group). The efficacy of GBR was assessed through histological and molecular analyses after 2 and 8 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 2 weeks, there were no significant differences in histologically measured areas of newly formed bone among the groups. At 8 weeks, however, the CL + fix group exhibited a larger area of new bone (5.08 ± 1.09 mm<sup>2</sup>, mean ± standard deviation) compared to the NCL + unfix (1.62 ± 0.42 mm<sup>2</sup>; <i>p</i> < .0083), NCL + fix (3.97 ± 1.39 mm<sup>2</sup>) and CL + unfix (2.55 ± 1.04 mm<sup>2</sup>) groups. Additionally, the expression levels of tumour necrosis factor-alpha, fibroblast growth factor-2, vascular endothelial growth factor, osteocalcin and calcitonin receptor were significantly higher in the CL + fix group compared to the other three groups (<i>p</i> < .0083).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cross-linked bone blocks stabilized with collagen membrane fixation can significantly enhance GBR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"35 10","pages":"1226-1239"},"PeriodicalIF":4.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.14309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261335","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

Sonography in the diagnosis of peri-implant bone defects: An in vitro study on native human mandibles 超声波诊断种植体周围骨缺损：对原生人类下颌骨的体外研究。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-04 DOI: 10.1111/clr.14302

Igor Bykhovsky, Alexander Hildner, Oliver D. Kripfgans, Reiner Mengel

Aim

The aim of this study on native human cadavers was to compare clinical, sonographic, and radiological measurements of fenestrations, dehiscences, and 3-wall bone defects on implants.

Materials and Methods

The examination was carried out on five human mandibles. After the insertion of 27 implants, dehiscences (n = 14), fenestrations (n = 7) and 3-wall bone defects (n = 6) were prepared in a standardized manner. The direct measurement of the bone defects was carried out with a periodontal probe and the radiological examination was carried out using digital volume tomography (DVT). The ultrasound examination (US) was performed using a clinical 24-MHz US imaging probe. Means and standard deviations of the direct, US, and DVT measurements were calculated. Measurements were statistically compared using the Pearson correlation coefficient and Bland–Altman analysis.

Results

Bone defects were on average 3.22 ± 1.58 mm per direct measurement, 2.90 ± 1.47 mm using US, and 2.99 ± 1.52 mm per DVT assessment. Pairwise correlations of these measurements were R = .94 (p < .0001) between direct and US, R = .95 (p < .0001) between DVT and US, and R = .96 (p < .0001) between direct and DVT. The mean differences of the measurements (and 95% CI) between direct and US was 0.41 (−0.47 to 1.29), US and DVT 0.33 (−0.30 to 0.97), and direct and DVT 0.28 (−0.50 to 1.07).

Conclusion

All peri-implant bone defects could be identified and sonographically measured. US measurements showed a strong correlation with direct and DVT measurements. The sonographic measurement accuracy was highest for dehiscences, followed by fenestrations and 3-wall bone defects.

目的：本研究以本地人体尸体为研究对象，目的是对种植体上的隙缝、开裂和三壁骨缺损的临床、声学和放射学测量结果进行比较：对五具人体下颌骨进行了检查。在植入 27 个种植体后，以标准化方式制备了开裂（14 个）、瘘管（7 个）和三壁骨缺损（6 个）。使用牙周探针对骨缺损进行直接测量，并使用数字容积断层扫描（DVT）进行放射学检查。超声波检查（US）使用临床 24-MHz US 成像探头进行。计算了直接测量、超声检查和 DVT 测量的平均值和标准偏差。使用皮尔逊相关系数和 Bland-Altman 分析对测量结果进行统计比较：结果：直接测量的骨缺损平均为 3.22 ± 1.58 毫米，US 测量为 2.90 ± 1.47 毫米，DVT 评估为 2.99 ± 1.52 毫米。这些测量值的配对相关性为 R = .94（p 结论）：所有种植体周围的骨缺损都能被识别出来并进行声学测量。超声测量结果与直接测量结果和深静脉血栓测量结果显示出很强的相关性。开裂的声学测量准确度最高，其次是隙缝和三壁骨缺损。

{"title":"Sonography in the diagnosis of peri-implant bone defects: An in vitro study on native human mandibles","authors":"Igor Bykhovsky, Alexander Hildner, Oliver D. Kripfgans, Reiner Mengel","doi":"10.1111/clr.14302","DOIUrl":"10.1111/clr.14302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study on native human cadavers was to compare clinical, sonographic, and radiological measurements of fenestrations, dehiscences, and 3-wall bone defects on implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The examination was carried out on five human mandibles. After the insertion of 27 implants, dehiscences (<i>n</i> = 14), fenestrations (<i>n</i> = 7) and 3-wall bone defects (<i>n</i> = 6) were prepared in a standardized manner. The direct measurement of the bone defects was carried out with a periodontal probe and the radiological examination was carried out using digital volume tomography (DVT). The ultrasound examination (US) was performed using a clinical 24-MHz US imaging probe. Means and standard deviations of the direct, US, and DVT measurements were calculated. Measurements were statistically compared using the Pearson correlation coefficient and Bland–Altman analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bone defects were on average 3.22 ± 1.58 mm per direct measurement, 2.90 ± 1.47 mm using US, and 2.99 ± 1.52 mm per DVT assessment. Pairwise correlations of these measurements were <i>R</i> = .94 (<i>p</i> < .0001) between direct and US, <i>R</i> = .95 (<i>p</i> < .0001) between DVT and US, and <i>R</i> = .96 (<i>p</i> < .0001) between direct and DVT. The mean differences of the measurements (and 95% CI) between direct and US was 0.41 (−0.47 to 1.29), US and DVT 0.33 (−0.30 to 0.97), and direct and DVT 0.28 (−0.50 to 1.07).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All peri-implant bone defects could be identified and sonographically measured. US measurements showed a strong correlation with direct and DVT measurements. The sonographic measurement accuracy was highest for dehiscences, followed by fenestrations and 3-wall bone defects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"35 9","pages":"1128-1137"},"PeriodicalIF":4.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.14302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261342","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

Maxillary and mandibular overdentures retained by two unsplinted narrow-diameter titanium-zirconium implants – A clinical pilot study 用两个无夹板窄直径钛锆种植体固定上下颌覆盖义齿--一项临床试验研究。

IF 4.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Implants Research

Pub Date : 2024-06-01 DOI: 10.1111/clr.14303

Jaana-Sophia Kern, Esra Salin, Dirk Elvers, Anne Rittich, Taskin Tuna, Frank Hölzle, Stefan Wolfart

Objectives

To evaluate the survival rates and marginal bone loss of narrow-diameter titanium-zirconium implants supporting complete maxillary and mandibular overdentures up to 3 years after loading.

Materials and Methods

Ten completely edentulous patients who were dissatisfied with their complete dentures were enrolled. Two narrow-diameter implants were placed in the canine region of the maxilla and mandible. After second-stage surgery, implant-supported overdentures (palatal-free) attached by parallel alignable stud-attachments were placed. Patients were followed periodically for up to 36 months. Standardized radiographs were taken at baseline, 12 and 36 months to analyze mean marginal bone level changes around the implants.

Results

The Kaplan–Meier survival rates were 100% for mandibular and 68.0% (SE ± 10.9%) for maxillary implants at 36 months (p = .008). Six maxillary implants failed after loading; no mandibular implants were lost. Five implants failed due to loss of osseointegration. One implant fractured. The mean marginal bone level changes around the analyzed implants (n = 28, 9 patients) were −0.71 ± 0.82 mm in the mandible and −2.08 ± 1.52 mm in the maxilla at the 36-month follow-up. The difference in marginal bone level changes between the maxilla and mandible was significant (p = .019) at the 12- and 36-month follow-ups.

Conclusion

Two narrow-diameter titanium-zirconium implants with stud-attachments showed a highly satisfactory outcome in the mandible. The maxillary implants showed a high failure rate and significantly more bone loss over time than the mandibular implants. The minimal concept of two implants and an overdenture should be limited to the edentulous mandible.

目的评估支撑上下颌全口义齿的窄直径钛锆种植体在装载后 3 年内的存活率和边缘骨流失情况：选取了10名对全口义齿不满意的完全无牙颌患者。在上颌骨和下颌骨的犬齿区植入两个窄直径种植体。第二阶段手术后，植入种植体支持的覆盖义齿（无腭侧），并通过平行可对准的螺柱连接。对患者进行了长达 36 个月的定期随访。分别在基线期、12个月和36个月时拍摄标准化X光片，分析种植体周围平均边缘骨水平的变化：36 个月时，下颌种植体的 Kaplan-Meier 成活率为 100%，上颌种植体的 Kaplan-Meier 成活率为 68.0%（SE ± 10.9%）（p = .008）。六颗上颌种植体在装载后失败；没有下颌种植体丢失。五颗种植体因骨结合丧失而失败。一个种植体断裂。随访 36 个月时，分析的种植体（n = 28，9 位患者）周围的平均边缘骨水平变化为：下颌 -0.71 ± 0.82 mm，上颌 -2.08 ± 1.52 mm。在 12 个月和 36 个月的随访中，上颌骨和下颌骨的边缘骨水平变化差异显著（p = .019）：结论：两颗带螺柱附着体的窄直径钛锆种植体在下颌的效果非常令人满意。与下颌种植体相比，上颌种植体的失败率较高，而且随着时间的推移，骨质流失明显增多。两个种植体和一个覆盖义齿的最小概念应仅限于无牙颌。

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引用次数: 0