Clinical Oral Implants Research最新文献_第9页

Influence of Bone Density and Guide Protocol on the Accuracy of Self-Cutting Implants Using Static Guided Implant Placement—An In Vitro Study 骨密度和引导方案对静态引导自切种植体植入精度的影响——一项体外研究

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

Clinical Oral Implants Research

Pub Date : 2025-07-03 DOI: 10.1111/clr.14470

Caroline Streichfuss, Stefan Wolfart, Lukas Waltenberger

Introduction

To investigate the influence of bone density and guide protocol on the accuracy of static guided implant placement of self-cutting implants in vitro.

Methods

A total of 242 implant replicas of self-cutting implants and implants with a tapered design as a control were placed in 40 maxilla replica models with healed posterior ridges differing in bone density and anterior extraction sockets. After full-guided osteotomy, the implants in the healed ridge were either placed through the template or freehand. In anterior extraction sockets, a pilot-guided group was additionally investigated. Postoperative scans were superimposed with the planning and investigated for angular, coronal, and apical deviation.

Results

For 3D coronal deviation, the study indicates significantly lower deviations in soft bone (p < 0.01) and for guided implant placement (p < 0.01) in posterior sites. Apical and angular deviations are significantly influenced by the placement protocol (p ≤ 0.03) and the presence of reference points from neighbouring teeth (p < 0.01). In the anterior site, the coronal deviation seems to be improved by a direct view of the surgical field, while 3D apical and angular accuracy appears to benefit from a high degree of guidance (p < 0.01).

Conclusion

Within the limitations of this in vitro study, for low bone density, immediate implant placement, and in clinically challenging situations without reference to the adjacent teeth, the use of template guidance for insertion statistically significantly reduced deviation.

前言：探讨骨密度和引导方式对体外自切种植体静态引导放置精度的影响。方法将242个自切种植体和锥形种植体作为对照，放置于40个骨密度和前拔牙槽不同的后嵴愈合的上颌骨复制模型中。在完全引导下截骨后，通过模板或徒手放置愈合脊中的植入物。在前拔牙槽中，飞行员引导组进行了额外的研究。术后扫描与计划叠加，并调查角、冠状和根尖偏差。结果对于三维冠状偏移，研究显示软骨偏移明显降低(p <；0.01)和引导种植体放置(p <；0.01)。放置方案（p≤0.03）和邻近牙齿参考点的存在(p <；0.01)。在前位，冠状偏移似乎可以通过直接观察手术视野而得到改善，而三维根尖和角度精度似乎受益于高度的引导(p <；0.01)。结论在本体外研究的局限性下，对于低骨密度，即刻种植体，以及在临床上具有挑战性的情况下，不参考邻牙，使用模板引导插入可以显著减少偏差。

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引用次数: 0

Factors Affecting the Efficacy of Airflowing in Cleaning Implant Surfaces in a Surgical Peri-Implantitis Treatment Simulation—A Laboratory Study 影响外科种植体周围炎治疗模拟中空气流动清洁种植体表面效果的因素-实验室研究。

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

Clinical Oral Implants Research

Pub Date : 2025-06-22 DOI: 10.1111/clr.14464

Andreas Stavropoulos, Ahmad Al Said, Ola Mustafa, Loukia M. Spineli, Patrick Heimel, Kristina Bertl

Objective

To evaluate, in a simulation of surgical peri-implantitis treatment, the impact of type of handpiece, device settings, and instrumentation time on the efficacy of airflowing in cleaning the implant surface, depending on the type of bone defect and implant surface.

Methods

Turned and modified surface implants (54 each) were coated with biofilm imitation and mounted on resin models replicating purely horizontal or circumferential intraosseous peri-implant defects (both 5 mm deep). Implants were instrumented with an airflowing device using a supra- or submucosal handpiece, with three settings: (a) power 5, 5 s (b) power 10, 5 s, and (c) power 5, 15 s per implant/defect sextant.

Results

The amount of residual biofilm imitation was associated with defect configuration, type of handpiece, and device settings (p < 0.15); implant surface did not have an effect. In horizontal defects, with the supramucosal handpiece, only 3 of 54 implants showed > 5% residual biofilm imitation and 23 of 54 implants were completely clean; with the submucosal handpiece, 12 of 18 implants showed ≤ 5% residual biofilm imitation when used for 15 s/sextant, yet none were completely clean. In intraosseous defects, all implants presented ≤ 5% residual biofilm imitation and 10 of 18 implants were completely clean with the submucosal handpiece used for 15 s/sextant; the supramucosal handpiece was largely inefficacious.

Conclusion

Within the limitations of this laboratory study, peri-implant bone defect configuration should dictate the choice of airflowing handpiece (i.e., for horizontal defects, the supramucosal handpiece; for intraosseous defects, the submucosal handpiece) and intrasurgical airflowing requires a prolonged instrumentation time, but not increased power.

目的：在模拟手术种植体周围炎治疗中，根据骨缺损和种植体表面的类型，评估手机类型、设备设置和器械使用时间对气流清洁种植体表面效果的影响。方法：将旋转和改良的表面种植体（各54个）涂覆仿制生物膜，并安装在树脂模型上，复制纯粹的水平或周向骨内种植体周围缺陷（均为5mm深）。种植体使用粘膜上或粘膜下机头使用气流装置进行检测，有三种设置：(a)功率5,5秒(b)功率10,5秒，(c)功率5,15秒每个种植体/缺陷六分仪。结果：残留生物膜仿制品的数量与缺损形态、机头类型和器械设置相关(p . 5%的残留生物膜仿制品和54个植入物中的23个完全清洁；使用粘膜下手机，当使用15 s/六分仪时，18个植入物中有12个显示≤5%的残留生物膜模仿，但没有一个是完全清洁的。在骨内缺损中，所有种植体的残留生物膜模仿率≤5%，18个种植体中有10个种植体完全清洁，粘膜下机头使用15 s/六分仪；粘膜上的手机基本上是无效的。结论：在本实验室研究的限制范围内，种植体周围骨缺损的形态应决定气流式修复装置的选择(即，对于水平缺损，粘膜上修复装置；对于骨内缺损，粘膜下机头和术中气流需要延长器械时间，但不需要增加功率。

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引用次数: 0

Long-Term Treatment Outcomes of Peri-Implantitis Reconstructive Therapy: 7-Year Survival and Success of a Randomized Clinical Trial 种植体周围重建治疗的长期治疗结果：一项随机临床试验的7年生存率和成功。

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

Clinical Oral Implants Research

Pub Date : 2025-06-20 DOI: 10.1111/clr.14466

Sila Cagri Isler, Fatma Soysal, Tugce Ceyhanli, Berrin Unsal, Jean-Claude Imber, Andrea Roccuzzo

Objectives

To report the 7-year outcomes of a randomized clinical trial evaluating a reconstructive surgical procedure of peri-implantitis with a bone substitute in combination with either concentrated growth factor (CGF) or collagen membrane (CM).

Materials and Methods

The original population consisted of 57 patients with at least one implant diagnosed with peri-implantitis exhibiting two-, three-, or four-wall intrabony defects ≥ 3 mm which were filled with a xenogenic bone grafting material and covered with either CGF or CM. Clinical and radiographic parameters, treatment success, and disease recurrence frequencies were evaluated over the 7-year follow-up period of supportive periodontal/peri-implant care. Relationships between prognostic indicators/predictors and treatment success and failure were investigated.

Results

Sixteen patients (24 implants) (CGF group) and 18 (25 implants) (CM group) completed the 7-year follow-up. Although short-term improvements in clinical and radiographic outcomes were observed, a tendency toward relapse was detected through time. At implant level, CM group demonstrated significantly more favorable outcomes for deepest PPD and radiographic vertical defect depth (p = 0.040 and p = 0.043) compared to CGF group. At 7 years, treatment success was achieved in 23.1% of CGF and 30.8% of CM patients, while disease recurrence occurred in 34.6% and 30.8%, respectively (p > 0.05). The presence of baseline suppuration was the only significant patient-level predictor for treatment failure (OR = 15.45; 95% CI: 1.42–168.5; p = 0.02).

Conclusion

Both protocols led to comparable clinical and radiographic outcomes. Long-term treatment success was limited, with increasing failure rates over time. Baseline suppuration had a significant negative impact on treatment outcomes.

目的：报告一项随机临床试验的7年结果，评估骨替代物联合浓缩生长因子（CGF）或胶原膜（CM）治疗种植体周围炎的重建手术。材料和方法原始人群包括57例患者，其中至少有一个种植体被诊断为种植体周围炎，表现为两、三或四壁骨内缺陷≥3mm，用异种植骨材料填充，并用CGF或CM覆盖。临床和影像学参数、治疗成功率和疾病复发率在7年的支持性牙周/种植体周围护理随访期间进行评估。研究预后指标/预测因子与治疗成败的关系。结果16例（24颗种植体）（CGF组）和18例（25颗种植体）（CM组）完成了7年的随访。虽然观察到临床和影像学结果的短期改善，但随着时间的推移，发现了复发的趋势。在种植体水平，与CGF组相比，CM组在最深PPD和x线垂直缺损深度方面表现出更有利的结果（p = 0.040和p = 0.043）。7年时，23.1%的CGF和30.8%的CM患者治疗成功，34.6%和30.8%的患者复发（p < 0.05）。基线化脓的存在是治疗失败的唯一显著患者水平预测因子(OR = 15.45；95% ci: 1.42-168.5；p = 0.02)。结论两种方案的临床和影像学结果相当。长期治疗的成功是有限的，失败率随着时间的推移而增加。基线化脓对治疗结果有显著的负面影响。

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引用次数: 0

Surgical Treatment of Peri-Implantitis Combined With Keratinized Mucosa Augmentation: Results of a Dual-Center 3-Year RCT 种植体周围炎合并角化粘膜增强术的手术治疗：一项双中心3年随机对照研究的结果

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

Clinical Oral Implants Research

Pub Date : 2025-06-20 DOI: 10.1111/clr.14465

Myroslav Solonko, Erik Regidor, Alberto Ortiz-Vigón, Eduardo Montero, Blanca Vilchez, Mariano Sanz

Aim

To evaluate the medium-term efficacy of using a xenogeneic collagen matrix to augment the width of the peri-implant keratinized mucosa (PIKM) as an adjunct to the surgical treatment of peri-implantitis.

Material and Methods

In this 36-month parallel-arm randomized controlled clinical trial, patients with peri-implantitis were randomly assigned to a combined protocol of resective peri-implantitis surgery and a PIKM augmentation procedure, either with an autologous free gingival graft (FGG) or a collagen matrix (CM). Primary outcomes were the increase in the width of PIKM and probing pocket depth (PPD) reduction at 36 months. As secondary outcomes, radiographic and patient-reported outcomes were assessed.

Results

Forty-one patients (20 in the CM group and 21 in the FGG group) completed the three-year follow-up. PIKM increased in both groups, but the increase was significantly higher in the APF (apically positioned flap) + FGG group compared to the APF + CM group [2.0 (95% CI: 1.3, 2.7) mm in the FGG group compared to 1.0 (95% CI: 0.5, 1.5) mm in the CM group; p = 0.048]. PPDs were reduced by 1.5 mm (95% CI: 1.1, 1.9) and 1.4 mm (95% CI: 0.6, 2.2), respectively. Disease resolution (maximum one site with bleeding on probing, no suppuration, no further bone loss > 0.5 mm, and PD ≤ 5 mm) was 47.6% in the FGG group and 35.0% in the CM group.

Conclusion

Tested surgical modalities resulted in similar improvements in the clinical parameters. Both FGG and CM increased the PIKM, but PIKM was greater at the 36-month examination in the FGG group.

目的评价异种胶原基质增加种植体周围角化粘膜（PIKM）宽度作为种植体周围炎手术治疗辅助手段的中期疗效。材料和方法在这项为期36个月的平行随机对照临床试验中，种植周炎患者被随机分配到一组联合方案，分别是自体游离牙龈移植物（FGG）或胶原基质（CM）。主要结果是36个月时PIKM宽度增加和探查袋深度（PPD）减少。作为次要结局，我们评估了影像学和患者报告的结局。结果41例患者（CM组20例，FGG组21例）完成了3年的随访。两组PIKM均增加，但APF（根尖定位皮瓣）+ FGG组比APF + CM组增加明显更高[FGG组为2.0 (95% CI: 1.3, 2.7) mm，而CM组为1.0 (95% CI: 0.5, 1.5) mm；P = 0.048]。ppd分别减少1.5 mm （95% CI: 1.1, 1.9）和1.4 mm （95% CI: 0.6, 2.2）。疾病解决（最多一个部位有探探出血，无化脓，无进一步骨质流失）；0.5 mm, PD≤5 mm)， FGG组为47.6%，CM组为35.0%。结论经过测试的手术方式在临床参数上有相似的改善。FGG和CM均增加PIKM，但FGG组在36个月检查时PIKM更高。

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引用次数: 0

The Impact of Peri-Implant Diseases and Complications on Oral Health-Related Quality of Life Following Dental Implant Therapy in Norway: A Cross-Sectional Study 挪威种植牙治疗后种植周疾病和并发症对口腔健康相关生活质量的影响：一项横断面研究

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

Clinical Oral Implants Research

Pub Date : 2025-06-19 DOI: 10.1111/clr.14467

Erik Klepsland Mauland, Mehrnaz Beheshti Maal, Elisabeth Lind Melbye, Naomi Østergren Aarbu, Karoline Sørensen, Stig Aanerød Ellingsen, Dagmar Fosså Bunæs, Roya Torabi Gaarden, Anders Verket

Objectives

To report oral health-related quality of life (OHRQoL) in a sample rehabilitated with dental implants and assess the influence of self-reported implant complications and clinical peri-implant status. A secondary aim was to investigate associations between OHIP-14 scores and patient-related variables.

Materials and Methods

The Norwegian National Insurance Scheme registry for implant rehabilitation in 2014 was searched, and patients (n = 3083) were mailed a survey including OHIP-14, questions about peri-implant status, and patient-related variables. A subsample was examined clinically (n = 242). Associations of self-reported implant complications and clinical peri-implant status with OHIP-14 scores were evaluated by the Kruskal–Wallis test and logistic regression models.

Results

The OHIP-14 mean sum score reported by the 1299 survey respondents was 4.1 (± 6.4). Self-report of complications was associated with higher OHIP-14 scores in a dose-dependent manner. Lower education (OR 1.54, 95% CI 1.05–2.22), female sex (OR 1.75, 95% CI 1.23–2.56), technical complication(s) (OR 1.58, 95% CI: 1.07–2.34), biological complication(s) (OR 2.41, 95% CI 1.67–3.49) and poor cleansability (OR 2.94, 95% CI 1.64–5.37) were associated (p < 0.05) with higher OHIP-14 mean sum scores in the adjusted regression model. For the 242 patients examined clinically, the OHIP-14 mean sum score was 3.8 (± 6.5). Peri-implant soft tissue dehiscence (OR 2.53, 95% CI 1.17–5.49) was associated with higher OHIP-14 mean sum scores in the adjusted regression model.

Conclusions

OHIP-14 scores were low in this study, indicating good OHRQoL following implant rehabilitation in Norway. Complications lowered OHRQoL in a dose–response manner, confirmed by self-reports of complications and by the presence of peri-implant soft tissue dehiscence.

目的报告口腔健康相关生活质量（OHRQoL），并评估自我报告种植并发症和临床种植期状态的影响。第二个目的是调查OHIP-14评分与患者相关变量之间的关系。材料与方法检索2014年挪威国民保险计划种植体康复登记，并邮寄患者（n = 3083）一份调查问卷，包括OHIP-14、种植体周围状态和患者相关变量的问题。临床检查亚样本（n = 242）。采用Kruskal-Wallis检验和logistic回归模型评估自我报告种植体并发症和临床种植体周围状态与OHIP-14评分的关系。结果1299名被调查者OHIP-14平均总分为4.1（±6.4）分。并发症的自我报告与较高的OHIP-14评分呈剂量依赖性。在调整后的回归模型中，低学历（OR 1.54, 95% CI 1.05-2.22）、女性（OR 1.75, 95% CI 1.23-2.56）、技术并发症（OR 1.58, 95% CI 1.07-2.34）、生物并发症（OR 2.41, 95% CI 1.67-3.49）和清洁能力差（OR 2.94, 95% CI 1.64-5.37）与较高的o嘻哈-14平均总分相关（p < 0.05）。242例临床检查患者OHIP-14平均总分为3.8（±6.5）分。在调整后的回归模型中，种植体周围软组织破裂（OR 2.53, 95% CI 1.17-5.49）与较高的OHIP-14平均和评分相关。结论本研究sohip -14评分较低，表明挪威种植体康复后的OHRQoL较好。并发症以剂量反应的方式降低了OHRQoL，这由并发症的自我报告和种植体周围软组织开裂的存在证实。

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引用次数: 0

Comprehensive Update on Implants in Patients With Head and Neck Cancer (2021–2024): Systematic Review and Meta-Analysis of the Impact of Radiotherapy and Chemotherapy on Implant Survival 头颈癌患者种植体的全面更新（2021-2024）：放疗和化疗对种植体生存影响的系统回顾和Meta分析

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

Clinical Oral Implants Research

Pub Date : 2025-06-18 DOI: 10.1111/clr.14450

Shengchi Fan, Leonardo Diaz, Gustavo Sáenz-Ravello, Eduard Valmaseda-Castellon, Bilal Al-Nawas, Eik Schiegnitz

Objectives

This study aimed to investigate implant outcomes in patients with head and neck cancer undergoing radiotherapy or chemotherapy by incorporating the latest research findings.

Methods

The present review was conducted to update the focused question: What is the survival rate of implants placed in patients with head and neck cancer receiving radiotherapy or chemotherapy compared to non-irradiated patients? It built upon two previous systematic reviews (2014 and 2022) and provided an updated synthesis of the literature, focusing on clinical studies published between 2021 and 2024. The earlier reviews were included in the quantitative synthesis only to offer a broader longitudinal perspective.

Results

Nine studies were identified, with seven included in the quantitative synthesis and meta-analysis. The implant survival rate was significantly lower in irradiated patients (85.6%) compared to non-irradiated patients (90.0%) (RR = 1.62, 95% CI: 1.33–1.98, p < 0.0001, I² = 0.2%). Additionally, implant failure risk was higher in grafted bone (RR = 2.03, 95% CI: 1.39–2.96, p = 0.0018, I² = 21.9%) than in native bone. Among irradiated patients, those receiving radiochemotherapy exhibited an even greater risk of implant failure (RR = 1.97, 95% CI: 1.09–3.56, p = 0.0331, I² = 0%) compared to non-irradiated patients.

Conclusions

Current evidence indicates that radiotherapy/chemotherapy significantly increases the risk of implant loss in patients with head and neck cancer, with higher radiation doses possibly being associated with increased peri-implant bone loss, while implants placed in native bone exhibit a lower risk of failure compared to those placed in grafted bone.

目的结合最新研究成果，探讨头颈癌放疗或化疗患者种植体的预后。方法本综述旨在更新焦点问题：与未放疗的患者相比，头颈癌放疗或化疗患者植入植入物的生存率如何？它建立在之前的两次系统综述（2014年和2022年）的基础上，并提供了最新的文献综合，重点关注2021年至2024年发表的临床研究。早期的评论被纳入定量综合只是为了提供更广泛的纵向观点。结果共纳入9项研究，其中7项纳入了定量综合和荟萃分析。放疗组种植体存活率（85.6%）明显低于未放疗组（90.0%）(RR = 1.62, 95% CI: 1.33-1.98, p <；0.0001, i2 = 0.2%)。此外，移植骨的种植体失败风险高于原生骨（RR = 2.03, 95% CI: 1.39-2.96, p = 0.0018, I2 = 21.9%）。在接受放疗的患者中，与未接受放疗的患者相比，接受放化疗的患者表现出更大的种植失败风险（RR = 1.97, 95% CI: 1.09-3.56, p = 0.0331, I2 = 0%）。结论：目前的证据表明，放疗/化疗显著增加头颈癌患者种植体丢失的风险，较高的辐射剂量可能与种植体周围骨质丢失增加有关，而种植体放置在天然骨中的失败风险较放置在移植物骨中的低。

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引用次数: 0

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

Clinical Oral Implants Research

Pub Date : 2025-06-18 DOI: 10.1111/clr.14453

Sanne Werner Moeller Andersen, Nishma Vandvig Hindocha, Iben Poulsen, Henning Schliephake, Simon Storgård Jensen

Objectives

Patients receiving antiresorptive medication (AR) for osteoporosis or cancer are at risk of medication-related osteonecrosis of the jaws (MRONJ), especially after surgical procedures. Dental implant (DI) placement in high-dose AR (HDAR) patients is widely discouraged, and thorough counseling is recommended for low-dose AR (LDAR) patients. However, data on the role of AR type, dose, and duration remain limited. This review evaluates MRONJ associated with DIs, focusing on AR type and accumulated dose, and identifies local and systemic risk factors.

Materials and Methods

This review follows the PCC framework for PRISMA-ScR, comparing patients on AR who developed DI-related MRONJ to those who did not, based on the available clinical evidence. A systematic search was conducted on April 13, 2024, in PubMed, Embase, and Cochrane Library. Two reviewers independently screened and extracted data; a third reviewer resolved disagreements. Data extraction included demographics, primary disease, AR type, dose, treatment duration, DI location, and MRONJ details.

Results

Of 2201 articles, 28 studies were included involving 76 patients with 215 DI (154 in LDAR, 61 in HDAR). The development of MRONJ was reported in 15 studies involving LDAR and four studies on HDAR.

Conclusions

Evidence was insufficient to confirm an association between accumulated AR dose and MRONJ associated with DIs. No specific risk factors were identified, emphasizing the need for standardized reporting on AR type, dosage, treatment duration, and intervals to facilitate comprehensive risk assessment. Until evidence-based guidelines emerge, DI therapy in HDAR or long-term LDAR patients should be limited to specialized centers.

目的骨质疏松症或癌症患者接受抗吸收药物治疗（AR）有发生药物相关性颌骨骨坏死（MRONJ）的风险，尤其是在手术后。高剂量AR （HDAR）患者普遍不建议种植牙，低剂量AR （LDAR）患者建议进行彻底的咨询。然而，关于AR类型、剂量和持续时间的作用的数据仍然有限。本综述评估了与DIs相关的MRONJ，重点关注AR类型和累积剂量，并确定了局部和全身危险因素。材料和方法本综述遵循PRISMA - ScR的PCC框架，根据现有的临床证据，比较AR患者发生DI相关MRONJ和未发生MRONJ的患者。系统检索于2024年4月13日在PubMed， Embase和Cochrane图书馆进行。两名审稿人独立筛选和提取数据；第三位审稿人解决了分歧。数据提取包括人口统计学、原发疾病、AR类型、剂量、治疗持续时间、DI位置和MRONJ细节。结果在2201篇文章中，纳入了28项研究，涉及76例215例DI患者（154例LDAR， 61例HDAR）。MRONJ的发展在涉及LDAR的15项研究和涉及HDAR的4项研究中得到报道。结论没有足够的证据证实累积AR剂量与与DIs相关的MRONJ之间存在关联。没有确定具体的危险因素，强调需要标准化报告AR类型、剂量、治疗持续时间和间隔时间，以便进行全面的风险评估。在以证据为基础的指南出现之前，HDAR或长期LDAR患者的DI治疗应限于专门的中心。

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引用次数: 0

Efficacy of Air Powder Water-Jet Devices in Cleaning Implant Surfaces in a Non-Surgical Peri-Implantitis Treatment Simulation—A Laboratory Study 空气粉末水射流装置在非手术性种植体周围炎治疗模拟中清洁种植体表面的效果-实验室研究

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

Clinical Oral Implants Research

Pub Date : 2025-06-18 DOI: 10.1111/clr.14452

Kristina Bertl, Alexandra Isik, Tai Truong, Loukia M. Spineli, Patrick Heimel, Wolfgang Manschiebel, Andreas Stavropoulos

Objective

To evaluate the impact of implant surface and instrumentation time on the efficacy of two air powder water-jet (APWJ) devices in cleaning the implant surface in a simulation of non-surgical peri-implantitis treatment.

Materials and Methods

Turned and modified surface implants (28 each) were coated with a biofilm imitation and mounted on resin models replicating peri-implant intra-osseous defects, including a soft tissue replica. The entire implant periphery was instrumented for 5 or 15s per implant sextant (i.e., in total 30 or 90s per implant), with one of two different APWJ devices using either a glycine or an erythritol powder. Residual biofilm imitation was automatically assessed on standardized photographs and expressed as percentage of the exposed implant surface.

Results

Implant surface (ε²:0.253, p < 0.001) and instrumentation time (ε²:0.044, p = 0.036) had a moderate and small effect, respectively, on the outcome, that is, instrumenting turned compared to modified surface implants as well as using a longer compared to a shorter instrumentation time resulted in less residual biofilm imitation. Complete biofilm imitation removal was achieved only in four turned implants, treated for 15s per sextant. Every second turned implant presented with a maximum of 5% residual biofilm imitation, while only two modified implants achieved this level of cleanliness.

Conclusion

In a non-surgical peri-implantitis treatment simulation with APWJ devices, superior biofilm imitation removal was achieved at turned implants, and a longer instrumentation time resulted in less residual biofilm imitation. Modified implants had high chances of incomplete biofilm imitation removal, especially at the apical part of the defect. Complete biofilm imitation removal was in general largely unpredictable.

目的评价两种空气粉末水射流（APWJ）装置在模拟非手术性种植体周围炎治疗中对种植体表面清洁效果的影响。材料和方法：用生物膜仿制品涂覆表面植入物（每种28个），并将其安装在树脂模型上，以复制植入物周围骨内缺陷，包括软组织复制品。每个种植体六分仪对整个种植体外围进行5或15秒的检测（即每个种植体总共30或90秒），使用两种不同的APWJ装置中的一种，使用甘氨酸或赤藓糖醇粉末。残留生物膜模仿在标准化照片上自动评估，并以暴露的种植体表面的百分比表示。结果植物表面(ε2:0.253, p <；0.001)和仪器时间（ε2:0.044, p = 0.036）分别对结果有中等和小的影响，即与改良的表面植入物相比，仪器转向以及使用较长的仪器时间比使用较短的仪器时间导致较少的残留生物膜模仿。仅在4个旋转的植入物中实现了完全的生物膜模拟去除，每六分仪处理15秒。每一秒钟翻转的种植体最多有5%的残留生物膜模仿，而只有两个改良的种植体达到了这种清洁水平。结论APWJ装置在非手术性种植体周围炎治疗模拟中，在旋转种植体中获得了较好的生物膜模拟去除效果，并且较长的植入时间导致较少的残留生物膜模拟。改良种植体有很高的机会不完全去除生物膜，特别是在缺损的根尖部分。完全去除生物膜仿制品在很大程度上是不可预测的。

{"title":"Efficacy of Air Powder Water-Jet Devices in Cleaning Implant Surfaces in a Non-Surgical Peri-Implantitis Treatment Simulation—A Laboratory Study","authors":"Kristina Bertl, Alexandra Isik, Tai Truong, Loukia M. Spineli, Patrick Heimel, Wolfgang Manschiebel, Andreas Stavropoulos","doi":"10.1111/clr.14452","DOIUrl":"10.1111/clr.14452","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the impact of implant surface and instrumentation time on the efficacy of two air powder water-jet (APWJ) devices in cleaning the implant surface in a simulation of non-surgical peri-implantitis treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Turned and modified surface implants (28 each) were coated with a biofilm imitation and mounted on resin models replicating peri-implant intra-osseous defects, including a soft tissue replica. The entire implant periphery was instrumented for 5 or 15s per implant sextant (i.e., in total 30 or 90s per implant), with one of two different APWJ devices using either a glycine or an erythritol powder. Residual biofilm imitation was automatically assessed on standardized photographs and expressed as percentage of the exposed implant surface.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Implant surface (<i>ε</i><sup>2</sup>:0.253, <i>p</i> < 0.001) and instrumentation time (<i>ε</i><sup>2</sup>:0.044, <i>p</i> = 0.036) had a moderate and small effect, respectively, on the outcome, that is, instrumenting turned compared to modified surface implants as well as using a longer compared to a shorter instrumentation time resulted in less residual biofilm imitation. Complete biofilm imitation removal was achieved only in four turned implants, treated for 15s per sextant. Every second turned implant presented with a maximum of 5% residual biofilm imitation, while only two modified implants achieved this level of cleanliness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a non-surgical peri-implantitis treatment simulation with APWJ devices, superior biofilm imitation removal was achieved at turned implants, and a longer instrumentation time resulted in less residual biofilm imitation. Modified implants had high chances of incomplete biofilm imitation removal, especially at the apical part of the defect. Complete biofilm imitation removal was in general largely unpredictable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"36 9","pages":"1075-1085"},"PeriodicalIF":5.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/clr.14452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319325","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

Effect of Irrigation, Bur Size and Rotational Speed on Thermographic Heat at Implant Site Osteotomy Interface. An In Vitro Study 灌洗、骨块大小和转速对种植体截骨界面热成像的影响。一项体外研究

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

Clinical Oral Implants Research

Pub Date : 2025-06-16 DOI: 10.1111/clr.14462

Karl Paeßens, Leonard van Bebber, Holger Zipprich, Paul Weigl

Objectives

This study aimed to evaluate the impact of drill diameter, rotational speed, and irrigation on critical heat generation (≥ 47°C) at the dynamic bone-drill interface during dental implant osteotomy in pre-existing pilot bone cavities.

Material and Methods

Bone samples were cut such that immediate and direct thermographic measurements at the dynamic bone-drill interface were possible. Osteotomy cavities of 2.4 mm width were expanded to either 3.2 or 3.8 mm in cortical bovine bone with a thickness of 3.5 mm, using two-bladed twist drills at rotational speeds of 200, 600, or 1000 rpm, with or without saline irrigation. A logistic regression model was developed to predict the likelihood of reaching temperatures ≥ 47°C during osteotomy based on these parameters.

Results

The absence of irrigation, major osteotomy diameter expansion, and higher rotational speeds were identified as significant risk factors for increasing the bone-drill interface temperature by more than 10°C (OR: irrigation 177.53; expansion step 9.94; speed by 400 rpm 4.94). No osteotomy performed at a low rotational speed (200 rpm) resulted in a critical temperature rise in either drill diameter group when irrigation was provided. However, temperatures exceeded 47°C across all groups when irrigation was absent.

Conclusions

Dental implant osteotomy procedures without irrigation result in critical heat stress at the bone-drill interface, even at low drilling speeds. Shortened protocols with large drill diameter differences of up to 1.4 mm can be safely implemented when drilling at 200 rpm with irrigation. Osteotomy protocols can therefore be shortened while maintaining safety.

Trial Registration

No clinical trial was included in the study

目的：本研究旨在评估钻头直径、转速和灌洗对在预先存在的先导骨腔中种植体截骨时动态骨-钻头界面临界产热（≥47°C）的影响。材料和方法骨样品被切割，使得在动态骨-钻界面上进行即时和直接的热成像测量成为可能。在厚度为3.5 mm的牛皮质骨中，使用双刃麻花钻，以200、600或1000 rpm的转速，进行或不进行盐水冲洗，将宽度为2.4 mm的切骨腔扩展到3.2或3.8 mm。基于这些参数，建立了一个逻辑回归模型来预测截骨术中达到≥47°C温度的可能性。结果未冲洗、主要截骨直径扩张和较高的旋转速度是导致骨-钻界面温度升高超过10°C的重要危险因素(OR：冲洗177.53；膨胀步骤9.94；转速由400转4.94)。在低转速（200转/分）下进行截骨术，在提供冲洗时，两组钻孔直径均未出现临界温升。然而，当没有灌溉时，所有组的温度都超过47°C。结论无冲洗的种植体截骨术即使在低钻孔速度下也会导致骨-钻头界面出现临界热应激。当以200转/分钟的速度进行灌水钻井时，可以安全地使用缩短的方案，最大钻孔直径差异可达1.4毫米。因此，截骨术可以在保证安全性的同时缩短手术时间。试验注册本研究未纳入临床试验。

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引用次数: 0

Effect of Horizontal and Vertical Intraoral Scan Bodies on the Trueness of Complete-Arch Digital Implant Impressions: A Comparative In Vitro Study With Six Implants 水平和垂直口内扫描体对全弓数字种植体印象真实性的影响：六种种植体的体外比较研究。

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

Clinical Oral Implants Research

Pub Date : 2025-06-11 DOI: 10.1111/clr.14463

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

Objective

To evaluate the interaction between intraoral scan body (ISB) type, operator, and intraoral scanner (IOS) selection on the trueness of complete-arch digital implant impressions. This study also compared horizontal ISBs (H-ISBs) and vertical ISBs (V-ISBs) across four IOS devices.

Material and Methods

Digital impressions of a definitive mandibular cast with six multi-unit analogs were made using four H-ISBs from different manufacturers (denoted as H-NB, H-NS, H-M6, and H-SF), with a V-ISB (V-EA) as the reference. Each ISB was scanned using a desktop scanner and by two operators who scanned each ISB system 10 times using four IOS devices i5D, PS, T3, T4, generating 400 digital impressions. Deviations were measured using root-mean-square (RMS) error (α = 0.05).

Results

All independent variables (operator, IOS, ISB) significantly affected trueness (p < 0.05). V-EA with i5D had the lowest trueness (78 [27] μm), while H-NS on PS showed the highest (12 [3] μm). H-M6 maintained high trueness across IOS devices. PS was the most stable IOS, while T4 showed the most variability.

Conclusions

Complete-arch digital impressions are influenced by ISBs, IOSs, and operators. H-ISBs demonstrated better trueness and consistency across IOSs and operators.

目的：评价口内扫描体（ISB）类型、操作人员和口内扫描仪（IOS）选择对全弓数字种植体印模准确性的影响。该研究还比较了四个IOS设备的水平ISBs （H-ISBs）和垂直ISBs （V-ISBs）。材料和方法：使用来自不同制造商的四种h - isb（分别表示为H-NB， H-NS， H-M6和H-SF），以V-ISB （V-EA）作为参考，制作具有六个多单元类似物的确定下颌铸造的数字印模。每个ISB使用桌面扫描仪进行扫描，并由两名操作员使用四个IOS设备i5D， PS, T3， T4扫描每个ISB系统10次，产生400个数字印象。采用均方根误差（RMS）测量偏差（α = 0.05）。结果：所有自变量（操作人员、IOS、ISB）均显著影响全弓数字印模的准确性(p)。结论：ISB、IOS和操作人员均影响全弓数字印模。H-ISBs在ios和运营商之间表现出更好的真实性和一致性。

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引用次数: 0