International Journal of Implant Dentistry最新文献

Objective: To introduce a novel digital technique for precise assessment of peri-implant bone heights, enhancing accuracy and objectivity in dental implantology research.

Methods: This study utilized digital intraoral scans and digitized impressions obtained during implant exposure surgery, combined with computer-aided design (CAD) software, to measure peri-implant bone heights accurately during flap-raising procedures. The peri-implant bone measurements were quantified circumferentially and validated through a comparative analysis of intraoral and extraoral scans.

Results: The technique demonstrated high precision, with a strong correlation (ICC = 0.902) between bone heights determined from intraoral and extraoral scans, highlighting minimal deviations and similar measurement outcomes. This approach enables comprehensive circumferential data and surface area measurements of peri-implant bone levels.

Conclusion: The proposed digital technique provides an objective, reliable method for peri-implant bone height assessment, offering precise, reproducible data that addresses the limitations of traditional probing and conventional imaging methods. This technique has broad applicability in dental implantology research, particularly for assessing peri-implant bone levels when a flap is raised.

Purpose: to quantify the soft tissue dimensional changes after single-gap implant placement, during healing abutment and crown delivery phase for butt-joint and conical implant-abutment connection type.

Methods: forty patients were enrolled in the study and received randomly allocated implants with butt-joint and conical implant-abutment connection type. A standard healing abutment was placed after 6 months for two weeks. The definitive screw retained full-ceramic crowns were manufactured in a digital workflow. The soft tissue profile was digitized using IOS on following stages: pre-op, immediately, two, 7 and 14 days post-op, pre-exposure, immediately after exposure, two weeks after exposure (pre-delivery), immediately after crown delivery, 6 and 12 months after delivery. The intraoral scans were matched in the metrology software (Geomagic Control X). The mean maximum and mean average differences in mm were gathered to assess the soft tissues change. Various anamnesis parameters have been taken into account.

Results: the conical connection implant system exhibited more soft tissue gain and less recession, compared to the butt-joint connection type within the 12 months follow-up period. A higher loss of soft tissue was observed in the distal papilla than in the mesial one.

Conclusions: the implant-abutment connection type may influence the reaction of peri-implant soft tissue within the 12 months follow-up period.

Purpose: Currently, maxillary sinus floor (SF) elevation is based on off-the-shelf allogeneic, xenogeneic or synthetic bone augmentation materials (BAM) that are implanted via an open lateral sinus wall approach (OSFE). However, this invasive method is associated with postoperative complications caused by an inadequate blood supply of the alveolar ridge. Balloon-assisted procedures are minimal invasive alternatives with lower complication rates. The aim was to evaluate local new bone (NB) formation in the SF following the application of a particulate BAM (Easy graft) via two different SF elevation techniques in a split mouth mini-pig sinus augmentation model.

Material and methods: Seven adult Goettingen minipigs were used for evaluation of a biphasic ceramic (PLGA/ß-TCP) BAM in the elevated SF region. Treatments were randomized to the contralateral sinus sites and included two procedures: OSFE (control group) versus minimally invasive SF elevation by a balloon-lift-control system (BLC) (treatment group). The animals were euthanized after 28 and 56 days for analysis of new bone (NB) formation.

Results: The biphasic synthetic BAM implanted via BLC increased more NB formation (5.2 ± 1.9 mm and 4.9 ± 1.6 mm vs. 2.6 ± 0.5 mm) and osseointegration of the particles (18.0 ± 6.0% and 25.1 ± 18.2% vs. 10.1 ± 8.0%, p < 0.05) compared to the control.

Conclusions: Implantation of a biphasic synthetic BAM enhanced NB formation in the mini-pig maxillary sinus at both time points and in both groups, although BLC resulted in a slightly better total NB formation compared to the control.

Purpose: To evaluate whether there are clinical benefits by preparing dental implant sites using piezosurgery instead of conventional rotary drills in healed bone crests and if initial crestal soft tissue thickness could have an impact on marginal bone loss.

Methods: Twenty-five partially edentulous patients requiring two single implants in molar/premolar areas had each site randomly allocated to either piezosurgery or to conventional rotary drill preparation according to a split-mouth design. Definitive screw-retained metal-ceramic crowns were delivered after 6 months. All patients were followed to 5 years after placement. Outcome measures were: implant/crown failures, complications, peri-implant marginal bone level changes, resonance frequency analysis (RFA), and time required to complete site preparation, recorded, when possible, by blinded assessors.

Results: No patients dropped-out and no implant failed. Five years after placement, there were no statistically significant differences for complications (only one complication in the piezo group: difference = 0.04; P = 1), for peri-implant bone loss (difference = -0.11 mm; 95% CI -0.24 to 0.01; P = 0.083), and for RFA changes (6 months) (difference = -0.35; 95% CI -1.95 to 1.25; P = 0.672 between groups). Significantly more time was needed to prepare implant sites with piezosurgery (difference = 236.8 s; 95% CI -286.12 to -187.48; P < 0.0001). Initial soft tissue thickness had no effect on peri-implant bone loss (estimate = 0.05; 95% CI -0.03; 0.12; P = 0.239).

Conclusions: No clinically appreciable differences were noticed when placing implants using piezosurgery or conventional instrumentation with rotary drill, however, the preparation with rotary drills was on average 4 min faster. No effect of initial crestal soft tissue thickness was observed on peri-implant bone loss.

Purpose: Prophylactic antibiotics are used in dental implants to reduce infection risk and implant failure, especially benefiting patients with risk factors. However, evidence suggests that using clindamycin or extending antibiotics postoperatively has an unfavorable risk-benefit ratio.

Methods: This national cross-sectional study analyzed antibiotic prophylaxis during implant insertion across Germany. Dentists from the German Society for Oral Implantology (DGOI) provided demographic information and data on the next 10 consecutive implant patients, including age, sex, risk factors, type of implantation, and antibiotic details.

Results: 103 dentists participated, providing data on 1040 patients. Most dentists were male and aged 30-64. Patients were evenly split between genders, with an average age of 51 years. Antibiotics were administered in 87.6% of all cases, more frequently for patients undergoing bone augmentation (OR 7.01, p < 0.0001), immediate (OR 3.11, p = 0.002) or delayed (OR 5.30, p < 0.0001) implant insertion, and those with cardiovascular disease (OR 3.24, p = 0.009). 74.8% of implantologists tended to use antibiotic prophylaxis routinely, while the remaining implantologists decided on a case-by-case basis. Implantologists primarily used aminopenicillins for 63.8% of prescriptions and clindamycin for the remaining 35.6%. Additionally, 78.8% of patients with prophylaxis received postoperative, multi-day treatments.

Conclusions: The study reveals extensive antibiotic use for perioperative prophylaxis in implant surgery, often not justified by current recommendations, particularly concerning the choice of antibiotic (e.g., clindamycin) and duration (e.g., postoperative use). Specialized clinical guidelines and targeted training for dentists on antibiotic prophylaxis are needed.

Purpose: Customized healing abutments are utilized to enhance aesthetics and peri-implant soft and hard tissue health, and play a crucial role in the implant-prosthetic workflow. This systematic review was performed to assess and compare the clinical outcomes of customized healing abutments with conventional ones.

Methods: The review was registered with PROSPERO (ID: CRD42024532449) and followed the PRISMA-guidelines. The PICO-question addressed was: "In patients with dental implants, do customized healing abutments result in beneficial peri-implant conditions compared with conventional healing abutments?" Clinical trials involving immediate and late implant placement that compared different healing abutments based on quantifiable outcomes were included. The "PubMed", "PubMed Central", "Cochrane Library", and "Web of Science databases" were screened for eligible studies until 4/20/2024.

Results: Of 1,396 titles retrieved, 5 studies met the inclusion criteria and were analyzed. The included studies showed a low risk of bias as assessed by the RoB2 tool and Joanna Briggs Institute Critical Assessment questionnaire. Compared to conventional healing abutments, customized abutments were associated with a trend toward better clinical outcomes in peri-implant soft and hard tissue, as well as aesthetics. Several results within the cohorts using customized healing abutments showed significantly improved values in soft and hard tissue results as well as aesthetic parameters. Importantly, none of the included studies reported biological or aesthetic disadvantages associated with the use of customized healing abutments.

Conclusions: Customized healing abutments maintain stability of peri-implant hard and soft tissue. However, further studies with larger sample sizes and longer follow-up periods are needed to validate these findings.

Introduction and aim: There is a need for studies assessing the efficacy of different therapeutic approaches in the reconstructive surgical treatment of peri-implantitis. The aim of this case series is to evaluate the clinical outcomes and radiographic bone fill of reconstructive surgical treatment using the oscilating chitosan brush for implant surface decontamination.

Materials and methods: Nine patients with 11 Class I and III peri-implantitis defects were included. Following implant surface decontamination performed with a chitosan brush, guided bone regeneration (GBR) was performed by means of a bovine derived cancellous bone graft and collagen membrane. Clinical parameters such as full mouth plaque score (FMPS), probing depth (PD), bleeding on probing (BoP), recession, and radiographic bone level (RBL) were recorded at baseline and 1 year following treatment.

Results: All evaluated parameters, including PD, BoP, recession, RBL, and full mouth plaque scores, revealed significant improvements at 1 year follow-up compared to baseline (p < 0.05). The mean PD values reduced from 7.30 ± 1.29 to 3.78 ± 0.65 (p = 0.000). RBL was detected 5.50 ± 1.31 and 1.38 ± 0.74 at baseline and 1-year, respectively (p = 0.010).

Conclusion: Reconstructive surgical treatment of Class I and III peri-implantitis defects with GBR may be an effective treatment protocol when an oscilitating chitosan brush is used for surface decontamination.

Clinical trial number: Not applicable.

Purpose: The present study aims to determine whether the brain-derived neurotrophic factor (BDNF)/high-molecular-weight hyaluronic acid (HMW-HA) complex could regenerate bone around implants lost due to peri-implantitis.

Methods: Dogs had their three premolars extracted, and three implants were placed on each side. After osseointegration, 3-0 silk threads were ligated around the healing abutment for 12 weeks. Implants were classified into four groups-no treatment (control group), non-surgical debridement (debridement group), non-surgical debridement with application of HMW-HA (HMW-HA group), and non-surgical debridement with application of BDNF/HMW-HA complex (BDNF/HMW-HA group). Probing pocket depth (PPD), attachment level (AL), and bleeding on probing (BOP) were recorded before and 12 weeks after each treatment. Standardized intraoral radiographs were obtained, and histological analysis was conducted.

Results: The bone level on radiographs significantly improved (median -0.15 mm, IQR -0.31 to 0.10) only in the BDNF/HMW-HA group, while changes in PPD and AL were similar to those in other groups. The BOP positivity rate decreased in the debridement and BDNF/HMW-HA groups. Unlike images of the other groups, histological images of the BDNF/HMW-HA group showed no epithelial migration toward the tip of the implant. Inflammatory cell infiltration was reduced compared with that in the other groups. New bone was observed around the implants only in the BDNF/HMW-HA group.

Conclusions: The BDNF/HMW-HA complex appears to promote bone regeneration when combined with non-surgical debridement for peri-implantitis.

Both commercially pure titanium and titanium alloys are established biomaterials for implantation in bone and are widely used today in dentistry. Titanium particulates have been shown in some patient clusters to induce cellular immune mediators responsible for type I and IV hypersensitivity reactions, causing amplified corrosion, osteolysis, and increased odds of implant failure. Systemically, titanium particles were found to affect varying organ tissues and cause potentially harmful effects. In vivo and vitro studies have shown that titanium dental implant corrosion can be induced by factors relating to bio-tribocorrosion. In this literature review, the consequences of titanium implant corrosion and particulate dissemination are discussed and later juxtaposed against a promising novel implant material, zirconia. Zirconia offers characteristics similar to titanium along with additional advantages such as being non-corrosive and having a lower propensity for inducing immune responses. From the mounting evidence discussed in this article, metal allergy testing would be advantageous for choosing an appropriate implant material to minimize potential adverse effects on cellular functions of local and diffuse tissues. Objective: This literature review aims to elucidate and describe mechanisms in which titanium implants may become corroded and induce cellular aberrations both locally and systemically in vivo. Implications of this study provide supportive evidence regarding the selection of appropriate biomaterials for implant patients susceptible to mounting a hypersensitivity reaction to titanium.

Purpose: This systematic review (SR) aimed to investigate whether the presence of a cantilever affects the results of implant treatment for partial edentulism, including an analysis of the anterior and posterior regions of the dental arches.

Methods: An electronic search was performed, and original articles published between 1995 and November 2023 were included. The outcomes were the implant survival rate, patient satisfaction, occurrence of mechanical complications, and marginal bone loss around the implants. Two SR members independently examined the validity of the studies, extracted evidence from the included studies, and performed risk of bias assessment, comprehensive evidence evaluation, and meta-analysis.

Results: Nine studies met our inclusion criteria. Implant survival rate tended to be lower in the cantilever group, and marginal bone loss tended to be higher in the cantilever group; however, there was no significant difference. There was no significant difference in patient satisfaction based on the presence or absence of a cantilever. Moreover, the incidence of mechanical complications was significantly higher in the cantilever group. According to the analysis of anterior and posterior regions, implant survival rate tended to be lower in the cantilever group of the posterior region, and marginal bone loss around the implants tended to be higher in the cantilever group of the anterior region.

Conclusion: Implant-supported fixed prostheses with cantilevers did not negatively affect implant survival rate, marginal bone loss, or patient satisfaction. However, the incidence of mechanical complications significantly increased in the cantilever group.