International Journal of Implant Dentistry最新文献

Background: Oral implantology has become a standard procedure for replacing missing teeth. However, patients with severe maxillary bone resorption often require complex surgical interventions, such as Le Fort I osteotomy with interpositional bone grafting, prior to implant placement. This study aimed to evaluate the long-term outcomes of oral implants placed following this surgical technique.

Patients and methods: The present study was two-fold. First, a retrospective review was performed using medical records and conventional panoramic radiographs from 26 patients who had undergone Le Fort I osteotomy with interpositional bone grafting and received either Astra Tech or Brånemark oral implants. Patients were followed for up to 5 years. Marginal bone loss was measured from the implant shoulder to the bone level. Implant survival and success rates were assessed, with success defined as bone loss of ≤ 2 mm during the first year and < 0.2 mm annually thereafter. Second, to assess the long-term outcomes of the two oral implant systems, all traceable patients were invited to undergo a follow-up radiographic examination up to 29 years post-treatment.

Results: The combined survival rates for Astra Tech and Brånemark oral implants were 97.0%, 94.6%, and 94.1% at 1, 2, and 3 years, respectively, with no additional implant loss observed by year 5. The overall success rate at 5 years was 56.1%, with Astra Tech implants showing a higher success rate (70.8%) compared to Brånemark implants (51.4%). Although there was no statistically significant difference in survival rates between the two systems, Astra Tech implants demonstrated significantly less marginal bone loss at both 1-year (p < 0.01) and 3-year (p = 0.021) follow-ups. For the long-term evaluation, 14 patients (54%) from the original cohort were traceable, of whom 4 patients (29%) participated in the follow-up. Among the 28 Brånemark implants assessed, none were lost, resulting in a 100% survival rate up to 29 years. The mean marginal bone loss of 2.6 ± 1.8 mm.

Conclusion: Le Fort I osteotomy with interpositional bone grafting, followed by oral implant placement and prosthetic rehabilitation, appears to be a reliable long-term treatment option for patients with severe maxillary atrophy, demonstrating favorable long-term survival-, and success rates.

Objectives: This prospective cohort study aimed to evaluate the clinical and radiographic outcomes of one-piece zirconia implants and compare them to those of titanium implants over a period of up to 108 months (85.3 ± 31.6 months).

Methods: A total of 33 implants (22 zirconia/Ziterion Zit-Z® and 11 titanium/Ziterion Zit-T®) were placed in 32 patients (15 male, 17 female), all of whom required neither bone nor soft tissue augmentation. These implant systems are no longer commercially available. Radiographic bone levels, clinical peri-implant parameters, and implant survival were recorded for up to 108 months.

Results: Implant fractures were not observed. In the titanium group, two implant failures (18.2%) were reported, while eight zirconia implants (36.4%) failed. Kaplan-Meier analysis showed survival rates of 80.8 and 62.2% for titanium and zirconia implants, respectively, for up to 108 months. The bleeding on probing values gradually increased over time in both groups. A statistically significant decrease in the plaque index was observed for zirconia implants at 36 and 108 months (p < 0.001). Additionally, both groups showed a statistically significant reduction in marginal bone resorption within the first year after implant placement (p < 0.05). However, no significant difference between the two groups was observed over time (p > 0.05).

Conclusions: Immediately temporized one-piece zirconia implants showed lower survival rates than those of titanium implants, highlighting the need for further validation in larger trials.

Clinical relevance: Immediate temporization of non-commercial zirconia implants is not recommended due to their compromised survival rates.

Purpose: This scoping review was carried out to discover and compare all the possibilities the researchers have thought of in the recent past to perform in silico studies on bone healing after implantation of dental implants.

Methods: An electronic search was conducted in Pubmed, Web of Science, Science Direct and google scholar database to find out related articles in dental peri-implant healing simulations from the period of 2010 until 2025.

Results: In total, 40 articles were found relevant for this review. Different theories have been applied in the literature to simulate the mechanobiology of bone healing. Success has been found in predicting bone healing via in silico studies. The finite element was used often for these studies; however, the application of artificial intelligence is increasing with time in this sector.

Conclusions: In silico platforms provide a non-invasive and fast approach to study the bone healing process. They can be used as an aid to predict peri-implant bone healing in dentistry. The rise of artificial intelligence in this sector opens a new path, where these studies can be performed with high accuracy at an astounding fast pace. These methods can be a boon to clinicians, patients as well as implant developers.

Purpose: Despite decades of clinical success with microrough implant surfaces, persistent challenges-particularly the biological trade-off between osteoblast proliferation and differentiation-highlight the need for novel surface design strategies. This review investigates the potential of meso-scale topography (10-500 μm) as a promising and underexplored dimension in implant surface engineering, situated between macro-level implant geometry and conventional microroughness.

Methods: A systematic review, supplemented by a targeted literature search, was conducted to evaluate the biological and mechanical roles of meso-scale surface features on titanium, zirconia, and scaffold materials. Studies employing laser texturing, chemical etching, and 3D printing/additive manufacturing were critically assessed. Comparative insights across nano-, micro-, and meso-scale features were synthesized to delineate their distinct and synergistic contributions to osseointegration.

Results: Meso-scale features confer unique biological and mechanical advantages not achievable by nano- or micro-scale designs alone. These include enhanced osteoblast recruitment/attachment, spatial organization, extracellular matrix alignment, and mechanical interlocking. Notably, meso-topography appears to resolve the classic proliferation-differentiation dichotomy observed with microrough surfaces. Many meso-scale designs also exhibit increased interfacial surface area, correlating with superior mechanical fixation. Biomimetic meso-patterns-mimicking osteoblast dimensions and native bone microarchitecture-demonstrate contact-guidance effects that promote cell alignment and matrix deposition. Most importantly, titanium and zirconia surfaces with engineered meso-topography consistently improve biological integration and biomechanical anchorage. Yet, these features remain largely absent in current clinical implants due to knowledge gaps, technical constraints, and manufacturing limitations.

Conclusion: Meso-scale topography offers a powerful yet underutilized strategy to enhance osseointegration. Future implant designs should adopt an integrative, hierarchical approach that combines microroughness with meso-scale structuring to achieve synergistic improvements in cellular behavior, mechanical stability, and early healing. This strategy aligns with the hierarchical organization of natural bone and holds the potential to overcome longstanding biological bottlenecks in implant dentistry. Bridging the gap between biological potential and technological feasibility will be essential to advancing next-generation implant surface design.

Patients: Twenty patients with residual bone heights of 4-7 mm in the posterior maxilla were randomly divided into two groups: Group 1 (conventional crestal approach) and Group 2 (endoscopic-assisted crestal approach). A 2.7 mm rigid endoscope was used to monitor membrane integrity after each surgical step. Bone grafting with a xenograft-platelet-rich fibrin mix was performed, followed by implant placement. Membrane perforation rates, surgical time, and bone density changes were evaluated.

Results: Twenty-two implants were placed (11 in each group). Membrane perforation occurred in 33% of cases in Group 1 and 10% in Group 2 (p = 0.582). Group 2 had significantly longer surgical times (27.3 ± 2.00 min) compared to Group 1 (15.4 ± 2.22 min, p < 0.0001). Bone density increased significantly from 609.55 ± 108.71 HU postoperatively to 878.38 ± 114.60 HU at six months (p < 0.001). Endoscopic-assisted techniques significantly reduced perforation rates and improved surgical precision.

Conclusions: The endoscopic-assisted crestal sinus lifting is a unique technique allowing visualization and assessment of membrane integrity and may enhance the safety and the predictability during membrane elevation, reducing complications such as membrane perforation. However, its benefits must be weighed against increased surgical time and cost.

Gingival biotype is decisive for the outcome of rehabilitation treatments, and its impact on therapeutic prognosis is directly related to tissue fragility and marginal tissue recessions. This study aimed to evaluate the effect of enamel matrix derivative (EMD) and porcine collagen matrix, alone or combined, on wounds made on the rat dorsum. Wounds were created in the dorsum of 40 Wistar rats divided into 4 sample groups: G1 = clot, G2 = porcine collagen matrix (Straumann^® Mucoderm^®), G3 = enamel matrix derivative (EMD, Emdogain^®), G4 = porcine collagen matrix (Straumann^® Mucoderm^®) and EMD (Emdogain^®). The animals were euthanized on days 7 and 14, and their wound was evaluated histologically to assess wound closure and re-epithelialization, and to measure tissue inflammation. At 7 days, groups treated with EMD (G3 and G4) exhibited significantly lower inflammation scores compared to G1 and G2 (p < 0.05). At 14 days, all groups showed complete wound closure with no significant differences in inflammatory scores. However, G3 demonstrated a markedly greater epithelial thickness, with epithelial projections into the underlying connective tissue and evidence of keratin formation. Collagen fiber organization was also more evident in G3 and G4. Therefore, porcine collagen matrix, whether alone or combined, promoted tissue regeneration, and the combination of these substitutes with EMD, resulted in less tissue inflammation and greater epithelial thickness. These advantages emphasize their use for soft tissue augmentation and improvement.

Purpose: This study aims to develop and evaluate a dental implant drill system capable of preventing maxillary sinus membrane perforation, a common complication in cases with limited alveolar bone height, particularly in the maxillary molar region. The primary objective is to design a mechanism that autonomously detects changes in bone quality and halts drill rotation upon reaching the sinus floor.

Methods: A novel dental implant drill incorporating an integrated bone quality detection mechanism was developed. The system includes a centrally mounted detector that actuates a switch controlling drill rotation. When cortical bone is penetrated and softer tissue is encountered, the detector extends outward, interrupting power to the motor. A penetration test was conducted using a 5 mm thick wooden board as a surrogate bone model to evaluate the drill's response to cortical penetration.

Results: Experimental trials demonstrated that the drill automatically ceased rotation upon advancing approximately 0.47 mm beyond a simulated bone surface. Given that the maxillary sinus membrane is typically less than 1 mm in thickness, this minimal protrusion indicates a significantly reduced risk of perforation.

Conclusion: The proposed drill system effectively detects transitions in bone quality and prevents over-penetration, offering a promising solution for enhancing surgical safety during maxillary implant procedures.

Statement of problem: A well-defined protocol for self-performed interproximal oral hygiene around implant-supported restorations is currently lacking.

Purpose: To assess the efficacy of home-care interproximal cleaning measures used adjunctively to mechanical toothbrushing in reducing signs of inflammation in patients with peri-implant mucositis.

Methods: A systematic electronic literature search followed by a manual search using the PRISMA guidelines was performed. Randomized controlled trials and prospective studies evaluating the effectiveness of different interproximal cleaning devices in reducing inflammation signs in patients with peri-implant mucositis were selected according to pre-determined inclusion and exclusion criteria. The meta-analysis was carried out using the Rev Man 5.4 software program.

Results: Out of a preliminary pool of 792 articles, 6 relevant studies were identified for final evaluation. Interproximal cleaning devices investigated were: dental floss, interproximal brush, oral irrigator(water), oral irrigator(CHX). The following clinical variables were analysed: plaque index(PI), gingival index(GI), bleeding on probing (BOP) and interleukin 6. Due to hetergeneity, only two studies fulfilled the eligibility criteria for meta-analysis. Oral irrigators and interdental brushes showed a higher but not-significant improvement in signs of peri-implant mucositis than dental floss. The meta-analysis revealed no statistically significant difference between toothbrushing alone and toothbrushing with an oral irrigator (water) in reducing BOP and PI.

Conclusion: All interproximal cleaning devices evaluated in this review demonstrated some degree of effectiveness in controlling biofilm accumulation and mitigating peri-implant inflammation. However, evidence on self-performed oral hygiene around dental implants-especially concerning interproximal devices-remains limited.

Purpose: This study aims to evaluate the effects of hyperbaric oxygen treatment (HBOT) on new bone formation after sinus lift operation in diabetic rabbits.

Methods: 27 New Zealand White rabbits that were alloxan monohydrate-induced diabetics were divided into four groups following the sinus lift procedure. Hyperbaric oxygen treatment was applied to 14 rabbits in experimental groups (HBOT-1, HBOT-2). Subjects were sacrificed after 4 (HBOT-1, C-1) and 8 (HBOT-2, C-2) weeks. Histomorphometry and immunohistochemistry were used in histopathological evaluation.

Results: The new bone area in the HBOT-1 group is statistically more significant than the C-1 group (p = 0.002) and the new bone area in the HBOT-2 group is statistically more significant than the C-2 group (p = 0.001). The area intensity and severity of staining with anti-collagen I in HBOT-1 group is statistically significant compared to C-1 group (p = 0.001) and in HBOT-2 group compared to C-2 group (p = 0.001). The area intensity and intensity of staining with anti-BMP-2 in the HBOT-1 group is statistically significant compared to the C-1 group (p = 0.000) and in the HBOT-2 group compared to the C-2 group (p = 0.001). The number of new vessels in HBOT-2 group is statistically significant compared to C-2 group (p = 0.000).

Conclusions: Hyperbaric oxygen treatment in the long and short term increases new bone formation, and intensity the level of collagen type I, bone morphogenetic protein-2, and the vascular endothelial growth factor level, in the long term. Based on these results, it was concluded that the negative impact of diabetes on new bone formation can be recovered with hyperbaric oxygen treatment.

The management of a loosened screw of an implant-based restoration - whether or not documentation of the respective implant system is available - is a common and challenging complication in dental practice simply due to the fact that the right screw driver must be available. This short communication highlights the need for technical standardization of certain components in implant prosthodontics. For example, screw head geometries, show a wide range between the systems and manufacturers, and make it necessary to provide matching screw drivers. Subsequently, prosthetic maintenance becomes less time and cost effective. Comparisons to the consumer electronics industry are drawn, where standardization improves usability and sustainability. It suggests that voluntary cooperation within the industry could create a unified standard. Standardization would facilitate clinical workflows in particular when complications occur, enhance patient safety, reduce costs, and improve long-term outcomes of implant-based restorations.