International Journal of Implant Dentistry最新文献

Objectives: The feasibility of dental implants in patients with osteoporosis remains controversial, with limited prospective studies on quantitative changes in bone mineral density (BMD) and bone turnover markers (BTMs). This study assessed implant survival and clinical outcomes while evaluating systemic changes during 1 year of implant treatment.

Materials and methods: Postmenopausal women requiring dental implants were enrolled at the Yonsei University Dental Hospital. BMD and BTMs were evaluated in collaboration with the endocrinology department. Participants were divided into two groups: Group A (T-score ≥ -2) and Group B (T-score < -2). All implants used in the study were surface-treated with hydroxyethyl piperazine ethane sulfonic acid (HEPES), and clinical, radiographic, and systemic parameters were monitored for over 1 year.

Results: Between April 2022 and May 2024, 45 implants were placed in 36 patients (mean age: 68 years). Group A included 17 patients with 21 implants (mean age: 66 years), and Group B included 19 patients with 24 implants (mean age: 70 years). The cumulative survival rate was 100%. Resonance frequency analysis at 12 months revealed a mean implant stability tester value of 71.4 ± 5.52, indicating excellent osseointegration. Peri-implant bone loss averaged 0.54 ± 0.35 mm. No implant failures occurred, with stable plaque scores, probing depths, and bleeding upon probing. BMD and BTMs changes were minimal.

Conclusions: Both groups achieved high implant survival and stable clinical outcomes. Systemic evaluations confirmed only minor changes in BMD and BTMs over 1 year. Larger multicenter studies are required to confirm the systemic safety of dental implants in patients with osteoporosis.

Clinical relevance: Dental implants show excellent survival and stability in postmenopausal women with osteoporosis, with minimal impact on bone density and turnover-supporting their safe use in this population.

Clinical trial registration: This study was prospectively registered at the Clinical Research Information Service of the National Research Institute of Health, Republic of Korea (KCT0007100). The registration details can be accessed at https://cris.nih.go.kr .

Purpose: This study aimed to compare commercial allogeneic cortical bone plates (cCP) with innovative, differently demineralized CP (dCP) in biomechanics and human osteoblast (HOB) viability ex-vivo and in-vitro.

Methods: Breaking strength (BS; in N) and flexibility (F; in mm) of cCP and dCP were assessed and compared using four groups ((1) non-hydrated, (2) hydrated for 10, (3) 30, and (4) 60 min in saline), respectively. Cell viability of HOB was evaluated by resazurin reduction on non-hydrated cCP and dCP after 3, 7, and 10 days. Scanning electron microscopy (SEM) visualized CP breaking edges, internal structures, HOB cell morphology, and growth patterns.

Results: BS of hydrated dCP (d10: 15.45 ± 7.01 N, d30: 19.40 ± 3.78 N, d60: 20.31 ± 4.90 N) was significantly lower than that of non-hydrated dCP (d0: 74.70 ± 29.48 N) and native and hydrated cCP (c0: 75.00 ± 19.27 N, c10: 83.73 ± 10.92 N, c30: 83.80 ± 22.63 N, c60: 75.58 ± 14.25 N, p < 0.001 each). Next, dCP groups (d0: 2.64 ± 0.78 mm, d10: 2.14 ± 1.15 mm, d30: 2.76 ± 3.78 mm, d60: 2.86 ± 0.89 mm) exhibited significantly higher F than cCP groups (c0: 0.49 ± 0.14 mm, c10: 0.66 ± 0.10 mm, c30: 0.67 ± 0.16 mm, c60: 0.59 ± 0.12 mm, p < 0.05 each). No significant differences in F were observed among the different dCP groups. HOB cell viability was significantly increased on cCP compared to dCP after 7 (97.64 ± 2.11% vs. 76.88 ± 4.82%) and 10 days (96.14 ± 4.13% vs. 76.45 ± 4.64%; p < 0.001 each). SEM revealed well-defined breaking edges in cCP, whereas dCP displayed tear-off edges with shearing extensions. SEM showed disordered growth patterns and a physiological HOB cell morphology on dCP, contrasting with a parallel growth of fibroblast-like-looking HOB on cCP.

Conclusions: Compared to cCP, dCP showed increased flexibility but lower breaking strength and reduced HOB vitality. The increased flexibility and a decrease in breaking strength are likely due to differences in elasticity between dCP and cCP. The use of dCP may improve clinical handling efficiency.

Purpose: To evaluate early versus conventional loading in immediate implants for molars. This study aims to answer the following PICO (Patient, Intervention, Comparison, and Outcome) question: In patients over 18 years of age, does early loading of immediately placed implants in molar areas result in a similar implant survival rate and marginal bone loss as conventional loading?

Methods: Twenty-seven patients (15 women and 12 men) received a total of 30 implants immediately after molar extraction. The surgical treatment protocol entailed atraumatic tooth extraction without flap elevation. Non-invasive quantitative analyses were used to assess implant stability. After an uneventful healing period, the 30 implants were restored with screw-retained monolithic zirconia prosthesis, half of which after 6 weeks (G1) and the other half after 3 months (G2).

Results: Regarding the survival rate, the Kaplan-Meier and log-rank test showed that there was no statistically significant difference between both groups (p = 1). Implant stability quotient at the prosthetic phase of both groups (6 weeks in G1 and 3 months in G2) revealed no statistically significant difference (G1 RFA74.4 (SD 5.54) - DCA 79.07 (SD 5.75))/G2 RFA 73.67 (SD 5.7), - DCA78.93 (SD 4.48).

Conclusions: Early loading of immediately placed implants in molar sites is considered a predictable treatment modality provided that ideal implant position and adequate insertion torque are achieved.

Purpose: Dynamic navigation systems and surgical guides have been reported to be equally accurate. However, the accuracy of dynamic navigation systems is affected by the movement of the patient tracker fixed to the tooth. We hypothesized that fixing the patient tracker to the oral appliance could improve accuracy. Therefore, this study aimed to compare accuracy between a dynamic navigation system with a patient tracker fixed to an oral appliance and a surgical guide.

Methods: This observational study was conducted on patients who had undergone complete implant treatment at Kanagawa Dental University from 2020 to September 2024. Fifty implant bodies were placed in 42 patients with anterior tooth defects in both the dynamic navigation and surgical guide groups (25 implants each). DTX Studio™ (Nobel Biocare AG, Kloten, Switzerland) was used to overlay planning data on postoperative Digital Imaging and Communications in Medicine data to calculate entry point, apex point, and angular deviation accuracy.

Results: The entry point, apex point, and angular deviation values were 0.99 ± 0.33 mm, 0.97 ± 0.43 mm, and 2.64 ± 0.87° in the dynamic navigation group and 1.33 ± 0.26 mm, 1.38 ± 0.3 mm, and 3.42 ± 1.03° in the surgical guide group, respectively, differing significantly at all measurement sites (P < 0.01).

Conclusions: The fixation of the X-clip to the oral appliance improved intra-oral stability and inhibited intraoperative movement of the X-clip, resulting in high accuracy. These results suggest that dynamic navigation by oral appliance fixation is more accurate than surgical guides.

Background: Maxillary canine impaction is the second most common dental eruption anomaly, affecting approximately 0.2-3% of individuals, with a higher incidence in females. This condition often results in complications such as the misalignment of adjacent teeth, root resorption, and the development of cystic lesions. In some cases, abstention is recommended for impacted canine is kept with the lacteal tooth held on the dental arch. But in the longer term an implant therapy is nevertheless indicated.

Case presentation: A 42-year-old man presented with persistent swelling and pain in the maxillary region associated with a transcanine implant placed one year ago by his dental practitioner. Imaging assessment showed the implant's apex inserted into the impacted canine which presented a crown and root resorption and was associated to a radiolucency around. In order to preserve implant and reduce morbidity related to a full extraction of the tooth, a coronectomy was performed allowing inflammatory surrounding tissues curettage.

Discussion: This case shows an infectious complication of a transcanine implant and demonstrates an approach for managing these complications while preserving this implant. The coronectomy is a less invasive technique that reduces potential surgical complications and supports healing. A 2-year follow-up revealed complete bone reossification reinforcing the effectiveness of this method in similar clinical scenarios.

Conclusion: This case suggests that coronectomy may be a viable option for managing impacted canines in proximity to implants when complete extraction poses a high risk of complications. However, given the limited number of reported cases and the absence of long-term data, this approach should be considered with caution. Further studies are necessary to better define the indications, long-term outcomes, and potential risks of this technique.

Purpose: Maxillary sinus floor elevation is a safe and effective surgical technique for achieving vertical bone height, performed through either a lateral or crestal approach. The latter includes both the osteotome technique and osseodensification. The aim of this systematic review was to compare the outcomes of the classic crestal sinus lift technique and the osseodensification sinus lift approach in terms of the bone gain, marginal bone loss, survival rate, follow-up time and complications.

Methods: This review was performed following PRISMA guidelines. An electronic search was conducted across three databases: (1) The National Library of Medicine (MEDLINE/PubMed); (2) SCOPUS; and (3) Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Quality Assessment Scale and the Cochrane Collaboration tool for evaluating risk of bias. A meta-analysis for random effects was carried out for implant survival, residual bone height and bone gain.

Results: Thirteen studies were included, ten studies performed the osteotome (OST) approach and three performed the osseodensification (OD) approach, with a total of 519 sites treated. The residual bone height was 5.94 and 5.00 mm for OD and OST, respectively. For bone gain, similar results were found for both groups, being 3.37 mm for OD and 3.18 mm for OST. For both groups, the most used diameter and length of the implant was 4 and 10 mm, respectively, and the implant survival rates ranged from 94.1% to 100%. OST technique reflected a complication rate of 14.32%, compared to the OD technique, which showed a complication rate of 2.78%.

Conclusions: It can be concluded that the maxillary sinus lift by osseodesinfication approach is a safe, predictable and successful technique compared to the osteotome approach, with similar outcomes regarding bone gain which is an important parameter for implant placement.

Objectives: This systematic review aimed to investigate and compare the accuracy of free-hand and computer-aided implant surgery (CAIS) approaches in dental implant placement.

Material and methods: The PICO question as follows: In patients receiving dental implants, does computer-aided implant surgery superior in accuracy compared to non-computer-aided implant surgery? The primary outcome was angular deviation between the planned and placed position of the implant. An electronic search was made to identify all relevant studies reporting the accuracy of CAIS approaches and freehand for dental implant placement. The data were extracted in the descriptive description, and a meta-analysis of single means was performed to estimate the deviations for each variable using a random-effects model.

Results: Out of 1609 initial articles, 55 were selected for data extraction. The mean value of angular, entry, and apex deviations were 7.46°, 1.56 mm, and 2.22 mm for freehand, 5.94°, 1.13 mm, and 1.43 mm for pilot drill-sCAIS, 2.57°, 0.72 mm, 0.88 mm for fully guided-sCAIS (fg-sCAIS), and 3.67°, 1.01 mm, and 1.36 for dynamic CAIS (dCAIS), respectively. Significant differences were found between the freehand and CAIS approaches (p < 0.04). Fg-sCAIS was significantly more accurate than dCAIS systems at the entry (p < 0.001).

Conclusions: Compared to the freehand approach, both sCAIS and dCAIS improve implant placement accuracy, with angular deviations ranging from 2° to 6°. Detailed planning is crucial for CAIS, particularly for fg-sCAIS, which demonstrated the highest accuracy than others. As apex deviations of 1 to 2 mm have been observed in CAIS approaches, a 2-mm safety margin should be implemented to minimize surgical risks.

Purpose: To evaluate the survival and success rates of a novel two-piece zirconia implant system restored with screw-retained glass-ceramic crowns over 12 months, including assessment of bone levels, soft tissue parameters, and patient-reported outcome measures.

Methods: Twenty-four patients received single two-piece zirconia implants (CERALOG^® Hexalobe) in healed sites. After a 6-month healing period, implants received provisional screw-retained crowns on PEKK temporary abutments, followed by definitive lithium disilicate crowns (IPS e.max Press) on PEKK abutments. Clinical and radiographic examinations were performed at implant placement, re-entry, definitive loading, and 12-month follow-up, along with patient-reported outcome measures.

Results: The implant survival rate at 12 months was 60.9%. Nine implants were lost: two due to lack of osseointegration at re-entry, four due to mobility after loading, and three due to fractures in the coronal third after loading. Surviving implants showed stable soft tissue parameters with mean probing pocket depths of 2.7 ± 0.7 mm at 12 months. The mean distance from implant shoulder to first bone contact decreased from 1.9 ± 0.6 mm at loading to 1.4 ± 0.6 mm at 12 months. Patients with surviving implants reported high satisfaction scores (4.8 ± 0.4) for function and aesthetics.

Conclusions: The two-piece zirconia implant system with screw-retained restorations showed unsatisfactory survival rates. The combination of ceramic implants with screw-retained prosthetic restorations may have contributed to the higher failure rates observed. As a pilot study with a relatively small sample size, these findings should be confirmed by larger multicenter studies to validate these preliminary results.

Purpose: To report the evaluation of in vivo retention forces after replacement of O-rings in one-piece mini dental implants (MDIs), retaining mandibular implant overdentures (IODs) with ball/O-ring attachments during 10 years assessed.

Methods: Twenty patients received new complete dentures, which were converted into IODs through stabilization with four MDIs (Condent GmbH; diameter: 1.8 mm) placed in the interforaminal region. Retention forces were measured at the male and female parts at baseline, 5, and 10 years using a validated strain gauge. Fourteen patients completed the 10-year follow-up.

Results: After 10 years, a minor but significant reduction in retention force was observed in the male part of the implant at position 44. In contrast, neither the male part at the other implant positions nor the female part at any position showed a significant decrease in retention force compared to baseline. After replacement of the O-ring inserts, baseline values could be restored and no significant changes in retention forces were observed at the 10-year follow-up. No difference in anterior and posterior implants could be determined.

Conclusions: Initial retention forces of mandibular IODs supported by four MDIs can be reestablished by replacing the O-rings with pristine ones after 10 years, with stable retention forces at both the male and female parts throughout the functional period, with no discernible differences between anterior and posterior implants.