International Journal of Oral & Maxillofacial Implants最新文献

One of the most important parts of any research project is the statistical analysis through which results are described and deemed significant or otherwise. Given this role of statistical analyses, it is imperative to understand what statistical tests are available and, most importantly, when they are appropriate. This is because choosing an improper statistical test can lead to inaccurate results and meaningless conclusions. We have written this data analysis guide to assist dental researchers with carrying out a proper analysis plan in consultation with a statistician. In this first part, we detail common types of outcome and predictor variables and include some common tests that can be used for each scenario. Using different simulated datasets, we also provide examples of common data visualization techniques and how a proper statistical test can be applied. We hope this guide provides some general background knowledge on common statistical techniques and allows for easier and more effective conversations with your statistician.

Purpose: To evaluate the efficacy of split-thickness labial eversion periosteoplasty (EPP) for soft tissue closure in horizontal ridge augmentation of posterior mandibular regions using a bone shell onlay grafting technique. Materials and Methods: Sixteen patients (12 female and 4 male; mean age: 46.2 ± 8.7 years) with 18 horizontal bone defects in posterior mandibular regions were included for lateral onlay bone grafting using the bone shell technique. After lateral bone augmentation, the EPP was used for soft tissue closure and was prospectively followed up for wound healing efficacy using a modified scoring index. The scoring index included dichotomous (yes: 0 / no: 1) evaluation of the following items: (1) bleeding on palpation or spontaneously, (2) tissue color difference, (3) presence of hematoma, (4) presence of granulation tissue, (5) incomplete incision margin closure, (6) dehiscence with visible augmentation material, (7) presence of exudation, and (8) presence of suppuration. In addition, a visual analog scale (VAS) was used to quantify and record the amount of pain and swelling (0 = no pain/swelling and 5 = severe pain/swelling); VAS scores of 0, 1, and 2 were rated as 1 in the dichotomous scoring index, and VAS scores of 3, 4, and 5 were rated as 0. A summarized wound healing score consisting of all 10 items was assessed at days 2, 7, and 14 and at months 1 and 4 postoperatively, including a comparison of the follow-up evaluations. Results: The summarized healing score increased significantly (P < .01) between day 2 (score: 6.6 ± 1.1) and day 7 (score: 8.9 ± 1.0) but showed little difference between day 14 (score: 9.6 ± 0.6) and the 1- and 4-month follow-ups (score: 10.0 ± 0). There was no wound dehiscence and no incomplete incision margin adaptation. For the individual parameters evaluated, bleeding on palpation, hematoma, and exudation were the most frequent side effects at day 2 at 50%, 100%, and 22.2%, respectively, and at day 7 at 16.7%, 55.6%, and 22.2%, respectively. The average pain score and the swelling/edema score were initially 4.0 ± 0 and 3.0 ± 0.77 on day 2, with a significant decrease (P < .001) by day 7 (pain: 2.0 ± 0; edema/swelling: 2.0 ± 0.59) and day 14 (pain: 1.0 ± 0.42; edema/swelling: 2.0 ± 0.79) and complete absence (score: 0) at months 1 and 4. Conclusions: Labial split-thickness EPP facilitates flap advancement and enables tight soft tissue coverage in large horizontal posterior mandibular bone augmentations as a result of offset double-layer wound closure. Although this procedure is shown to be surgically demanding, the postoperative complication rate may be reduced significantly.

Purpose: To evaluate the incorporation of liquid platelet-rich fibrin in different collagen matrices in vitro. Materials and Methods: Collagen matrices with liquid platelet-rich fibrin were used and divided into the following test groups (n = 5): Mucoderm (MD), Mucograft (MG), and Fibro-Gide (FG). After incubating the collagen matrices in liquid platelet-rich fibrin, histologicl and fluid absorption capacity analysis were performed. Intergroup comparisons of cell count, blood plasma penetration area, and fluid absorption capacity were performed using one-way ANOVA and Tukey tests. Intragroup comparisons of fluid absorption capacity were made using the independent t test with a 5% significance level. Results: Descriptive qualitative analysis showed total incorporation of liquid platelet-rich fibrin in the FG group, while the MG and MD groups showed only partial and shallow incorporation, respectively. There was a statistically significant difference among the three groups regarding inflammatory cell infiltration (P = .000), with the FG group presenting the highest number of cells in the matrices (577.15 ± 54.88). The FG group showed an area of total blood plasma penetration into the matrix, followed by the MG group with partial penetration, and the MD group with minor penetration area (P = .000). Considering the fluid absorption capacity analysis, only groups FG and MG were statistically different when comparing the liquid platelet-rich fibrin absorption coefficient (P = .017), with higher absorption in group FG (14.30 ± 3.35). Conclusions: The FG collagen matrix showed a good capacity for liquid platelet-rich fibrin incorporation in vitro.

Purpose: To evaluate the gain in peri-implant keratinized mucosa (KM) using a combination of a free gingival graft (FGG) strip with a xenogeneic collagen matrix (XCM) and compare it to that of an FGG alone. Materials and Methods: This randomized controlled clinical study included a total of 30 patients with a minimal amount of peri-implant KM (≤ 1 mm) in the maxillary and mandibular anterior regions (including the premolars). The study population was divided into two groups using a randomization protocol; group A (n = 15) received a combination of FGG strip and XCM, and group B (n = 15) received FGG only to augment the KM. Clinical parameters included width of KM (WKM) measured at baseline, 1 month, and 6 months; a customized pink esthetic score (PES) measured at baseline and 6 months; and patient morbidity using visual analog scale (VAS) at days 1, 7, and 14 postoperatively. Results: After 1 month, both groups showed statistically significant gain in KM that reduced slightly by the 6-month follow-up but remained statistically significant when compared to baseline. When the gain was compared between the two groups, the difference was not statistically significant. Better esthetic outcomes and lower morbidity were reported in group A compared to group B, and this difference was statistically significant. Conclusions: Within the limitations of the study, it can be concluded that the combination of FGG strip with XCM is a viable alternative to the use of FGG in augmenting peri-implant KM.

Purpose: To compare glycated multilayered membranes (OV) to a commercially available thin-layer membrane (OP) in a lateral ridge augmentation model in dogs. Materials and Methods: This was designed as a three-arm study, where one negative control (empty defect) was compared to two test arms: alveolar bone defects grafted with a mixture of 90% deproteinized bovine bone mineral and 10% porcine collagen, then covered with either a thick- (OV) or thin-layered (OP) membrane. Animals were randomly divided into three groups corresponding to the final sacrifice times of 4 weeks, 12 weeks, and 24 weeks. Sections underwent microCT, histology, histopathology, and histomorphometry. Results: No statistical differences were observed for OV compared to OP regarding the percentage of mineral volume and mean mineral density, amount of bone maturation, percentage of bone graft and membrane remaining in the grafted area, alveolar ridge width measurements, membrane mineralization, or ossification. Test groups presented significantly higher values compared to the empty control for all the endpoints. Conclusions: Within its limitations, this in vivo study highlighted that multilayered thick glycated membranes can serve as effective occlusive barriers for up to 6 months.

Purpose: To analyze the effects of age on the sinus graft remodeling of transalveolar sinus floor elevation (SFE) with simultaneous placement of dental implants. Materials and Methods: A retrospective study design was adopted. A total of 222 sites in 216 patients who underwent transalveolar SFE with immediate implant placement were included. The clinical and radiographic data were collected at preoperative, postoperative, and postloading time points. Age was divided into three groups: < 30 years, 30 to 50 years, and > 50 years. The ratio of sinus graft resorption (Ratio) was used to evaluate the outcomes of the surgery and loading. ANOVA was applied to explore the correlation of total elevation height (TEH) with implant loading. The Ridge regression model was used to explore the relationship between Ratio and age and other possible factors. Results: A total of 222 implants in 216 patients were included for implant-based analysis. The TEH averaged 6.983 ± 2.251 mm on the day after surgery (T1), and sinus graft resorption was found during the healing period and after implant loading (P < .01). Age was found to be a reliable correlation with the Ratio (P < .01). A significantly decreased bone formation efficiency was found with aging. Conclusion: According to the results of this retrospective chart review, age was the main factor affecting the outcomes when applying transalveolar SFE with simultaneous implant placement. This finding could be a guide for clinical treatment.

Purpose: To study the effect of BMP-2 on the volumetric and histometric changes in peri-implant defect treatments in animal models. Materials and Methods: An electronic search of four databases and a manual search of peer-reviewed journals for relevant articles were performed. Animal studies with data that compared the volumetric and/or histometric outcomes of peri-implant defect treatment with and without the use of BMP-2 were included. Meta-analyses were performed to analyze the weighted mean difference (WMD) and confidence interval (CI) for the recorded variables. Results: After completing the search process, 21 randomized controlled trials were included. The results of the meta-analyses showed that the WMD of bone-to-implant contact (%BIC) with 4 to 8 weeks and 12 to 24 weeks of follow-up was 15.50% (95% CI = 3.28% to 27.72%, P = .01) and 16.17% (95% CI = 11.17% to 21.16%, P < .00001), respectively, favoring the BMP-2 group. The WMD for the percentage of defect fill with 4 to 8 weeks and 12 to 24 weeks of follow-up was 15.88% (95% CI = 3.90% to 27.86%, P = .009) and 10.48% (95% CI = 0.95% to 20.02%, P = .03), respectively, favoring the BMP-2 group. The WMD for the vertical bone gain with 8 to 16 weeks of follow-up was 1.63 mm (95% CI = 0.58 to 2.67 mm, P = .002), also favoring the BMP-2 group. Conclusion: This review demonstrated that the use of BMP-2 in treating peri-implant defects showed better clinical and histometric outcomes than defects not treated with BMP-2 in animal models.

Purpose: To evaluate differences in the temperature rise at the cervical area of one-piece vs two-piece implants during the setting of relined provisional crowns. Materials and Methods: A K-type thermocouple was fixed to the coronal thread of 15 one-piece implants and 15 two-piece implants that were mounted on a plexiglass apparatus. Baseline temperature (Bl Temp) was recorded before starting the curing process. The maximum temperature (Max Temp) reached during the process in both implant groups was also recorded. Total heat flux (THF) was calculated as well as the thermal amplitude (Temp-Amp) at the implant surface. Finally, the differences between the implant types were compared using unpaired t test. Results: The increase in temperature from baseline was statistically significantly greater in the one-piece implants than in the two-piece implants (P < .01). Similarly, the THF and Temp-Amp were significantly greater in the one-piece implants compared to two-piece implants (P < .01). Conclusions: The polymerization of PMMA-based resin temporary crowns produces a significant temperature rise in both one-piece and two-piece implants. It is advisable to use two-piece implants to restore immediately loaded implants to reduce the risk to implant surroundings that may occur due to the temperature rise at the implant neck.