Clinical Implant Dentistry and Related Research最新文献

Objectives

This randomized controlled trial compared the clinical performances after 1 year of implant-supported, partial fixed dental prostheses (FDPs) fabricated from monolithic high-translucency zirconia, veneered high-translucency zirconia, and titanium-ceramic.

Material and Methods

Forty-nine adult participants who required posterior implant-supported FDPs were randomly assigned to three groups: monolithic zirconia (MZ, n = 23 FDPs), veneered zirconia (VZ, n = 20 FDPs), and veneered titanium (TC; n = 20 FDPs). Clinical and radiographical evaluations were performed at the 1-year follow-up, assessing prosthetic and implant survival, biological and technical complications, and marginal bone levels.

Results

A total of 59 FDPs were examined at follow-up (MZ, n = 21; VZ, n = 20; TC, n = 18). The overall prosthetic survival rate was 96.8%. One FDP in the VZ group failed due to a framework fracture, and one FDP in the TC group was replaced due to extensive chipping. Survival rates were 100% for MZ, 95% for VZ, and 95% for TC. Technical complications occurred in 6.8% of the FDPs, with chipping being the most frequent complication in the TC (11.1%) and VZ (5.0%) groups. Screw loosening occurred in one MZ FDP (4.8%). No chipping was observed in the MZ group. The overall implant survival rate was 99.2%. Biological complications were minimal, with peri-implant mucositis observed in 8.3% of the FDPs. There were no statistically significant differences in marginal bone level changes between the groups.

Conclusions

Short-span, implant-supported, partial FDPs composed of monolithic zirconia, veneered zirconia, and titanium-ceramic demonstrate high clinical survival rates at the 1-year follow-up in posterior regions. Longer-term studies are needed to confirm the long-term durability and clinical performance levels of these FDPs.

Trial Registration: https://clinicaltrials.gov/study/NCT05296291.

Objective

To evaluate the relationship between cone-beam computed tomography (CBCT)-derived bone microstructure parameters and marginal bone loss (MBL) around platform-switched subcrestal implants over 1–8 years.

Methods

A retrospective analysis assessed 142 platform-switched implants in 100 patients. CBCT-based bone microstructure parameters—bone volume (BV), tissue volume (TV), bone volume fraction (BV/TV), bone surface (BS), bone surface fraction (BS/BV), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp)—were measured in peri-implant and cervical regions. Radiographic MBL was evaluated at baseline (T0: prosthetic insertion) and follow-ups (T1: 1–3 years post-loading, T2: 3–8 years post-loading). Associations between bone microstructure parameters and MBL were analyzed using Generalized estimating equations (GEE).

Results

GEE analysis of 142 implants from 100 patients, adjusting for covariates, linked baseline bone microstructure to MBL at T0, T1 and T2. No significant associations were found at T0 or T1 (p > 0.05). At T2, cervical bone microstructure parameters were not significant. However, peri-implant parameters were predictive: BV/TV was protective (B = −1.028, p = 0.0125), while BS/BV (B = 0.008, p = 0.0384) and Tb.Sp (B = 1.214, p = 0.0270) were significant risk factors for long-term MBL.

Conclusion

Peri-implant BV/TV, BS/BV and Tb.Sp might be critical predictors of long-term MBL progression in platform-switched subcrestal implants, while cortical bone thickness has limited impact. CBCT-based bone microstructure analysis could aid MBL risk prediction and clinical management.

Trial Registration

This study has been registered in the Chinese Clinical Trial Registry, with the registration number ChiCTR2500098567

Objectives

This study aimed to evaluate clinical outcomes, marginal bone loss (MBL) trends, risk factors, and patient-reported outcomes (PROs) of immediate full-arch implant restoration to guide clinical decision-making.

Materials and Methods

A retrospective analysis was conducted on 50 patients with 256 implants who underwent immediate restoration. Clinical and imaging data, implant survival rates, and mechanical complications were analyzed. MBL was measured at five time points using cone beam computed tomography (CBCT): T0 (immediately post-implantation), T1 (6 months), T2 (1 year), T3 (2 years), and T4 (3–5 years). PROs were assessed using the Oral Health Impact Profile-14 (OHIP-14) and the European Five-Dimensional Health Inventory-5 L (EQ-5D-5L).

Results

The implant survival rate was 98%, with an average follow-up of 42 ± 16.36 months. Mechanical complications occurred in 46% of cases. MBL was most rapid between T0 and T2 and slowed from T2 to T4. Significant risk factors for increased MBL included smoking, maxillary implants, female gender, and advanced age. Furthermore, 30° angled multi-unit abutments on posterior implants were associated with greater MBL compared to straight (0°) angled abutments. Overall, patients reported high satisfaction with the immediate restoration, as reflected by the OHIP-14 and EQ-5D-5L scores.

Conclusions

Immediate restoration with full-arch implants yields excellent clinical outcomes and improves Oral Health-Related Quality of Life (OHRQoL). While bone levels tend to stabilize after 2 years, the high incidence of prosthetic complications underscores the critical need for rigorous long-term maintenance protocols.

Objectives

This study aimed to evaluate the effects of anti-resorptive drugs (ARD), including denosumab, on dental implant survival in post-menopausal women with osteoporosis, compared with those receiving non-ARD, and to identify risk factors associated with ARD that may influence implant outcomes.

Material and Methods

This retrospective cohort study examined 1694 implants placed in 806 women aged 55 years or older with at least of follow-up of 12 months. Implants were categorized according to exposure to anti-resorptive drugs (ARD), including bisphosphonates or denosumab, or assignment to a non-ARD control group. The assessed variables included demographic, ARD-related, implant/prosthesis-related factors, and marginal bone loss. Propensity score matching was used to balance group characteristics. Statistical analyses included Firth logistic regression with patient-level clustering and a linear mixed model for longitudinal bone changes. Kaplan–Meier curves were illustrated to describe implant survival trends among the groups.

Results

Implant survival rates were 99.13% (bisphosphonates), 98.08% (denosumab), and 98.24% (control), with no significant differences in implant failure or marginal bone loss between the groups. However, diabetes mellitus, alcohol consumption, and overdenture prosthesis were associated with a significantly increased risk of implant failure.

Conclusion

Implant-based prosthetic rehabilitation is also feasible in post-menopausal women receiving ARD for osteoporosis. Although the implant survival rate was comparable to non-ARD users, caution is advised for patients on high doses of ARD or undergoing long-term therapy due to their pharmacological effects compromising bone metabolism. Additionally, the risk of failure associated with invasive procedures needs to be further evaluated.

Objective

To investigate longitudinal occlusal alterations in implant-supported fixed prostheses (ISFPs) with light contact or non-light contact design and to analyze their clinical outcomes observed over a 5-year follow-up period.

Materials and Methods

This retrospective study categorized implants into two groups based on initial occlusal design: light occlusion group (12 μm articulating film removable at maximum intercuspal position [MIP] between ISFPs and opposing dentition) and non-light occlusion group (12 μm articulating film could not be removed). All participants were evaluated at 6–12 months, 1–3 years, and 3–5 years after ISFPs delivery. Occlusal patterns at MIP and during eccentric movements were monitored using articulating papers of different colors (blue/red) and thicknesses (12 μm/100 μm). Proximal contact loss rates, marginal bone loss, and technical complication rates were also evaluated.

Results

A total of 46 patients with 63 implants were included in this study. ISFPs in both groups exhibited rapid occlusal changes at MIP, characterized by reduced occlusal clearance, increased occlusal contact area, and stabilizing overtime regardless of initial design. Eccentric occlusion showed minimal alterations. Proximal contact loss rates, marginal bone loss, and technical complication rates revealed no significant intergroup differences. Multivariate regression analysis identified initial occlusal design, edentulous type, and implant systems as significant factors influencing the occlusal variation.

Conclusion

Light occlusion on ISFPs was not stable over time, and the occlusal status of ISFPs showed a similar development trend in both groups. Compared with non-light occlusion, the light contact design did not significantly affect the long-term success of ISFPs.

Trial Registration: This study was registered in a clinical trial registry (www.chictr.org.cn, no: ChiCTR2400080874)

Objective

Previous studies have identified an association between dental anxiety and pain perception; however, the nature of this relationship in the context of oral implant surgery, particularly with respect to pain perception across multiple time points, remains unclear. This study aimed to examine the association between dental anxiety and peak pain perception following oral implant surgery.

Methods

We conducted a prospective observational study involving 332 patients undergoing oral implant surgery. Pain perception was evaluated using a Visual Analogue Scale at five time points: preoperatively (T0), intraoperatively (T1), and at 6 h (T2), 24 h (T3), and 7 days postoperatively (T4). Dental anxiety was assessed with the Modified Dental Anxiety Scale. Logistic regression analysis was conducted to investigate the association between dental anxiety and peak pain perception. A generalized additive model was used to identify nonlinear associations, and a segmented logistic regression model was employed to identify break points.

Results

The mean score for pain perception increased from 0.26 ± 0.87 at T0 to 4.36 ± 1.70 at T2, then gradually decreased to 2.55 ± 1.34 at T3 and 0.55 ± 0.80 at T4, where T2 was the time point of peak pain intensity. Logistic regression analysis revealed that the odds ratio (OR) for the association between dental anxiety and pain perception was 1.38 (95% CI: 1.26, 1.53), indicating a 38% increase in the likelihood of pain perception for each one-unit increase in dental anxiety score. A nonlinear relationship was observed, with a break point identified at a dental anxiety score of 14.01. Below this threshold, the odds of pain perception increased substantially with increasing anxiety (OR = 1.51, 95% CI: 1.34, 1.69; p < 0.001). However, beyond this point, the level of anxiety was not associated with pain perception risk (OR = 0.91, 95% CI: 0.76, 1.07; p > 0.05).

Conclusion

A nonlinear relationship was observed between dental anxiety and pain perception following oral implant surgery. Even at subclinical levels, elevated anxiety was associated with an increased likelihood of pain perception. These findings highlight the importance of early identification and management of dental anxiety to improve postoperative pain control. Further research is warranted to evaluate the clinical utility of integrating anxiety assessment into preoperative care.

Objective

To identify the site-related, implant characteristic-related, prosthetic, and patient-related factors associated with marginal bone level around dental implant-supported fixed prostheses.

Materials and Methods

This cross-sectional study analyzed clinical and radiographic data obtained during maintenance visits. The interproximal radiographic bone levels were selected at the site showing the greatest bone loss. The implants were classified as having a bone level ≥ 2 mm (BL group) or < 2 mm (NBL group). Multivariate multilevel logistic regression was used to assess the association between multiple factors and bone level ≥ 2 mm.

Results

A total of 196 subjects with 404 implants were included, with a mean follow-up period of 5.21 years. Implementing multifactorial analysis, the results demonstrated that probing depth ≥ 6 mm (odds ratios [OR] 5.39; 95% confidence intervals [CI] 1.21–24.06; p = 0.027), absence of keratinized mucosa (OR 3.54; 95% CI 1.11–11.28; p = 0.033), presence of an implant abutment microgap (OR 2.82; 95% CI 1.12–7.12; p = 0.028), transmucosal height < 2 mm (OR 4.79; 95% CI 1.85–12.41; p = 0.001), and a history of periodontitis (OR 2.80; 95% CI 1.08–7.24; p = 0.034) exhibited a significantly higher risk of marginal bone level ≥ 2 mm.

Conclusion

Marginal bone level around implant-supported prostheses was influenced by the interplay of multiple factors consisting of deep probing depth, absence of keratinized mucosa, inadequate transmucosal height, microgap configuration, and history of periodontitis. These findings emphasized the need for comprehensive peri-implant assessment, which included monitoring probing depths and soft tissue quality. Additionally, it was crucial to ensure that prostheses were well-designed and had the appropriate transmucosal height. Patients with a history of periodontitis were advised to follow a strict maintenance program. Further prospective studies are needed to confirm the causality for ongoing investigation into the specific aspects and mechanisms involved.