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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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)
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.
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.
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).
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.
To identify the site-related, implant characteristic-related, prosthetic, and patient-related factors associated with marginal bone level around dental implant-supported fixed prostheses.
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.
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.
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.
This 3D analysis assessed the accuracy of zygomatic implant (ZI) placement using a static surgical guide in correlation with ZAGA classification and the rehabilitation type.
Pre-surgical CT scans were used to create a virtual surgical plane, exported as .stl files, and to define the ZAGA classification of each implant. A CT scan was taken 6 months post-surgery, and segmentation of the zygomatic implants was performed. The 3D analysis on 3DSlicer software compared planned and placed zygomatic implants, measuring linear and angular displacements at the apex and base of each model. Displacements were correlated with the ZAGA classification and the type of rehabilitation (if quad, twin, or mono zygomatic implant).
The study included 45 patients and 150 zygomatic implants, all placed using bone-supported surgical guides with no bone modifications. The implant survival rate was 100% at 6 months. Most patients received quad rehabilitation with 4 implants, and there was strong overlap between planned and placed implants. The mean surface displacement was 0.43 mm on the right and 0.45 mm on the left. The angular deviation between the planned and placed implant orientations was lower than 1° for both the anterior and posterior implants. According to ZAGA classification, surface displacement increased from class 0 to 4. No significant differences were found among the type of rehabilitation (p > 0.289).
The study highlights the accuracy of fully guided surgery for zygomatic implant placement, recommending its consideration in clinical decision-making. It also shows greater accuracy in lower ZAGA classes and no significant difference across rehabilitation types.
Perforation is the most common complication of sinus floor elevation (SFE) surgery, and is closely associated with the thickness of the maxillary sinus membrane. This study aimed to evaluate the relationship between maxillary sinus membrane thickness and anatomical variations in the osteomeatal complex (OMC).
Cone beam computed tomography scans were retrospectively analyzed, encompassing 1957 sinuses. Mucosal thickness (MT) and mucosal appearance (MA) were classified as normal, flat thickening, polypoid thickening, or ostium obstruction. Ostium width (OW), infundibulum length (IL), and ethmoidal bulla diameter (EBD) were measured. The presence of Haller cells (HC), concha bullosa (CB), and superior attachment of the uncinate process (UPSA) was recorded. Kruskal–Wallis, Mann–Whitney U, Chi-square, and GEE models were used.
Mucosal thickening was observed in 54% of the sinuses, with flat thickening (23.5%) being the most prevalent pattern. A significant association was found between ostium obstruction and MT greater than 10 mm. MT, IL, OW, and EBD values were significantly higher in men than in women. Significant correlations were also identified between MT and IL, OW, EBD, and HC. No significant relationship was found between CB and MT. However, UPSA types 3, 4, and 6 were significantly associated with polypoid thickening and ostium obstruction.
The findings demonstrate that anatomical variations in the OMC influence maxillary sinus membrane thickness. A comprehensive evaluation of these variations should be performed before planning for SFE procedures. Dentists should be proficient in identifying and assessing the osteomeatal region during routine radiographic examinations to prevent potential complications.
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