Clinical Implant Dentistry and Related Research最新文献

Objectives

The necessity of a second molar region implant for Kennedy Class II classification of unilateral partially edentulous arches remains controversial. This study aims to compare the effects of implant treatment in the first and second molar regions, providing a basis for planning implant treatments for Kennedy Class II dentition.

Methods

This prospective cohort study included 16 patients with implant therapy up to the first molar and 16 patients treated up to the second molar. Bite force, masticatory function, oral health-related quality of life (OHRQoL), and food and nutrient intakes were evaluated as outcomes.

Results

While the two groups showed improvements in occlusal force and masticatory function with implant treatment, the increase was significantly greater with implant treatment extending to the second molar. The improvement in OHRQoL was comparable between both groups. Furthermore, the increases in vegetable, dietary fiber, and vitamin K intakes were significantly greater in the implant treatment group extending to the second molar.

Conclusion

From the perspective of OHRQoL, implant treatment up to the first molar may be sufficient.

Objective

In this update of a previous systematic review, we compared the effects of surgical and non-surgical treatments for peri-implantitis through the component network meta-analysis (CNMA) with probing depth (PD) reduction as the outcome.

Materials and Methods

Literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials, and Embase databases from August 2010 to June 2023. Randomized controlled trials (RCTs), comparing non-surgical or surgical treatments for peri-implantitis with 6–12 months of follow-up and reported changes in PD, were included. Treatment effects were assessed using a CNMA model based on additivity assumption. We calculated the intraclass correlation coefficient (ICC) to adjust the standard errors for multiple implants within the same patient.

Results

Our systematic review identified 44 RCTs, which included 46 treatment regimens consisting of 15 components. These RCTs formed a disconnected network consisting of 11 subnetworks. Surgical treatments with bone grafts and membranes generally attained greater PD reduction than non-surgical treatments, although bone grafts and membranes as components provided moderate benefits. The effect size of antibiotics is greater in non-surgical than surgical treatments, while there is considerable uncertainty regarding the effect size of implantoplasty. Additionally, the effectiveness of components varied between surgical and non-surgical treatments.

Conclusion

Current evidence does not yield sufficiently robust estimates for identifying optimal surgical and non-surgical treatment regimens for peri-implantitis, so the findings of our study should be interpreted cautiously. A coordinated strategy is required for designing future trials to fill the gaps in our current knowledge and develop more reliable recommendations.

Introduction

The aim of this study was to evaluate perfusion parameters and clinical features of healthy implants and implants affected by peri-implant disease in patients who had undergone microvascular jaw reconstruction.

Methods

A total of 25 patients with 92 implants placed in microvascular transplants were included. Of these, 68 implants showed healthy peri-implant tissue, 12 were affected by peri-implant mucositis, and 12 were diagnosed with peri-implantitis. Peri-implant perfusion was measured mesially and distally at the implant shoulder using laser Doppler flowmetry and tissue spectrophotometry (LDF-TS), followed by a clinical evaluation, including measurement of probing depths, bleeding on probing (BOP), plaque index, biotype, type of implant, the restoration and the presence of keratinized tissue. Perfusion parameters were compared between the healthy implants and the implants with peri-implant disease based on the conventional BOP–based diagnosis of peri-implantitis, and the associations between the perfusion values and clinical measurements were analyzed. Optimal cut-off values for predicting peri-implantitis were calculated with receiver operating characteristics.

Results

The mean relative amount of hemoglobin and mean blood flow were significantly different between healthy implants and implants with peri-implant mucositis and peri-implantitis (p = 0.003 and p = 0.002, respectively). However, there are interindividual differences that appear to influence blood flow values as well. When a linear mixed regression model was applied, including the patient as a random variable, the difference in blood flow was no longer statistically significant (p = 0.400). Still, the optimal cut-off value of mean blood flow for predicting peri-implantitis was determined to be > 46.5 AU (AUC = 0.788; p < 0.001; CI = 0.695–0.881; sensitivity = 1.00, specificity = 0.60).

Conclusion

Implants in microvascular flaps are particularly vulnerable to peri-implant disease. Risk factors are the lack of keratinized peri-implant tissue, fixed restorations, bone-level implants, and high plaque levels.

As a noninvasive and objective method, LDF-TS can contribute to risk assessment by evaluating perfusion parameters and help detect the early onset of peri-implant disease.

Background

Dental crowns have surface pollutants after their manufacturing. We know that these pollutants can be a source of peri-implant inflammation for some cases. This study aimed to compare two dental crowns cleaning methods that are simple and quick to apply in the dental lab.

Objectives

To characterize qualitatively and quantitatively the pollution of transmucosal parts of zirconia monolithic crowns after supra-mucosal glazing in the lab and to compare the efficacy of steam versus ultrasonic cleaning protocols.

Material and Methods

Eighteen customized zirconia monolithic crowns were divided into two groups of 9 crowns receiving a different cleaning protocol. The first group was treated with steam cleaning, whereas the second group was initially rubbed with a sterile compress soaked in a detergent and then cleaned in three successive ultrasonic baths containing a detergent, sterile water, and 70% ethanol. The presence and nature of the contaminants were investigated by BSE-SEM and energy-dispersive X-ray spectroscopy microanalysis.

Results

Organic (e.g., paint, sweat) and inorganic (e.g., zirconia fragments, silica, and metals) were identified on the surface of the zirconia crown before the cleaning treatments. At baseline, pollutants cover 0.51% ± 0.26% of the total area. This percentage dropped, respectively, to 0.02% ± 0.03% after steam cleaning (p < 0.0001) and to 0.02% ± 0.01 after the ultrasonic cleaning protocol (p = 0.0026). No difference was observed between the two decontamination techniques (p > 0.9999), but the variance in the steam group was higher compared to the ultrasound group (p = 0.0042).

Conclusions

Both protocols allowed the cleaning of the transmucosal parts of the zirconia crowns to an extent of 99.98% of the studied surface. However, the ultrasound technique displayed less variability in the removal of residual pollutants and therefore should be preferred.

Objectives

Vitamin D has been reported to be crucial for bone mineralization and to play a significant role in immune and inflammatory responses. Its deficiency has been stated to be highly prevalent and might alter osseointegration of dental implants. Successful osseointegration has been claimed to be a critical aspect of implant survival and the effects of vitamin D on implant osseointegration have not been well documented. This study aimed to evaluate bone markers and cytokine levels of patients with or without vitamin D insufficiency.

Material and Methods

A total of 42 patients were included and divided into two groups: vitamin D insufficient (Group IN-S; n = 21) and vitamin D sufficient (Group S; n = 21). Besides clinical periodontal parameters and implant stability measurements, the levels of RANKL, OPG, osteocalcin (OC), calcium (Ca), tumor necrosis factor alpha (TNF-α), IL-1β, caspase-1 (CASP1), and IL-10 in bone biopsy from implant preparation sockets and peri-implant crevicular fluid (PICF) were determined by enzyme-linked immunosorbent assay (ELISA). The results were represented as concentration and total amount.

Results

PICF RANKL levels (both concentration and total amount) were higher in patients with Vitamin D insufficiency compared to sufficient controls (p < 0.05). Concentration and total amount of IL-10 were significantly lower in vitamin D insufficient participants than those of vitamin D sufficient group (p < 0.05). No differences were detected between the groups in terms of other parameters. Bone levels of all evaluated parameters also did not differ between the groups (p > 0.05).

Conclusion

It may be concluded that a low serum level of vitamin D may affect peri-implant health through altering IL-10 and RANKL.

Background

This retrospective study aimed to assess the impact of maxillary and mandibular autogenous bone grafts on maxillary bone height in patients who underwent maxillary sinus floor elevation (MSFE).

Methods

The study involved 92 patients, divided into two groups: 37 patients receiving maxillary bone grafts for MSFE and 55 patients receiving mandibular bone grafts for MSFE. Bone height after MSFE was measured on panoramic radiographs up to 60 months postoperatively, comparing different positions and situations.

Results

In general, both maxillary and mandibular bone grafts resulted in an increase in bone height directly after the MSFE procedure, followed by a bone height loss over time, with no significant differences between the two groups for gap and free-end positions. However, at distal to implant positions, mandibular bone grafts showed less bone loss. Despite gradual bone height loss, all implants remained covered with bone without exposure or subsequent loss, indicating a successful MSFE procedure.

Conclusion

This radiologic study showed that over a long-term period there is a similar bone height pattern at dental implant sites and sites distal to implants when maxillary or mandibular bone grafts are used in MSFE.

Introduction

This retrospective study aimed to evaluate peri-implant marginal bone loss (MBL) and prosthetic complications between two types of locator attachments in two implant-supported mandibular overdentures.

Material and Method

From the archived records, information about patients who had two implants inserted utilizing two different types of locator attachments into the interforaminal region between November 2019 and December 2023 was obtained. Overall, 60 patients (Total = 120 implants) from the archive records of the Prosthodontics Department, Faculty of Dentistry, Mansoura University, with ages ranging from 40 to 60 (mean age 50), were included in the study. Group I (control): Overall, 30 patients who would be delivered mandibular implant overdenture using conventional locator attachments. Group II (study): Overall, 30 patients who would be delivered mandibular implant overdenture using RTx locator attachments. After the placement of the mandibular overdenture (T0), 6 months (T6), 12 months (T12), and 3 years (T3) later, the marginal bone loss (MBL) was assessed. Prosthetic complications were evaluated for both groups 3 years after prosthetic delivery.

Result

A statistically significant increase (p = 0.000) was found in MBL scores at all observation times between both groups. Group II showed a statistical increase in MBL than Group I. For prosthetic complications, no significant difference was found between both groups. Group II showed more matrix wear than Group I however, it was not statistically significant (p = 0.60).

Conclusion

Within the limitation of this study, we can conclude the following: Both types of locator attachment (conventional and RTx locator) can be used clinically with no preference concerning the frequency of prosthetic complications. From the MBL perspective, conventional locators are more favorable than RTx locators.

Introduction

This is a comprehensive, long-term follow-up study of single-implant treatments. At the Brånemark Clinic in Gothenburg, Sweden, during the period of 1982–1985, 16 patients received single-tooth implants.

Objective

This study evaluates the survival rate of the implants after nearly four decades, focusing on the biological and technical complications.

Methods

Of the original 16 patients with a total of 23 implants, 13 patients with 18 implants were available for the follow-up and were included in the study. Clinical and radiographic examinations were performed on these patients.

Results

The cumulative survival rates were 95.6% for the implants and 60.9% for the implant-supported crowns after 38–40 years in function. The marginal bone level changes were 0.9 ± 1.0 mm (range, −0.5─3.0 mm) over the follow-up period.

The frequency of biological complications was low; although mucositis was common, no cases of peri-implantitis were observed. The mean plaque index was 16.9% ± 11.6% (range, 1%─34%) and the mean probing depth around the implants was 3.8 ± 2.2 mm (range, 0.0─7.0 mm). Few technical complications were observed, although many of the original implant-supported crowns had been replaced for esthetic reasons.

Conclusion

The findings emphasize the importance of long-term follow-up in implant dentistry, particularly for younger patients, to improve understanding of potential complications and the longevity of treatment outcomes. Overall, single-tooth implants have a favorable long-term prognosis, though crown replacement may eventually be necessary.

Objective

Maxillary sinus mucosal cysts represent prevalent oral and maxillofacial diseases, and their precise diagnosis is essential for surgical planning in maxillary sinus floor elevation. This study aimed to develop a deep learning-based pipeline for the classification of maxillary sinus lesions in cone beam computed tomography (CBCT) images to provide auxiliary support for clinical diagnosis.

Methods

This study utilized 45 136 maxillary sinus images from CBCT scans of 541 patients. A cascade network was designed, comprising a semi-supervised maxillary sinus area object detection module and a maxillary sinus lesions classification module. The object detection module employed a semi-supervised pseudo-labelling training strategy to expand the maxillary sinus annotation dataset. In the classification module, the performance of Convolutional Neural Network and Transformer architectures was compared for maxillary sinus mucosal lesion classification. The object detection and classification modules were evaluated using metrics including Accuracy, Precision, Recall, F1 score, and Average Precision, with the object detection module additionally assessed using Precision-Recall Curve.

Results

The fully supervised pseudo-label generation model achieved an average accuracy of 0.9433, while the semi-supervised maxillary sinus detection model attained 0.9403. ResNet-50 outperformed in classification, with accuracies of 0.9836 (sagittal) and 0.9797 (coronal). Grad-CAM visualization confirmed accurate focus on clinically relevant lesion features.

Conclusion

The proposed pipeline achieves high-precision detection and classification of maxillary sinus mucosal lesions, reducing manual annotation while maintaining accuracy.