The cover image is based on the article Effects of sterilization and disinfection methods on digitally designed surgical implant guide accuracy: An in vitro study by Ruikun Li et al., https://doi.org/10.1111/cid.13350.
The cover image is based on the article Effects of sterilization and disinfection methods on digitally designed surgical implant guide accuracy: An in vitro study by Ruikun Li et al., https://doi.org/10.1111/cid.13350.
The effect of antiplatelet and anticoagulant medications on the outcomes of sinus floor augmentation remains unclear.
This retrospective cohort study analyzed data from electronic medical records of consecutive patients undergoing sinus floor augmentation at a single medical center. Patients were categorized into three categories: patients under antiplatelet medications, patients under anticoagulation medications, and healthy individuals. Data collected included tobacco smoking, residual alveolar bone height, timing of implant placement, materials used, vertical bone gain, early implant failure (EIF), and complications such as Schneiderian membrane perforation and postoperative bleeding. Multivariable analysis was performed to assess risk factors for EIF. Statistical significance was considered below 5%.
Among 110 patients with 305 implants, EIF occurred in 10% of patients and 4.65% of implants. No significant difference in postoperative bleeding or EIF was found between study groups. Univariate and multivariable analyses highlighted tobacco smoking (odds ratio [OR] = 7.92), lower residual alveolar ridge height (OR = 0.81), and staged implant placement (OR = 4.64) as significant EIF risk factors in this cohort.
Anticoagulant and antiplatelet therapies do not significantly elevate the risk of EIF or postoperative bleeding following sinus floor augmentation. Tobacco smoking, residual alveolar ridge height and staged sinus floor augmentation were risk factors for EIF in patients using antiplatelet or anticoagulation medications undergoing sinus floor augmentation.
The implant disease risk assessment (IDRA) tool was designed to assess an individual's risk of developing peri-implant diseases by evaluating and integrating multiple risk factors. This study aimed to evaluate the IDRA tool to determine the risk of developing peri-implant disease in patients rehabilitated with dental implants.
A retrospective observational cross-sectional study was conducted, collecting data from 92 patients with 92 selected dental implants. Data included the history of periodontitis, sites with bleeding on probing (BoP), teeth and/or implants with probing depths (PDs) ≥ 5 mm, alveolar bone loss relative to the patient's age, susceptibility to periodontitis, the frequency of supportive periodontal therapy (SPT), the distance from the restorative margin (RM) of the implant-supported prosthesis to the marginal bone crest (MBC), and factors related to the prosthesis itself. Additionally, the validated instrument periodontal risk assessment (PRA) was employed for comparison. Statistical analyses utilized Chi-square, Mann–Whitney, and ROC curve.
Outcomes indicated that 62 implants (67.4%) were classified as high-risk. Among the IDRA parameters, history of periodontitis was the primary factor contributing to an increased risk (p < 0.001). IDRA revealed high sensitivity (100%) and low specificity (63%) (AUC = 0.685; 95% CI: 0.554–0.816; p = 0.047), and there was a low agreement between the IDRA and PRA tools (Kappa = 0.123; p = 0.014). The peri-implant disease developed in 16 implants with 5.44 (±2.50) years of follow-up, however, no significant association was observed between the high- and low-medium risk groups and the occurrence of peri-implant diseases.
Most of the evaluated implants presented high IDRA risk. The IDRA tool exhibited high sensitivity and low specificity; no significant association was observed between the risk profile and the development of peri-implant diseases.
The alveolar ridge split (ARS) technique is a pivotal advancement in dental implantology, addressing the limitation of insufficient bone width for implant placement. This review traces the historical development of ARS from its initial conceptualization to current practices and future directions. Emphasizing the technique's development, indications, procedural overview, and osteotomy variations, we highlight its minimally invasive nature, which reduces patient morbidity and treatment time. This article reviews various osteotomy methods within ARS, examining their applications, benefits, and limitations. Furthermore, it discusses the technique's role in expanding treatment options for patients with compromised alveolar structures, underpinned by a high implant survival rate and the potential for immediate implant placement. We also cover the necessity of meticulous surgical technique, the importance of patient-specific factors, and the promising future of ARS facilitated by advancements in biomaterials and regenerative medicine. In summary, this review provides a comprehensive overview of ARS, offering valuable insights for dental professionals and informing future clinical practices and research in implantology.
This study aimed to systematically compare the patients undergoing lateral MSFA therapies utilizing bovine-originated xenografts versus varied synthetic bone grafting materials.
Pubmed, Scopus, Embase, and Cochrane Library were searched up to April 2023, compensated by a manual search in selected journals. Studies reporting histological outcomes (residual bone graft, newly formed bone, non-mineralized tissue) and clinical outcomes (implant survival, ISQ value) were included. Several analyses were performed, including meta-analysis, sensitivity study, and Egger's regression tests.
Sixteen clinical/randomized control trials were included in this systematic review, among which 12 were enrolled in a meta-analysis. The percentage of newly formed bone within the grafted sinuses by hybrid HA/TCP was significantly higher than those by xenografts (WMD 2.85, 95%CI [0.72; 4.99]), but those grafted by pure HA (WMD −1.72, 95%CI [−3.15; −0.29]) or TCP (WMD −7.10, 95%CI [−13.02; −1.17]) were significantly lower than xenograft counterparts. The residual bone graft and non-mineralized tissue yielded by synthetic HA, TCP, and HA/TCP showed no significant differences with the xenograft group.
The chemistry of grafted bone substitutes in lateral MSFA influenced the quantity of newly formed bone. Those grafted with hybrid HA/TCP yielded the highest amount of new bone compared to bovine-originated HA. However, this influence was not significant on residual bone graft and non-mineralized tissue.
The aim of this investigation was to evaluate the effect on clinical and radiological outcomes of the one-abutment, one-time protocol (test) versus placing the definitive abutment on the day of functional loading after having disconnected and connected three times the healing abutment during the prosthetic phase (control).
Forty patients with 80 implants were randomly allocated to either the test or the control group. Changes in the radiographic marginal bone levels (MBLs), clinical outcomes, prosthetic-related outcomes, and patient-reported outcomes measures (PROMs) were assessed and compared 6 and 12 months after functional loading.
Thirty-seven patients with 74 implants were followed at 12 months. A statistically significant bone remodeling was observed in both groups following implant placement. MBLs were significantly greater in the control group at the 6- (−0.13 mm vs. −0.61 mm) and 12-month visits (−0.01 mm vs. −0.53 mm). Bone loss was significantly greater in the control group from surgery to 6 and 12 months and from loading to 6 and 12 months. The abutment height was significantly greater in the test group, however, there were no significant differences in the restorative angle. Similarly, there were no statistically significant differences between groups for the measured clinical variables (probing depth, plaque, and bleeding index) and PROMs.
Disconnecting and reconnecting the healing abutment was associated with significantly higher bone loss after 12 months, as compared to the placement of the definitive abutment at implant installation.
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