Clinical Implant Dentistry and Related Research最新文献

Objective

To compare the clinical, radiographic, esthetic outcomes, and success and survival rates of dental implants placed after bone augmentation techniques.

Methods

This retrospective study included a total of 764 patients receiving 764 dental implants between 2009 and 2019. Four hundred implants were placed without bone augmentation (control), and 364 were placed after bone augmentation. Bone augmentation techniques were guided bone regeneration (GBR), ridge split, and onlay bone grafting. Gingival index (GI), plaque index (PI), probing depth (PD), bleeding on probing (BOP), pink esthetic score (PES) and marginal bone loss (mm) and area (mm²) were measured. The study variables of the implants among augmentation groups were compared statistically.

Results

The mean PI and GI scores, and BOP values of the implants in the augmentation and control groups were comparable (p = 0.365, p = 0.230, and p = 0.371 resp.) The mean PD scores of the implants were 2.82 ± 1.22 in the augmentation and 2.54 ± 1.29 in the control groups; the difference was significant (p = 0.002). The mean vertical bone loss of the implants was 0.78 ± 0.70 in augmentation and 0.82 ± 0.82 in the control groups, which was comparable (p = 0.461). The mean PES total values of the implants were 8.30 ± 1.55 in augmentation and 10.04 ± 2.43 in the control groups; the difference was significant (p < 0.001). There were no significant differences between the augmentation and control groups in implant survival (99.18% vs. 98%, p = 0.228) and success (82.97% vs. 85.50%, p = 0.389) rates. Significant differences in some study variables were observed among the augmentation groups. The survival and success rates of the implants in GBR (99.21% and 85.04%), ridge split (99.19% and 79.68%), onlay (99.12% and 84.21%), and control (98.00% and 85.50%) groups were similar (p = 0.630 and p = 0.479, resp.) in the 6-year mean follow-up.

Conclusion

The implants placed in augmented bone showed similar cumulative success and survival rates compared to implants placed in natural bone with a 6-year mean follow-up. The augmentation group showed lower esthetic scores. There are some differences in clinical parameters among augmentation groups; however, all the augmentation groups showed similar success and survival rates.

Objectives

Predicting implant stability preoperatively remains a challenge. Computed tomography (CT) based finite element (FE) simulations virtually evaluate the mechanical performance of the bone-implant construct. However, translation requires trustworthy simulations based on clinically relevant CT data. The aim of the present study was to evaluate the prediction accuracy of FE models created from cone-beam CT (CBCT) images against experimental results of primary implant stability in human bone specimens.

Material and Methods

Twenty-three dental implants were inserted into bone biopsies extracted from three cadaveric mandibles, and biomechanical testing was performed to determine the load-bearing capacity in a previous study. CBCT-based sample-specific homogenized FE (hFE) models were used to predict ultimate force. The accuracy of the CBCT-based hFE model predictions was compared to the experimental results and to previous μCT-based hFE models.

Results

The ultimate load predicted by the CBCT-based hFE models correlated well with the experimental one (R² = 0.66) and was a better estimator than the peri-implant CBCT-based bone density (R² = 0.39) or μCT-based bone volume fraction (R² = 0.57). Although the results of the two hFE models were strongly correlated (R² = 0.91), the μCT-based simulation better predicted the experiments (R² = 0.81).

Conclusion

By showing that CBCT-based hFE modeling can predict primary stability, this study represents an important step forward toward the clinical translatability of these numerical models as preoperative predictors of primary stability. Nevertheless, several challenges remain to be addressed, such as the lack of an accurate and quantitative way to calibrate CBCT images.

Introduction

The acquisition of digital impressions has become an integral part of clinical dentistry. The purpose of the present clinical simulation study was to evaluate the accuracy of digital impressions for maxillary full-arch implant-supported prostheses using two modern intraoral scanners with different acquisition technologies.

Material and Methods

Two models of edentulous maxilla, with six implants at positions #16,14,12,22,24,26 (FDI World Dental Federation System, ISO 3950) or #3,5,7,10,12,14 (Universal Numbering system) were digitally designed, and 3D-printed in resin material (Asiga DentaMODEL, Australia). In the first scenario, all implants were parallelized, while in the second, implants #12/#7 and #22/#10 had a 20° angulation buccally, while implants #16/#3 and #26/#14 20° angulation distally. The models were scanned with two different intraoral scanners, Trios3 (3Shape, Denmark) and CS3600 (Carestream Dental, USA). Linear (x, y, z axes—top point) and angular deviations (x, y, z axes—Δφ) were assessed. Statistical analysis was performed using Kolmogorov–Smirnov tests (significance at p < 0.05).

Results

Implant angulation showed a significant impact on accuracy, while the two scanners showed statistically significant differences. CS3600 demonstrated superior trueness, while Trios3 superior precision in both clinical scenarios. In the first clinical scenario a predominant occurrence of angular deviations was observed, while in the second scenario both angular and linear deviations were recorded. Scan body position also influenced scanning outcomes, with the last scan body captured demonstrating higher deviations.

Conclusion

Both scanners provided acceptable accuracy in the acquisition of digital impressions. Implant angulation and scan body position significantly affected trueness and precision. Clinicians should carefully consider implant angulations in full-arch implant restorations, as well as the scanning protocol.

Aim

To assess the impact of the timing of soft tissue augmentation on soft tissue changes and esthetic outcome following single immediate implant placement (IIP) in the anterior maxilla.

Materials and Methods

Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15–25) were enrolled in this RCT. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate soft tissue augmentation performed in the same surgical procedure—ISTA) or the test group (delayed soft tissue augmentation performed 3 months later—DSTA). Implants were placed with a surgical guide and immediately restored with an implant-supported provisional crown. Changes in soft tissue dimensions were assessed by a blinded clinician using superimposed STL files taken prior to surgery and at 1-year follow-up. The esthetic outcome was rated by a blinded clinician and the patient at 1-year follow-up. The study adhered to the STA-COSM (Soft Tissue Augmentation—Core Outcome Set and Measurements for implant dentistry trials) guidelines.

Results

Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). The mean change in buccal soft tissue profile was −0.251 and 0.083 mm for ISTA and DSTA, respectively. The mean difference of −0.318 mm in favor of DSTA was not significant (95% CI: −0.860 to 0.224, p = 0.241). Median midfacial recession was −0.200 and − 0.350 mm for ISTA and DSTA, respectively. The median difference of 0.200 mm in favor of ISTA was not significant (95% CI: −0.210 to 0.700, p = 0.311). Mesial and distal papillary recession, Pink Esthetic Score and patients' esthetic satisfaction failed to demonstrate a significant difference between the groups.

Conclusion

In patients with an intact buccal bone wall, the timing of soft tissue augmentation following IIP had no significant impact on soft tissue changes and esthetic outcome.

Trial Registration: ClinicalTrials.gov: NCT05537545

Purpose

To assess the effect of scanbody (SB)-type, edentulous site, and restoration-type on the scan quality of SBs used in the treatment of short-span edentulism.

Materials and Methods

The cohort consisted of SBs with different specifications connected to bone-level implants for intraoral digitalization in the fabrication of fixed restorations. SBs matched with library CAD files for digital implant position transfer into dental CAD software were enrolled in the study group. Intraoral implant digital records were categorically evaluated to assess the quality of SB scans. In statistical analyses, the chi-squared test was used to describe the clinical variables, and logistic regression models were constructed to reveal the association between the clinical variables and SB scan quality.

Results

A total of 243 SBs were eligible for scan quality evaluation. Scan quality did not differ statistically (p > 0.05) in the SB reference area, while texture in the representation of SB was significantly affected (p < 0.05) by the variables SB-type and edentulous-site. Cylindrically designed SBs without specific geometrical features presented remarkably higher risks for reduced scan quality in SB representation.

Conclusion

SBs successfully aligned with library CAD files based on a software algorithm may not consistently present similar scan quality. Intraoral scanning of a SB is highly vulnerable with regard to scan deterioration in texture and geometry.

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.