Clinical Implant Dentistry and Related Research最新文献_第2页

Maxillary sinus lift augmentation: A randomized clinical trial with histological data comparing deproteinized bovine bone grafting vs graftless procedure with a 5–12-year follow-up 上颌窦提升增量术：一项包含组织学数据的随机临床试验，比较了去蛋白牛骨移植与无移植手术，并进行了 5-12 年的随访。

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-07-09 DOI: 10.1111/cid.13359

Daniela Carmagnola DDS, PhD, Alberto Pispero DDS, PhD, Gaia Pellegrini DDS, PhD, Samuele Sutera DDS, PhD, Dolaji Henin DDS, PhD, Giovanni Lodi DDS, PhD, Antonio Achilli DDS, Claudia Dellavia DDS, PhD

Introduction

Different protocols and procedures for sinus lift and implant placement are available, generally involving the use of grafts to increase the tissue volume and/or prevent the Schneiderian membrane from collapsing. Among xenografts, deproteinised bovine bone graft (DBBP) is frequently used in sinus lift procedures. Leaving an ungrafted space following membrane elevation has proven to have a bony regenerative potential as well. This study aimed to compare the clinical and histological features of sinus lift surgery performed with or without biomaterials.

Methods

Patients with severe maxillary posterior atrophy (residual bone height 2–6 mm and residual crest thickness ≥4 mm), and in need of sinus lift surgery to allow the placement of three implants were enrolled and randomly divided into two groups. They underwent sinus lifts with DBBP (control) or with a graftless technique (test) and immediate placement of two implants (a mesial and distal one). After 6 months, a bone sample was retrieved from the area between the previously inserted fixtures, and a third, central implant was placed. The collected bone samples were analyzed morphologically and histomorphometrically. The patients were provided with prosthetic restorations after 6 months and followed up for 5–12 years.

Results

Ten patients were enrolled in the test and nine in the control group. The 6-month follow-up showed in the control group an average augmentation of 10.31 mm (±2.12), while in the test group it was 8.5 mm (±1.41) and a success rate of 96.3% in the control and 86.7% in the test group (p > 0.05). The histological analysis evidenced the presence of new bone tissue surrounded by immature osteoid matrix in the test group, and a variable number of DBBP particles surrounded by an immature woven bone matrix in the control group.

Conclusion

The results of the present trial indicate that, with residual bone height of 2–6 mm and residual crest thickness ≥4 mm, sinus lift surgery with or without biomaterials followed by implant restoration, produces similar clinical and histological outcomes.

简介：上颌窦提升术和种植体植入术有不同的方案和程序，一般都需要使用移植物来增加组织体积和/或防止施奈德膜塌陷。在异种移植物中，脱蛋白牛骨移植物（DBBP）经常用于上颌窦提升术。事实证明，在抬高骨膜后留下未移植的空间也具有骨再生的潜力。本研究旨在比较使用或不使用生物材料进行上颌窦提升手术的临床和组织学特征：方法：研究人员选取了上颌后部严重萎缩（残余骨高度为 2-6 毫米，残余嵴厚度≥4 毫米）、需要进行上颌窦提升手术以植入三颗种植体的患者，并将其随机分为两组。他们分别接受了 DBBP（对照组）或无移植技术（试验组）的上颌窦提升术，并立即植入了两颗种植体（中侧和远侧）。6 个月后，从先前植入的固定装置之间的区域采集骨样本，并植入第三个中心种植体。对采集的骨样本进行了形态学和组织形态计量学分析。6 个月后为患者提供修复体，并随访 5-12 年：试验组有 10 名患者，对照组有 9 名患者。6 个月的随访结果显示，对照组的平均增量为 10.31 毫米（±2.12），而试验组为 8.5 毫米（±1.41），对照组的成功率为 96.3%，试验组为 86.7%（P > 0.05）。组织学分析表明，试验组存在由未成熟骨基质包围的新骨组织，而对照组存在由未成熟编织骨基质包围的不同数量的 DBBP 颗粒：本试验结果表明，在残余骨高度为 2-6 毫米、残余嵴厚度≥4 毫米的情况下，使用或不使用生物材料进行上颌窦提升手术，然后进行种植修复，都能产生相似的临床和组织学结果。

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引用次数: 0

Accuracy of navigation guided implant surgery for immediate loading complete arch restorations: Prospective clinical trial 导航引导下的种植手术对即刻装载全牙弓修复体的准确性：前瞻性临床试验。

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-07-05 DOI: 10.1111/cid.13360

Alessandro Pozzi, Paolo Carosi, Andrea Laureti, Nikos Mattheos, Atiphan Pimkhaokham, James Chow, Lorenzo Arcuri

Objectives

To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.

Materials and Methods

Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05.

Results

Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation.

Conclusions

Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.

目的评估全牙弓种植体植入的导航准确性，并立即加载数字化预制临时材料：在 2020 年 12 月至 2022 年 1 月期间，对至少需要一颗全牙弓 FDP 的无牙和末牙患者进行连续治疗。通过叠加术前和术后锥形束计算机断层扫描（CBCT）、记录线性（毫米）和角度（度）偏差来评估准确性。进行了T检验，以研究注册算法（基于靶标与无靶标）、无靶标算法的参考类型（牙齿与骨螺钉）、部位特征（愈合后与拔牙后）、种植体角度（轴向与倾斜）、牙弓类型（上颌与下颌）对准确性的潜在影响，P值为结果：25 名患者、36 个完整牙弓和 161 个种植体被植入。总体平均角度偏差为 2.19°（标准偏差为 1.26°）。总体平台和顶点平均偏差分别为 1.17 毫米（标准差 0.57 毫米）和 1.30 毫米（标准差 0.62 毫米）。只有在愈合后和拔牙后的部位才会出现有意义的整体平台（p = 0.0009）和根尖（p = 0.0109）偏差。没有一个分析变量对角度偏差有明显影响。颌骨类型（种植体平台和顶点的 y 轴）、配准算法（y 轴平台和 z 轴偏差）以及无靶标算法的参照类型都会导致轻微的单轴偏差。与种植体角度有关的差异没有统计学意义：在研究限制范围内，使用即刻加载数字预制 FDP 进行全牙弓种植体植入时，导航是可靠的。人工智能驱动的表面解剖学识别和校准协议使无靶标注册与有靶标注册一样准确，牙齿和骨螺钉是相同的参照物。种植部位特征是唯一具有统计学意义的变量，与拔牙后相比，愈合部位的准确性更高。无论种植体角度和颌骨类型如何，实时跟踪导航手术都能提高操作者的表现和准确性。应考虑约1毫米和2°的平均安全空间。

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引用次数: 0

Artificial intelligence and mixed reality for dental implant planning: A technical note 人工智能和混合现实技术用于牙科植入规划：技术说明。

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-06-28 DOI: 10.1111/cid.13357

Francesco Guido Mangano, Kyung Ran Yang, Henriette Lerner, Oleg Admakin, Carlo Mangano

Aim

The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).

Methods

This protocol involves the acquisition of three-dimensional (3D) patient data through intraoral scanning (IOS) and cone beam computed tomography (CBCT). These data are loaded into AI software which automatically segments and aligns the patient's 3D models. These 3D models are loaded into MR software and used for planning implant surgery through holography. The files are then exported and used to design surgical guides via open-source software, which are 3D printed and used to prepare the implant sites through static computer-assisted implant surgery (s-CAIS). The case is finalized prosthetically through a fully digital protocol. The accuracy of implant positioning is verified by comparing the planned position with the actual position of the implants after surgery.

Results

As a proof of principle, the present protocol seems to be to be reliable and efficient when used for planning simple cases of s-CAIS in partially edentulous patients. The clinician can plan the implants in an authentic 3D environment without using any radiology-guided surgery software. The precision of implant placement seems clinically acceptable, with minor deviations.

Conclusions

The present study suggests that AI and MR technologies can be successfully used in s-CAIS for an authentic 3D planning. Further clinical studies are needed to validate this protocol.

目的：这项工作旨在提出一种新的种植手术规划方案，该方案涉及人工智能（AI）和混合现实（MR）的结合使用：该方案包括通过口内扫描（IOS）和锥形束计算机断层扫描（CBCT）获取患者的三维（3D）数据。这些数据被载入人工智能软件，该软件会自动分割和对齐患者的三维模型。这些三维模型被载入磁共振软件，通过全息成像技术用于规划种植手术。然后将文件导出，通过开源软件设计手术导板，并通过静态计算机辅助种植手术（s-CAIS）将导板三维打印出来，用于准备种植部位。病例最终通过全数字化方案完成修复。通过比较计划位置和术后种植体的实际位置，验证种植体定位的准确性：结果：作为一项原理验证，本方案用于规划部分无牙颌患者的简单 s-CAIS 病例时，似乎既可靠又高效。临床医生可以在真实的三维环境中规划种植体，而无需使用任何放射学引导的手术软件。种植体植入的精确度在临床上似乎是可以接受的，只有轻微的偏差：本研究表明，人工智能和磁共振技术可成功用于 s-CAIS 的真实三维规划。还需要进一步的临床研究来验证这一方案。

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引用次数: 0

Volumetric assessment of volume stable collagen matrix in maxillary single implant site development: A randomized controlled clinical trial 上颌单种植体部位开发中体积稳定胶原基质的体积评估：随机对照临床试验

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-06-27 DOI: 10.1111/cid.13353

Ahmed Hamdy, Suzan Seif Allah Ibrahim, Dalia Ghalwash, Doaa Adel-Khattab

Introduction

The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume stable collagen matrix (VCMX) versus connective tissue graft (CTG) in the augmentation of soft tissue profiles in single implant sites with a class I Siebert ridge defect.

Materials and Methods

Twenty patients (14 females and 6 males) were enrolled in the present study. After implant placement and augmentation of the buccal defect by VCMX or CTG, post-operative evaluation of the volumetric changes at the augmented implant site was carried out at 3, 6, and 9 months as primary outcome, clinical and radiographic soft tissue thickness were carried out at baseline and 9-month intervals, visual analog scale (VAS) and oral health impact profile-14 (OHIP14) were recorded 2 weeks after the surgery.

Results

A statistically significant difference in soft tissue volume was found between baseline and 3, 6, and 9 months postoperatively in both groups with the highest value at 9 months (136.33 ± 86.80) (mm³) in VCMX and (186.38 ± 57.52) (mm³) in CTG. Soft tissue thickness was significantly increased in both groups at 9 months in comparison to baseline. However, there was a significantly higher increase in soft tissue thickness at 9 months in CTG (3.87 ± 0.91) than in VCMX (2.94 ± 0.31). Regarding the radiographic soft tissue thickness, there was a statistically significant increase in both groups at 9 months in comparison to baseline. However, there was a statistically higher increase in the radiographic soft tissue thickness at 9 months in CTG (3.08 ± 0.97) than in VCMX (2.37 ± 0.29). VAS showed a statistically lower value in VCMX (0.4 ± 0.7) than CTG (2.8 ± 1.48). The OHIP recorded lower values in the VCMX group than the CTG group with no statistical significance. In addition, there was no difference in the PES between the two groups.

Conclusion

The present study showed that CTG and VCMX were both effective in soft tissue augmentation around implants in the esthetic zone. However, CTG proved more efficient in increasing peri-implant soft tissue volume and mucosal thickness around single implants at a 9-month follow-up period. VCMX was associated with less pain or discomfort and reduced patient morbidity, as reflected by the significantly reduced VAS value in the VCMX group.

简介牙科种植体周围软组织体积的稳定性是最终美学效果的一个重要因素。本研究的主要目的是比较体积稳定胶原基质（VCMX）和结缔组织移植（CTG）在I类Siebert脊缺损的单颗种植体软组织增量中的效果：本研究共招募了 20 名患者（14 名女性和 6 名男性）。在植入种植体并使用 VCMX 或 CTG 增量颊面缺损后，术后 3、6 和 9 个月对增量种植体部位的体积变化进行评估，作为主要结果；在基线和 9 个月间隔期对软组织厚度进行临床和影像学评估；术后 2 周记录视觉模拟量表（VAS）和口腔健康影响档案-14（OHIP14）：两组患者的软组织体积在基线与术后 3、6 和 9 个月之间均存在统计学差异，其中 VCMX 患者在 9 个月时的软组织体积值最高（136.33 ± 86.80）（立方毫米），CTG 患者在 9 个月时的软组织体积值最高（186.38 ± 57.52）（立方毫米）。与基线相比，两组患者在 9 个月时的软组织厚度均有明显增加。但 CTG 组软组织厚度在 9 个月时的增加幅度（3.87 ± 0.91）明显高于 VCMX 组（2.94 ± 0.31）。在放射学软组织厚度方面，与基线相比，两组患者在 9 个月时的软组织厚度均有统计学意义上的显著增加。然而，与 VCMX（2.37 ± 0.29）相比，CTG（3.08 ± 0.97）的软组织厚度在 9 个月时有了统计学意义上的增加。据统计，VCMX 的 VAS 值（0.4 ± 0.7）低于 CTG（2.8 ± 1.48）。VCMX 组的 OHIP 值低于 CTG 组，但无统计学意义。此外，两组之间的 PES 没有差异：本研究表明，CTG 和 VCMX 在美学区种植体周围软组织增量方面都很有效。但在 9 个月的随访中，CTG 在增加单个种植体周围软组织体积和粘膜厚度方面更有效。VCMX 组的 VAS 值显著降低，这反映出 VCMX 带来的疼痛或不适更少，患者的发病率也更低。

{"title":"Volumetric assessment of volume stable collagen matrix in maxillary single implant site development: A randomized controlled clinical trial","authors":"Ahmed Hamdy, Suzan Seif Allah Ibrahim, Dalia Ghalwash, Doaa Adel-Khattab","doi":"10.1111/cid.13353","DOIUrl":"10.1111/cid.13353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume stable collagen matrix (VCMX) versus connective tissue graft (CTG) in the augmentation of soft tissue profiles in single implant sites with a class I Siebert ridge defect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Twenty patients (14 females and 6 males) were enrolled in the present study. After implant placement and augmentation of the buccal defect by VCMX or CTG, post-operative evaluation of the volumetric changes at the augmented implant site was carried out at 3, 6, and 9 months as primary outcome, clinical and radiographic soft tissue thickness were carried out at baseline and 9-month intervals, visual analog scale (VAS) and oral health impact profile-14 (OHIP14) were recorded 2 weeks after the surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A statistically significant difference in soft tissue volume was found between baseline and 3, 6, and 9 months postoperatively in both groups with the highest value at 9 months (136.33 ± 86.80) (mm<sup>3</sup>) in VCMX and (186.38 ± 57.52) (mm<sup>3</sup>) in CTG. Soft tissue thickness was significantly increased in both groups at 9 months in comparison to baseline. However, there was a significantly higher increase in soft tissue thickness at 9 months in CTG (3.87 ± 0.91) than in VCMX (2.94 ± 0.31). Regarding the radiographic soft tissue thickness, there was a statistically significant increase in both groups at 9 months in comparison to baseline. However, there was a statistically higher increase in the radiographic soft tissue thickness at 9 months in CTG (3.08 ± 0.97) than in VCMX (2.37 ± 0.29). VAS showed a statistically lower value in VCMX (0.4 ± 0.7) than CTG (2.8 ± 1.48). The OHIP recorded lower values in the VCMX group than the CTG group with no statistical significance. In addition, there was no difference in the PES between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study showed that CTG and VCMX were both effective in soft tissue augmentation around implants in the esthetic zone. However, CTG proved more efficient in increasing peri-implant soft tissue volume and mucosal thickness around single implants at a 9-month follow-up period. VCMX was associated with less pain or discomfort and reduced patient morbidity, as reflected by the significantly reduced VAS value in the VCMX group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"26 5","pages":"930-941"},"PeriodicalIF":3.7,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accuracy of immediately placed implants using surgical guides from different 3-dimensional printers: An in vitro study 使用来自不同三维打印机的手术导板即时植入种植体的准确性：体外研究

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-06-26 DOI: 10.1111/cid.13354

Jeremy Pitman, Jan Cosyn, Véronique Christiaens, Faris Younes, Thomas de Bruyckere, Stijn Vervaeke, Maarten Glibert

Aim

The aim of this study was to evaluate the accuracy of 3-dimensional (3D)-printed surgical guides for fully guided immediate implants from different manufacturers.

Methods

Eighteen 3D printed fully guided surgical guides (split into 3 groups [n = 6] according to their manufacturer: Company, Desktop, or Lab), were used to place 72 implants (n = 24) in identical maxillary models. After placement, the mean global, angular, mesiodistal, buccopalatal, and vertical deviation at the platform and apex of the placed implants, relative to their preoperatively planned positions, was calculated.

Results

Significant differences in global apex deviation, angular deviation, mesiodistal apex deviation, and vertical platform and apex deviation were found between the Lab and Desktop groups (p ≤ 0.007). Significant differences in mesiodistal platform and apex deviation and buccopalatal apex deviation were also found between the Company and Desktop groups (p ≤ 0.005). Finally, significant differences in buccopalatal apex deviation, and vertical platform and apex deviation were found between the Company and Lab groups (p ≤ 0.003). Mean differences between guide groups across all parameters never exceeded 0.5 mm or 1°.

Conclusions

The choice of 3D printer has a significant effect on the accuracy of fully guided immediate implants. However, the clinical relevance of these differences may be considered limited.

目的：本研究旨在评估不同制造商生产的用于全引导即刻种植体的三维（3D）打印手术导板的准确性：方法：18 个三维打印全引导手术导板（根据其制造商分为 3 组 [n = 6]：公司、桌面或实验室）：公司、桌面或实验室），在相同的上颌模型中植入 72 个种植体（n = 24）。植入后，计算植入种植体的平台和顶点相对于术前计划位置的平均整体偏差、角度偏差、中轴偏差、颊腭偏差和垂直偏差：结果：实验室组和桌面组之间在整体顶点偏差、角度偏差、中碘顶点偏差以及垂直平台和顶点偏差方面存在显著差异（P ≤ 0.007）。公司组和桌面组之间在齿间平台和顶偏差以及颊腭顶偏差方面也存在显著差异（p ≤ 0.005）。最后，公司组和实验室组在颊腭顶偏差、垂直平台和顶偏差方面存在明显差异（p ≤ 0.003）。导板组之间所有参数的平均差异从未超过 0.5 毫米或 1°：结论：三维打印机的选择对全引导即刻种植体的准确性有显著影响。结论：三维打印机的选择对全引导即刻种植体的精确度有显著影响，但这些差异的临床意义可能有限。

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引用次数: 0

Impact of peri-implant keratinized mucosa width on the long-term reconstructive outcomes of peri-implantitis: A retrospective analysis with a follow-up up to 10 years 种植体周围角化粘膜宽度对种植体周围炎长期重建效果的影响：随访长达 10 年的回顾性分析。

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-06-24 DOI: 10.1111/cid.13358

Sila Cagri Isler DDS, PhD, Fatma Soysal DDS, Seher Tunc DDS, PhD, Özlem Kaymaz PhD, Berrin Unsal DDS, PhD, Andrea Roccuzzo Dr. med. dent, MAS, PhD

Purpose

To investigate the effect of mid-buccal peri-implant keratinized mucosa width (KMW) ≥2 mm or peri-implant KMW >0 mm and <2 mm on the long-term outcomes of peri-implantitis reconstructive treatment.

Materials and Methods

Twenty-nine patients (40 implants; mean follow-up: 9.2 ± 1.4 years) with at least one implant affected by peri-implantitis and surgically treated through a reconstructive procedure followed by a submerged healing were included. Patients were categorized according to their initial KMW: Group 1 (KMW ≥2 mm) and Group 2 (KMW >0 mm and <2 mm). Peri-implant clinical and radiographic parameters and a dedicated composite outcome were assessed at different follow-up visits during supportive peri-implant therapy for up to 10 years. Regression analyses were utilized to identify possible risk/predictive indicators for probing pocket depth (PPD) change and treatment success at the latest follow-up.

Results

The mean PPD did not exhibit any statistical difference from the baseline to the latest follow-up between the groups at both patient and implant levels. Long-term treatment success was 46.6% (Group 1) and 42.6% (Group 2) at patient level, it was 42.8% (Group 1) and 33.3% (Group 2), respectively, at implant level (p > 0.05). Group 1 demonstrated significantly higher vertical defect depth reduction than Group 2 (p = 0.018). Presence of buccal bony wall and mean PPD at the baseline were found to be associated with mean PPD change, while KMW at 6 months following surgery was identified as the only significant indicator for treatment success (p < 0.05).

Conclusion

Implants with KMW ≥2 mm did not present significantly better long-term clinical outcomes following reconstructive therapy than those exhibiting KMW >0 mm and <2 mm. However, KMW values at the end of healing phase following a submerged approach had a significant impact on long-term treatment success.

目的：研究中颊面种植体周围角化粘膜宽度（KMW）≥2 毫米或种植体周围角化粘膜宽度>0 毫米对材料和方法的影响：29 例患者（40 个种植体；平均随访时间：9.2 ± 1.4 年）至少有一个种植体受到种植体周围炎的影响，并通过重建手术进行了治疗，随后进行了潜行愈合。根据患者的初始KMW进行分类：第1组（KMW≥2 mm）和第2组（KMW>0 mm）：从基线到最近一次随访，两组患者和种植体的平均 PPD 均无统计学差异。患者层面的长期治疗成功率分别为 46.6%（第一组）和 42.6%（第二组），种植体层面的长期治疗成功率分别为 42.8%（第一组）和 33.3%（第二组）（P > 0.05）。第一组的垂直缺损深度明显高于第二组（p = 0.018）。发现颊骨壁的存在和基线时的平均 PPD 与平均 PPD 的变化有关，而术后 6 个月时的 KMW 被认为是治疗成功的唯一重要指标（p 结论：KMW ≥ 0.05 的种植体比 KMW ≥ 0.05 的种植体更容易获得成功，而 KMW ≥ 0.05 的种植体比 KMW ≥ 0.05 的种植体更容易获得成功：KMW≥2毫米的种植体与KMW>0毫米和KMW≥2毫米的种植体相比，在重建治疗后的长期临床效果并没有明显的改善。

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引用次数: 0

Randomized split-mouth clinical trial comparing osteoblastic activity and osteogenic potential of autogenous particle harvesting during implant surgery without irrigation and with irrigation 随机分口临床试验：比较种植手术中自体颗粒采集的成骨细胞活性和成骨潜力（无灌洗和有灌洗）。

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-06-23 DOI: 10.1111/cid.13355

Fabio Camacho-Alonso DDS, PhD, Ana María Mercado-Díaz DDS, PhD, Rebeca Rivas-Ballester DDS, Juan Carlos Bernabeu-Mira DDS, David Peñarrocha-Oltra DDS, PhD, María del Rosario Tudela-Mulero BS, PhD

Objective

To compare the osteoblastic activity and osteogenic potential of autogenous particle harvesting during implant surgery using low-speed drilling without irrigation and high-speed drilling with irrigation.

Materials and Methods

Thirty patients with bilateral missing teeth of 3.6 and 4.6 were randomized into two groups (Group 1: low-speed drilling without irrigation and Group 2: high-speed drilling with irrigation) and 60 single dental implants were placed. The temperature at the tip of each drill was recorded and the harvested bone was weighed; particle size and Ca and P levels were also analyzed. After osteoblast culture, cell viability, cell cycle assay, cell migration, vascular endothelial growth factor (VEGF) concentration, and mineralized nodule formation were assessed.

Results

Although the temperature of the drills was slightly higher in Group 1, no statistically significant differences were observed (p ≤ 0.05); however, the amount of harvested bone was higher (p < 0.001) and the size of the particles was higher (p = 0.019). In relation to osteoblastic activity and osteogenic potential, higher cell proliferation, higher number of cells in G2/M and S phases, higher cell migration capacity, higher VEGF concentration, and higher amount of mineralized nodule formation were observed in Group 1.

Conclusions

Low-speed drilling without irrigation does not result in a significant increase in bone temperature compared to conventional drilling. However, a greater amount of bone is obtained; in addition, osteoblastic activity and osteogenic potential are higher with this technique, but further clinical studies are necessary.

目的比较在种植手术中使用低速钻孔（不灌水）和高速钻孔（灌水）采集自体颗粒的成骨细胞活性和成骨潜能：将30名双侧3.6和4.6缺失牙患者随机分为两组（第1组：无灌洗低速钻孔和第2组：灌洗高速钻孔），植入60颗单颗种植体。记录每个钻头顶端的温度并对采集的骨进行称重，同时分析颗粒大小、Ca 和 P 含量。成骨细胞培养后，对细胞活力、细胞周期测定、细胞迁移、血管内皮生长因子（VEGF）浓度和矿化结节形成进行了评估：结果：虽然第 1 组的钻孔温度略高，但没有观察到统计学上的显著差异（p ≤ 0.05）；不过，收获的骨量更高（p 结论：第 1 组的钻孔温度略高，但收获的骨量更高（p ≤ 0.05）：与传统钻孔相比，不灌洗的低速钻孔不会导致骨温显著升高。但获得的骨量更大；此外，这种技术的成骨细胞活性和成骨潜能更高，但还需要进一步的临床研究。

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引用次数: 0

Progressive bone loss and bleeding on probing: A cohort study 渐进性骨质流失和探针出血：一项队列研究。

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-06-23 DOI: 10.1111/cid.13356

Ausra Ramanauskaite DDS, Dr. Med. Dent., PhD, Ninad Padhye DDS, Sandra Kallab Dr. Med. Dent, Iulia Dahmer PhD, Amira Begic Dr. Med. Dent, Stefanie Tiede DDS, Frank Schwarz Prof., DDS, Dr. Med. Dent

Aim

To investigate whether a progressive marginal bone loss (PMBL) occurring beyond the initial bone remodeling (IBR) is linked with bleeding on probing.

Materials and Methods

A total of 70 partially edentulous patients exhibiting 112 two-piece bone-level implants were included in this retrospective study. Panoramic radiographs were obtained after implant insertion (T0), after delivery of a final prosthetic restoration (T1) and subsequently during the 1-(T2), 5-(T3), 10-(T4), and 15-years (T5) follow-up visits. At each time point, radiographic marginal bone levels were assessed from the implant shoulder to the first bone-to-implant contact at mesial and distal aspects. The IBR was defined as a bone loss occurring up to prosthesis delivery, that is, from T0 to T1. The PMBL was defined as bone loss occurring after T1. At T2, T3, T4, and T5, the presence or absence of bleeding on probing (BOP) was recorded at four sites. A median regression with mixed models was performed to assess the difference of PMBL in PMBL + BOP⁺ and PBML + BOP⁻ groups.

Results

Over the mean implant functioning time of 4.44 ± 4.91 years, 38 (34%) implants showed no PBML, whereas 74 (66%) implants featured PMBL. Of these, 35 (47%) and 39 (53%) implants were assigned to the PMBL + BOP⁻ and PMBL + BOP⁺ groups, respectively. The mean PMBL after 1, 5, 10, and 15 years were comparable between implants featuring PMBL with or without BOP. At 1 year, BOP intensity significantly correlated PMBL, with each increase in one BOP-positive site being associated with increase in PMBL by 0.55 mm (p = 0.038), whereas this association was not found at 5, 10, and 15 years. The IBR values in the no PBML, PMBL + BOP⁺, and PBML + BOP⁻ groups were −0.24 ± 0.31, −0.41 ± 0.59, and −0.24 ± 0.33 mm, respectively, with no significant differences found among the groups.

Conclusion

Progressive bone loss at implant sites is not always linked with bleeding on probing.

目的：研究在初始骨重塑（IBR）后出现的渐进性边缘骨缺损（PMBL）是否与探诊出血有关：这项回顾性研究共纳入了 70 名部分缺牙患者，他们共植入了 112 颗两件式骨水平种植体。在种植体植入后（T0）、最终修复体交付后（T1）以及随后的 1 年（T2）、5 年（T3）、10 年（T4）和 15 年（T5）随访期间分别拍摄了全景照片。在每个时间点，都会对从种植体肩部到种植体中、远端第一次骨与种植体接触处的边缘骨水平进行放射学评估。IBR 被定义为假体植入前发生的骨质流失，即从 T0 到 T1。PMBL 被定义为 T1 之后发生的骨质流失。在T2、T3、T4和T5，记录四个部位是否有探诊出血（BOP）。采用混合模型进行中位回归，以评估 PMBL + BOP+ 组和 PBML + BOP- 组中 PMBL 的差异：在平均 4.44 ± 4.91 年的种植体功能时间内，38 个（34%）种植体没有出现 PBML，而 74 个（66%）种植体出现了 PMBL。其中，35 个（47%）和 39 个（53%）种植体分别被分配到 PMBL + BOP- 组和 PMBL + BOP+ 组。1年、5年、10年和15年后的平均PMBL值在使用或不使用BOP的植入物之间具有可比性。1 年时，BOP 强度与 PMBL 显著相关，BOP 阳性部位每增加一个，PMBL 就会增加 0.55 mm（p = 0.038），而在 5、10 和 15 年时，则没有发现这种关联。无 PBML 组、PMBL + BOP+ 组和 PBML + BOP- 组的 IBR 值分别为 -0.24 ± 0.31、-0.41 ± 0.59 和 -0.24 ± 0.33 mm，各组间无显著差异：结论：种植部位的骨质逐渐流失并不总是与探诊出血有关。

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引用次数: 0

Histomorphometric and microtomographic analysis of maxillary sinus augmentation surgeries with and without collagen membrane on the lateral window: A randomized clinical trial 上颌窦侧窗有胶原膜和无胶原膜隆鼻手术的组织形态计量学和显微断层扫描分析：随机临床试验

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-06-21 DOI: 10.1111/cid.13331

Ramiro Beato Souza DDS, MDSc, PhD, Haimon Diniz Lopes Alves DDS, MDSc, PhD, Luciano Santos Oliveira DDS, MDSc, PhD, Fabio Ramoa Pires DDS, MDSc, PhD, Guaracilei Maciel Vidigal Jr DDS, MDSc, PhD, Ricardo Guimaraes Fischer MD, DDS, MDSc, PhD

Objective

To evaluate the histomorphometric and computerized microtomographic (Micro-CT) analysis of the regenerated bone tissue from maxillary sinus augmentation surgery, with and without using the collagen membrane on the external osteotomy window.

Materials and Methods

Twelve patients were selected for this prospective, controlled, and randomized study. The patients were submitted to bilateral maxillary sinus surgery in a split-mouth design. On the test side, the maxillary sinus augmentation procedure included using Geistlich Bio-Oss® and a Geistlich Bio-Gide® collagen membrane covering the lateral osteotomy window. On the control side, only Geistlich Bio-Oss® was used without the presence of the membrane. After 6 months, the surgeries for implant installation were performed. In this surgical phase, specimens of the regenerated tissue were collected for histological and Micro-CT analysis.

Results

In the histomorphometric evaluation, the mean (±SD) percentages of newly formed bone were 43.9% (±11.5) and 40.8% (±8.9) in the test and control groups, respectively. The corresponding values of the Micro-CT analysis were 36.6% (±3.4) and 37.2% (±4.7) in the test and control groups, respectively. There was no statistically significant difference between the test and control groups in the two methods. In addition, there was no statistically significant difference between the mean percentage of biomaterial remaining between the test and control groups. However, the mean percentage of newly formed bone was significantly higher and the mean percentage of remaining biomaterial was significantly lower in the histomorphometric analysis compared to the values obtained through microtomography.

Conclusion

The additional use of collagen membranes in maxillary sinus surgery does not offer advantages in newly formed bone.

材料和方法这项前瞻性、对照和随机研究选择了 12 名患者。患者采用分口设计接受双侧上颌窦手术。在试验侧，上颌窦增量手术包括使用 Geistlich Bio-Oss® 和覆盖侧截骨窗的 Geistlich Bio-Gide® 胶原膜。对照组只使用 Geistlich Bio-Oss®，不使用薄膜。6 个月后，进行种植体安装手术。结果在组织形态学评估中，试验组和对照组新形成骨的平均百分比（±SD）分别为 43.9%（±11.5）和 40.8%（±8.9）。在 Micro-CT 分析中，试验组和对照组的相应数值分别为 36.6%（±3.4）和 37.2%（±4.7）。试验组和对照组在两种方法上的差异无统计学意义。此外，试验组和对照组剩余生物材料的平均百分比也没有明显的统计学差异。然而，与通过显微断层扫描获得的数值相比，组织形态计量分析中新形成骨的平均百分比明显更高，而剩余生物材料的平均百分比则明显更低。

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引用次数: 0

3D evaluation of sagittal inclination of the maxillary dentition in relation to facial landmarks: A cohort study 上颌牙齿矢状倾角与面部地标的关系的三维评估：一项队列研究。

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2024-06-12 DOI: 10.1111/cid.13351

Basel El-Sabbagh, Kathrin Seidel DMD, Babak Sayahpour DMD, Jan-Frederik Güth DMD, PhD

<div> <section> <h3> Background</h3> <p>The determination of the maxillary occlusal plane presents a significant clinical challenge in the treatment of edentulous patients as well as it is critical for complex full-mouth reconstructions in dentate patients, including those with implant-supported rehabilitations. While the use of a Fox plane plate is standard in edentulous cases, its application in dentate patients lacks thorough documentation in existing literature.</p> </section> <section> <h3> Purpose</h3> <p>This clinical study assessed the sagittal position of the maxillary dentition in relation to facial landmarks using a digital three-dimensional analysis and evaluated the suitability and reliability of applying a simulated Fox plane plate, also known as an occlusal plane guide, in dentate patients.</p> </section> <section> <h3> Materials and Methods</h3> <p>Eighty-one subjects were recruited at the Department of Prosthetic Dentistry of Goethe University Frankfurt, Germany, according to specific inclusion criteria. Intraoral and facial scans were obtained and analyzed using GOM Inspect Pro software (GOM, Braunschweig, Germany). The angles between the maxillary occlusal plane and three variations each of Camper's plane and ala-tragus line, relating to superior, middle, and inferior tragus points, were measured. These modified planes were then compared to a plane established by a simulated digital Fox plane plate, which was adapted to the maxillary anterior teeth and the lowest point of the posterior teeth in both quadrants.</p> </section> <section> <h3> Results</h3> <p>A total of 81 subjects (58 female and 23 male) with a mean age of 23.9 years were evaluated in this study. No significant angular difference was found between the angles of the maxillary occlusal plane compared with superior Camper's plane, middle Camper's plane, or superior ala-tragus line (<i>p</i> >0.05). The smallest angle occurred between superior Camper's plane and the maxillary occlusal plane on both the right (3.443°) and left (3.535°) sides. The application of a Fox plane plate resulted in two different occlusal planes in 70% of patients, significantly deviating from the digitally determined plane (<i>p</i> <0.05).</p> </section> <section> <h3> Conclusion</h3> <p>Superior and middle Camper's planes, along with superior ala-tragus line, can be considered approximately parallel reference planes and are suitable for routine determining of the maxillary occlusal plane

背景：上颌咬合平面的确定是无牙颌患者治疗中的一个重大临床挑战，同时也是有牙患者复杂全口重建的关键，包括那些接受种植体支持修复的患者。目的：这项临床研究使用数字三维分析评估了上颌牙体与面部地标的矢状位置关系，并评估了在无牙颌患者中使用模拟福克斯平面板（也称为咬合平面引导板）的适宜性和可靠性：根据特定的纳入标准，在德国法兰克福歌德大学修复牙科系招募了 81 名受试者。使用 GOM Inspect Pro 软件（GOM，德国布伦瑞克）获取口内和面部扫描结果并进行分析。测量了上颌咬合平面与坎珀平面和腭嵴线各三个变体之间的角度，分别与上、中、下腭嵴点有关。然后将这些修改后的平面与模拟数字福克斯平面板建立的平面进行比较，该平面与上颌前牙和两个象限后牙的最低点相适应：本研究共评估了 81 名受试者（58 名女性和 23 名男性），他们的平均年龄为 23.9 岁。上颌咬合面的角度与上康氏面、中康氏面或上腭嵴线的角度相比没有发现明显的角度差异（P>0.05）。右侧（3.443°）和左侧（3.535°）康帕上平面与上颌咬合平面之间的角度最小。70% 的患者在使用 Fox 平面板后会出现两个不同的咬合平面，与数字确定的平面有明显偏差（p 结论：Fox 平面板与数字确定的咬合平面有明显偏差：上、中Camper平面以及上ala-ragus线可视为近似平行的参考平面，适用于修复治疗中上颌咬合平面的常规确定。然而，与数字评估方法相比，在牙质较好的患者中应用福克斯平面板的变异性很大，这表明由于其在上颌牙体上的定位不明确，其可重复性很低。临床试验注册网站：https://drks.de/search/de/trial/DRKS00030166。

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引用次数: 0