Gabriel Guerra David Reis, Ricardo Júnior Denardi, Sergio Luís Scombatti de Souza, Pedro Henrique Felix Silva, Flávia Furlaneto, Richard J. Miron, Carlos Fernando Mourão, Michel Reis Messora
Objective
To evaluate the effects of maxillary sinus augmentation (MSA) using deproteinized bovine bone material (DBBM) combined with or without platelet-rich fibrin obtained by horizontal centrifugation (H-PRF) after a short healing period of 4 months.
Materials and Methods
Thirteen patients underwent bilateral two-stage MSA using a split-mouth model. Each side was randomly assigned to receive DBBM alone (control group) or DBBM + H-PRF (test group). Bone tissue samples were harvested 4 months after implant placement and evaluated using microcomputed tomography (micro-CT), as well as histological and histomorphometric analyses. Data were statistically analyzed using paired t-tests (Wilcoxon signed-rank test; p < 0.05).
Results
Histomorphometric analysis demonstrated higher amounts (p < 0.05) of newly formed bone in the DBBM + H-PRF group compared to the control group (51.33% ± 6.17% versus 45.68% ± 6.65%, respectively). Micro-CT also revealed significantly higher bone volume (30.38% ± 11.24% and 21.38% ± 9.83%, respectively) and connectivity density (4485 ± 1469 and 2562 ± 1271, respectively) in the DBBM + H-PRF group than in the DBBM-alone group (p < 0.05).
Conclusions
Compared with DBBM alone, maxillary sinuses augmented with H-PRF combined with DBBM exhibited improved qualitative and quantitative new bone formation after 4 months of healing. However, the effects on the long-term survival and early stability of dental implants remain unknown and warrant further investigation with long-term follow-up.
{"title":"Sinus Floor Elevation With Platelet-Rich Fibrin From Horizontal Centrifugation and Xenograft: Randomized Clinical Trial","authors":"Gabriel Guerra David Reis, Ricardo Júnior Denardi, Sergio Luís Scombatti de Souza, Pedro Henrique Felix Silva, Flávia Furlaneto, Richard J. Miron, Carlos Fernando Mourão, Michel Reis Messora","doi":"10.1111/cid.70093","DOIUrl":"10.1111/cid.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effects of maxillary sinus augmentation (MSA) using deproteinized bovine bone material (DBBM) combined with or without platelet-rich fibrin obtained by horizontal centrifugation (H-PRF) after a short healing period of 4 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Thirteen patients underwent bilateral two-stage MSA using a split-mouth model. Each side was randomly assigned to receive DBBM alone (control group) or DBBM + H-PRF (test group). Bone tissue samples were harvested 4 months after implant placement and evaluated using microcomputed tomography (micro-CT), as well as histological and histomorphometric analyses. Data were statistically analyzed using paired <i>t</i>-tests (Wilcoxon signed-rank test; <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histomorphometric analysis demonstrated higher amounts (<i>p</i> < 0.05) of newly formed bone in the DBBM + H-PRF group compared to the control group (51.33% ± 6.17% versus 45.68% ± 6.65%, respectively). Micro-CT also revealed significantly higher bone volume (30.38% ± 11.24% and 21.38% ± 9.83%, respectively) and connectivity density (4485 ± 1469 and 2562 ± 1271, respectively) in the DBBM + H-PRF group than in the DBBM-alone group (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with DBBM alone, maxillary sinuses augmented with H-PRF combined with DBBM exhibited improved qualitative and quantitative new bone formation after 4 months of healing. However, the effects on the long-term survival and early stability of dental implants remain unknown and warrant further investigation with long-term follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Berceste Guler Ayyildiz, Halil Ayyildiz, Tolga Fikret Tözüm
Introduction
The objective of the present study was to determine the emergence angle (EA) values and emergence profiles (EP) for single-unit fixed prosthetic restorations at the bone level, placed in different locations, and to evaluate their effect on radiographic marginal bone loss.
Methods
The study included 226 patients (mean age 63.61 ± 14.9 years), and 500 single-unit dental implants were analyzed in three implant localizations: molar, premolar, and anterior. Patient-related factors, implant length and diameter, implant brand, abutment retention type, implant placement time, prosthetic delivery loading type, prosthetic suprastructure type, and duration of prosthetic delivery time—from implant placement to long-term prosthetic functional loading—were recorded. Radiographically, EA, EP, marginal bone level changes (ΔMBL) at mesial and distal aspects were calculated. Receiver operating characteristic (ROC) curve analysis was employed to determine the cut-off point for all implant locations. Binary logistic regression analysis was utilized to identify confounding factors affecting MBL.
Results
The cut-off value of mesial EA was determined for molar, premolar, and anterior regions as 36.422°, 29.703°, and 25.12°, respectively. An increase in the duration of prosthetic delivery time, by every 1 month, the probability of MBL risk was 1.072 times higher. (OR: 1.072; CI: 1.009–1.139; p = 0.025) For the premolar localization variable, the OR value was determined as 2.381, and this indicated that the probability of bone loss in premolar implants is 2.381 times higher than in molar implants. Finally, the OR value of the anterior localization variable was obtained as 3.655, and this value indicated that the probability of bone loss in anterior implants is 3.655 times higher than in molar implants.
Conclusions
The findings of this study indicate that ΔMBL can be evaluated over a range of EA values. It can be stated that as the duration of prosthetic delivery time increases following the surgical placement of dental implants, the risk of marginal bone loss also increases.
本研究的目的是确定在骨水平放置不同位置的单单元固定假体修复体的涌现角（EA）值和涌现剖面（EP），并评估其对放射学边缘骨丢失的影响。方法：226例患者（平均年龄63.61±14.9岁），对500个单单元种植体在臼齿、前臼齿和前臼齿三个种植体定位中进行分析。记录患者相关因素：种植体长度和直径、种植体品牌、基台保持类型、种植体放置时间、假体运送载荷类型、假体上部结构类型、假体运送时间——从种植体放置到长期假体功能负荷。x线摄影，计算EA， EP，中、远端边缘骨水平变化（ΔMBL）。采用受试者工作特征（ROC）曲线分析确定所有种植体位置的分界点。采用二元logistic回归分析确定影响MBL的混杂因素。结果：磨牙区、前磨牙区、前磨牙区近缘EA切点值分别为36.422°、29.703°、25.12°。植入假体的时间每增加1个月，发生MBL风险的概率增加1.072倍。（OR: 1.072; CI: 1.009-1.139; p = 0.025）对于前磨牙定位变量，OR值为2.381，表明前磨牙种植体发生骨丢失的概率是磨牙种植体的2.381倍。最后得到前牙定位变量的OR值为3.655，该值表明前牙种植体发生骨丢失的概率是磨牙种植体的3.655倍。结论：本研究结果表明ΔMBL可以在EA值范围内进行评估。可以这样说，随着牙种植体手术植入后假体交付时间的增加，边缘骨质流失的风险也增加。
{"title":"Correlation of Implant Location to Marginal Bone Level Changes in Single-Unit Restorations: A Retrospective Study","authors":"Berceste Guler Ayyildiz, Halil Ayyildiz, Tolga Fikret Tözüm","doi":"10.1111/cid.70092","DOIUrl":"10.1111/cid.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The objective of the present study was to determine the emergence angle (EA) values and emergence profiles (EP) for single-unit fixed prosthetic restorations at the bone level, placed in different locations, and to evaluate their effect on radiographic marginal bone loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 226 patients (mean age 63.61 ± 14.9 years), and 500 single-unit dental implants were analyzed in three implant localizations: molar, premolar, and anterior. Patient-related factors, implant length and diameter, implant brand, abutment retention type, implant placement time, prosthetic delivery loading type, prosthetic suprastructure type, and duration of prosthetic delivery time—from implant placement to long-term prosthetic functional loading—were recorded. Radiographically, EA, EP, marginal bone level changes (ΔMBL) at mesial and distal aspects were calculated. Receiver operating characteristic (ROC) curve analysis was employed to determine the cut-off point for all implant locations. Binary logistic regression analysis was utilized to identify confounding factors affecting MBL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cut-off value of mesial EA was determined for molar, premolar, and anterior regions as 36.422°, 29.703°, and 25.12°, respectively. An increase in the duration of prosthetic delivery time, by every 1 month, the probability of MBL risk was 1.072 times higher. (OR: 1.072; CI: 1.009–1.139; <i>p</i> = 0.025) For the premolar localization variable, the OR value was determined as 2.381, and this indicated that the probability of bone loss in premolar implants is 2.381 times higher than in molar implants. Finally, the OR value of the anterior localization variable was obtained as 3.655, and this value indicated that the probability of bone loss in anterior implants is 3.655 times higher than in molar implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study indicate that ΔMBL can be evaluated over a range of EA values. It can be stated that as the duration of prosthetic delivery time increases following the surgical placement of dental implants, the risk of marginal bone loss also increases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194122","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}
Alec Scott Griffin, Aaron John Miller, Mark Richards Durham, Layne Clair Brown, Guo Wei, Gregory J. Stoddard, Sujee Jeyapalina
Introduction
While numerous studies have examined overall dental implant failure, only a few have focused on the distinct risk factors associated with early (within 6 months of post-implantation) and late (after 6 months of post-implantation) failures, especially in the veteran population. Consequently, understanding the nuances of early and late DIFs specific to veterans is necessary to improve clinical decision-making and enhance VA dental surgeons' ability to mitigate failure risks.
Methods
Electronic health records (EHRs) were obtained between January 1, 2000, and December 1, 2021, for veteran patients aged 18 years or older and those who received a dental implant. Univariable analysis was initially conducted to identify significant risk factors, which were subsequently controlled for in multivariable analysis. A mixed-effect logistic regression model was then used to estimate the odds ratio of early/late failures. The intra-class correlation coefficient (ICC) was calculated using a mixed-effects model to assess the proportion of variance attributable to patient-level clustering.
Results
A total of 132 675 US veterans with 468 496 dental implants were included in the multivariable models. Within this cohort, 13 492 failures were reported in 9423 unique veterans, resulting in a 7.1% failure rate over 21 years. Adjusted odds ratios indicated that being 70 years or older at the time of implant placement, Asian race, having osteoporosis, and undergoing reimplantation were significantly associated with increased odds of early implant failure. In contrast, patients aged 40–60 years at the time of placement, African American race, active periodontitis, and alendronate use were associated with increased odds of late implant failure. The ICC of 86% calculated for the cohort indicated a high level of patient-level clustering.
Conclusion
Veterans with active periodontitis and those using Alendronate exhibited markedly increased odds—approximately 139% and 114% respectively—for late implant failures. Conversely, veterans aged 70 years or older and those undergoing reimplantation had 257% and 89% increased odds respectively in the early failure cohort. The high ICC value for this cohort indicated that the outcome of implant placement was strongly influenced by the patients' prior history of implant failure or success.
{"title":"Insights Into Early and Late Dental Implant Failures in Veterans—A Retrospective Cohort Analysis","authors":"Alec Scott Griffin, Aaron John Miller, Mark Richards Durham, Layne Clair Brown, Guo Wei, Gregory J. Stoddard, Sujee Jeyapalina","doi":"10.1111/cid.70091","DOIUrl":"10.1111/cid.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>While numerous studies have examined overall dental implant failure, only a few have focused on the distinct risk factors associated with early (within 6 months of post-implantation) and late (after 6 months of post-implantation) failures, especially in the veteran population. Consequently, understanding the nuances of early and late DIFs specific to veterans is necessary to improve clinical decision-making and enhance VA dental surgeons' ability to mitigate failure risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electronic health records (EHRs) were obtained between January 1, 2000, and December 1, 2021, for veteran patients aged 18 years or older and those who received a dental implant. Univariable analysis was initially conducted to identify significant risk factors, which were subsequently controlled for in multivariable analysis. A mixed-effect logistic regression model was then used to estimate the odds ratio of early/late failures. The intra-class correlation coefficient (ICC) was calculated using a mixed-effects model to assess the proportion of variance attributable to patient-level clustering.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 132 675 US veterans with 468 496 dental implants were included in the multivariable models. Within this cohort, 13 492 failures were reported in 9423 unique veterans, resulting in a 7.1% failure rate over 21 years. Adjusted odds ratios indicated that being 70 years or older at the time of implant placement, Asian race, having osteoporosis, and undergoing reimplantation were significantly associated with increased odds of early implant failure. In contrast, patients aged 40–60 years at the time of placement, African American race, active periodontitis, and alendronate use were associated with increased odds of late implant failure. The ICC of 86% calculated for the cohort indicated a high level of patient-level clustering.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Veterans with active periodontitis and those using Alendronate exhibited markedly increased odds—approximately 139% and 114% respectively—for late implant failures. Conversely, veterans aged 70 years or older and those undergoing reimplantation had 257% and 89% increased odds respectively in the early failure cohort. The high ICC value for this cohort indicated that the outcome of implant placement was strongly influenced by the patients' prior history of implant failure or success.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076926","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}
Veronika Pohl, Robert Haas, Rebecca Rosen, Nikolaus Fürhauser, Sebastian Pohl
Objective
This randomized controlled trial aimed to evaluate the impact of early versus delayed change of abutment on bone levels, soft tissue, and patient satisfaction with single-tooth immediate implants.
Material and Methods
In 26 patients, flapless immediate implants were placed in the anterior maxillary region (13–23). Postoperatively, all patients received a resin abutment with an emergence profile identical to that of the extracted tooth and were provided with a provisional resin crown. Based on the provisional abutment, a custom digital copy abutment made of zirconium with a titanium adapter was manufactured. The patients were randomized into two groups: the test group received the definitive zirconia abutment after 4 days, while the control group had the abutment changed after 3 months. In both groups, the definitive ceramic crowns were inserted 3 months post-surgery. The primary study outcome was the marginal bone level after 1 year, with peri-implant soft tissue (PES/Pink Esthetic Score) and oral-health-related quality of life (OHIP/Oral Health Impact Profile) defined as secondary parameters.
Results
No statistically significant differences for initial bone level remodeling or later bone loss were found between both groups after 1 year. Two prosthetic complications (one per group) required abutment replacement, but no implant failures occurred. Mean marginal bone levels were 0.71 ± 0.95 mm (mesial: 0.55 ± 0.97 mm, distal: 0.86 ± 1.07 mm) in the test group and 0.22 ± 0.93 mm (mesial: 0.15 ± 1.10 mm, distal: 0.30 ± 0.89 mm) in the control group. The Pink Esthetic Score (PES) was 11.9 ± 1.6 in the test group and 10.62 ± 2.87 in the control group (p = 0.39), showing no significant difference in esthetic outcomes. The Oral Health Impact Profile (OHIP) score at 6 months was also not statistically significant for both groups.
Conclusion
In immediate implants in the anterior maxilla, the timing of definitive zirconia abutment placement (4 days versus after 3 months) did not result in any statistically significant differences in peri-implant bone level, peri-implant esthetics, or patient-related quality of life.
{"title":"Effect of Final Abutment Timing on Immediate Implant Success in Anterior Maxilla: A Randomized Controlled Trial","authors":"Veronika Pohl, Robert Haas, Rebecca Rosen, Nikolaus Fürhauser, Sebastian Pohl","doi":"10.1111/cid.70088","DOIUrl":"10.1111/cid.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This randomized controlled trial aimed to evaluate the impact of early versus delayed change of abutment on bone levels, soft tissue, and patient satisfaction with single-tooth immediate implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>In 26 patients, flapless immediate implants were placed in the anterior maxillary region (13–23). Postoperatively, all patients received a resin abutment with an emergence profile identical to that of the extracted tooth and were provided with a provisional resin crown. Based on the provisional abutment, a custom digital copy abutment made of zirconium with a titanium adapter was manufactured. The patients were randomized into two groups: the test group received the definitive zirconia abutment after 4 days, while the control group had the abutment changed after 3 months. In both groups, the definitive ceramic crowns were inserted 3 months post-surgery. The primary study outcome was the marginal bone level after 1 year, with peri-implant soft tissue (PES/Pink Esthetic Score) and oral-health-related quality of life (OHIP/Oral Health Impact Profile) defined as secondary parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No statistically significant differences for initial bone level remodeling or later bone loss were found between both groups after 1 year. Two prosthetic complications (one per group) required abutment replacement, but no implant failures occurred. Mean marginal bone levels were 0.71 ± 0.95 mm (mesial: 0.55 ± 0.97 mm, distal: 0.86 ± 1.07 mm) in the test group and 0.22 ± 0.93 mm (mesial: 0.15 ± 1.10 mm, distal: 0.30 ± 0.89 mm) in the control group. The Pink Esthetic Score (PES) was 11.9 ± 1.6 in the test group and 10.62 ± 2.87 in the control group (<i>p</i> = 0.39), showing no significant difference in esthetic outcomes. The Oral Health Impact Profile (OHIP) score at 6 months was also not statistically significant for both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In immediate implants in the anterior maxilla, the timing of definitive zirconia abutment placement (4 days versus after 3 months) did not result in any statistically significant differences in peri-implant bone level, peri-implant esthetics, or patient-related quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071377","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}
Qingwei Tang, Linhong Wang, Yude Ding, Yuchen Zheng, Xulan Yang, Jie Xia, Fan Yang
Objectives
This study aimed to evaluate the effects of bone density, cortical bone thickness, and implant design on the accuracy of implant placement using a novel semi-autonomous robotic-assisted surgery system (sa-RASS).
Materials and Methods
A total of 160 implants were placed in artificial bone models simulating four bone densities (D1, D2, D3, D4) and three cortical bone thicknesses (0.5, 1, 1.5 mm) using sa-RASS. Two implant designs (self-tapping and non-self-tapping) were evaluated under standardized cortical bone thickness conditions. The postoperative CBCT data and preoperative surgical plan were superimposed to calculate the deviations of the implant. Deviations were quantified for platform/apex positions (global, horizontal, vertical) and implant angulation.
Results
The sa-RASS achieved mean deviations of 0.58 ± 0.19 mm at platform, 0.60 ± 0.24 mm at apex, and 1.46° ± 0.78° for angulation. Bone density significantly influenced accuracy (p < 0.05), with maximum deviations in medium-density (D2/D3) models and minimal errors in high-density (D1) and low-density (D4) groups. Cortical thickness exhibited a moderate positive correlation with linear deviations (platform: r = 0.598; apex: r = 0.593; both p < 0.001). Self-tapping implants demonstrated superior precision compared to non-self-tapping designs (p < 0.05), with reduced deviations at both platform (0.48 ± 0.16 mm) and apex (0.49 ± 0.16 mm).
Conclusions
This in vitro study demonstrated that bone condition and implant design significantly influence the accuracy of sa-RASS. Understanding these factors can help optimize robotic-assisted implant placement and improve clinical outcomes.
Clinical Significance
Bone condition and implant design significantly affect the accuracy of robotic-assisted implant placement. Preoperative assessment and proper implant selection can enhance precision and improve clinical outcomes.
{"title":"Influence of Bone Condition and Implant Design on Accuracy of Semi-Autonomous Robotic Dental Implant Surgery In Vitro","authors":"Qingwei Tang, Linhong Wang, Yude Ding, Yuchen Zheng, Xulan Yang, Jie Xia, Fan Yang","doi":"10.1111/cid.70090","DOIUrl":"10.1111/cid.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the effects of bone density, cortical bone thickness, and implant design on the accuracy of implant placement using a novel semi-autonomous robotic-assisted surgery system (sa-RASS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 160 implants were placed in artificial bone models simulating four bone densities (D1, D2, D3, D4) and three cortical bone thicknesses (0.5, 1, 1.5 mm) using sa-RASS. Two implant designs (self-tapping and non-self-tapping) were evaluated under standardized cortical bone thickness conditions. The postoperative CBCT data and preoperative surgical plan were superimposed to calculate the deviations of the implant. Deviations were quantified for platform/apex positions (global, horizontal, vertical) and implant angulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sa-RASS achieved mean deviations of 0.58 ± 0.19 mm at platform, 0.60 ± 0.24 mm at apex, and 1.46° ± 0.78° for angulation. Bone density significantly influenced accuracy (<i>p</i> < 0.05), with maximum deviations in medium-density (D2/D3) models and minimal errors in high-density (D1) and low-density (D4) groups. Cortical thickness exhibited a moderate positive correlation with linear deviations (platform: <i>r</i> = 0.598; apex: <i>r</i> = 0.593; both <i>p</i> < 0.001). Self-tapping implants demonstrated superior precision compared to non-self-tapping designs (<i>p</i> < 0.05), with reduced deviations at both platform (0.48 ± 0.16 mm) and apex (0.49 ± 0.16 mm).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This in vitro study demonstrated that bone condition and implant design significantly influence the accuracy of sa-RASS. Understanding these factors can help optimize robotic-assisted implant placement and improve clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Significance</h3>\u0000 \u0000 <p>Bone condition and implant design significantly affect the accuracy of robotic-assisted implant placement. Preoperative assessment and proper implant selection can enhance precision and improve clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071367","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}
This in vitro study evaluated how different forces applied to the dental drill handle during static computer-assisted implant surgery influence surgical guide deformation and implant placement accuracy.
Methods
Twenty-four virtual implants were divided into six groups (0–10 N, in 2 N increments). Surgical guides were scanned under loaded conditions, and deviations were quantified by superimposition with the baseline model.
Results
At high forces (≥ 8 N), buccal and palatal deformations increased markedly, with the 10 N group showing the largest displacement and angular deviation. Apical deviations (up to 1.554 mm) exceeded platform deviations (0.720 mm), and angular changes reached 9.595°. Under low forces (2–4 N), deformations were minimal, and anterior regions showed greater stability than posterior regions.
Conclusion
Forces above 6 N approach or exceed clinically acceptable thresholds, while 0 to 4 N produced the most precise outcomes. A single overload (≥ 8 N) can jeopardize surgical precision and long-term implant stability, underscoring the importance of controlling drill handle force. Clinicians are therefore advised to limit applied forces to ≤ 4 N to preserve surgical accuracy and minimize guide distortion.
{"title":"Effect of Drill Handle Force Applied to Digital Surgical Guides on Implant Deviation: An In Vitro Study","authors":"ChengI Chu, Youming Luo, Xueyuan Li, Songhang Li","doi":"10.1111/cid.70089","DOIUrl":"https://doi.org/10.1111/cid.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This in vitro study evaluated how different forces applied to the dental drill handle during static computer-assisted implant surgery influence surgical guide deformation and implant placement accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-four virtual implants were divided into six groups (0–10 N, in 2 N increments). Surgical guides were scanned under loaded conditions, and deviations were quantified by superimposition with the baseline model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At high forces (≥ 8 N), buccal and palatal deformations increased markedly, with the 10 N group showing the largest displacement and angular deviation. Apical deviations (up to 1.554 mm) exceeded platform deviations (0.720 mm), and angular changes reached 9.595°. Under low forces (2–4 N), deformations were minimal, and anterior regions showed greater stability than posterior regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Forces above 6 N approach or exceed clinically acceptable thresholds, while 0 to 4 N produced the most precise outcomes. A single overload (≥ 8 N) can jeopardize surgical precision and long-term implant stability, underscoring the importance of controlling drill handle force. Clinicians are therefore advised to limit applied forces to ≤ 4 N to preserve surgical accuracy and minimize guide distortion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012615","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}
Furkan Selvi, Berk Bilgen, Meltem Özdemir Karataş, Ali Balık
Introduction
Screw loosening remains a frequent mechanical complication in implant-supported prostheses, primarily caused by the gradual loss of abutment-screw preload. The aim of this study was to evaluate the mechanical performance of CAD-CAM custom and stock abutments by measuring removal torque values (RTV) at multiple time points and assessing surface morphology by scanning electron microscopy (SEM), following prolonged loading up to 2 × 106 cycles.
Methods
Forty-four implant-abutment assemblies with an internal conical-hex connection were divided into two groups: Stock abutments (SA) and custom abutments (CA). After initial tightening, baseline RTVs were recorded. The samples underwent cyclic loading following ISO-14801 standards. RTVs were measured after 50 000, 1 × 106, 1.5 × 106 and 2 × 106 cycles and after post-fatigue re-tightening. SEM analysis was performed at baseline, after 1 × 106 and 2 × 106 cycles.
Results
Baseline RTVs were higher in SA than CA. Both groups exhibited a progressive decrease in RTVs until 1 × 106 cycles, with significantly lower values in the CA. Thereafter, a partial recovery was observed up to 2 × 106 cycles, with no significant difference between groups. SEM images revealed more extensive surface wear in the SA group, while the CA group demonstrated localized adaptations; however, thread integrity was maintained in all samples.
Conclusion
Custom abutments showed lower baseline removal-torque values yet maintained preload as effectively as stock abutments after two-million cycles, confirming the mechanical suitability of both designs for functional loading. The greatest preload loss occurred between 50 000 and 1 × 106 cycles; therefore, retightening the abutment screws during the early post-insertion period is recommended to maintain preload stability.
{"title":"Two Million Cycle Fatigue Performance of Custom and Stock Conical-Hex Abutments: A Removal Torque and SEM Study","authors":"Furkan Selvi, Berk Bilgen, Meltem Özdemir Karataş, Ali Balık","doi":"10.1111/cid.70087","DOIUrl":"https://doi.org/10.1111/cid.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Screw loosening remains a frequent mechanical complication in implant-supported prostheses, primarily caused by the gradual loss of abutment-screw preload. The aim of this study was to evaluate the mechanical performance of CAD-CAM custom and stock abutments by measuring removal torque values (RTV) at multiple time points and assessing surface morphology by scanning electron microscopy (SEM), following prolonged loading up to 2 × 10<sup>6</sup> cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-four implant-abutment assemblies with an internal conical-hex connection were divided into two groups: Stock abutments (SA) and custom abutments (CA). After initial tightening, baseline RTVs were recorded. The samples underwent cyclic loading following ISO-14801 standards. RTVs were measured after 50 000, 1 × 10<sup>6</sup>, 1.5 × 10<sup>6</sup> and 2 × 10<sup>6</sup> cycles and after post-fatigue re-tightening. SEM analysis was performed at baseline, after 1 × 10<sup>6</sup> and 2 × 10<sup>6</sup> cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline RTVs were higher in SA than CA. Both groups exhibited a progressive decrease in RTVs until 1 × 10<sup>6</sup> cycles, with significantly lower values in the CA. Thereafter, a partial recovery was observed up to 2 × 10<sup>6</sup> cycles, with no significant difference between groups. SEM images revealed more extensive surface wear in the SA group, while the CA group demonstrated localized adaptations; however, thread integrity was maintained in all samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Custom abutments showed lower baseline removal-torque values yet maintained preload as effectively as stock abutments after two-million cycles, confirming the mechanical suitability of both designs for functional loading. The greatest preload loss occurred between 50 000 and 1 × 10<sup>6</sup> cycles; therefore, retightening the abutment screws during the early post-insertion period is recommended to maintain preload stability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998864","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}
To assess the stability of hard tissue following simultaneous guided bone regeneration (GBR) in the anterior maxilla, analyze the impact of the buccal bone arch contour on postoperative bone remodeling and restorative outcomes.
Methods
Patients who underwent anterior maxillary implantation and simultaneous GBR were included. Radiographic metrics were evaluated using preoperative, immediate postoperative, and follow-up cone beam computer tomography (CBCT) scans, and esthetic indicators were extracted from follow-up clinical records. The buccal bone arch contour of the edentulous area was reconstructed using the mirror symmetry technique. Implants were grouped based on the relative position of the bone grafts and implant to the contour immediately after surgery for comparisons of radiographic and esthetic outcomes.
Results
A total of 66 patients (66 implants) were ultimately included. For simultaneous GBR in the anterior maxilla, a bone gain of approximately 0.55–0.75 units was expected for every additional unit of bone graft. Bone grafts augmented outside the buccal bone arch contour tended to resorb back to the contour, suggesting that excessive bone augmentation may not provide significant benefits. Implants placed more than 3 mm palatally from the contour tended to achieve greater buccal bone wall thickness and more predictable esthetic outcomes.
Conclusions
The buccal bone arch contour provides an individualized reference for determining the appropriate bone graft volume and implant position. Placing the implant at least 2 mm palatally from the contour and augmenting bone grafts to exceed the contour by at least 1 mm appears to be a practical and effective strategy.
{"title":"Impact of Buccal Bone Arch Contour on Bone Remodeling and Esthetics in Guided Bone Regeneration: A Retrospective Study","authors":"Minghao Zuo, Heng Zhang, Zhijian Xie, Yiqun Zhou","doi":"10.1111/cid.70086","DOIUrl":"https://doi.org/10.1111/cid.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the stability of hard tissue following simultaneous guided bone regeneration (GBR) in the anterior maxilla, analyze the impact of the buccal bone arch contour on postoperative bone remodeling and restorative outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent anterior maxillary implantation and simultaneous GBR were included. Radiographic metrics were evaluated using preoperative, immediate postoperative, and follow-up cone beam computer tomography (CBCT) scans, and esthetic indicators were extracted from follow-up clinical records. The buccal bone arch contour of the edentulous area was reconstructed using the mirror symmetry technique. Implants were grouped based on the relative position of the bone grafts and implant to the contour immediately after surgery for comparisons of radiographic and esthetic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 66 patients (66 implants) were ultimately included. For simultaneous GBR in the anterior maxilla, a bone gain of approximately 0.55–0.75 units was expected for every additional unit of bone graft. Bone grafts augmented outside the buccal bone arch contour tended to resorb back to the contour, suggesting that excessive bone augmentation may not provide significant benefits. Implants placed more than 3 mm palatally from the contour tended to achieve greater buccal bone wall thickness and more predictable esthetic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The buccal bone arch contour provides an individualized reference for determining the appropriate bone graft volume and implant position. Placing the implant at least 2 mm palatally from the contour and augmenting bone grafts to exceed the contour by at least 1 mm appears to be a practical and effective strategy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998863","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}
Cláudio Rodrigues Leles, Thalita Fernandes Fleury Curado, José Luiz Rodrigues Leles, Nádia Lago Costa, Manrique Fonseca, Martin Schimmel, Gerald McKenna
Objectives
To assess the 3-year clinic-radiographic features and risk factors for apical fracture of mini-implants for mandibular overdentures.
Material and Methods
Participants in a clinical trial (n = 74) were assessed for post-insertion identification of apical fractures of one-piece titanium–zirconium mini-implants (Straumann Mini-Implant System). Fractures were identified during implant insertion or in follow-up imaging exams. Cases were clinically and radiographically monitored up to the 3-year follow-up.
Results
Five implants in five patients had apical fractures (1.69% of the 296 inserted implants). No clinical signs of peri-implant complications were found, and overall treatment outcomes were positive for all patients. Satisfactory osseointegration was achieved, and no evidence of periapical pathology was noted on panoramic radiographs. The patients were notified about the apical implant fracture at the time of the surgery, and during follow-up appointments, they were reassured about the absence of further complications in the long term. It was hypothesized that the increased risk of fracture was associated with high insertion torques (around 80 N cm) and implant insertion in areas where the tip engages into a hard basal cortical bone (Types I–II) with an inclined cortical surface in the lingual aspect of the alveolar bone.
Conclusions
The incidence of apical fracture was low and did not result in any clinically relevant complications and may be detected during the surgery or in follow-up radiographs. Although the intraosseous implant tip fragment may not be of major concern, additional caution to prevent excessive insertion torque and to avoid anatomical regions of higher risk may be advisable.
{"title":"Apical Fracture of One-Piece Titanium–Zirconium Mini-Implant for Mandibular Overdenture: A Prospective 3-Year Follow-Up","authors":"Cláudio Rodrigues Leles, Thalita Fernandes Fleury Curado, José Luiz Rodrigues Leles, Nádia Lago Costa, Manrique Fonseca, Martin Schimmel, Gerald McKenna","doi":"10.1111/cid.70084","DOIUrl":"https://doi.org/10.1111/cid.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the 3-year clinic-radiographic features and risk factors for apical fracture of mini-implants for mandibular overdentures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Participants in a clinical trial (<i>n</i> = 74) were assessed for post-insertion identification of apical fractures of one-piece titanium–zirconium mini-implants (Straumann Mini-Implant System). Fractures were identified during implant insertion or in follow-up imaging exams. Cases were clinically and radiographically monitored up to the 3-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five implants in five patients had apical fractures (1.69% of the 296 inserted implants). No clinical signs of peri-implant complications were found, and overall treatment outcomes were positive for all patients. Satisfactory osseointegration was achieved, and no evidence of periapical pathology was noted on panoramic radiographs. The patients were notified about the apical implant fracture at the time of the surgery, and during follow-up appointments, they were reassured about the absence of further complications in the long term. It was hypothesized that the increased risk of fracture was associated with high insertion torques (around 80 N cm) and implant insertion in areas where the tip engages into a hard basal cortical bone (Types I–II) with an inclined cortical surface in the lingual aspect of the alveolar bone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The incidence of apical fracture was low and did not result in any clinically relevant complications and may be detected during the surgery or in follow-up radiographs. Although the intraosseous implant tip fragment may not be of major concern, additional caution to prevent excessive insertion torque and to avoid anatomical regions of higher risk may be advisable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The primary aim of this study was to compare the histomorphometric characteristics of two different cortico-cancellous collagenic porcine bone (CCPB) formulations combined with a stabilizing agent used for alveolar ridge preservation (ARP), and the secondary aim was to evaluate and compare clinical and aesthetic outcomes of dental implants placed in augmented sites.
Materials and Methods
This was a prospective, cohort-comparative study conducted on patients requiring a tooth extraction followed by ARP and subsequent implant placement. Tooth extractions were performed trying to reduce the surgical trauma as much as possible, and then ARP was performed using two different formulations of CCPB combined with a thermogel in different ratios (50:50 hand-mixed and 80:20 pre-mixed). After 4 months of healing, implant placement was performed, and a bone biopsy was retrieved from the surgical site for histomorphometric analyses. Implants were rehabilitated 3 months following placement with screw-retained crowns, then patients were re-evaluated 1 year following prosthetic loading.
Results
We report the clinical and histomorphometric outcomes of 20 patients divided into the two study groups (10 patients per group). ARP performed with a hand-mixed biomaterial in a 50:50 ratio had higher percentages of newly formed bone (36.15% vs. 27.18%) when compared to a pre-mixed biomaterial in an 80:20 ratio, even though the difference was not statistically significant (p = 0.064). Implants placed in ARP-treated sites showed a very low mean marginal bone loss at the 1-year follow-up in both experimental groups (0.06 ± 0.15 mm in the 50:50 group and 0.25 ± 0.35 mm in the 80:20 group) with no statistically significant differences (p = 0.42), as well as the aesthetic outcomes assessed through the pink aesthetic score.
Conclusions
Both biomaterials showed effective and favorable outcomes, and the histomorphometric differences observed in our sample did not have any impact on the final clinical and aesthetic outcomes.
本研究的主要目的是比较两种不同的皮质松质胶原猪骨（CCPB）配方与用于牙槽嵴保存（ARP）的稳定剂的组织形态学特征，次要目的是评估和比较放置在增强部位的牙种植体的临床和美学结果。材料和方法这是一项前瞻性的队列比较研究，对需要拔牙，然后进行ARP和随后的种植体放置的患者进行了研究。拔牙尽量减少手术创伤，然后使用两种不同配方的CCPB与不同比例的热凝胶（50:50手工混合和80:20预混合）进行ARP。愈合4个月后，进行种植体植入，并从手术部位取骨活检进行组织形态学分析。植入螺钉保留冠3个月后修复种植体，然后在植入假体1年后对患者进行重新评估。我们报告了将20例患者分为两个研究组（每组10例）的临床和组织形态学结果。与以80:20比例预先混合的生物材料相比，以50:50比例手工混合的生物材料进行ARP的新骨形成百分比更高（36.15% vs. 27.18%），尽管差异无统计学意义（p = 0.064）。在1年的随访中，两个实验组放置在arp处理部位的种植体的平均边缘骨损失非常低（50:50组为0.06±0.15 mm， 80:20组为0.25±0.35 mm），差异无统计学意义（p = 0.42），通过粉红色美学评分评估美学结果。结论两种生物材料均具有良好的效果，在我们的样本中观察到的组织形态学差异对最终的临床和美学结果没有任何影响。
{"title":"Cortico-Cancellous Collagenic Porcine Bone for Alveolar Ridge Preservation: A Cohort Comparative Study","authors":"Chiara Cinquini, Emira D'amico, Giovanna Iezzi, Mattia Priami, Simonetta Santarelli, Antonio Barone","doi":"10.1111/cid.70085","DOIUrl":"https://doi.org/10.1111/cid.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary aim of this study was to compare the histomorphometric characteristics of two different cortico-cancellous collagenic porcine bone (CCPB) formulations combined with a stabilizing agent used for alveolar ridge preservation (ARP), and the secondary aim was to evaluate and compare clinical and aesthetic outcomes of dental implants placed in augmented sites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This was a prospective, cohort-comparative study conducted on patients requiring a tooth extraction followed by ARP and subsequent implant placement. Tooth extractions were performed trying to reduce the surgical trauma as much as possible, and then ARP was performed using two different formulations of CCPB combined with a thermogel in different ratios (50:50 hand-mixed and 80:20 pre-mixed). After 4 months of healing, implant placement was performed, and a bone biopsy was retrieved from the surgical site for histomorphometric analyses. Implants were rehabilitated 3 months following placement with screw-retained crowns, then patients were re-evaluated 1 year following prosthetic loading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We report the clinical and histomorphometric outcomes of 20 patients divided into the two study groups (10 patients per group). ARP performed with a hand-mixed biomaterial in a 50:50 ratio had higher percentages of newly formed bone (36.15% vs. 27.18%) when compared to a pre-mixed biomaterial in an 80:20 ratio, even though the difference was not statistically significant (<i>p</i> = 0.064). Implants placed in ARP-treated sites showed a very low mean marginal bone loss at the 1-year follow-up in both experimental groups (0.06 ± 0.15 mm in the 50:50 group and 0.25 ± 0.35 mm in the 80:20 group) with no statistically significant differences (<i>p</i> = 0.42), as well as the aesthetic outcomes assessed through the pink aesthetic score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both biomaterials showed effective and favorable outcomes, and the histomorphometric differences observed in our sample did not have any impact on the final clinical and aesthetic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897818","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}
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