Clinical Implant Dentistry and Related Research最新文献_第4页

Artificial Intelligence Segmentation Errors in Implant Planning Software Programs: An Overview 人工智能在植入规划软件程序中的分割错误：综述。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-10-07 DOI: 10.1111/cid.70095

Ghida Lawand, Luiz Gonzaga, Julien Issa, Marta Revilla-Leon, Hani Tohme, Adam Saleh, William Martin

Background

Static computer-assisted implant surgery (s-CAIS) utilizes 3D imaging data to guide implant placement with high precision. Accurate segmentation of CBCT and intraoral scan data is crucial to creating reliable anatomical models. While AI-driven segmentation has emerged as a promising solution to reduce manual workload, its performance is hindered by technical and algorithmic limitations.

Objective

To evaluate the accuracy and limitations of AI-based segmentation in dental implant planning software and to identify common sources of segmentation errors, their clinical implications, and strategies for mitigation.

Methods

This work is framed as a narrative literature review and educational practice overview. Observations on software functionality were based on direct use and exploration of varying implant planning software programs. This was conducted to qualitatively describe common segmentation error patterns (boundary errors, over-/under-segmentation, misidentification, and partial volume effects), and demonstrate editing functionalities across four implant planning systems (coDiagnostiX, BlueSkyPlan, Atomica, and Relu). These demonstrations are intended for illustrative purposes and do not constitute a formal, reproducible performance comparison.

Results

AI-based segmentation frequently encounters errors due to imaging artifacts, motion blur, anatomical variability, and algorithmic biases. These errors can lead to inaccurate implant positioning, compromised surgical guide designs, and clinical complications. While advanced methods such as U-Net, GANs, and SISTR improve segmentation quality, manual intervention remains essential. The effectiveness of AI tools varies significantly across platforms, and limited editing capabilities often hinder error correction.

Conclusion

Despite advances in AI, segmentation errors remain a critical barrier in s-CAIS workflows. Enhanced imaging protocols, algorithmic refinement, clinician oversight, and regulatory transparency are essential to improve segmentation accuracy and ensure safe, effective digital implant planning.

背景：静态计算机辅助种植手术（s-CAIS）利用三维成像数据高精度指导种植体放置。准确分割CBCT和口内扫描数据对于创建可靠的解剖模型至关重要。虽然人工智能驱动的分割已经成为减少人工工作量的一种有前途的解决方案，但其性能受到技术和算法限制的阻碍。目的：评估种植体规划软件中基于人工智能的分割的准确性和局限性，并确定分割错误的常见来源、其临床意义和缓解策略。方法：本研究以叙述性文献综述和教育实践综述为框架。对软件功能的观察是基于直接使用和探索不同的植入计划软件程序。这是为了定性地描述常见的分割错误模式（边界错误、分割过度/不足、错误识别和部分体积效应），并演示跨四个植入计划系统（coDiagnostiX、BlueSkyPlan、Atomica和Relu）的编辑功能。这些演示仅用于说明目的，不构成正式的、可重复的性能比较。结果：由于成像伪影、运动模糊、解剖变异和算法偏差，基于人工智能的分割经常遇到错误。这些错误可能导致植入物定位不准确，手术引导设计受损和临床并发症。虽然U-Net、gan和SISTR等先进方法可以提高分割质量，但人工干预仍然是必不可少的。人工智能工具的有效性在不同平台上差异很大，有限的编辑能力往往会阻碍错误纠正。结论：尽管人工智能取得了进步，但分割错误仍然是s-CAIS工作流程中的关键障碍。增强成像协议、改进算法、临床医生监督和监管透明度对于提高分割准确性和确保安全、有效的数字植入计划至关重要。

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引用次数: 0

Peri-Implant Supracrestal Tissue Characteristics Related to Abutment Materials: A Comparative Histomorphometry Study 与基台材料相关的种植体周围的植体上组织特征：一项比较组织形态学研究。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-10-07 DOI: 10.1111/cid.70083

Manon Borie, Dieter Bosshardt, Lemmy Liegeois, Geoffrey Lecloux, Håvard Jostein Haugen, Dorien Van Hede, France Lambert

Background

The peri-implant soft tissue integration is critical to maintain peri-implant health and the long-term success of dental implant rehabilitations.

Aim

This comparative histomorphometry study aims to characterize the peri-implant soft tissues (PIST) around experimental abutments made of titanium (Ti), dental resin (Re), and polyetheretherketone (PEEK).

Methods

Thirty bone-level implants were placed, each receiving an experimental transmucosal healing abutment made of one of the three materials. After an 8-week healing period, the abutments and surrounding tissues were harvested and prepared for histological and histomorphometric analyses. Dimensions of sulcus depth, epithelial and connective tissue adhesion were measured. In addition, the abutment surface characteristics, levels of inflammation, plaque accumulation, and peri-implant bone level changes were evaluated.

Results

The dimensions of the different components of the PIST were comparable across the three experimental groups. The mean overall dimensions of the PIST were 2.68 ± 0.51 mm for Ti, 2.66 ± 0.47 mm for Re, and 2.32 ± 0.55 mm for PEEK. Mean sulcus depth was 0.71 ± 0.69 mm for Ti, 0.74 ± 0.50 mm for Re, and 0.68 ± 0.63 mm for PEEK. Mean junctional epithelium was 1.82 ± 0.67 mm for Ti, 1.56 ± 0.47 mm for Re, and 1.53 ± 0.40 mm for PEEK. Mean harvested connective tissue (until abutment platform) was 0.30 ± 0.29 mm for Ti, 0.36 ± 0.38 mm for Re, and 0.09 ± 0.10 mm for PEEK. However, the resin group exhibited significantly more supramucosal biofilm adhesion (p = 0.026).

Conclusion

The PIST around abutments made of PEEK, resin, or titanium tend to develop in a similar pattern. However, longer observation periods are required to evaluate the long-term effects.

背景：种植体周围软组织的整合是维持种植体周围健康和种植体康复长期成功的关键。目的：本比较组织形态学研究旨在表征由钛（Ti）、牙树脂（Re）和聚醚醚酮（PEEK）制成的实验基台周围种植体周围软组织（ist）。方法：放置30个骨水平种植体，每个种植体接受由三种材料中的一种制成的实验性经黏膜愈合基台。8周愈合后，收集基牙和周围组织，准备进行组织学和组织形态学分析。测量沟深、上皮和结缔组织粘连的尺寸。此外，还评估了基牙表面特征、炎症水平、菌斑积累和种植体周围骨水平的变化。结果：在三个实验组中，不同成分的维度具有可比性。Ti、Re、PEEK的平均整体尺寸分别为2.68±0.51 mm、2.66±0.47 mm和2.32±0.55 mm。Ti的平均沟深为0.71±0.69 mm， Re为0.74±0.50 mm， PEEK为0.68±0.63 mm。Ti的平均结上皮为1.82±0.67 mm， Re为1.56±0.47 mm， PEEK为1.53±0.40 mm。平均收获的结缔组织（直到基台）Ti为0.30±0.29 mm， Re为0.36±0.38 mm， PEEK为0.09±0.10 mm。然而，树脂组表现出更明显的粘膜上生物膜粘附（p = 0.026）。结论：聚醚醚酮基台、树脂基台和钛基台周围的牙体形成规律相似。然而，需要更长的观察期来评估长期影响。

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引用次数: 0

Sinus Floor Elevation With Platelet-Rich Fibrin From Horizontal Centrifugation and Xenograft: Randomized Clinical Trial 从水平离心和异种移植中获得富血小板纤维蛋白的窦底抬高：随机临床试验。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-10-02 DOI: 10.1111/cid.70093

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.

目的：评价牛去蛋白骨材料（DBBM）联合或不联合水平离心获得的富血小板纤维蛋白（H-PRF）进行上颌窦增强术（MSA）短愈合期4个月后的效果。材料和方法：13例患者采用裂口模型行双侧两期MSA。每组随机分为DBBM单独治疗组（对照组）和DBBM + H-PRF治疗组（试验组）。种植体放置4个月后采集骨组织样本，并使用显微计算机断层扫描（micro-CT）以及组织学和组织形态学分析进行评估。采用配对t检验对数据进行统计学分析（Wilcoxon sign -rank检验；p）结果：组织形态计量学分析显示更高的量(p)结论：与单独DBBM相比，H-PRF联合DBBM增强上颌窦在愈合4个月后，定性和定量的新骨形成都有所改善。然而，对种植体的长期生存和早期稳定性的影响尚不清楚，需要进一步的长期随访研究。

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引用次数: 0

Correlation of Implant Location to Marginal Bone Level Changes in Single-Unit Restorations: A Retrospective Study 单单元修复体种植体位置与边缘骨水平变化的相关性：一项回顾性研究。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-09-30 DOI: 10.1111/cid.70092

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}

引用次数: 0

Insights Into Early and Late Dental Implant Failures in Veterans—A Retrospective Cohort Analysis 对退伍军人早期和晚期牙种植失败的见解——回顾性队列分析。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-09-17 DOI: 10.1111/cid.70091

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.

导语：虽然有大量研究调查了整体种植体失败，但只有少数研究关注与早期（种植后6个月内）和晚期（种植后6个月）失败相关的独特风险因素，特别是在退伍军人人群中。因此，了解针对退伍军人的早期和晚期dif的细微差别对于改善临床决策和增强VA牙科外科医生减轻失败风险的能力是必要的。方法：获取2000年1月1日至2021年12月1日期间18岁及以上的退伍军人和种植牙患者的电子健康记录（EHRs）。最初进行单变量分析以确定重要的风险因素，随后在多变量分析中对其进行控制。然后使用混合效应逻辑回归模型来估计早期/晚期失败的优势比。使用混合效应模型计算类内相关系数（ICC），以评估可归因于患者水平聚类的方差比例。结果：多变量模型共纳入美国退伍军人132 675人，种植体468 496颗。在这个队列中，9423名独特的退伍军人报告了13492次失败，导致21年的失败率为7.1%。调整后的优势比表明，种植体植入时年龄在70岁及以上、亚洲种族、骨质疏松症和接受再植与早期种植体失败的几率显著相关。相比之下，植入时年龄在40-60岁、非裔美国人、活动性牙周炎和使用阿仑膦酸钠的患者与晚期种植失败的几率增加有关。该队列计算的ICC为86%，表明患者水平的聚类水平很高。结论：患有活动性牙周炎的退伍军人和使用阿仑膦酸钠的退伍军人晚期种植失败的几率明显增加，分别约为139%和114%。相反，70岁及以上的退伍军人和接受再植的退伍军人在早期失败队列中分别增加了257%和89%的几率。该队列的高ICC值表明，种植体放置的结果受到患者先前种植失败或成功史的强烈影响。

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引用次数: 0

Effect of Final Abutment Timing on Immediate Implant Success in Anterior Maxilla: A Randomized Controlled Trial 上颌前牙最终基牙时机对即刻种植成功的影响：一项随机对照试验。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-09-15 DOI: 10.1111/cid.70088

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.

目的：本随机对照试验旨在评估早期与延迟基牙变化对骨水平、软组织和单牙即刻种植患者满意度的影响。材料和方法：26例患者在上颌前区放置无瓣即刻种植体（13-23）。术后，所有患者均接受与拔牙相同的树脂基牙，并提供临时树脂冠。在临时基台的基础上，制作了一个由锆和钛适配器制成的定制数字复制基台。将患者随机分为两组，试验组在4天后更换氧化锆基牙，对照组在3个月后更换基牙。两组均在术后3个月植入最终瓷冠。主要研究结果是1年后的边缘骨水平，种植体周围软组织（PES/Pink美学评分）和口腔健康相关生活质量（OHIP/口腔健康影响概况）被定义为次要参数。结果：1年后，两组患者的初始骨水平重塑和后期骨质流失均无统计学差异。2例假体并发症（每组1例）需要更换基台，但未发生假体失败。试验组平均边缘骨水平为0.71±0.95 mm（近端：0.55±0.97 mm，远端：0.86±1.07 mm），对照组平均边缘骨水平为0.22±0.93 mm（近端：0.15±1.10 mm，远端：0.30±0.89 mm）。实验组的粉红美学评分（PES）为11.9±1.6分，对照组为10.62±2.87分（p = 0.39），差异无统计学意义。6个月时两组的口腔健康影响评分（OHIP）也无统计学意义。结论：在上颌前牙即刻种植中，确定的氧化锆基台放置时间（4天与3个月后）在种植体周围骨水平、种植体周围美观或患者相关生活质量方面没有任何统计学上的显著差异。

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引用次数: 0

Influence of Bone Condition and Implant Design on Accuracy of Semi-Autonomous Robotic Dental Implant Surgery In Vitro 骨状态和种植体设计对半自主牙种植机器人体外手术精度的影响。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-09-15 DOI: 10.1111/cid.70090

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.

目的：本研究旨在利用一种新型半自主机器人辅助手术系统（sa-RASS）评估骨密度、皮质骨厚度和种植体设计对种植体放置准确性的影响。材料与方法：采用sa-RASS模拟4种骨密度（D1、D2、D3、D4）和3种皮质骨厚度（0.5、1、1.5 mm）的人工骨模型，共植入160颗种植体。两种种植体设计（自攻和非自攻）在标准化皮质骨厚度条件下进行评估。将术后CBCT数据与术前手术计划叠加计算种植体的偏差。对平台/顶点位置（全局、水平、垂直）和种植体角度的偏差进行量化。结果：sa-RASS的平均误差为平台0.58±0.19 mm，尖端0.60±0.24 mm，成角1.46°±0.78°。结论：体外研究表明，骨状况和种植体设计显著影响sa-RASS的准确性。了解这些因素有助于优化机器人辅助植入物的放置和改善临床结果。临床意义：骨状况和种植体设计显著影响机器人辅助种植体放置的准确性。术前评估和正确选择种植体可提高准确性，改善临床效果。

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引用次数: 0

Effect of Drill Handle Force Applied to Digital Surgical Guides on Implant Deviation: An In Vitro Study 钻头柄力对数字手术导向器植入体偏差影响的体外研究

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-09-08 DOI: 10.1111/cid.70089

ChengI Chu, Youming Luo, Xueyuan Li, Songhang Li

Introduction

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.

本体外研究评估了在静态计算机辅助种植手术中，牙钻手柄施加的不同力如何影响手术导向变形和种植体放置精度。方法24枚虚拟种植体分为6组（0 ~ 10 N，每组2 N）。在加载条件下扫描手术指南，并通过与基线模型叠加来量化偏差。结果在大外力（≥8 N）作用下，颊部和腭部变形明显增加，其中10 N组移位和角度偏差最大。顶点偏差（最大1.554 mm）超过平台偏差（0.720 mm），角度变化达到9.595°。在低力（2-4牛）下，变形最小，前区比后区表现出更大的稳定性。结论大于6n的力接近或超过临床可接受的阈值，而0 ~ 4n的力产生最精确的结果。单次过载（≥8n）会影响手术精度和种植体的长期稳定性，因此控制钻柄力非常重要。因此，临床医生建议将施加的力限制在≤4n，以保持手术精度并最大限度地减少导尿管变形。

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引用次数: 0

Two Million Cycle Fatigue Performance of Custom and Stock Conical-Hex Abutments: A Removal Torque and SEM Study 定制和库存锥形-六角基台的200万次疲劳性能：去除扭矩和扫描电镜研究

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-09-05 DOI: 10.1111/cid.70087

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.

螺钉松动仍然是种植体支持的假体中常见的机械并发症，主要是由基台螺钉预紧力逐渐丧失引起的。本研究的目的是通过测量多个时间点的移除扭矩值（RTV）和通过扫描电子显微镜（SEM）评估表面形貌，评估CAD-CAM定制和库存基台在长时间加载高达2 × 106次循环后的力学性能。方法将44例种植体-基台内锥体-六角连接组分为常规基台组（SA）和定制基台组（CA）。初始收紧后，记录基线rtv。试样按照ISO-14801标准进行循环加载。分别在5万次、1 × 106次、1.5 × 106次和2 × 106次循环以及疲劳后再拧紧后测量rtv。在基线、1 × 106和2 × 106周期后进行扫描电镜分析。结果SA组的基线rtv高于CA组。两组rtv均逐渐下降至1 × 106周期，CA组的rtv值显著降低。此后，部分恢复至2 × 106周期，组间无显著差异。扫描电镜图像显示，SA组表面磨损更广泛，而CA组表现出局部适应；然而，在所有样品中都保持了线程完整性。结论：在200万次循环后，自定义基台具有较低的基线移除扭矩值，但与库存基台一样有效地保持预载荷，证实了两种设计在功能载荷方面的机械适用性。预载损失最大的时段为5万~ 1 × 106次循环；因此，建议在插入后早期重新拧紧基台螺钉，以保持预紧力的稳定性。

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引用次数: 0

Impact of Buccal Bone Arch Contour on Bone Remodeling and Esthetics in Guided Bone Regeneration: A Retrospective Study 口腔骨弓轮廓对引导骨再生中骨重塑和美学影响的回顾性研究

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research

Pub Date : 2025-09-05 DOI: 10.1111/cid.70086

Minghao Zuo, Heng Zhang, Zhijian Xie, Yiqun Zhou

Objectives

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.

目的探讨上颌前牙同步引导骨再生（GBR）术后硬组织的稳定性，分析颊骨弓轮廓对术后骨重塑及修复效果的影响。方法对行上颌前牙种植同时行GBR的患者进行回顾性分析。通过术前、术后即刻和随访的锥形束计算机断层扫描（CBCT）评估放射学指标，并从随访的临床记录中提取美学指标。采用镜像对称技术重建无牙区颊骨弓轮廓。根据植骨体的相对位置和植骨体与术后轮廓的相对位置对植骨体进行分组，以比较影像学和美学结果。结果共纳入66例患者（66个种植体）。对于同时在前上颌进行GBR，预计每增加一个骨移植单位，骨增加约0.55-0.75个单位。在颊骨弓轮廓外增加的骨移植物倾向于再吸收回轮廓，这表明过度的骨增加可能不会带来显著的好处。种植体放置在离轮廓超过3mm的腭侧，往往可以获得更大的颊骨壁厚度和更可预测的美学结果。结论口腔骨弓轮廓为确定合适的植骨体积和种植体位置提供了个体化参考。将种植体放置在离轮廓至少2mm的腭侧，并将骨移植物增加到超过轮廓至少1mm似乎是一种实用而有效的策略。

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引用次数: 0