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}
<div> <section> <h3> Statement of Problem</h3> <p>Due to its biomechanical advantages, the Novaloc attachment system with angulated abutments has gained popularity in two-implant-supported mandibular overdentures. However, limited data are available on how implant position, angulation, and arch form affect stress and strain distribution within the attachment system. Understanding these factors is essential for optimizing prosthetic longevity and clinical outcomes.</p> </section> <section> <h3> Purpose</h3> <p>This finite element analysis (FEA) study aimed to evaluate the impact of implant position, angulation, and mandibular arch form on stress and strain distribution in Novaloc overdenture attachment systems.</p> </section> <section> <h3> Materials and Methods</h3> <p>A computed tomography (CT) scan of an edentulous mandible was segmented using 3D Slicer software, and three mandibular arch forms (ovoid, tapered, square) were modeled in a three-dimensional FEA environment (ANSYS Workbench, ANSYS Inc.). Implants and the Novaloc attachment system were designed and integrated using ANSYS SpaceClaim software. Finite element models were generated with implant angulations of 0°, 15°, 40°, and 60°, positioned at three locations: lateral incisor region, midpoint between lateral incisor and canine, and canine region. Vertical and oblique loads were applied in the first molar region to simulate masticatory forces. Von Mises stress distribution and dislocation forces were recorded and analyzed.</p> </section> <section> <h3> Results</h3> <p>The highest stresses were observed in canine-positioned implants within tapered arches under 30° oblique loading. Stresses in Novaloc abutments (36.85–40.27 MPa) and inserts (13.89–15.31 MPa) approached their mechanical limits. Increasing implant angulation up to a total of 60° between implants increased stresses on the abutments while reducing stresses and displacement in the inserts. Oblique forces (30°) generated higher stresses compared to vertical and 45° oblique forces. Among mandibular arch forms, stress distribution followed the pattern: tapered > ovoid > square.</p> </section> <section> <h3> Conclusions</h3> <p>Anterior implant positioning in two-implant-supported overdentures resulted in more favorable stress distribution within the Novaloc attachment system. Implant angulations up to 60° had a minimal effect on stress patterns, suggesting that angulated abutments may be a viable alternative in cases with anatomical limitations. These findings provide biomechanical insights that may aid in optimizing implant pl
{"title":"Finite Element Analysis of Novaloc Attachments at Extreme Angulations and Arch Forms: A Specification Study","authors":"Sultan Merve Uçar, Rafat Sasany, Hanan Al-Johani","doi":"10.1111/cid.70082","DOIUrl":"https://doi.org/10.1111/cid.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Statement of Problem</h3>\u0000 \u0000 <p>Due to its biomechanical advantages, the Novaloc attachment system with angulated abutments has gained popularity in two-implant-supported mandibular overdentures. However, limited data are available on how implant position, angulation, and arch form affect stress and strain distribution within the attachment system. Understanding these factors is essential for optimizing prosthetic longevity and clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This finite element analysis (FEA) study aimed to evaluate the impact of implant position, angulation, and mandibular arch form on stress and strain distribution in Novaloc overdenture attachment systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A computed tomography (CT) scan of an edentulous mandible was segmented using 3D Slicer software, and three mandibular arch forms (ovoid, tapered, square) were modeled in a three-dimensional FEA environment (ANSYS Workbench, ANSYS Inc.). Implants and the Novaloc attachment system were designed and integrated using ANSYS SpaceClaim software. Finite element models were generated with implant angulations of 0°, 15°, 40°, and 60°, positioned at three locations: lateral incisor region, midpoint between lateral incisor and canine, and canine region. Vertical and oblique loads were applied in the first molar region to simulate masticatory forces. Von Mises stress distribution and dislocation forces were recorded and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The highest stresses were observed in canine-positioned implants within tapered arches under 30° oblique loading. Stresses in Novaloc abutments (36.85–40.27 MPa) and inserts (13.89–15.31 MPa) approached their mechanical limits. Increasing implant angulation up to a total of 60° between implants increased stresses on the abutments while reducing stresses and displacement in the inserts. Oblique forces (30°) generated higher stresses compared to vertical and 45° oblique forces. Among mandibular arch forms, stress distribution followed the pattern: tapered > ovoid > square.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Anterior implant positioning in two-implant-supported overdentures resulted in more favorable stress distribution within the Novaloc attachment system. Implant angulations up to 60° had a minimal effect on stress patterns, suggesting that angulated abutments may be a viable alternative in cases with anatomical limitations. These findings provide biomechanical insights that may aid in optimizing implant pl","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869194","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}
Rachel Duhan Wåhlberg, Victoria Franke Stenport, Ann Wennerberg, Lars Hjalmarsson
Background
Recent advancements in dental implant materials, designs, and surgery have increased their use, especially for challenging local conditions. As guidelines for individualized risk assessment are increasingly emphasized, implant treatment has become available to patients with diverse medical backgrounds. However, clinical research with large patient groups is needed to investigate the effects of patient-related factors associated with early implant failure.
Purpose
This paper investigates patient factors in two patient cohorts associated with early implant complications and failures.
Materials and Methods
The collected data were analyzed and presented in two studies. Both studies followed the same data collection methodology and compared cohorts treated in 2007 and 2017. The same patient-level dataset was analyzed, although the second study included additional analyses of diseases and allergies. Data were analyzed univariately (p < 0.20) to select variables for the multivariable logistic regression model (p < 0.05), with early implant failures and complications as dependent variables.
Results
In total, 1875 patients with 4670 implants were included. There were 74 (3.7%) dropouts, mainly due to lack of data. The 2007 cohort comprised 799 patients with 2473 implants, and the 2017 cohort comprised 1076 patients with 2287 implants. Differences were observed between the two cohorts for the number of implants per patient, exposed implant threads, and preoperative antibiotics. In the 2007 cohort, 23 (2.9%) patients had early implant failure. In the 2017 cohort, 40 (3.7%) had early implant failure (p > 0.30). Significantly more implants failed in the 2017 cohort (n = 56, 2.4%) than in the 2007 cohort (n = 26, 1.1%) (p < 0.001). Early complications were reported for 56 (7.0%) patients in 2007 and 145 (13.5%) patients in 2017 (p < 0.001). Three patient-related variables were associated with an increased risk of early failure—food allergy, exposed implant threads, and increased number of implants. Seven variables were related to an increased risk of complications: smoking, exposed threads, no preoperative antibiotics, number of implants, sinus perforations, food allergy, and metal allergy.
{"title":"A Multicenter Study of Factors Related to Early Implant Failures—Part 2: Patient Factors","authors":"Rachel Duhan Wåhlberg, Victoria Franke Stenport, Ann Wennerberg, Lars Hjalmarsson","doi":"10.1111/cid.70081","DOIUrl":"https://doi.org/10.1111/cid.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent advancements in dental implant materials, designs, and surgery have increased their use, especially for challenging local conditions. As guidelines for individualized risk assessment are increasingly emphasized, implant treatment has become available to patients with diverse medical backgrounds. However, clinical research with large patient groups is needed to investigate the effects of patient-related factors associated with early implant failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This paper investigates patient factors in two patient cohorts associated with early implant complications and failures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The collected data were analyzed and presented in two studies. Both studies followed the same data collection methodology and compared cohorts treated in 2007 and 2017. The same patient-level dataset was analyzed, although the second study included additional analyses of diseases and allergies. Data were analyzed univariately (<i>p</i> < 0.20) to select variables for the multivariable logistic regression model (<i>p</i> < 0.05), with early implant failures and complications as dependent variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 1875 patients with 4670 implants were included. There were 74 (3.7%) dropouts, mainly due to lack of data. The 2007 cohort comprised 799 patients with 2473 implants, and the 2017 cohort comprised 1076 patients with 2287 implants. Differences were observed between the two cohorts for the number of implants per patient, exposed implant threads, and preoperative antibiotics. In the 2007 cohort, 23 (2.9%) patients had early implant failure. In the 2017 cohort, 40 (3.7%) had early implant failure (<i>p</i> > 0.30). Significantly more implants failed in the 2017 cohort (<i>n</i> = 56, 2.4%) than in the 2007 cohort (<i>n</i> = 26, 1.1%) (<i>p</i> < 0.001). Early complications were reported for 56 (7.0%) patients in 2007 and 145 (13.5%) patients in 2017 (<i>p</i> < 0.001). Three patient-related variables were associated with an increased risk of early failure—food allergy, exposed implant threads, and increased number of implants. Seven variables were related to an increased risk of complications: smoking, exposed threads, no preoperative antibiotics, number of implants, sinus perforations, food allergy, and metal allergy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This stu","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144725501","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}
Nicola De Angelis, Paolo Pesce, Vito Carlo Alberto Caponio, Giulia Santamaria, Oriana Spanu, Maria Menini
Introduction
This retrospective study compares the clinical outcomes of analog impressions versus intraoral scanning in full-arch immediate loading rehabilitations. Specifically, it evaluates peri-implant marginal bone level (MBL) changes at different time intervals (implant placement, loading, and at 2 and 5 years), as well as rates of mechanical and prosthetic complications.
Materials and Methods
The study included 62 patients who underwent full-arch rehabilitation with immediate implant placement between 2019 and 2020. Patients were divided into two groups: analog impression and digital intraoral scanning. All patients were rehabilitated with fixed titanium-PMMA screw retained restorations. Bone level was assessed through standardized intraoral radiographs at key time points. Additional parameters recorded included procedural time, prosthetic complications, and implant failures. Statistical analyses involved repeated measures ANOVA and post hoc Bonferroni tests.
Results
The follow-up period was 5 years. Implant survival was 99.6%. No significant differences were found in prosthetic complications. MBL was slightly higher in the analog group at baseline (mean = 0.21, SD = 0.04 vs. digital mean = 0.17, SD = 0.04, t-test p-value < 0.001) than in the digital group. Despite this, the overall bone loss remained within clinically acceptable limits during the follow-up period. Digital impressions significantly reduced procedural time compared to analog methods.
Conclusions
Both impression techniques provided satisfactory clinical outcomes. Digital impressions demonstrated efficiency advantages but were associated with slightly greater bone loss over time. Analog impressions remain a reliable standard for full-arch immediate loading rehabilitations, though digital methods show promise for improved patient experience. Further randomized, long-term studies are needed.
Clinical Significance
Digital impressions offer a faster and more comfortable workflow for full-arch immediate loading rehabilitations, potentially improving patient compliance. However, their association with slightly greater bone loss warrants further investigation to optimize long-term stability.
{"title":"Marginal Bone Level Changes in Full-Arch Rehabilitation: Digital Versus Analog Protocols—A 5-Year Retrospective Study","authors":"Nicola De Angelis, Paolo Pesce, Vito Carlo Alberto Caponio, Giulia Santamaria, Oriana Spanu, Maria Menini","doi":"10.1111/cid.70080","DOIUrl":"https://doi.org/10.1111/cid.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This retrospective study compares the clinical outcomes of analog impressions versus intraoral scanning in full-arch immediate loading rehabilitations. Specifically, it evaluates peri-implant marginal bone level (MBL) changes at different time intervals (implant placement, loading, and at 2 and 5 years), as well as rates of mechanical and prosthetic complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The study included 62 patients who underwent full-arch rehabilitation with immediate implant placement between 2019 and 2020. Patients were divided into two groups: analog impression and digital intraoral scanning. All patients were rehabilitated with fixed titanium-PMMA screw retained restorations. Bone level was assessed through standardized intraoral radiographs at key time points. Additional parameters recorded included procedural time, prosthetic complications, and implant failures. Statistical analyses involved repeated measures ANOVA and post hoc Bonferroni tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The follow-up period was 5 years. Implant survival was 99.6%. No significant differences were found in prosthetic complications. MBL was slightly higher in the analog group at baseline (mean = 0.21, SD = 0.04 vs. digital mean = 0.17, SD = 0.04, <i>t</i>-test <i>p</i>-value < 0.001) than in the digital group. Despite this, the overall bone loss remained within clinically acceptable limits during the follow-up period. Digital impressions significantly reduced procedural time compared to analog methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both impression techniques provided satisfactory clinical outcomes. Digital impressions demonstrated efficiency advantages but were associated with slightly greater bone loss over time. Analog impressions remain a reliable standard for full-arch immediate loading rehabilitations, though digital methods show promise for improved patient experience. Further randomized, long-term studies are needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Significance</h3>\u0000 \u0000 <p>Digital impressions offer a faster and more comfortable workflow for full-arch immediate loading rehabilitations, potentially improving patient compliance. However, their association with slightly greater bone loss warrants further investigation to optimize long-term stability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717007","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}
Pedro Molinero-Mourelle, Manrique Fonseca, Marc Emmanuel Grossen, Anina N. Zuercher, Martin Schimmel, Joannis Katsoulis
Purpose
To assess the clinical and radiographic outcomes of computer-aided design–computer-assisted manufacturing (CAD-CAM) zirconia bars supporting mandibular implant overdentures (IODs) up to a follow-up period of 3 years.
Materials and Methods
A prospective cohort observational single-center study involving 30 edentulous patients rehabilitated with two dental implants (Ø4.3 × 10 mm) at the crestal bone level and an IOD supported by a zirconia bar with distal extensions (maximum length 10.6 mm). At the 1- and 3-year follow-up, implant, prosthetic survival, marginal bone level (MBL) changes, biological, and technical complications were recorded.
Results
A total of 25 patients were assessed at the 12-month (dropout of 19.4%), and 14 patients completed the 36- month follow-up (dropout of 54.8%). Implant survival and success rates were both 100%, while prosthetic survival was 100% with a success rate of 96%. No biological complications were observed during the follow-up period; however, one patient exhibited generalized mucosal hyperplasia around the zirconia bar at the 12-month evaluation. No prosthetic prosthodontic maintenance needs were reported. A mean marginal MBL of −1.28 mm (SD ± 0.37) was recorded at the initial 12-month follow-up, and − 1.32 mm (SD ± 0.32) at the 36-month follow-up. The difference in MBL between the two time points was not statistically significant (p = 0.529).
Conclusion
Zirconia bars with distal extensions for mandibular IODs appear to be a reliable treatment option for the rehabilitation of edentulous patients, demonstrating favorable clinical outcomes up to 3 years of follow-up. A 100% implant and prosthetic survival rate was achieved, along with stable MBLs.
Clinicaltrials.gov identifier: NCT06471881.
目的评价计算机辅助设计-计算机辅助制造（CAD-CAM）氧化锆条支撑下颌种植覆盖义齿（iod）的临床和影像学结果，随访3年。材料与方法一项前瞻性队列观察性单中心研究，纳入30名无牙患者，采用两颗牙种植体（Ø4.3 × 10 mm）在嵴骨水平和由远端延伸（最大长度10.6 mm）的氧化锆棒支撑的IOD进行康复。在1年和3年的随访中，记录了种植体、假体存活率、边缘骨水平（MBL）变化、生物学和技术并发症。结果12个月随访25例，中途退学率19.4%，36个月随访14例，中途退学率54.8%。种植体成活率和成功率均为100%，假体成活率为100%，成功率为96%。随访期间未见生物学并发症；然而，在12个月的评估中，一名患者表现出氧化锆棒周围的全身性粘膜增生。无义肢修复维护需求报告。在最初12个月的随访中，平均边缘MBL为- 1.28 mm (SD±0.37)，在36个月的随访中为- 1.32 mm （SD±0.32）。两个时间点MBL差异无统计学意义（p = 0.529）。结论氧化锆棒带远端延伸用于下颌iod是无牙患者康复的可靠治疗选择，随访3年临床效果良好。种植体和假体的存活率达到100%，MBLs稳定。Clinicaltrials.gov识别码：NCT06471881。
{"title":"Clinical and Radiographic Evaluation of Zirconia Bars for Mandibular Implant Overdentures: A Prospective Cohort Study With up to 3 Years of Follow-Up","authors":"Pedro Molinero-Mourelle, Manrique Fonseca, Marc Emmanuel Grossen, Anina N. Zuercher, Martin Schimmel, Joannis Katsoulis","doi":"10.1111/cid.70066","DOIUrl":"https://doi.org/10.1111/cid.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess the clinical and radiographic outcomes of computer-aided design–computer-assisted manufacturing (CAD-CAM) zirconia bars supporting mandibular implant overdentures (IODs) up to a follow-up period of 3 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A prospective cohort observational single-center study involving 30 edentulous patients rehabilitated with two dental implants (Ø4.3 × 10 mm) at the crestal bone level and an IOD supported by a zirconia bar with distal extensions (maximum length 10.6 mm). At the 1- and 3-year follow-up, implant, prosthetic survival, marginal bone level (MBL) changes, biological, and technical complications were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 25 patients were assessed at the 12-month (dropout of 19.4%), and 14 patients completed the 36- month follow-up (dropout of 54.8%). Implant survival and success rates were both 100%, while prosthetic survival was 100% with a success rate of 96%. No biological complications were observed during the follow-up period; however, one patient exhibited generalized mucosal hyperplasia around the zirconia bar at the 12-month evaluation. No prosthetic prosthodontic maintenance needs were reported. A mean marginal MBL of −1.28 mm (SD ± 0.37) was recorded at the initial 12-month follow-up, and − 1.32 mm (SD ± 0.32) at the 36-month follow-up. The difference in MBL between the two time points was not statistically significant (<i>p</i> = 0.529).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Zirconia bars with distal extensions for mandibular IODs appear to be a reliable treatment option for the rehabilitation of edentulous patients, demonstrating favorable clinical outcomes up to 3 years of follow-up. A 100% implant and prosthetic survival rate was achieved, along with stable MBLs.</p>\u0000 \u0000 <p>Clinicaltrials.gov identifier: NCT06471881.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695822","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}
Vincent J. J. Donker, Gerry M. Raghoebar, Arjan Vissink, Henny J. A. Meijer
Introduction
Immediate implant placement and provisionalization in the maxillary aesthetic zone necessitates meticulous treatment planning. The integration of intraoral scanning with cone beam computed tomography allows for three-dimensional prosthetic-driven planning of the implant. Additionally, it facilitates static computer-assisted implant surgery and prefabrication of a temporary restoration, enabling chairside restoration of the immediate implant. This study aimed to evaluate the clinical, aesthetic, radiographic, and patient-reported outcomes after immediate implant placement and restoration.
Materials and Methods
In a prospective case series, 30 patients with a failing tooth in the maxillary aesthetic zone were included and received immediate implant placement with a bone graft and a prefabricated temporary restoration. The definitive restoration was placed 3 months later. The clinical, aesthetic, radiographic, and patient-reported outcomes were collected prior to implant treatment, 6 weeks after the temporary restoration, and 1 month and 1 year after the definitive restoration.
Results
The prefabricated temporary restoration could be placed in all patients. Three cases of early implant failure were observed (implant survival rate 90%); hence, 27 patients were evaluated after 1 year. The survival and success rates were 100% for the temporary and 100% and 96%, respectively, for the definitive restorations. Plaque, bleeding on probing, and peri-implant inflammation were absent in most cases. At the 1-year follow-up, the mean (SD) Pink Esthetic Score and White Esthetic Score (scale 0–20) was 15.4 (2.5). The mean (SD) marginal bone level change between implant placement and the 1-year follow-up was −0.18 mm (0.57) on the mesial side and −0.44 mm (1.23) on the distal side. The median buccal bone thickness remained stable after immediate implant placement and grafting. The mean (SD) patient satisfaction (scale 0–10) was 9.2 (0.8) at the 1-year evaluation.
Conclusion
The digital workflow has the potential to enable the manufacture of prefabricated temporary restorations, leading to satisfactory clinical, aesthetic, radiographic, and patient-reported outcomes after immediate placement of single-tooth implants in the aesthetic zone.
{"title":"Immediate Implant Placement and Provisionalization in the Aesthetic Zone Using a Digital Workflow: A 1-Year Prospective Case Series Study","authors":"Vincent J. J. Donker, Gerry M. Raghoebar, Arjan Vissink, Henny J. A. Meijer","doi":"10.1111/cid.70079","DOIUrl":"https://doi.org/10.1111/cid.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Immediate implant placement and provisionalization in the maxillary aesthetic zone necessitates meticulous treatment planning. The integration of intraoral scanning with cone beam computed tomography allows for three-dimensional prosthetic-driven planning of the implant. Additionally, it facilitates static computer-assisted implant surgery and prefabrication of a temporary restoration, enabling chairside restoration of the immediate implant. This study aimed to evaluate the clinical, aesthetic, radiographic, and patient-reported outcomes after immediate implant placement and restoration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In a prospective case series, 30 patients with a failing tooth in the maxillary aesthetic zone were included and received immediate implant placement with a bone graft and a prefabricated temporary restoration. The definitive restoration was placed 3 months later. The clinical, aesthetic, radiographic, and patient-reported outcomes were collected prior to implant treatment, 6 weeks after the temporary restoration, and 1 month and 1 year after the definitive restoration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prefabricated temporary restoration could be placed in all patients. Three cases of early implant failure were observed (implant survival rate 90%); hence, 27 patients were evaluated after 1 year. The survival and success rates were 100% for the temporary and 100% and 96%, respectively, for the definitive restorations. Plaque, bleeding on probing, and peri-implant inflammation were absent in most cases. At the 1-year follow-up, the mean (SD) Pink Esthetic Score and White Esthetic Score (scale 0–20) was 15.4 (2.5). The mean (SD) marginal bone level change between implant placement and the 1-year follow-up was −0.18 mm (0.57) on the mesial side and −0.44 mm (1.23) on the distal side. The median buccal bone thickness remained stable after immediate implant placement and grafting. The mean (SD) patient satisfaction (scale 0–10) was 9.2 (0.8) at the 1-year evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The digital workflow has the potential to enable the manufacture of prefabricated temporary restorations, leading to satisfactory clinical, aesthetic, radiographic, and patient-reported outcomes after immediate placement of single-tooth implants in the aesthetic zone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <p>Registered","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695746","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}
Vitālijs Gnusins, Samuel Akhondi, Tadas Zvirblis, Kevser Pala, German O. Gallucci, Algirdas Puisys
Objectives
This randomized clinical trial aimed to compare changes in soft tissue height, probing depth, and buccal contour volume loss following immediate implant placement using either chairside composite or prefabricated zirconia Sealing Socket Abutments (SSAs) in the posterior region.
Materials and Methods
47 patients requiring posterior tooth extraction and immediate implant placement were randomly assigned to one of two groups: the composite Sealing Socket Abutment (CS) group (n = 24), receiving chairside-fabricated abutments, or the zirconia Sealing Socket Abutment (ZR) group (n = 23), receiving prefabricated abutments. Implants were placed immediately after extraction, using static computer-assisted implant surgery (sCAIS). Supra-Platform Tissue Height (SPTH) and total horizontal tissues (THT) were assessed using cone-beam computed tomography (CBCT) over a 3-month healing period. Implant survival, probing pocket depths (PPD), bleeding on probing (BOP) and plaque index (PI) were recorded clinically, while volumetric analysis was performed using digital impressions.
Results
SPTH remained stable from baseline to the 3-month follow-up, with a mean change of −0.17 mm in the CS group and −0.44 mm in the ZR group. These differences were not statistically significant (p > 0.05). THT exhibited significant horizontal shrinkage in both groups over the 3-month period. In the CS group, THT decreased by 1.00 mm, while the ZR group showed a reduction of 1.17 mm (p < 0.001). PPD increased in the CS group from 2.8 mm to 3.7 mm on the palatal/lingual aspect and from 2.5 mm to 3.2 mm on the buccal aspect (p = 0.026). In contrast, the ZR group showed a decrease from 3.1 mm to 2.7 mm palatally/lingually and remained stable buccally at 2.6 mm to 2.7 mm (p = 0.001). BOP in the CS group decreased from 42.3% to 7.7% (p = 0.009), while the ZR group maintained low BOP levels, decreasing slightly from 17.4% to 4.4% (p = 0.346).
Conclusions
Both approaches showed comparable outcomes. ZR abutments resulted in shallower probing depths, while CS abutments showed less volumetric shrinkage. SPTH remained stable in both groups.
Trial Registration
This trial was registered prior to patient enrollment at ClinicalTrials.gov identifier: NCT05748379
{"title":"Chairside vs Prefabricated Sealing Socket Abutments for Posterior Immediate Implants: A Randomized Clinical Trial","authors":"Vitālijs Gnusins, Samuel Akhondi, Tadas Zvirblis, Kevser Pala, German O. Gallucci, Algirdas Puisys","doi":"10.1111/cid.70076","DOIUrl":"https://doi.org/10.1111/cid.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This randomized clinical trial aimed to compare changes in soft tissue height, probing depth, and buccal contour volume loss following immediate implant placement using either chairside composite or prefabricated zirconia Sealing Socket Abutments (SSAs) in the posterior region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>47 patients requiring posterior tooth extraction and immediate implant placement were randomly assigned to one of two groups: the composite Sealing Socket Abutment (CS) group (<i>n</i> = 24), receiving chairside-fabricated abutments, or the zirconia Sealing Socket Abutment (ZR) group (<i>n</i> = 23), receiving prefabricated abutments. Implants were placed immediately after extraction, using static computer-assisted implant surgery (sCAIS). Supra-Platform Tissue Height (SPTH) and total horizontal tissues (THT) were assessed using cone-beam computed tomography (CBCT) over a 3-month healing period. Implant survival, probing pocket depths (PPD), bleeding on probing (BOP) and plaque index (PI) were recorded clinically, while volumetric analysis was performed using digital impressions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SPTH remained stable from baseline to the 3-month follow-up, with a mean change of −0.17 mm in the CS group and −0.44 mm in the ZR group. These differences were not statistically significant (<i>p</i> > 0.05). THT exhibited significant horizontal shrinkage in both groups over the 3-month period. In the CS group, THT decreased by 1.00 mm, while the ZR group showed a reduction of 1.17 mm (<i>p</i> < 0.001). PPD increased in the CS group from 2.8 mm to 3.7 mm on the palatal/lingual aspect and from 2.5 mm to 3.2 mm on the buccal aspect (<i>p</i> = 0.026). In contrast, the ZR group showed a decrease from 3.1 mm to 2.7 mm palatally/lingually and remained stable buccally at 2.6 mm to 2.7 mm (<i>p</i> = 0.001). BOP in the CS group decreased from 42.3% to 7.7% (<i>p</i> = 0.009), while the ZR group maintained low BOP levels, decreasing slightly from 17.4% to 4.4% (<i>p</i> = 0.346).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both approaches showed comparable outcomes. ZR abutments resulted in shallower probing depths, while CS abutments showed less volumetric shrinkage. SPTH remained stable in both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This trial was registered prior to patient enrollment at ClinicalTrials.gov identifier: NCT05748379</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672012","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}
Alberto Monje, Sofía Navarro-Mesa, Costanza Soldini, Giorgio Zappalá, Pedro Peña, Jose Manuel Navarro Sr., Ramón Pons
Objective
To compare the clinical/radiographic outcomes and the rate of disease resolution of the adjunctive use of electrolysis (GS) or hydrogen peroxide (HP) for mechanical decontamination in the reconstructive treatment of peri-implantitis-related intrabony defects.
Material and Methods
A multicenter randomized clinical trial was designed to compare the effectiveness and safety of two strategies for the surface decontamination of crater-like and circumferential intrabony defects subjected to reconstructive therapy. Clinical evaluation was made at baseline (T0), 6 months (T1) and 12 months (T2), while radiographic assessment was carried out at T0 and T2. Disease resolution was the primary outcome. Supportive therapy was administered following surgical treatment. Simple and multiple generalized estimating equations (GEE) models were applied to compare the outcomes achieved and to explore potential confounders. Post hoc power calculation was performed to validate the statistical power of the findings.
Results
Overall, 58 patients completed the study. All the clinical parameters/indices, namely probing pocket depth, modified sulcular bleeding index, suppuration grading index, and width of keratinized mucosa, showed a significant reduction (p < 0.001) from T0 to T2 in both tested groups. Mucosal recession increased (p < 0.001) from T0 to T2. Marginal bone level and radiographic defect angle increased (p < 0.001) from T0 to T2. The disease resolution rate was 87.5% for the GS group and 64.5% for the HP group at T2 (p = 0.08). No major postoperative complications were reported.
Conclusion
Both tested surface decontamination methods are effective in resolving peri-implantitis, in gaining radiographic marginal bone levels, and in enhancing clinical peri-implant conditions in the surgical reconstructive therapy (NCT05615051).
{"title":"Surface Decontamination on the Reconstructive Therapy of Peri-Implantitis: A Multicenter Randomized Clinical Trial","authors":"Alberto Monje, Sofía Navarro-Mesa, Costanza Soldini, Giorgio Zappalá, Pedro Peña, Jose Manuel Navarro Sr., Ramón Pons","doi":"10.1111/cid.70075","DOIUrl":"https://doi.org/10.1111/cid.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the clinical/radiographic outcomes and the rate of disease resolution of the adjunctive use of electrolysis (GS) or hydrogen peroxide (HP) for mechanical decontamination in the reconstructive treatment of peri-implantitis-related intrabony defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>A multicenter randomized clinical trial was designed to compare the effectiveness and safety of two strategies for the surface decontamination of crater-like and circumferential intrabony defects subjected to reconstructive therapy. Clinical evaluation was made at baseline (T<sub>0</sub>), 6 months (T<sub>1</sub>) and 12 months (T<sub>2</sub>), while radiographic assessment was carried out at T<sub>0</sub> and T<sub>2</sub>. Disease resolution was the primary outcome. Supportive therapy was administered following surgical treatment. Simple and multiple generalized estimating equations (GEE) models were applied to compare the outcomes achieved and to explore potential confounders. Post hoc power calculation was performed to validate the statistical power of the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 58 patients completed the study. All the clinical parameters/indices, namely probing pocket depth, modified sulcular bleeding index, suppuration grading index, and width of keratinized mucosa, showed a significant reduction (<i>p</i> < 0.001) from T<sub>0</sub> to T<sub>2</sub> in both tested groups. Mucosal recession increased (<i>p</i> < 0.001) from T<sub>0</sub> to T<sub>2</sub>. Marginal bone level and radiographic defect angle increased (<i>p</i> < 0.001) from T<sub>0</sub> to T<sub>2</sub>. The disease resolution rate was 87.5% for the GS group and 64.5% for the HP group at T<sub>2</sub> (<i>p</i> = 0.08). No major postoperative complications were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both tested surface decontamination methods are effective in resolving peri-implantitis, in gaining radiographic marginal bone levels, and in enhancing clinical peri-implant conditions in the surgical reconstructive therapy (NCT05615051).</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673199","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}
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