David Palombo, Federico Rivara, Liebert Parreiras Nogueira, Fabio Vignoletti, Javier Sanz Esporrin, Håvard Jostein Haugen, Mariano Sanz
Objectives
To evaluate the three-dimensional hard and soft tissue healing around a modified dental implant presenting a tissue level connection and a convergent transmucosal neck (test), compared with a conventional bone level implant (control).
Material and Methods
Sixteen test and 16 control implants were placed in 8 experimental animals, following a random allocation sequence. Peri-implant bone volume and surface, 360° bone to implant contact (360-BIC), peri-implant soft tissue volume, and buccal and lingual peri-implant soft tissue thickness, were evaluated through Micro-CT and digital volumetric analysis at 4 and 12 weeks of healing.
Results
In the most coronal mm of the implant surface apical to the implant platform, both at 4 and 12 weeks, 360-BIC was higher at test implants. At 4 weeks, it was approximately 4 times higher (+303.26%; ∆ = 39.83%; p = 0.05) and at 12 weeks, 2.50 times higher (+151.8%; ∆ = 43.23%; p = 0.03). In the same area of interest, a statistically non-significant trend towards a higher 360° peri-implant bone volume was also observed in the test group, both at 4 weeks (+ 272.72%; ∆ = 8.70 mm3; p = 0.07) and 12 weeks (+ 154.54%; ∆ = 8.32 mm3; p = 0.09), being statistically significant only for the lingual bone volume at 4 weeks (+246.47%; ∆ = 5.94 mm3; p = 0.02). No significant differences were observed when comparing the soft tissue volumes and thicknesses among the two groups.
Conclusions
Test implants demonstrate superior 360-BIC and bone volumes around the most coronal implant surface, below the implant platform, while no relevant differences in soft tissue volumes and thickness were observed.
{"title":"Three-Dimensional Hard and Soft Tissue Healing at Implants With A Modified Neck Design: An In Vivo Preclinical Study","authors":"David Palombo, Federico Rivara, Liebert Parreiras Nogueira, Fabio Vignoletti, Javier Sanz Esporrin, Håvard Jostein Haugen, Mariano Sanz","doi":"10.1111/cid.70065","DOIUrl":"https://doi.org/10.1111/cid.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the three-dimensional hard and soft tissue healing around a modified dental implant presenting a tissue level connection and a convergent transmucosal neck (test), compared with a conventional bone level implant (control).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Sixteen test and 16 control implants were placed in 8 experimental animals, following a random allocation sequence. Peri-implant bone volume and surface, 360° bone to implant contact (360-BIC), peri-implant soft tissue volume, and buccal and lingual peri-implant soft tissue thickness, were evaluated through Micro-CT and digital volumetric analysis at 4 and 12 weeks of healing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the most coronal mm of the implant surface apical to the implant platform, both at 4 and 12 weeks, 360-BIC was higher at test implants. At 4 weeks, it was approximately 4 times higher (+303.26%; <i>∆</i> = 39.83%; <i>p</i> = 0.05) and at 12 weeks, 2.50 times higher (+151.8%; <i>∆</i> = 43.23%; <i>p</i> = 0.03). In the same area of interest, a statistically non-significant trend towards a higher 360° peri-implant bone volume was also observed in the test group, both at 4 weeks (+ 272.72%; <i>∆</i> = 8.70 mm<sup>3</sup>; <i>p</i> = 0.07) and 12 weeks (+ 154.54%; <i>∆</i> = 8.32 mm<sup>3</sup>; <i>p</i> = 0.09), being statistically significant only for the lingual bone volume at 4 weeks (+246.47%; <i>∆</i> = 5.94 mm<sup>3</sup>; <i>p</i> = 0.02). No significant differences were observed when comparing the soft tissue volumes and thicknesses among the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Test implants demonstrate superior 360-BIC and bone volumes around the most coronal implant surface, below the implant platform, while no relevant differences in soft tissue volumes and thickness were observed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574004","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}
Tingyu Xie, Ikiru Atsuta, Ikue Narimatsu, Bin Ji, Kiyoshi Koyano, Yasunori Ayukawa
Background
Achieving stable bone regeneration and soft tissue integration is critical for the success of dental implants, especially in patients with alveolar bone defects. Carbonate apatite (CO3Ap), a synthetic bone substitute, has emerged as a promising alternative due to its excellent osteoconductivity and biocompatibility. However, CO3Ap lacks osteoinductive capacity, which limits its effectiveness in promoting bone regeneration on its own.
Purpose
This study aimed to evaluate the effects of a CO3Ap–autogenous bone (AB) mixture on bone regeneration and soft tissue integration in a rat maxillary implant model.
Materials and Methods
Sixty rats underwent extraction of their maxillary molars, followed by titanium implant placement. The extraction sockets were filled with three different materials: CO3Ap, AB, or a CO3Ap–AB mixture. In vivo bone tissue and soft tissue evaluations were performed at specified time points. Additionally, in vitro experiments were conducted to assess the osteogenic differentiation of mesenchymal stem cells when exposed to the CO3Ap–AB mixture.
Results
In vivo experiments showed that the CO3Ap–AB mixture significantly enhanced bone volume and maintained high bone mineral density compared to CO3Ap and AB alone. Furthermore, the mixture promoted longer epithelial attachment, suggesting its potential for long-term soft tissue stabilization. In vitro, the CO3Ap–AB mixture effectively promoted osteogenic differentiation of mesenchymal stem cells.
Conclusions
The combination of CO3Ap and AB exhibited a synergistic effect, enhancing early bone regeneration, osseointegration, and soft tissue sealing, which are crucial for implant stability. The CO3Ap–AB mixture shows great potential as a clinically effective bone substitute for dental implant treatment in patients with compromised bone conditions.
{"title":"Effects of Carbonate Apatite and Bone Mixture on Bone and Soft Tissue Integration in a Rat Implant Model","authors":"Tingyu Xie, Ikiru Atsuta, Ikue Narimatsu, Bin Ji, Kiyoshi Koyano, Yasunori Ayukawa","doi":"10.1111/cid.70077","DOIUrl":"https://doi.org/10.1111/cid.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Achieving stable bone regeneration and soft tissue integration is critical for the success of dental implants, especially in patients with alveolar bone defects. Carbonate apatite (CO<sub>3</sub>Ap), a synthetic bone substitute, has emerged as a promising alternative due to its excellent osteoconductivity and biocompatibility. However, CO<sub>3</sub>Ap lacks osteoinductive capacity, which limits its effectiveness in promoting bone regeneration on its own.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the effects of a CO<sub>3</sub>Ap–autogenous bone (AB) mixture on bone regeneration and soft tissue integration in a rat maxillary implant model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Sixty rats underwent extraction of their maxillary molars, followed by titanium implant placement. The extraction sockets were filled with three different materials: CO<sub>3</sub>Ap, AB, or a CO<sub>3</sub>Ap–AB mixture. In vivo bone tissue and soft tissue evaluations were performed at specified time points. Additionally, in vitro experiments were conducted to assess the osteogenic differentiation of mesenchymal stem cells when exposed to the CO<sub>3</sub>Ap–AB mixture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In vivo experiments showed that the CO<sub>3</sub>Ap–AB mixture significantly enhanced bone volume and maintained high bone mineral density compared to CO3Ap and AB alone. Furthermore, the mixture promoted longer epithelial attachment, suggesting its potential for long-term soft tissue stabilization. In vitro, the CO<sub>3</sub>Ap–AB mixture effectively promoted osteogenic differentiation of mesenchymal stem cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of CO<sub>3</sub>Ap and AB exhibited a synergistic effect, enhancing early bone regeneration, osseointegration, and soft tissue sealing, which are crucial for implant stability. The CO<sub>3</sub>Ap–AB mixture shows great potential as a clinically effective bone substitute for dental implant treatment in patients with compromised bone conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524698","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}
RETRACTION: J. Gottlow, L. Sennerby, “ Influence of diameter and length on primary stability in various implant site densities—An in vitro study in polyurethane blocks,” Clinical Implant Dentistry and Related Research26, no. 2 (2024): 327–332, https://doi.org/10.1111/cid.13290.
The above article, published online on November 5, 2023, in Wiley Online Library (wileyonlinelibrary.com), has been retracted by mutual agreement of the authors, Johan Gottlow, DDS, and Lars Sennerby, DDS, PhD; the journal's Editor-in-Chief, Prof. Philippe Hujoel; Prof. Hom-Lay Wang; and Wiley Periodicals LLC. This retraction has been issued due to the identification of unattributed overlap between this article and an unpublished study conducted by a former colleague of the authors during their student years. This finding was confirmed by an institutional investigation. Accordingly, the article has been retracted to maintain the integrity of the scientific record.
撤回：J. Gottlow， L. Sennerby，“不同种植体密度下直径和长度对初始稳定性的影响-聚氨酯块体的体外研究”，临床种植牙科学与相关研究26，no。2 (2024): 327-332, https://doi.org/10.1111/cid.13290。上述文章于2023年11月5日在线发表在Wiley在线图书馆（wileyonlinelibrary.com）上，经作者（DDS的Johan Gottlow和DDS的Lars Sennerby博士）共同同意撤回；该杂志主编Philippe Hujoel教授；王仁礼教授；和Wiley期刊有限责任公司。由于本文与作者学生时期的前同事进行的一项未发表的研究之间存在未归因于的重叠，因此发布了此撤回。这一发现得到了一项机构调查的证实。因此，该文已被撤回，以保持科学记录的完整性。
{"title":"RETRACTION: Influence of diameter and length on primary stability in various implant site densities—An in vitro study in polyurethane blocks","authors":"","doi":"10.1111/cid.70073","DOIUrl":"https://doi.org/10.1111/cid.70073","url":null,"abstract":"<p>\u0000 <b>RETRACTION</b>: <span>J. Gottlow</span>, <span>L. Sennerby</span>, “ <span>Influence of diameter and length on primary stability in various implant site densities—An in vitro study in polyurethane blocks</span>,” <i>Clinical Implant Dentistry and Related Research</i> <span>26</span>, no. <span>2</span> (<span>2024</span>): <span>327</span>–<span>332</span>, https://doi.org/10.1111/cid.13290.\u0000 </p><p>The above article, published online on November 5, 2023, in Wiley Online Library (wileyonlinelibrary.com), has been retracted by mutual agreement of the authors, Johan Gottlow, DDS, and Lars Sennerby, DDS, PhD; the journal's Editor-in-Chief, Prof. Philippe Hujoel; Prof. Hom-Lay Wang; and Wiley Periodicals LLC. This retraction has been issued due to the identification of unattributed overlap between this article and an unpublished study conducted by a former colleague of the authors during their student years. This finding was confirmed by an institutional investigation. Accordingly, the article has been retracted to maintain the integrity of the scientific record.</p>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519866","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}
Juan Ballesteros, Solange Vásquez, Marta Revilla-León, Miguel Gómez-Polo
<div> <section> <h3> Purpose</h3> <p>The present study aims to evaluate whether differences in accuracy of the implant positions exist for static computer-aided implant placement based on the manufacturing process of surgical guides and the inclusion or not of metal sleeves.</p> </section> <section> <h3> Methods</h3> <p>Seventy-two implants (6 per model) were placed in 12 models simulating a partially edentulous maxilla using 12 dentally supported surgical guides anchored with 2 anchor pins. The surgical guides were divided into three groups: additive manufactured with a metal sleeve (Group PS), additive manufactured without a metal sleeve (Group PNS), and subtractive manufactured without a metal sleeve (Group MNS). The internal drilling diameter was standardized for all groups (4.85 mm). Deviations between the planned virtual implant positions and the scanned postoperative models were assessed in three parameters: 3D deviations at the crest, 3D deviations at the apex, and angular deviations in the implant insertion axis. The Shapiro–Wilk test was applied to analyze the normality of the sample distribution. Kruskal–Wallis and Mann–Whitney tests were used to analyze the deviations among the groups (<i>α</i> = 0.05).</p> </section> <section> <h3> Results</h3> <p>Statistical differences were reported among the groups in the parameters: 3D deviations at the crest, 3D deviations at the apex, and angular deviations in the implant insertion axis (<i>p</i> < 0.05). At the crest, the smallest 3D deviation was recorded in the MNS group (0.498 ± 0.337 mm) followed by the PNS group (0.660 ± 0.572 mm) and the PS group (1.028 ± 0.424 mm) (<i>p</i> < 0.05). At the apex, as well, the lowest deviation was observed in the MNS group (0.810 ± 0.544 mm) followed by the PNS group (0.840 ± 0.620) and the PS group (1.360 ± 0.990 mm) (<i>p</i> < 0.05). Regarding angular deviations, the best results were obtained by the PNS group (1.44° ± 1.57°) with statistically significant differences with both the MNS group (2.90° ± 2.35°) and the PS group (3.88° ± 2.85°) (<i>p</i> < 0.05).</p> </section> <section> <h3> Conclusions</h3> <p>The accuracy of the implant position was affected by the inclusion or absence of metal sleeves and the manufacturing method. Overall, non-sleeved guides deliver better accuracy by reducing crestal and apical deviations, as well as angular errors. Differences between the groups without metal sleeves, 3D printed and milled, were found in the implant angulation, where the 3D printed group obtained more accurate results.</p> </s
{"title":"A Comparative Study on the Accuracy of Implant Placement Using 3D-Printed and Milled Guides Without Metal Sleeves","authors":"Juan Ballesteros, Solange Vásquez, Marta Revilla-León, Miguel Gómez-Polo","doi":"10.1111/cid.70072","DOIUrl":"https://doi.org/10.1111/cid.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The present study aims to evaluate whether differences in accuracy of the implant positions exist for static computer-aided implant placement based on the manufacturing process of surgical guides and the inclusion or not of metal sleeves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-two implants (6 per model) were placed in 12 models simulating a partially edentulous maxilla using 12 dentally supported surgical guides anchored with 2 anchor pins. The surgical guides were divided into three groups: additive manufactured with a metal sleeve (Group PS), additive manufactured without a metal sleeve (Group PNS), and subtractive manufactured without a metal sleeve (Group MNS). The internal drilling diameter was standardized for all groups (4.85 mm). Deviations between the planned virtual implant positions and the scanned postoperative models were assessed in three parameters: 3D deviations at the crest, 3D deviations at the apex, and angular deviations in the implant insertion axis. The Shapiro–Wilk test was applied to analyze the normality of the sample distribution. Kruskal–Wallis and Mann–Whitney tests were used to analyze the deviations among the groups (<i>α</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Statistical differences were reported among the groups in the parameters: 3D deviations at the crest, 3D deviations at the apex, and angular deviations in the implant insertion axis (<i>p</i> < 0.05). At the crest, the smallest 3D deviation was recorded in the MNS group (0.498 ± 0.337 mm) followed by the PNS group (0.660 ± 0.572 mm) and the PS group (1.028 ± 0.424 mm) (<i>p</i> < 0.05). At the apex, as well, the lowest deviation was observed in the MNS group (0.810 ± 0.544 mm) followed by the PNS group (0.840 ± 0.620) and the PS group (1.360 ± 0.990 mm) (<i>p</i> < 0.05). Regarding angular deviations, the best results were obtained by the PNS group (1.44° ± 1.57°) with statistically significant differences with both the MNS group (2.90° ± 2.35°) and the PS group (3.88° ± 2.85°) (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The accuracy of the implant position was affected by the inclusion or absence of metal sleeves and the manufacturing method. Overall, non-sleeved guides deliver better accuracy by reducing crestal and apical deviations, as well as angular errors. Differences between the groups without metal sleeves, 3D printed and milled, were found in the implant angulation, where the 3D printed group obtained more accurate results.</p>\u0000 </s","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503140","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}
<div> <section> <h3> Background</h3> <p>Uneven data distribution (due to rare outcomes) and repeated measurements (from multiple implants per patient) hinder the creation of a precise oral implant failure risk model.</p> </section> <section> <h3> Purpose</h3> <p>The aim of this study was to explore variable selection methods suitable for oral implant data, assess risk factors of early failure and postoperative complications, and apply the two-step cluster analysis to establish a risk prediction model for oral implant failure, providing a reference for clinical practice.</p> </section> <section> <h3> Materials and Methods</h3> <p>This study was a retrospective analysis, with early failure and postoperative complications serving as the outcome indicators. Given the repeated measurements and uneven distribution in oral implant data, our study conducted a comparative analysis between GEE and GEE with Firth penalization. This study evaluated the influencing factors screened by a more suitable model and utilized them for subsequent risk prediction. A two-step cluster analysis was applied to identify different subgroups of early failure and postoperative complications; their clinical characteristics were compared, and relevant risk prediction models were developed.</p> </section> <section> <h3> Results</h3> <p>Among a total of 677 patients and 1200 implants, 21 implants were lost prior to loading, and postoperative complications occurred in 74 patients involving 94 implants. The GEE model with Firth's penalty term indicated that non-submerged healing (<i>p</i> < 0.001), shorter implant length (<i>p</i> < 0.001), and thinner diameter (<i>p</i> = 0.007) were risk factors for early failure. The GEE model showed that non-submerged healing (<i>p</i> = 0.039) was a protective factor against postoperative complications, whereas unhealed extraction sockets at the implant site (<i>p</i> = 0.048), the use of bone substitutes (<i>p</i> = 0.008), and a history of periodontal disease (<i>p</i> = 0.009) were risk factors. Additionally, the use of bovine tendon-derived absorbable biomembranes (<i>p</i> = 0.036) may elevate the risk of postoperative complications. The two-step cluster analysis identified two patient subgroups, categorized as high-risk and low-risk, and the prediction model demonstrated good discrimination ability.</p> </section> <section> <h3> Conclusions</h3> <p>Early failure data were highly imbalanced, and the incorporation of the Firth penalty term provided significant benefits. However, its effectiveness in managing postoperative complication dat
{"title":"Predicting Implant Failure and Complications Using Cluster Analysis After Variable Selection: A Retrospective Study","authors":"Jinlin Zhang, Yufeng Gao, Yannan Cao, Zhuang Ding, Bo Chen, Fangyong Zhu","doi":"10.1111/cid.70063","DOIUrl":"https://doi.org/10.1111/cid.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Uneven data distribution (due to rare outcomes) and repeated measurements (from multiple implants per patient) hinder the creation of a precise oral implant failure risk model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to explore variable selection methods suitable for oral implant data, assess risk factors of early failure and postoperative complications, and apply the two-step cluster analysis to establish a risk prediction model for oral implant failure, providing a reference for clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This study was a retrospective analysis, with early failure and postoperative complications serving as the outcome indicators. Given the repeated measurements and uneven distribution in oral implant data, our study conducted a comparative analysis between GEE and GEE with Firth penalization. This study evaluated the influencing factors screened by a more suitable model and utilized them for subsequent risk prediction. A two-step cluster analysis was applied to identify different subgroups of early failure and postoperative complications; their clinical characteristics were compared, and relevant risk prediction models were developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among a total of 677 patients and 1200 implants, 21 implants were lost prior to loading, and postoperative complications occurred in 74 patients involving 94 implants. The GEE model with Firth's penalty term indicated that non-submerged healing (<i>p</i> < 0.001), shorter implant length (<i>p</i> < 0.001), and thinner diameter (<i>p</i> = 0.007) were risk factors for early failure. The GEE model showed that non-submerged healing (<i>p</i> = 0.039) was a protective factor against postoperative complications, whereas unhealed extraction sockets at the implant site (<i>p</i> = 0.048), the use of bone substitutes (<i>p</i> = 0.008), and a history of periodontal disease (<i>p</i> = 0.009) were risk factors. Additionally, the use of bovine tendon-derived absorbable biomembranes (<i>p</i> = 0.036) may elevate the risk of postoperative complications. The two-step cluster analysis identified two patient subgroups, categorized as high-risk and low-risk, and the prediction model demonstrated good discrimination ability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early failure data were highly imbalanced, and the incorporation of the Firth penalty term provided significant benefits. However, its effectiveness in managing postoperative complication dat","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367314","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}
Stefan Matthijs, Véronique Christiaens, Carine Matthys, Hugo De Bruyn, Maarten Glibert
<div> <section> <h3> Background</h3> <p>In order to reduce crestal bone remodeling around the implant shoulder, different implant macrodesigns have been developed. The presence of microthreads at the coronal part of the implant, as well as platform-shifting using a conical internal abutment connection, is suggested to limit bone remodeling. However, long-term studies excluding confounding factors to confirm this are scarce.</p> </section> <section> <h3> Aim</h3> <p>This randomized controlled trial aimed to assess the effect of implant neck design (microthreaded vs. non-microthreaded) as well as type of abutment connection (internal conical vs. external flat-to-flat) on long-term crestal bone remodeling and peri-implant health. Additionally, the clinical outcome of bar-retained maxillary overdentures on 4 implants is reported after at least 6 years of function.</p> </section> <section> <h3> Materials and Methods</h3> <p>Twenty-five patients were treated with a bar-retained maxillary overdenture. Each patient received 4 different implants, one of each of the 4 experimental designs, with respectively: internal connection and microthreads on the implant neck (I MT); internal connection without microthreads (I NMT); external connection with microthreads (E MT); and external connection without microthreads (E NMT). Other features, such as diameter, surface topography, extent of platform switch, as well as the surgical and prosthetic treatment protocol, were identical. The implants were randomly allocated to the sites (posterior right, anterior right, anterior left, and posterior left), based on a pre-randomized, fixed-order assignment generated by a randomization software. Radiographic crestal bone loss (CBL), plaque score (PS), bleeding on probing (BoP) and probing pocket depth (PPD) were determined after 1 and 6 function years.</p> </section> <section> <h3> Results</h3> <p>Two implants in 2 patients were excluded because of protocol deviations, requiring the placement of a wider implant. Four out of 98 implants (4.1%) failed during the provisionalization process. These were replaced with the same type of implant after 3 months of healing and were included in further analysis. Due to the relatively small sample size and high drop-out rate, the effect of microthread design and connection on implant survival could only be reported descriptively. Twenty patients could be re-evaluated at the 1-year and 6-year time points, resulting in 78 examined implants. These showed a mean CBL of 0.39 mm (SD: 0.68; range: 0–3.42) after 1 year and 0.37 mm (SD: 0.61; range: −0.34—3.03) after 6 years. Between the 4 different study implants, no statisticall
背景为了减少假体肩部周围的嵴骨重塑，人们开发了不同的大尺寸假体。在种植体冠状部分存在微螺纹，以及使用锥形内基台连接的平台移动，建议限制骨重塑。然而，排除混杂因素来证实这一点的长期研究很少。目的：本随机对照试验旨在评估种植体颈部设计（微螺纹与非微螺纹）以及基台连接类型（内圆锥形与外平对平）对长期牙冠骨重塑和种植体周围健康的影响。此外，4种种植体的上颌覆盖义齿在功能至少6年后的临床结果也有报道。材料与方法对25例患者进行上颌覆盖义齿种植。每位患者接受4种不同的种植体，4种实验设计各一种，分别为：种植体颈部内连接和微螺纹（I MT）；无微螺纹内连接（I NMT）；微螺纹外连接（E MT）；无微螺纹外连接（E - NMT）。其他特征，如直径，表面形貌，平台切换的程度，以及手术和假体治疗方案，是相同的。根据随机化软件生成的预随机固定顺序分配，植入物被随机分配到位置（右后、右前、左前和左后）。分别在1年和6个功能年后测定胸膜嵴骨丢失（CBL）、斑块评分（PS）、探探出血（BoP）和探探袋深度（PPD）。结果2例患者2枚种植体因方案偏差被排除，需要放置更宽的种植体。98个植入物中有4个（4.1%）在预备过程中失败。在愈合3个月后用相同类型的植入物替换，并纳入进一步分析。由于样本量相对较小，退出率较高，微螺纹设计和连接对种植体存活的影响只能描述性报道。20例患者可以在1年和6年的时间点重新评估，结果检查了78个种植体。平均CBL为0.39 mm (SD: 0.68；范围：0-3.42)，1年后0.37 mm (SD: 0.61；范围：−0.34-3.03)6年后。在4种不同的研究植入物之间，随着时间的推移，CBL没有统计学上的显著差异。随着时间的推移，微螺纹和连接类型对CBL的影响都没有统计学意义，在6年的重新评估中，对PPD、BoP和PS也没有统计学意义。结论四种植体棒固位上颌覆盖义齿种植6年后，种植体和义齿成活率高，冠骨稳定。微螺纹的存在与否以及种植体-基台连接的类型对种植体周围CBL的影响有限。种植体周围健康参数表明没有种植体周围炎。临床试验注册ClinicalTrials.gov标识符：NCT06821308
{"title":"A 6-Year Randomized Controlled Trial on Different Implant Designs in Maxillary Overdenture Patients","authors":"Stefan Matthijs, Véronique Christiaens, Carine Matthys, Hugo De Bruyn, Maarten Glibert","doi":"10.1111/cid.70069","DOIUrl":"https://doi.org/10.1111/cid.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In order to reduce crestal bone remodeling around the implant shoulder, different implant macrodesigns have been developed. The presence of microthreads at the coronal part of the implant, as well as platform-shifting using a conical internal abutment connection, is suggested to limit bone remodeling. However, long-term studies excluding confounding factors to confirm this are scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This randomized controlled trial aimed to assess the effect of implant neck design (microthreaded vs. non-microthreaded) as well as type of abutment connection (internal conical vs. external flat-to-flat) on long-term crestal bone remodeling and peri-implant health. Additionally, the clinical outcome of bar-retained maxillary overdentures on 4 implants is reported after at least 6 years of function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Twenty-five patients were treated with a bar-retained maxillary overdenture. Each patient received 4 different implants, one of each of the 4 experimental designs, with respectively: internal connection and microthreads on the implant neck (I MT); internal connection without microthreads (I NMT); external connection with microthreads (E MT); and external connection without microthreads (E NMT). Other features, such as diameter, surface topography, extent of platform switch, as well as the surgical and prosthetic treatment protocol, were identical. The implants were randomly allocated to the sites (posterior right, anterior right, anterior left, and posterior left), based on a pre-randomized, fixed-order assignment generated by a randomization software. Radiographic crestal bone loss (CBL), plaque score (PS), bleeding on probing (BoP) and probing pocket depth (PPD) were determined after 1 and 6 function years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two implants in 2 patients were excluded because of protocol deviations, requiring the placement of a wider implant. Four out of 98 implants (4.1%) failed during the provisionalization process. These were replaced with the same type of implant after 3 months of healing and were included in further analysis. Due to the relatively small sample size and high drop-out rate, the effect of microthread design and connection on implant survival could only be reported descriptively. Twenty patients could be re-evaluated at the 1-year and 6-year time points, resulting in 78 examined implants. These showed a mean CBL of 0.39 mm (SD: 0.68; range: 0–3.42) after 1 year and 0.37 mm (SD: 0.61; range: −0.34—3.03) after 6 years. Between the 4 different study implants, no statisticall","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367315","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 compare the efficacy of free gingival graft (FGG) around implants in reconstructed mandibles with free fibula flaps (FFFs) or iliac bone flaps (IBFs).
Materials and Methods
We included patients receiving mandibular reconstruction with FFFs or IBFs due to the removal of maxillofacial tumors who underwent implant and FGG placement prior to restoration. Clinical data were evaluated before (T0), immediately after (T1), 3 months after (T2), 6 months after (T3) and 1 year after (T4) FGG placement. We analyzed the keratinized mucosa width (KMW) gain and the shrinkage rate.
Results
A total of 30 patients were enrolled in this study, including 15 patients with 48 implants in the FFFs group and 15 patients with 52 implants in the IBFs group. The buccal KMW gain and shrinkage rate in the FFFs group were not statistically significant compared with the IBFs group at T4. In the IBFs group, the buccal KMW gain and shrinkage rate remained relatively stable after 6 months. The lingual KMW gain in the FFFs group was significantly greater than that in the IBFs group at T4 (2.1 ± 0.2 mm vs. 1.5 ± 0.2 mm, p < 0.05). The lingual shrinkage rate in the FFFs group was significantly smaller than that in the IBFs group at T4 (27.8% ± 5.5% vs. 47.3% ± 5.5%, p < 0.05).
Conclusions
FGG can reconstruct the keratinized mucosa effectively in a reconstructed mandible. The keratinized mucosa width gain decreases over time.
目的比较游离腓骨瓣（FFFs）与髂骨瓣（IBFs）修复下颌骨种植体周围游离牙龈移植的效果。材料和方法我们纳入了因颌面部肿瘤切除而接受fff或ibf下颌重建的患者，这些患者在修复前接受了种植体和FGG放置。评估FGG放置前（T0）、放置后立即（T1）、放置后3个月（T2）、放置后6个月（T3）和放置后1年（T4）的临床资料。我们分析了角化后的粘膜宽度（KMW）增益和收缩率。结果本研究共纳入30例患者，其中fff组15例植入48个假体，ibf组15例植入52个假体。在T4时，FFFs组颊部KMW增加和萎缩率与IBFs组比较无统计学意义。在IBFs组，6个月后，颊部KMW的增加和收缩率保持相对稳定。T4时，fff组舌部KMW增加明显大于ibf组（2.1±0.2 mm vs. 1.5±0.2 mm, p < 0.05）。在T4时，FFFs组的舌萎缩率明显小于IBFs组（27.8%±5.5% vs. 47.3%±5.5%,p < 0.05）。结论FGG能有效重建下颌骨角化黏膜。角化后的粘膜宽度随时间增加而减小。
{"title":"Effect of Free Gingival Graft Around Implants in Reconstructed Mandibles With Free Fibula Flaps or Iliac Bone Flaps","authors":"Jianfeng Liufu, Yanjun Ge, Xiancheng Zeng, Jiayun Dong, Yifan Kang, Yuru Hu, Ruifang Lu, Xiaofeng Shan, Zhigang Cai","doi":"10.1111/cid.70070","DOIUrl":"https://doi.org/10.1111/cid.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare the efficacy of free gingival graft (FGG) around implants in reconstructed mandibles with free fibula flaps (FFFs) or iliac bone flaps (IBFs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We included patients receiving mandibular reconstruction with FFFs or IBFs due to the removal of maxillofacial tumors who underwent implant and FGG placement prior to restoration. Clinical data were evaluated before (T0), immediately after (T1), 3 months after (T2), 6 months after (T3) and 1 year after (T4) FGG placement. We analyzed the keratinized mucosa width (KMW) gain and the shrinkage rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 30 patients were enrolled in this study, including 15 patients with 48 implants in the FFFs group and 15 patients with 52 implants in the IBFs group. The buccal KMW gain and shrinkage rate in the FFFs group were not statistically significant compared with the IBFs group at T4. In the IBFs group, the buccal KMW gain and shrinkage rate remained relatively stable after 6 months. The lingual KMW gain in the FFFs group was significantly greater than that in the IBFs group at T4 (2.1 ± 0.2 mm vs. 1.5 ± 0.2 mm, <i>p</i> < 0.05). The lingual shrinkage rate in the FFFs group was significantly smaller than that in the IBFs group at T4 (27.8% ± 5.5% vs. 47.3% ± 5.5%, <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FGG can reconstruct the keratinized mucosa effectively in a reconstructed mandible. The keratinized mucosa width gain decreases over time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367327","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}
Jantien H. W. de Beus, Henny J. A. Meijer, Christiaan W. P. Pol, Ulf Schepke, Gerry M. Raghoebar, Marco S. Cune
Introduction
Full-zirconia (ZrO2) restorations were introduced to address the most common complications in implant-supported restorations in the posterior region: fractures of the veneering. The aim of this prospective case series study was to evaluate full-ZrO2 implant-supported restorations with angulated screw channel abutments (ASCs) in the molar region of the maxilla and mandible and their effect on hard and soft peri-implant tissues, and patient-related outcome measures (PROMs), during a 5-year follow-up period.
Material and Methods
Patients with a single missing molar in the maxilla or mandible with sufficient bone volume and an implant site free of infection were included. Thirty consecutive patients received a parallel-walled implant with conical connection. After 3 months, a full contour screw-retained ZrO2 restoration with an ASC was fabricated and connected to the implant. Clinical and radiographic examinations were performed 1 month, 12 months, and 5 years after placement of the restoration. Implant success probability was calculated using Kaplan–Meier statistics, and confidence intervals were given over the results at 5 years. Patient-reported outcome measures (PROMs) were scored prior to treatment and at follow-up intervals. The primary outcome measure was the success of the restoration.
Results
All patients could be evaluated after 5 years. Success probability at 5 years was 73.0% (95% CI [57.0%; 89.0%]). Implant survival was 100% and restoration survival was 97%. The encountered technical complications were easily repairable (n = 12). From loading to the 5-years follow-up, the mean marginal bone loss was 0.30 mm (SD 0.52 mm). Mean scores for plaque, calculus, peri-implant mucosa, bleeding, and pocket probing depth were low, depicting healthy peri-implant conditions. PROMs had significantly improved, and the mean overall score was 9.1 ± 0.7 (scale 1–10).
Conclusion
Full-ZrO2 implant-supported restorations with ASC abutments employed in this study, when applied in maxillary and mandibular posterior regions, show a 97% survival rate. However, a high incidence rate of technical complications (n = 12) was noted during the 5-year observation period.
全氧化锆（ZrO2）修复体用于解决后牙区种植体支持修复体中最常见的并发症：贴面骨折。这项前瞻性病例系列研究的目的是在5年的随访期间评估上颌和下颌骨磨牙区全zro2种植体支持的成角螺钉通道基台（ASCs）修复体及其对种植体周围硬、软组织的影响，以及患者相关的结果测量（PROMs）。材料与方法选取上颌或下颌骨单侧缺失磨牙且骨容量充足且种植部位无感染的患者为研究对象。连续30例患者接受平行壁锥形连接种植体。3个月后，制作带有ASC的全轮廓螺钉保留的ZrO2修复体并与种植体连接。在放置修复体后1个月、12个月和5年进行临床和影像学检查。使用Kaplan-Meier统计计算种植体成功概率，并给出5年结果的置信区间。在治疗前和随访期间对患者报告的结果测量（PROMs）进行评分。主要的结果衡量是修复的成功。结果所有患者5年后均可进行评估。5年的成功率为73.0% (95% CI [57.0%；89.0%)。种植体成活率100%，修复体成活率97%。遇到的技术并发症容易修复（n = 12）。从加载到5年随访，平均边缘骨丢失为0.30 mm （SD 0.52 mm）。菌斑、结石、种植体周围粘膜、出血和口袋探查深度的平均得分很低，表明种植体周围状况健康。两组患者的PROMs均有明显改善，平均总分为9.1±0.7分（量表1-10）。结论本研究采用全zro2种植体支持的ASC基牙修复体用于上颌和下颌后牙区，其成活率为97%。然而，在5年的观察期间，技术并发症的发生率很高（n = 12）。
{"title":"Full-Zirconia Single Molar Implant-Supported Restorations With Angulated Screw Channel Abutments: 5-Year Results of a Prospective Case Series Study","authors":"Jantien H. W. de Beus, Henny J. A. Meijer, Christiaan W. P. Pol, Ulf Schepke, Gerry M. Raghoebar, Marco S. Cune","doi":"10.1111/cid.70068","DOIUrl":"https://doi.org/10.1111/cid.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Full-zirconia (ZrO<sub>2</sub>) restorations were introduced to address the most common complications in implant-supported restorations in the posterior region: fractures of the veneering. The aim of this prospective case series study was to evaluate full-ZrO<sub>2</sub> implant-supported restorations with angulated screw channel abutments (ASCs) in the molar region of the maxilla and mandible and their effect on hard and soft peri-implant tissues, and patient-related outcome measures (PROMs), during a 5-year follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Patients with a single missing molar in the maxilla or mandible with sufficient bone volume and an implant site free of infection were included. Thirty consecutive patients received a parallel-walled implant with conical connection. After 3 months, a full contour screw-retained ZrO<sub>2</sub> restoration with an ASC was fabricated and connected to the implant. Clinical and radiographic examinations were performed 1 month, 12 months, and 5 years after placement of the restoration. Implant success probability was calculated using Kaplan–Meier statistics, and confidence intervals were given over the results at 5 years. Patient-reported outcome measures (PROMs) were scored prior to treatment and at follow-up intervals. The primary outcome measure was the success of the restoration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All patients could be evaluated after 5 years. Success probability at 5 years was 73.0% (95% CI [57.0%; 89.0%]). Implant survival was 100% and restoration survival was 97%. The encountered technical complications were easily repairable (<i>n</i> = 12). From loading to the 5-years follow-up, the mean marginal bone loss was 0.30 mm (SD 0.52 mm). Mean scores for plaque, calculus, peri-implant mucosa, bleeding, and pocket probing depth were low, depicting healthy peri-implant conditions. PROMs had significantly improved, and the mean overall score was 9.1 ± 0.7 (scale 1–10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Full-ZrO<sub>2</sub> implant-supported restorations with ASC abutments employed in this study, when applied in maxillary and mandibular posterior regions, show a 97% survival rate. However, a high incidence rate of technical complications (<i>n</i> = 12) was noted during the 5-year observation period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300394","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}
Jung-Hyun Park, Heon-Young Kim, Jae-Ryun Lee, Hyo-Jung Lee, Jin-Woo Kim
Introduction
This nationwide population-based cohort study aimed to investigate the relationship between bisphosphonate (BP) use and dental implant removal in patients with osteoporosis.
Methods
A total of 389 226 individuals aged ≥ 65 years with osteoporosis who underwent dental implant surgery between 2014 and 2018 were included. Patients were classified into BP and control groups based on their prescription records. Implant removal was identified using the procedural codes from 2019 to 2020. Multivariate logistic regression analysis was performed to examine the association between BP and implant removal. Subgroup analyses evaluated the impact of the BP administration route (oral vs. intravenous), BP type, and cumulative defined daily dose (DDD) on the risk of implant removal.
Results
The BP group demonstrated a modestly increased risk of implant removal compared to the control group (adjusted odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.05–1.15). Participants with periodontitis had a significantly higher risk of implant removal than participants without periodontitis (adjusted OR: 1.87; 95% CI: 1.63–2.15). Among BP users, the subgroup analysis revealed that intravenous BP administration was associated with a lower risk of implant removal than oral administration (adjusted OR: 0.87; 95% CI: 0.80–0.94). In addition, the risk of implant removal increased progressively with higher cumulative DDDs, highlighting the importance of total BP exposure.
Conclusion
This study underscores the critical role of cumulative BP exposure in the risk of implant removal, which challenges conventional assumptions regarding administration routes. Future research should explore strategies to optimize implant outcomes in patients with osteoporosis.
{"title":"Consequence of Bisphosphonate Use on Dental Implant Removal in Osteoporotic Patient: A Nationwide Cohort Study","authors":"Jung-Hyun Park, Heon-Young Kim, Jae-Ryun Lee, Hyo-Jung Lee, Jin-Woo Kim","doi":"10.1111/cid.70062","DOIUrl":"https://doi.org/10.1111/cid.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This nationwide population-based cohort study aimed to investigate the relationship between bisphosphonate (BP) use and dental implant removal in patients with osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 389 226 individuals aged ≥ 65 years with osteoporosis who underwent dental implant surgery between 2014 and 2018 were included. Patients were classified into BP and control groups based on their prescription records. Implant removal was identified using the procedural codes from 2019 to 2020. Multivariate logistic regression analysis was performed to examine the association between BP and implant removal. Subgroup analyses evaluated the impact of the BP administration route (oral vs. intravenous), BP type, and cumulative defined daily dose (DDD) on the risk of implant removal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The BP group demonstrated a modestly increased risk of implant removal compared to the control group (adjusted odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.05–1.15). Participants with periodontitis had a significantly higher risk of implant removal than participants without periodontitis (adjusted OR: 1.87; 95% CI: 1.63–2.15). Among BP users, the subgroup analysis revealed that intravenous BP administration was associated with a lower risk of implant removal than oral administration (adjusted OR: 0.87; 95% CI: 0.80–0.94). In addition, the risk of implant removal increased progressively with higher cumulative DDDs, highlighting the importance of total BP exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores the critical role of cumulative BP exposure in the risk of implant removal, which challenges conventional assumptions regarding administration routes. Future research should explore strategies to optimize implant outcomes in patients with osteoporosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256352","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}
Sergio Spinato, Fabio Bernardello, Claudio Stacchi, Carlo Maria Soardi, Marcello Messina, Antonio Rapani, Teresa Lombardi
Introduction
Early marginal bone loss (EMBL) is a non-infective phenomenon occurring around the implant neck from placement to the first year of prosthetic function, being influenced by both surgical and prosthetic factors. This multi-center prospective study assesses the impact of different variables potentially influencing marginal bone stability during the period from crown delivery to 18 months of functional loading.
Methods
Forty-seven patients requiring a single posterior mandibular implant were selected according to specific criteria. Tissue-level implants were placed at different crestal bone levels based on vertical mucosal thickness and followed in an unsubmerged healing protocol, as described in a previous study evaluating peri-implant bone levels (PBL) from implant placement (T0) to crown delivery (T1). The present study continues this evaluation, focusing on MBL from T1 to 18 months post-loading (T2). Host-related factors (age, gender, smoking, history of periodontitis, vertical mucosal thickness) and specific prosthetic parameters, including crown mesio-distal dimension, emergence angle, and transmucosal collar height were recorded. Multiple linear regression analysis explored associations between MBL and prosthetic or patient-related factors, with significance set at p < 0.05.
Results
Marginal bone levels remained stable from T1 to T2, with no significant association between MBL and host-related factors or defined prosthetic variables. However, total MBL from T0 to T2 was significantly higher around implants with thin mucosa at T0 compared to medium and thick mucosa. Multivariate analysis (T0-T2) identified thin mucosa and smoking as significant MBL predictors.
Conclusion
From T1 to T2, marginal bone levels around tissue-level implants remain stable, with no significant influence from variables analyzed. Conversely, peri-implant bone resorption between T0 and T2 is significantly associated with thin mucosa (primarily affecting T0-T1) and smoking.
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