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Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study 角质化粘膜对种植体健康相关参数的影响:一项为期 10 年的前瞻性再分析研究。
IF 3.7 2区 医学 Q1 Dentistry Pub Date : 2024-02-28 DOI: 10.1111/cid.13314
Leonardo Mancini, Franz J. Strauss, Hyun-Chang Lim, Lorenzo Tavelli, Ronald E. Jung, Nadja Naenni, Daniel S. Thoma

Aim

To investigate whether the lack of keratinized mucosa (KM) affects peri-implant health after 10 years of loading.

Materials and Methods

Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5-year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri-implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one-piece or two-piece) and compliance.

Results

A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri-implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri-implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two-piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two-piece implants were associated with reduced MBL and MBL changes (p < 0.05).

Conclusion

The lack of buccal KM appears to be linked with peri-implant parameters such as BOP and MBL, but the association is weak. The design of one-piece implants may account for their increased odds of exhibiting BOP.

目的:研究角化粘膜(KM)的缺乏是否会影响种植体植入 10 年后的种植体周围健康:纳入并分析了来自两项随机对照研究的 74 名患者的数据,这些患者共种植了 148 颗种植体,并对不同的种植体系统进行了比较。收集了基线(最终植入修复体时)、5 年和 10 年加载后的临床参数,包括探诊出血(BOP)、探诊深度(PD)、菌斑指数、边缘骨质流失(MBL)和颊侧 KM 宽度(KMW)。通过广义估计方程(GEE)建立多变量逻辑和线性回归模型,评估颊侧 KM 对种植体周围临床参数(BOP、MBL、PD)的影响,并根据种植体类型(一片式或两片式)和顺应性进行调整:共有 35 个(24.8%)种植体健康,67 个(47.5%)患有粘膜炎,39 个(27.6%)患有种植体周围炎。在没有口腔黏膜的情况下(KM = 0 mm),75%的种植体表现出黏膜炎,而在有口腔黏膜的情况下(KMW > 0 mm),41.2%的种植体表现出黏膜炎。至于种植体周围炎,相应的比例分别为 20%(KM = 0 毫米)和 26.7%(KM > 0 毫米)。未经调整的逻辑回归显示,颊面 KM 的存在往往会降低颊面部位出现 BOP 的几率(OR:0.28 [95% CI,0.07 至 1.09],p = 0.06)。调整后的逻辑回归模型显示,颊侧 KM(OR:0.21 [95% CI,0.05 至 0.85],p = 0.02)和使用两件式种植体(OR:0.34 [95% CI,0.15 至 0.75],p = 0.008)可显著降低出现 BOP 的几率。通过 GEE 进行调整后的线性回归显示,KM 和两件式种植体与 MBL 和 MBL 变化的减少有关(p 结论:KM 和两件式种植体与 MBL 变化的减少有关:颊面 KM 的缺乏似乎与 BOP 和 MBL 等种植体周围参数有关,但关联性较弱。一体式种植体的设计可能是其表现出 BOP 的几率增加的原因。
{"title":"Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study","authors":"Leonardo Mancini,&nbsp;Franz J. Strauss,&nbsp;Hyun-Chang Lim,&nbsp;Lorenzo Tavelli,&nbsp;Ronald E. Jung,&nbsp;Nadja Naenni,&nbsp;Daniel S. Thoma","doi":"10.1111/cid.13314","DOIUrl":"10.1111/cid.13314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate whether the lack of keratinized mucosa (KM) affects peri-implant health after 10 years of loading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5-year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri-implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one-piece or two-piece) and compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri-implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW &gt;0 mm) 41.2% exhibited mucositis. Regarding peri-implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM &gt;0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], <i>p</i> = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], <i>p</i> = 0.02) and using two-piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], <i>p</i> = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two-piece implants were associated with reduced MBL and MBL changes (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The lack of buccal KM appears to be linked with peri-implant parameters such as BOP and MBL, but the association is weak. The design of one-piece implants may account for their increased odds of exhibiting BOP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139992093","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}
引用次数: 0
Effect of prefabricated immediate interim prosthesis design and insertion workflow on seating accuracy on implants placed via static computer-assisted implant surgery: A cross-sectional in vitro study 预制即刻临时修复体设计和植入工作流程对通过静态计算机辅助种植手术植入的种植体就位准确性的影响:一项横断面体外研究。
IF 3.7 2区 医学 Q1 Dentistry Pub Date : 2024-02-25 DOI: 10.1111/cid.13316
Jaafar Abduo BDS, DClinDent, PhD, MRACDS (Pros), Douglas Lau BDSc, Grad Dip Clin Dent, DCD

Background

Immediate implant restoration by prefabricated prosthesis has multiple benefits. However, the design and insertion workflow of the prosthesis may influence the seating.

Purpose

Evaluation of seating accuracy of prefabricated interim prosthesis of different designs and insertion workflows for immediate restoration of implants placed via static computer-assisted implant surgery (sCAIS).

Materials and Methods

A maxillary model without incisors was used to plan for two implants at the lateral incisor locations. According to the planned implants, sCAIS surgical template and a four-unit interim prosthesis were designed. Four prostheses were fabricated based on the design and insertion workflow. The first prosthesis involved complete fabrication (CF) of the interim prosthesis, where the interim prosthesis is fabricated for laboratory attachment to abutments. The other three prostheses were produced by partial fabrication (PF), where the interim prosthesis shell was produced with internal spacing between the fitting surface and the abutments. The PF prostheses were cemented on abutments attached to the inserted implants. Three different PF prosthesis designs were included with different levels of internal spacing: 100 μm (PF.1), 200 μm (PF.2), and 300 μm (PF.3). A total of 15 surgical models received implants on which each prosthesis was seated and scanned by a laboratory scanner. The vertical, horizontal, and proximal contact errors were measured.

Results

Although all prostheses were seated on every model, the CF prostheses had greater vertical error, followed by PF.1, PF.2, and PF.3 prostheses, respectively. A similar pattern was observed for proximal contact error, where PF.3 was most superior. PF.3 prostheses had the least horizontal error than the other prostheses.

Conclusions

All interim prostheses experienced errors at the vertical, horizontal, and proximal surfaces, which can be attributed to deviations of the inserted implants. The PF of interim prosthesis with increased internal spacing for intraoral insertion appeared to reduce seating errors.

背景:使用预制假体进行即刻种植修复有很多好处。目的:评估通过静态计算机辅助种植手术(sCAIS)进行种植体即刻修复时,不同设计和插入流程的预制临时修复体的就位准确性:材料和方法:使用不含切牙的上颌模型,在侧切牙位置规划两颗种植体。根据规划的种植体,设计了 sCAIS 手术模板和四单元临时修复体。根据设计和植入工作流程制作了四个义齿。第一个修复体涉及临时修复体的完全制作(CF),即制作临时修复体,以便在实验室中与基台连接。其他三个修复体是通过部分制作(PF)制作的,在制作临时修复体外壳时,在安装面和基台之间留有内部间距。PF修复体粘结在基台上,与插入的种植体相连。三种不同的 PF 假体设计具有不同程度的内部间距:100 μm(PF.1)、200 μm(PF.2)和 300 μm(PF.3)。共有 15 个手术模型接受了假体植入,每个假体都安装在这些模型上,并由实验室扫描仪进行扫描。测量了垂直、水平和近端接触误差:结果:尽管所有假体都在每个模型上就位,但CF假体的垂直误差较大,其次分别是PF.1、PF.2和PF.3假体。在近端接触误差方面也观察到类似的模式,PF.3 最为优越。与其他假体相比,PF.3 假体的水平误差最小:所有临时假体的垂直面、水平面和近端表面都存在误差,这可能是由于植入假体的偏差造成的。PF临时义齿在口内插入时内部间距增大,似乎可以减少就位误差。
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引用次数: 0
Lateral bone augmentation with a composite graft covered with a stretched and pinned collagen membrane: A retrospective case series using cone-beam computed tomography 使用覆盖有拉伸和固定胶原蛋白膜的复合移植物进行外侧骨增量:使用锥形束计算机断层扫描的回顾性病例系列。
IF 3.7 2区 医学 Q1 Dentistry Pub Date : 2024-02-23 DOI: 10.1111/cid.13313
Florence Dewilde MD, DDS, Matthijs Hindryckx DDS, Faris Younes DDS, MSc, PhD, Thomas De Bruyckere DDS, MSc, PhD, Jan Cosyn DDS, MSc, PhD

Aims

(1) To assess the effectiveness of the Sausage Technique™ when applied for lateral bone augmentation by multiple experienced clinicians; (2) To identify risk indicators for a poor outcome and to assess the need for adjunctive surgery.

Materials and Methods

All patients who had been treated with the Sausage Technique™ for lateral bone augmentation by three experienced surgeons between January 2019 and December 2021 were included in a retrospective case series. The Sausage Technique™ technique includes the use of autogenous bone chips and deproteinized bovine bone mineral (1:1 ratio), covered with a stretched and pinned collagen membrane. The increase in alveolar width between the pre-operative situation and 9 months was assessed at different levels on superimposed cone-beam CT scans.

Results

Twenty-five augmentations performed in 25 patients (17 males, 8 females, mean age 51 years) were available for evaluation. Mean alveolar width increased from 4.35 to 7.43 mm at 3 mm below the crest. The mean increase of 3.08 mm (95% CI 2.10–4.06; p < 0.001) was significant. The outcome of non-containing single implant sites was significantly worse than the outcome of other sites (MD 2.67 mm; p = 0.008). The need for regrafting was 4% and the need for soft tissue augmentation was 48%. Twenty percent of the patients needed soft tissue augmentation due to a lack of keratinized mucosa width, and 32% due to a lack of buccal convexity. The former was mainly needed at multiple implant sites, whereas the latter was mainly required at single implant sites. All implant survived and remained healthy until the final follow-up.

Conclusion

The Sausage Technique™ is an effective bone augmentation technique. Non-containing single implant sites were associated with a poor outcome and adjunctive soft tissue augmentation was needed in about half of the patients.

目的:(1)评估多位经验丰富的临床医生采用香肠技术™进行侧方骨增量术的有效性;(2)确定不良结果的风险指标,并评估是否需要进行辅助手术:回顾性病例系列纳入了2019年1月至2021年12月期间由三位经验丰富的外科医生使用香肠技术™进行侧方骨增量治疗的所有患者。香肠技术(Sausage Technique™)包括使用自体骨片和去蛋白牛骨矿物质(1:1 比例),并覆盖一层拉伸和固定的胶原蛋白膜。通过叠加锥形束 CT 扫描,在不同层面上评估了术前情况和 9 个月后牙槽宽度的增加情况:共有 25 名患者(17 名男性,8 名女性,平均年龄 51 岁)接受了 25 次牙槽骨增量手术,可供评估。嵴下 3 毫米处的平均牙槽宽度从 4.35 毫米增至 7.43 毫米。平均增加了 3.08 毫米(95% CI 2.10-4.06;p 结论:"嚼香肠技术™"能使患者的牙槽骨宽度从 4.35 毫米增加到 7.43 毫米:香肠技术™是一种有效的骨增量技术。不包含单一种植体的部位效果较差,约有一半的患者需要进行辅助性软组织增量。
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引用次数: 0
Evaluation of buccal bone resorption in immediate implant placement in thin versus thick buccal bone plates: An 18-month follow-up prospective cohort study 薄颊骨板与厚颊骨板即刻种植体植入过程中的颊骨吸收评估:一项为期 18 个月的前瞻性队列随访研究。
IF 3.7 2区 医学 Q1 Dentistry Pub Date : 2024-02-21 DOI: 10.1111/cid.13312
Hani ElNahass, Omnia K. Tawfik, Suzy N. Naiem PhD, Nada Zazou, Mahmoud Moussa

Objectives

The current guidelines recommend that immediate implants be placed in patients with thick (>1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption.

Materials

The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score.

Results

Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results.

Conclusion

Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long-term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes.

https://classic.clinicaltrials.gov/ct2/results?cond=&term=NCT04731545&cntry=EG&state=&city=&dist=

目的:由于拔牙后不可避免的组织重塑,现行指南建议在颊骨较厚(>1 毫米)的患者中植入即刻种植体。本研究的目的是调查颊骨厚度对即刻种植体植入过程中骨吸收的影响,并对上述骨吸收的两种测量技术进行比较:本研究是一项前瞻性非随机对照临床试验。共有 30 颗种植体被分成颊骨薄和颊骨厚两个研究组。主要结果是通过锥形束扫描,对颊骨薄和颊骨厚患者术前、种植体植入后 2 个月和 18 个月的垂直骨变化进行放射学评估。次要结果包括颊骨板厚度的变化、边缘骨损失和粉色美学评分:由于每组均有一个早期失败案例,因此仅对 26 个种植体进行了统计分析。此外,厚种植体组中有 2 名患者退出了研究。锥形束计算机断层扫描测量显示,2 个月后,薄种植体组的垂直骨量损失为 1.09,厚种植体组为 0.85。薄骨组的颊骨板吸收为 0.39 毫米,厚骨组的颊骨板吸收为 0.52 毫米。薄骨组的颊骨板为 1.25 毫米,厚骨组的颊骨板为 1.88 毫米。PES没有显示出任何明显的差异,具有非常好的美学效果:在当前研究的限制条件下,两组患者种植后的颊骨板吸收量和随后获得的厚度都表明长期效果良好。事实证明,两种测量技术在测量颊骨板变化方面具有可比性和可靠性。https://classic.Clinicaltrials: gov/ct2/results?cond=&term=NCT04731545&cntry=EG&state=&city=&dist=。
{"title":"Evaluation of buccal bone resorption in immediate implant placement in thin versus thick buccal bone plates: An 18-month follow-up prospective cohort study","authors":"Hani ElNahass,&nbsp;Omnia K. Tawfik,&nbsp;Suzy N. Naiem PhD,&nbsp;Nada Zazou,&nbsp;Mahmoud Moussa","doi":"10.1111/cid.13312","DOIUrl":"10.1111/cid.13312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The current guidelines recommend that immediate implants be placed in patients with thick (&gt;1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials</h3>\u0000 \u0000 <p>The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long-term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes.</p>\u0000 \u0000 <p>https://classic.clinicaltrials.gov/ct2/results?cond=&amp;term=NCT04731545&amp;cntry=EG&amp;state=&amp;city=&amp;dist=</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139914264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From manufacturers to clinicians, the release of dental implant particles can no longer be ignored 从制造商到临床医生,都不能再忽视牙科植入物微粒的释放。
IF 3.7 2区 医学 Q1 Dentistry Pub Date : 2024-02-19 DOI: 10.1111/cid.13309
Fadi N. Barrak BDS, FDSRCS, MBBS, DipImpDent, RCSEd, FHEA, PhD, Siwei Li PhD

Dental implants offer a widely accepted and viable long-term treatment option for patients with missing teeth.1, 2 Since the discovery of its biocompatibility and capability of osseointegration, titanium (Ti) and its alloys have become the gold standard and most widely used in implant dentistry.3, 4 There are implants made with other materials, this opinion paper will focus on titanium-based implants. While such implants have proven to be highly reliable and have high success rates, it is not without complications. Some implants fail due to a variety of reasons including peri-implantitis, lack of osseointegration, material wear and corrosion, and hypersensitivity.5-7

For any implant system on the market, a series of complex and stringent standards need to be met during various stages including in vitro testing, in vivo and clinical trials, and manufacturing. Table 1 summarises the major standards dental implant companies follow.

Authors searched publicly available compliance documentations published by major dental implant companies, including BioHorizons, Dentsply Sirona, Nobel Biocare, Osstem, and Straumann. While all companies demonstrated compliance with ISO 13485 (Medical device quality management system) during the design, development, manufacture, and distribution of dental implants (and related components), information on how tests were conducted in accordance to above-mentioned ISO standards was not readily available to public. In addition, standards for biological evaluation of medical devices such as ISO 10993 permits the use of whole implant, and thus the biological implications of free Ti-based particles and metallic ions can be overlooked.

In patients that had dental implants, Ti particles, as a product of wear and/or degradation, have been detected in both intra- and extra-oral tissues. Ti particles have been found in peri-implant bone and/or soft tissues, submucosal plaque, and in distant lymph nodes in human pilot studies.13-15 Ti particles have also been shown in both animal and human studies to be present in lungs, kidneys, livers, spleen, and abdominal lymph nodes, with some suggesting that particles were transported in the bloodstream by phagocytic cells and plasma proteins to these distal organs.16-18 Authors' own ex vivo study has demonstrated that metallic nano- and micro-sized particles were released from dental implants immediately after placement.19 They can be seen embedded in peri-implant bone tissue as well as internalized by cells such as human gingival fibroblasts and macrophages. Another study involving human biopsies has also reported localization of Ti particles in macrophages and epithelium cells.20 It has been suggested that in cells with phagocytized Ti particles, alterations to basic cell mechanism may occur and subsequent

1, 2 自发现钛(Ti)及其合金具有生物相容性和骨结合能力以来,钛(Ti)及其合金已成为种植牙的黄金标准,并在种植牙领域得到了最广泛的应用。虽然这类种植体已被证明非常可靠,成功率很高,但也并非没有并发症。一些种植体失败的原因多种多样,包括种植体周围炎、缺乏骨结合、材料磨损和腐蚀以及过敏。5-7 对于市场上的任何种植体系统,都需要在体外测试、体内和临床试验以及制造等不同阶段达到一系列复杂而严格的标准。表 1 总结了牙科种植公司遵循的主要标准。作者搜索了主要牙科种植公司发布的公开合规文件,包括 BioHorizons、Dentsply Sirona、Nobel Biocare、Osstem 和 Straumann。虽然所有公司都证明在设计、开发、制造和销售牙科植入物(及相关组件)的过程中符合 ISO 13485(医疗器械质量管理体系)的要求,但有关如何根据上述 ISO 标准进行测试的信息并不容易获得。此外,ISO 10993 等医疗器械生物评估标准允许使用整个种植体,因此可能会忽略游离钛基微粒和金属离子对生物的影响。13-15 在动物和人体研究中,钛微粒也被证明存在于肺、肾、肝、脾和腹部淋巴结中,一些研究表明,微粒在血液中被吞噬细胞和血浆蛋白运送到这些远端器官中。作者自己的体内外研究表明,金属纳米级和微米级颗粒在植入牙科种植体后会立即从种植体中释放出来。19 可以看到它们嵌入种植体周围的骨组织中,并被牙龈成纤维细胞和巨噬细胞等细胞内化。另一项涉及人体活组织切片的研究也报告了钛颗粒在巨噬细胞和上皮细胞中的定位情况。20 有研究认为,在被钛颗粒吞噬的细胞中,可能会发生基本细胞机制的改变,随后导致反应性病变,如化脓性和/或周围巨细胞肉芽肿、22 种植体周围炎是发生在牙科种植体周围组织的一种斑块相关病理情况。23 其特征是种植体周围粘膜发炎,随后种植体固定的周围支撑骨逐渐丧失。与健康的种植体部位相比,种植体周围炎部位的钛微粒浓度更高24-28 ,但作者承认目前还没有确切的证据,种植体微粒释放与种植体周围炎之间存在密切联系。造成钛微粒释放的最常见可行原因是种植体植入过程中的摩擦、种植体表面腐蚀以及种植体与基台间的摩擦现象29。29 牙科卫生用品和消毒剂(如氟化物和洗必泰)的使用与种植体表面形貌的改变和腐蚀的增加有关。30, 31 此外,种植体清创程序,如在种植体维护和种植体周围炎治疗(如种植体成形术)过程中使用的机械和/或化学方法进行的表面清洁,据报道也是颗粒释放的原因、32 作者自己的体内外研究发现,植入过程中金属颗粒和离子的释放量取决于种植体的材料和设计,其中 5 级钛合金(Ti-6AL-4V)种植体与商用纯钛(4 级)或 Roxolid® (Ti-15Zr,一种含约 15% 锆的钛合金)种植体相比释放量更多。33 更有趣的是,研究发现与 4 级种植体相比,Roxolid®种植体与 Ti 或 Zr 基台配对时产生的颗粒更大。这些发现强调了对种植体材料和设计进行仔细的生产前评估的必要性,因为有越来越多的证据表明这些磨损颗粒存在潜在风险。 19、26、44 颗粒的大小可能因植入物的大小、设计和材料而异。19、33 作者承认,目前还不清楚哪种颗粒结构(如大小和表面化学性质)和分布位置会导致不利的生物反应。因此,对同一种植体系统的每种变体采用一套标准化的测试方法非常重要。磨损微粒,尤其是纳米级微粒对生物的影响仍不明确,存在争议。有些人观察到纳米钛微粒单独使用或与其他金属纳米微粒结合使用时具有积极的抗生物膜特性,因此认为这些纳米微粒可以防止种植体周围炎病原体的感染。39, 48, 49 有报告称,纳米和微小尺寸的钛粒子与炎症反应的激活和促炎细胞因子(如 TNF-α 和 IL-1β)的释放有关、52 据报道,钛纳米粒子可启动依赖于 TLR4(类收费受体 4)的通路,并随后导致 MUC5B(粘蛋白 5B)的过量产生,而 MUC5B 参与了人体气道的炎症反应。尽管大量证据表明,种植体(纳米)颗粒的生物效应是炎症性的,但还需要进行更具体的毒理学研究,并在种植体评估过程中纳入生物标志物检测。一些研究报告称,钛牙科植入物会引起过敏反应,如红斑、湿疹、坏死和骨质流失。其中一个例子是氧化锆和聚芳醚酮 (PEEK),主要由于其良好的生物相容性和生物力学特性,这种材料在牙科应用中越来越受到关注。本评论只关注以钛为基础的金属植入物,作者承认使用替代材料制造的植入物也存在颗粒释放和累积的倾向。然而,现在必须关注与钛种植体相关的潜在不良影响,尤其是其磨损颗粒。需要制定一套新的标准来评估生物对种植体磨损颗粒和金属离子的反应,目的是提高材料和牙科种植体临床前评估的预测能力。这些测试数据应随时可用,以便临床医生和患者了解牙科种植体所用材料的生物和机械影响。牙科植入物的提供者,无论是生产商还是植入物的临床医生,都需要意识到这些潜在的风险以及制定更多测试标准的必要性,因为他们不可避免地要对所使用的产品和向公众提供的治疗承担责任。SL参与了文章的起草和重要修改。
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引用次数: 0
Prefabricated shouldered abutments enable successful restoration of molar crowns on implants 预制的带肩基台可成功修复种植体上的磨牙冠。
IF 3.6 2区 医学 Q1 Dentistry Pub Date : 2024-02-15 DOI: 10.1111/cid.13308
Yu-Chi Cheng BS, Paolo Perpetuini, Mauro Marincola DDS, Drauseo Speratti DMD, Laura Murcko DMD, Muneki Hirayama DMD, Ernesto B. Benalcázar-Jalkh PhD, DDS, Estevam A. Bonfante PhD, DDS

Purpose

This retrospective study evaluated the effect of selected clinical and patient factors on survival, success, and peri-implant bone level changes of locking taper implants supporting molar crowns on Bicon's prefabricated shouldered abutments.

Methods

A total of 234 patients, who received 274 single molar crowns supported by locking taper implants were included in this retrospective study. Kaplan–Meier survival analysis was used to assess overall implant survival, prostheses survival, and success. Crowns were either monolithic (resin based) or bilayered (milled fiber-reinforced composite coping veneered with indirect composite). Early and late changes in marginal bone levels were plotted and analyzed with equivalence testing to compare the effects of different factors on crestal bone levels.

Results

At 9.5 years after implant surgery, the implant survival probability was 94.2%, the probability of prosthesis survival was 91.4%, and the probability of prosthetic success was 90.4%. Neither the use of different crown materials, nor the choice of monolithic versus bilayered crown construction, significantly affected the probability of prosthetic success. Marginal bone levels, on average, trended downwards towards the top of the implant within the first 2 years after functional loading, and remained stable on average, since then. Factors affecting bone levels included the use of nonsteroidal anti-inflammatory drugs, which precluded early implant bone loss; and subcrestal implant placement, which was linked to significantly higher long-term bone levels.

Conclusion

The implant and abutment system studied resulted in high implant and prosthetic survival rates, regardless of prosthetic material used, with stable bone levels over time.

目的:这项回顾性研究评估了选定的临床和患者因素对使用 Bicon 预制肩台支撑磨牙冠的锁定锥形种植体的存活率、成功率和种植体周围骨水平变化的影响:这项回顾性研究共纳入了 234 名患者,他们接受了 274 个由锁定锥形种植体支撑的单磨牙冠。采用卡普兰-梅尔生存分析法评估种植体的总生存率、修复体的生存率和成功率。修复体为单层(树脂基底)或双层(铣削纤维增强复合材料与间接复合材料贴面)。对边缘骨水平的早期和晚期变化进行绘图,并通过等效测试进行分析,以比较不同因素对骨嵴水平的影响:种植手术后 9.5 年,种植体存活率为 94.2%,修复体存活率为 91.4%,修复成功率为 90.4%。无论是使用不同的牙冠材料,还是选择单层或双层牙冠结构,都不会对修复成功率产生明显影响。在功能负荷后的头两年内,边缘骨量平均呈向种植体顶部下降的趋势,此后平均保持稳定。影响骨量的因素包括:使用非甾体类抗炎药物,这可以避免早期种植体骨量的流失;以及种植体放置在胸骨下,这与长期骨量显著增加有关:结论:所研究的种植体和基台系统具有较高的种植体和修复体存活率,无论使用的修复体材料如何,长期骨量都很稳定。
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引用次数: 0
Peri-implant epidermoid cyst: A case report and literature analysis 种植体周围表皮样囊肿:病例报告和文献分析
IF 3.7 2区 医学 Q1 Dentistry Pub Date : 2024-02-06 DOI: 10.1111/cid.13310
Shibo Wei, Xu Zhang, Fei Yu, Shuigen Guo, Hongwu Wei

Background

A peri-implant cystic lesion is a rare finding, and to date most investigators have considered that its pathogenesis is caused by trauma and infection related to dental implantation. However, the pathogenesis of these cysts remains unclear and is recognized to have multifactorial origins.

Case presentation

In February 2021, a 75-year-old male patient underwent implant restoration due to mobility of the left maxillary central incisor. The implant achieved good osseointegration and was successfully restored. However, in March 2023, the patient sought treatment due to mobility of the dental implant. Clinical examination showed that the implant had loosened in three directions (vertical, mesial-distal, and labial-lingual), and the peri-implant mucosa was slightly red and swollen. Radiographic examination (cone beam computed tomography) showed a large radiolucent area with clear boundaries involving the cervical and middle portions of the dental implant, and white bone lines were observed at the edge of the low-density shadow. Intraoperatively, we removed the patient's implant, performed a complete debridement, and conducted bone augmentation surgery in the area of bone defect. Postoperatively, the patient recovered well. The final histopathological result confirmed an epidermoid cyst.

Conclusions

Peri-implant epidermoid cyst is a rare complication that affects the long-term outcome of implant therapy. This case serves as a warning to clinicians to avoid involving epithelial tissue in the implant site during implant surgery, in order to prevent the potential occurrence of a peri-implant epidermoid cyst, thereby creating better conditions for the patient's recovery and the long-term efficacy of the implant.

背景:种植体周围囊肿是一种罕见的病变,迄今为止,大多数研究者认为其发病机制是与牙科种植有关的创伤和感染。然而,这些囊肿的发病机制仍不清楚,而且公认有多因素的起源:2021 年 2 月,一名 75 岁的男性患者因左上颌中切牙移动而接受了种植修复。种植体骨结合良好,修复成功。然而,2023 年 3 月,患者因种植体移动而寻求治疗。临床检查显示,种植体在三个方向(垂直、中-远侧和唇-舌侧)出现松动,种植体周围粘膜轻微红肿。X光检查(锥形束计算机断层扫描)显示,种植体颈部和中部有一大片边界清晰的放射影,低密度影边缘可见白色骨线。术中,我们拔除了患者的种植体,进行了彻底清创,并在骨缺损区域进行了骨增量手术。术后,患者恢复良好。最终的组织病理学结果证实为表皮样囊肿:种植体周围表皮样囊肿是一种罕见的并发症,会影响种植治疗的长期效果。本病例警示临床医生在进行种植手术时应避免涉及种植部位的上皮组织,以防止种植体周围表皮样囊肿的潜在发生,从而为患者的康复和种植体的长期疗效创造更好的条件。
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引用次数: 0
Horizontal ridge augmentation in the maxillary aesthetic region using the autogenous circular cortical-lamina anchoring technique: A case series study 使用自体圆形皮质-粘合剂锚定技术进行上颌美学区域的水平嵴增量术:病例系列研究。
IF 3.7 2区 医学 Q1 Dentistry Pub Date : 2024-02-06 DOI: 10.1111/cid.13311
Liqing Yang DDS, Qing Wang DDS, Xinyi Wang DDS, Zijing Yang, Yingyuan Ning DDS, Zehong Guo DDS

Aim

This case series aimed to evaluate the effectiveness of the autologous circular cortical lamina-anchoring (CCA) technique for horizontal bone augmentation in the maxillary aesthetic region.

Materials and methods

A total of 25 patients with 28 implants underwent horizontal bone augmentation using CCA followed by implant placement and crown delivery. The primary outcome measures were alveolar ridge width (ARW) and buccal bone thickness (BBT), whereas the secondary outcome measures included marginal bone loss (MBL), mid-facial mucosal margin loss (MML), clinical assessment of peri-implant and aesthetic parameters, patient-reported outcome measures (PROMs), and implant survival rates.

Results

All 25 patients with 28 implants completed the treatment, no dropouts occurred. After CCA, the mean ARW at 1, 2, and 4 mm below the alveolar crest significantly increased from 2.38 ± 0.48, 2.85 ± 0.51, and 3.21 ± 0.53 mm to 6.80 ± 0.48, 6.99 ± 0.50, and 8.08 ± 0.52 mm, respectively. At the 3-year follow-up, the mean BBT0, BBT2, and BBT4 slightly decreased from 2.51 ± 0.26, 2.63 ± 0.31, and 2.75 ± 0.29 mm to 2.43 ± 0.27, 2.51 ± 0.30, and 2.64 ± 0.28 mm, respectively. Although the overall MBL was <0.15 mm, the results were statistically significant. The mean MML at the 3-year follow-up was 0.02 mm. All implant sites showed acceptable peri-implant and aesthetic outcomes. Incisions healed without complications, and no significant differences in PROMs observed at any time point. The 3-year follow-up showed a 100% implant survival rate.

Conclusion

The autologous CCA technique is a useful method for increasing ARW and maintaining BBT in the maxillary aesthetic region.

目的:本病例系列旨在评估自体圆形皮质薄层锚定(CCA)技术用于上颌美学区域水平骨增量的有效性:共有 25 名患者接受了 CCA 水平骨增量术,共植入 28 颗种植体,随后植入种植体并制作牙冠。主要结果指标是牙槽嵴宽度(ARW)和颊骨厚度(BBT),次要结果指标包括边缘骨损失(MBL)、中面部粘膜边缘损失(MML)、种植体周围和美学参数的临床评估、患者报告结果指标(PROMs)和种植体存活率:所有 25 名患者的 28 个种植体都完成了治疗,无一辍学。CCA 治疗后,牙槽嵴下 1、2 和 4 mm 处的平均 ARW 分别从 2.38 ± 0.48、2.85 ± 0.51 和 3.21 ± 0.53 mm 显著增加到 6.80 ± 0.48、6.99 ± 0.50 和 8.08 ± 0.52 mm。在 3 年的随访中,平均 BBT0、BBT2 和 BBT4 分别从 2.51 ± 0.26 毫米、2.63 ± 0.31 毫米和 2.75 ± 0.29 毫米轻微下降到 2.43 ± 0.27 毫米、2.51 ± 0.30 毫米和 2.64 ± 0.28 毫米。虽然总体 MBL 是结论:自体 CCA 技术是增加上颌美学区域 ARW 和保持 BBT 的有效方法。
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引用次数: 0
Gene expression, micro-CT and histomorphometrical analysis of sinus floor augmentation with biphasic calcium phosphate and deproteinized bovine bone mineral: A randomized controlled clinical trial 使用双相磷酸钙和去蛋白牛骨矿进行窦底增量的基因表达、显微 CT 和组织形态计量学分析:随机对照临床试验。
IF 3.6 2区 医学 Q1 Dentistry Pub Date : 2024-02-05 DOI: 10.1111/cid.13303
Sirida Arunjaroensuk DDS, MSc, Katanchalee Nampuksa MSc, Naruporn Monmaturapoj PhD, Pasutha Thunyakitpisal DDS, PhD, Thantrira Porntaveetus DDS, PhD, Nikos Mattheos DDS, PhD, Atiphan Pimkhaokham DDS, PhD

Aims

The aim of this randomized controlled clinical trial was to compare the gene expression, micro-CT, histomorphometrical analysis between biphasic calcium phosphate (BCP) of 70/30 ratio and deproteinized bovine bone mineral (DBBM) in sinus augmentation.

Materials and Methods

Twenty-four patients in need for sinus floor augmentation through lateral approach were randomized into BCP 70/30 ratio or DBBM. After at least 6 months of healing, a total of 24 bone specimens were collected from the entire height of the augmented bone at the area of implant placement and underwent micro-CT, histomorphometric and gene expression analysis. The 12 bone specimens of BCP 70/30 ratio were equally allocated to micro-CT and histologic analysis (test group, n = 6) and gene expression analysis (test group, n = 6). Similarly, the 12 bone specimens of DBBM were also allocated to micro-CT and histologic analysis (control group, n = 6) and gene expression analysis (control group, n = 6). The newly formed bone, remaining graft materials and relative change in gene expression of four target genes were assessed.

Results

The micro-CT results showed no statistically significant difference in the ratio of bone volume to total volume (BV/TV ratio) for the two groups (BCP 41.51% vs. DBBM 40.97%) and the same was true for residual graft material to total volume (GV/TV ratio, BCP 9.97% vs. DBBM 14.41%). Similarly, no significant difference was shown in the histological analysis in terms of bone formation, (BCP 31.43% vs. DBBM was 30.09%) and residual graft area (DBBM 40.76% vs. BCP 45.06%). With regards to gene expression, the level of ALP was lower in both groups of bone grafted specimens compared with the native bone. On the contrary, the level of OSX, IL-1B and TRAP was higher in augmented bone of both groups compared with the native bone. However, the relative difference in all gene expressions between BCP and DBBM group was not significant.

Conclusions

The BCP, HA/β-TCP ratio of 70/30 presented similar histological and micro-CT outcomes in terms of new bone formation and residual graft particles with DBBM. The gene expression analysis revealed different gene expression patterns between augmented and native bone, but showed no significant difference between the two biomaterials.

目的:本随机对照临床试验旨在比较 70/30 比值的双相磷酸钙(BCP)和去蛋白牛骨矿物质(DBBM)在上颌窦增量术中的基因表达、显微 CT 和组织形态分析:24 名需要通过侧方入路进行上颌窦底增量术的患者被随机分为 70/30 比值的 BCP 和 DBBM。在愈合至少 6 个月后,从植入种植体区域的整个增量骨高度采集 24 块骨标本,并进行显微 CT、组织形态计量学和基因表达分析。BCP 70/30 比例的 12 块骨标本被平均分配进行显微 CT 和组织学分析(试验组,n = 6)以及基因表达分析(试验组,n = 6)。同样,12 块 DBBM 骨标本也被分配进行显微 CT 和组织学分析(对照组,n = 6)以及基因表达分析(对照组,n = 6)。对新形成的骨、剩余的移植材料和四个目标基因表达的相对变化进行评估:显微计算机断层扫描结果显示,两组骨量与总体积之比(BV/TV 比)无统计学差异(BCP 41.51% vs. DBBM 40.97%),残余移植材料与总体积之比(GV/TV 比,BCP 9.97% vs. DBBM 14.41%)也是如此。同样,在骨形成(BCP 31.43% vs. DBBM 30.09%)和残余移植物面积(DBBM 40.76% vs. BCP 45.06%)方面,组织学分析也没有显示出明显的差异。在基因表达方面,两组骨移植标本的 ALP 水平均低于原生骨。相反,OSX、IL-1B 和 TRAP 的水平在两组增量骨中都高于原生骨。然而,BCP组和DBBM组之间所有基因表达的相对差异均不显著:结论:BCP、HA/β-TCP 的比例为 70/30 与 DBBM 相比,在新骨形成和残留移植物颗粒方面具有相似的组织学和显微 CT 结果。基因表达分析显示,增量骨和原生骨的基因表达模式不同,但两种生物材料之间无显著差异。
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引用次数: 0
Treatment of peri-implant mucositis: Adjunctive effect of glycine powder air polishing to professional mechanical biofilm removal. 12 months randomized clinical study 种植体周围粘膜炎的治疗:甘氨酸粉末空气抛光对专业机械生物膜去除的辅助效果。为期12个月的随机临床研究。
IF 3.6 2区 医学 Q1 Dentistry Pub Date : 2024-02-05 DOI: 10.1111/cid.13304
Discepoli Nicola DDS MSc PhD, De Rubertis Isabella DDS, Ciocci Carolina DDS, Nicola Baldini DDS PhD, Mirra Raffaele DDS

Introduction

To evaluate the adjunctive effect of glycine-powder air-polishing (GPAP) to full-mouth ultrasonic debridement (Fm-UD) in the treatment of peri-implant mucositis, and to determine the impact of implant and patient-level variables for disease resolution.

Methods

Individuals with a diagnosis of peri-implant mucositis were consecutively included in this randomized parallel arm clinical study. All the participants received a session of Fm-UD. Only implants allocated to the test group were additionally treated with GPAP. Clinical assessments were recorded at baseline, at 3 and at 12 months following intervention. The primary outcomes were complete disease resolution (DR1), defined as absence of bleeding sites at probing per implants, and partial disease resolution (DR2), measured as the presence of less than two bleeding sites at probing per implant. A final logistic multivariate regression model was built to evaluate the predictive role of implant and patient-level variables on DR.

Results

Fifty two patients and 157 implants were included. Both groups displayed significant reduction in the extent of bleeding on probing and plaque levels. At 12 months, DR1 was achieved in 16% and 27% of participants for the test and the control group respectively. IDR1 was best predicted by the number of bleeding sites (OR = 2.7, p = 0.04) and the greatest PPD value (OR = 2.7, p = 0.05), while IDR2 by the prosthetic connection (OR = 2.59, p = 0.02), the mean PPD (OR = 2.23, p = 0.04), the FMBS (OR = 4.09, p = 0.04), and number of implants (OR = 4.59, p = 0.02).

Conclusions

Despite significant improvements of clinical signs of peri-implant inflammation, the use of GPAP appears to have no adjunctive effect as compared with Fm-UD alone in the achievement of DR. Elevated initial levels of bleeding and PD predicted inferior likelihood of reaching disease resolution. The present randomized parallel arm clinical study was registered on Clinicaltrials.gov and received the following registration number: NCT05801315. This clinical trial was not registered prior to participant recruitment and randomization (https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009965&selectaction=Edit&uid=U0004FXM&ts=2&cx=fje7l8).

简介评估甘氨酸粉末空气抛光术(GPAP)与全口超声波清创术(Fm-UD)在治疗种植体周围粘膜炎方面的辅助效果,并确定种植体和患者水平变量对疾病缓解的影响:这项随机平行臂临床研究连续纳入了被诊断为种植体周围粘膜炎的患者。所有参与者都接受了一次 Fm-UD 治疗。只有分配到试验组的种植体才额外接受了 GPAP 治疗。临床评估在基线、干预后 3 个月和 12 个月进行记录。主要结果是疾病完全缓解(DR1)和部分疾病缓解(DR2),前者的定义是每个种植体探诊时无出血点,后者的测量是每个种植体探诊时出血点少于两个。最后建立了一个逻辑多变量回归模型,以评估种植体和患者水平变量对 DR 的预测作用:共纳入 52 名患者和 157 个种植体。两组患者的探诊出血程度和牙菌斑水平均明显下降。12 个月后,测试组和对照组分别有 16% 和 27% 的参与者达到了 DR1。出血部位数量(OR = 2.7,p = 0.04)和最大 PPD 值(OR = 2.7,p = 0.05)对 IDR1 的预测效果最好,而修复体连接(OR = 2.59,p = 0.02)、平均 PPD(OR = 2.23,p = 0.04)、FMBS(OR = 4.09,p = 0.04)和种植体数量(OR = 4.59,p = 0.02)对 IDR2 的预测效果最好:尽管种植体周围炎症的临床症状有了明显改善,但与单独使用 Fm-UD 相比,使用 GPAP 似乎对实现 DR 没有辅助作用。初始出血和PD水平升高预示着疾病缓解的可能性较低。本随机平行臂临床研究已在 Clinicaltrials.gov 上注册,注册号如下:NCT05801315:NCT05801315。该临床试验在参与者招募和随机化之前并未注册(https://register.Clinicaltrials: gov/prs/app/action/SelectProtocol?sid=S0009965&selectaction=Edit&uid=U0004FXM&ts=2&cx=fje7l8)。
{"title":"Treatment of peri-implant mucositis: Adjunctive effect of glycine powder air polishing to professional mechanical biofilm removal. 12 months randomized clinical study","authors":"Discepoli Nicola DDS MSc PhD,&nbsp;De Rubertis Isabella DDS,&nbsp;Ciocci Carolina DDS,&nbsp;Nicola Baldini DDS PhD,&nbsp;Mirra Raffaele DDS","doi":"10.1111/cid.13304","DOIUrl":"10.1111/cid.13304","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To evaluate the adjunctive effect of glycine-powder air-polishing (GPAP) to full-mouth ultrasonic debridement (Fm-UD) in the treatment of peri-implant mucositis, and to determine the impact of implant and patient-level variables for disease resolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals with a diagnosis of peri-implant mucositis were consecutively included in this randomized parallel arm clinical study. All the participants received a session of Fm-UD. Only implants allocated to the test group were additionally treated with GPAP. Clinical assessments were recorded at baseline, at 3 and at 12 months following intervention. The primary outcomes were complete disease resolution (DR1), defined as absence of bleeding sites at probing per implants, and partial disease resolution (DR2), measured as the presence of less than two bleeding sites at probing per implant. A final logistic multivariate regression model was built to evaluate the predictive role of implant and patient-level variables on DR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty two patients and 157 implants were included. Both groups displayed significant reduction in the extent of bleeding on probing and plaque levels. At 12 months, DR1 was achieved in 16% and 27% of participants for the test and the control group respectively. IDR1 was best predicted by the number of bleeding sites (OR = 2.7, <i>p =</i> 0.04) and the greatest PPD value (OR = 2.7, <i>p =</i> 0.05), while IDR2 by the prosthetic connection (OR = 2.59, <i>p</i> = 0.02), the mean PPD (OR = 2.23, <i>p</i> = 0.04), the FMBS (OR = 4.09, <i>p</i> = 0.04), and number of implants (OR = 4.59, <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite significant improvements of clinical signs of peri-implant inflammation, the use of GPAP appears to have no adjunctive effect as compared with Fm-UD alone in the achievement of DR. Elevated initial levels of bleeding and PD predicted inferior likelihood of reaching disease resolution. The present randomized parallel arm clinical study was registered on Clinicaltrials.gov and received the following registration number: NCT05801315. This clinical trial was not registered prior to participant recruitment and randomization (https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009965&amp;selectaction=Edit&amp;uid=U0004FXM&amp;ts=2&amp;cx=fje7l8).</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Clinical Implant Dentistry and Related Research
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