Clinical Implant Dentistry and Related Research最新文献

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.

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.

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.

Trial Registration: www.clinicaltrials.gov: NCT05363306

Objective

The present cross-sectional study aimed to determine the prevalence and the risk indicators associated with peri-implant diseases (PIDs) in patients who were subjected to computer-guided implant surgery.

Methods

Patients that were treated and screened during regular maintenance visits at one university center were enrolled in this cross-sectional study. Implants were diagnosed into the categories of peri-implant health, peri-implant mucositis, or peri-implantitis according to the 2017 World Workshop established case definitions. Bivariate and multivariable analyzes were conducted to identify local parameters and patient characteristics as associated risk indicators with PIDs, bleeding on probing (BOP) and marginal bone level (MBL) change.

Results

A total of 115 patients with 417 implants were evaluated during a regular maintenance visit at one university center. Peri-implant mucositis and peri-implantitis prevalence in digitally-guided implant sites were 67.8% and 9.6% at the patient level, respectively. Former and active smokers, active or a history of periodontitis, implant loading time, plaque index (PI), and absence of soft tissue graft were significantly associated with peri-implantitis. Bruxism, gastrointestinal (GI) disorders, and type of oral hygiene aid (OHI) displayed a significant association with peri-implant MBL changes.

Conclusion

The prevalence of peri-implant diseases in digitally-guided implant sites was comparable for mucositis and appeared lower for peri-implantitis when compared to previous outcomes with nondigital guided implant placement. Notably, patient-related factors and local clinical characteristics such as smoking, periodontitis, higher PI scores, and implant loading time were significantly associated with the occurrence of PIDs, while soft tissue grafting had a protective effect.

Statement of the Problem

The application of digital impressions for complete-arch implant supported fixed dental prostheses (FDP) remains controversial, and data from a systematic review with meta-analysis comparing intraoral scanning (IOS) and stereophotogrammetry (SPG) remain limited.

Purpose

To evaluate and compare the accuracy of currently available digital technologies, specifically IOS and SPG, in capturing complete-arch implant impressions.

Materials and Methods

An electronic and manual search was conducted on May 4, 2024, across PubMed, Embase, and Cochrane CENTRAL databases following PRISMA guidelines. The search targeted studies (excluding case reports) that assessed the in vivo, in vitro, or ex vivo accuracy of IOS and SPG for complete-arch implant impressions. Two investigators screened eligible studies using the QUADAS-2 tool. Accuracy was the primary outcome, including linear, angular, surface deviations, and inter-implant distance. Three meta-analyses were performed on angular deviations, trueness, and surface deviations, trueness, and precision using a random-effect model.

Results

Thirteen studies (3 in vivo and 10 in vitro) met inclusion criteria, displaying methodological heterogeneity (8 analyzing surface, 3 linear, 8 angular, and 3 interimplant distance deviations). The studies evaluated seven IOS (Aoralscan 3, Carestream 3600, iTero Element 2, iTero Element 5D, Primescan, Trios 3, and Trios 4) and two SPG devices (PIC and ICam4D). The number of implants ranged from 4 to 8. SPG reported higher accuracy than IOS in 10 of 13 studies. One in vitro study found IOS to have higher trueness but lower precision, another in vitro study found higher accuracy with IOS, and one in vivo study showed comparable trueness. Meta-analyses of in vitro studies revealed significant differences favoring SPG in surface deviation trueness and precision, and angular deviation trueness (p < 0.05), with reported effects of 3.426, 4.893, and 1.199. SPG showed surface trueness and precision, and angular trueness mean ranges 5.18–48.74 and 0.10–5.46 μm, and 0.24°–0.80°, while IOS ranges 14.8–67.72 and 3.90–37.07 μm, and 0.28°–1.74°.

Conclusions

Within study limitations, SPG showed to be a more reliable technology than IOS for complete-arch digital implant impression, exh