Clinical Implant Dentistry and Related Research最新文献

Purpose

This study aimed to investigate the changes in healing abutments (HAs) after use based on an in vitro comparison with unused HAs and to evaluate the effectiveness and clinical implications of reusing HAs.

Materials and Methods

Fifty used HAs were collected from affiliated clinics of the Department of Dentistry at Hanyang University Hospital and analyzed for surface damage, protein contamination, and microgap formation using three-dimensional laser microscopy and microcomputed tomography. The interfacial microgap between the implant and the abutment was measured at different tightening torques (5 N·cm, 10 N·cm, and 15 N·cm). Additionally, bacterial leakage and growth at various tightening torques were assessed by incubating reused HAs over different time periods.

Results

Reused HAs exhibited significant surface roughness, protein contamination, and larger microgap compared to unused HAs. The average microgap for reused HAs was 43 μm, whereas unused HAs showed no detectable gap. Bacterial leakage was significantly higher with reused HAs, particularly in those subjected to more than two tightening cycles. Tightening torques of 15 N·cm effectively eliminated the microgap and minimized bacterial leakage, whereas lower torques (5 N·cm and 10 N·cm) resulted in considerable bacterial growth.

Conclusion

Reusing HAs increases the risk of surface damage, protein contamination, microgap formation, and bacterial leakage, potentially compromising implant treatment outcomes. Higher tightening torque, (15 N·cm) significantly reduces microgap and bacterial leakage at the implant - HA imterface. Clinicians are advised to limit the reuse of HAs. However, if reuse is necessary, an appropriate tightening torque should be applied following a careful assessment of the clinical conditions of each HA.

Objective

The primary aim was to investigate differences in patient-reported healing outcomes between static computer-assisted sinus floor augmentation (SCA-SFA) and the conventional freehand approach (SFA).

Material and Methods

Patient-reported healing outcomes were recorded in visual analog scale (VAS) on days 1–7 and 14, and intra and postoperative complications were assessed on weeks 2 and 4 after surgery. Operation time and operators' assessment of efficacy for SCA-SFA utility were recorded. Independent t-tests and Chi-square exact tests were performed for statistical evaluation between groups.

Results

Forty patients underwent lateral sinus augmentation (20 freehand-SFA + 20 SCA-SFA). No statistically significant difference was found between the two groups with regard to PROMs and intra, postoperative complications, apart from a higher level of swelling for SCA-SFA patients on day 2 after surgery (p = 0.04). The use of SCA-SFA significantly reduced the time needed to conduct the window osteotomy (SFA 18.56 ± 12.17 min vs. SCA-SFA 11.43 ± 4.75 min; p = 0.022) and the total surgery duration (SFA 69.89 ± 20.08 min vs. SCA-SFA 56.24 ± 16.01 min; p = 0.023).

Conclusions

Within the limitations of the study, SCA-SFA should be preferred when the reduction of surgical time is a priority while the costs of the intervention do not play a major role, and the design of the surgical guide should strive for minimal invasiveness.

Clinical Trial Registry: TCTR20230427005

Background

Maxillary sinus floor augmentation (MSFA) with lateral approach has undergone considerable changes since its inception, mainly due to the introduction of a variety of grafting materials and surgical protocols, with the aim of providing predictable and durable support to implants and improving treatment outcomes. The aim of this systematic review was to evaluate the performance of MSFA in terms of graft stability and implant survival, based on randomized clinical trials.

Methods

The study protocol was registered on PROSPERO. An electronic search was performed on Medline, Embase, and CENTRAL databases, integrated with hand-searching on the main pertinent Journals and search of gray literature. Randomized studies on MSFA with a lateral approach reporting on radiographic changes in graft height or volume after at least six months of healing, implant survival, and marginal bone level changes after at least 12 months of loading were included. Two independent reviewers selected the studies. Studies included underwent data extraction and risk of bias assessment using the ROB 2.0 Cochrane tool.

Results

Out of 3922 studies retrieved, 49 studies (57 articles) were included for data extraction and qualitative analysis. These studies reported on 1265 patients and 1722 MSFA procedures. Thirteen studies were at low risk, 30 had some concerns, and six were at high risk of bias. No quantitative synthesis was possible due to the characteristics of the studies and their methodology. The overall implant survival rate ranged from 84.6% to 100% without evidence of any relevant difference related to the grafting material.

Conclusion

The results of this review, based on descriptive statistics, may suggest that the success of the lateral MSFA procedure is independent of the graft type, at least in the short term. To verify this interpretation, formal statistical analyses on trustworthy and more detailed clinical data are needed. Also, long-term data on graft dimensional stability from evidence-based studies are needed.

Objectives

Smoking disrupts macrophage chemokine response and delays healing. This study aims to investigate the effect of smoking on peri-implant crevicular fluid (PICF) levels of macrophage-related chemokines, C-C motif chemokine ligand 2 (CCL-2), C-C motif chemokine ligand 8 (CCL-8), C-X-C motif chemokine ligand 9 (CXCL-9), and C-C motif ligand 3 (CCL-3), before and after non-surgical treatment of initial peri-implantitis.

Methods

Fifty-five implants (27 non-smoking [NSPI] and 28 smoking [SPI]) with initial peri-implantitis (bleeding on probing [BOP+], probing pocket depth [PPD] of 6–7 mm) were included in the study. Clinical parameters were recorded, and PICF samples were collected before and 4 months after non-surgical treatment. PICF concentrations of CCL-2, CCL-8, CCL-3, and CXCL-9 were measured with Luminex assay. The Mann–Whitney U-test, Wilcoxon signed-rank test, and repeated measures analysis of variance test were used to analyze differences between and within the groups.

Results

Baseline CCL-2 (p < 0.001) and CXCL-9 (p = 0.026) levels (pg/30 s) were significantly lower in smokers compared to non-smokers, while no difference was observed for CCL-3 between the two groups (p = 0.320). Only CCL-2 levels (pg/30 s) decreased in the NSPI group in response to non-surgical treatment (p = 0.037).

Conclusion

Smoking disturbs the expressions of macrophage-related chemokines in the early phase of peri-implantitis. These findings may indicate the impaired control of infection during initial peri-implantitis and explain the accelerated progression of the disease in smokers. This study was not registered prior to participant recruitment.

Trial Registration

https://clinicaltrials.gov/study/NCT06810401

Background

Robot-assisted implant surgery has been shown to achieve high levels of accuracy. However, there is currently a paucity of clinical studies evaluating the accuracy of marker-based intraoral scanner (IOS) registration (IR) methods.

Purpose

The purpose of this study was to compare the accuracy of the marker-based cone beam computed tomography (CBCT) registration (CR) method and the IR method in the dental implant in the robotic computer-aided implant system (R-CAIS).

Materials and Methods

This retrospective study included 20 participants, with 10 undergoing implant surgery using the CR method within a robotic system, and the remaining 10 receiving implants using the IR method. Preoperative CBCT images used for implant planning were aligned with the postoperative CBCT images to assess and quantify positional deviations in implant placement. The primary outcome measures were FRE, entry deviation, apical deviation, and angular deviation. A Student's t-test was performed to compare differences between the two groups, with a p-value of < 0.05 considered statistically significant.

Results

The mean ± standard deviation values for FRE were 0.027 ± 0.007 mm for the CR group and 0.031 ± 0.006 mm for the IR group (p = 0.149). The mean ± standard deviation values for entry deviation were 0.58 ± 0.11 mm for the CR group and 0.53 ± 0.15 mm for the IR group (p = 0.072). The mean ± standard deviation values for apical deviation were 0.52 ± 0.12 mm for the CR group and 0.50 ± 0.14 mm for the IR group (p = 0.730). The mean ± standard deviation values for apical deviation were 1.10 ± 0.34 mm for the CR group and 1.17 ± 0.23 mm for the IR group (p = 0.730).

Conclusions

In R-CAIS, the IR method demonstrated accuracy comparable to that of the CR method, with both methods yielding clinically satisfactory outcomes.

Aim

To analyze the scientific profile of the 100 most cited articles on maxillary sinus lift.

Materials and Methods

A search was conducted in the Web of Science Core Collection database in February 2024. Two reviewers retrieved the 100 most cited articles. The number of citations for the articles was compared in the Scopus and Google Scholar databases. The VOSviewer software was employed to generate collaborative network maps for authors and keywords. Dimension was consulted to measure altimetry data. Google Trends was used to explore the global popularity of research on maxillary sinus lift.

Results

The number of citations ranged from 120 to 1259. The articles were published between the years 1991 and 2017. The most frequent study design was observational (21%), and the surgical technique was the lateral window (76%). The most used bone graft was autogenous (15%). The journal with the highest number of articles was Clinical Oral Implants Research (29%). The United States was the most prevalent country (27%), and New York University had the highest number of publications (8%). However, the European continent stood out (66%). Froum SJ was the author with the highest number of publications (6%). The most common keywords were “dental implants” (38%). Intense mentions were identified primarily on Mendeley. According to Google Trends, Ukraine was the country that researched maxillary sinus lift the most.

Conclusion

It can be concluded that the 100 most cited articles on sinus elevation were observational studies that evaluated the lateral window technique for sinus elevation.

Objectives

In vitro studies were conducted to evaluate the effectiveness of combining glycine powder air-polishing (AP) and ultrasonic scaling (US) in surgical bone reconstructive therapy for peri-implantitis.

Materials and Methods

Twenty clinically failed implants and 60 pristine implants were treated in vitro with AP and/or US by using stainless steel, titanium, or carbon fiber tips. Implant surface topography, contaminant distribution, elemental proportion, and composition were analyzed using scanning electron microscopy and energy-dispersive X-ray spectroscopy.

Results

AP effectively removed bacterial plaques but was unable to eliminate calcified deposits involving calculi and bone fragments. Conversely, US exhibited a high capacity for removing calcified deposits but inevitably altered implant surface topography and the atomic percentages of oxygen (O) and titanium (Ti) regardless of the ultrasonic tip used. AP showed minimal effects on the implant surface and even alleviated the adverse effects of US on the surface topography and the atomic percentages of O, Ti, and even carbon. A sequential protocol involving AP followed by US, with a final AP step, effectively removed contaminants from infected implants while minimally affecting the original surface features.

Conclusions

The combined application of AP and US in surgical peri-implantitis therapy may be a preferred and effective approach for obtaining bone regeneration around infected dental implants.

Objective

This study aimed to investigate the accuracy of conventional and digital impression-making and cast-fabrication using coded healing abutments on an edentulous mandibular model under in vitro conditions.

Materials and Methods

Our study investigated the accuracy of the On1 Concept (Nobel Biocare; Kloten, Switzerland) coded healing abutment system using conventional and digital workflows. The Conical Connection (CC) system (Nobel Biocare; Kloten, Switzerland) was used as the control group in both workflows. 10–10 open-tray impressions and intraoral scans were made from the reference model with each system. Models built from intraoral scans were additively fabricated, and open-tray impressions were poured with type-4 dental stone. The prepared models were digitized using a desktop scanner with an accuracy of 4 μm (E4, 3Shape; Copenhagen, Denmark) and superimposed on the reference scan. Four linear distances and root mean square (RMS) deviations were measured using metrology software.

Results

Five dimensions were measured using signed and absolute deviations, resulting in nine outcomes. RMS and diagonal deviations provided the most insight into overall model deviations. Mean RMS deviations were: 58.30 (14.95) μm for CC_conv, 47.66 (13.04) μm for On1_conv, 204.97 (37.40) μm for CC_dig, and 136.64 (13.49) μm for On1_dig. Significant differences were found between On1_conv vs. CC_dig, On1_conv vs. On1_dig, and CC_conv vs. CC_dig. Mean linear deviations between the molar positions were: 24.49 (58.20) μm for CC_conv, 87.46 (106.70) μm for On1_conv, −104.76 (125.83) μm for CC_dig, and 140.64 (190.56) μm for On1_dig. Significant differences were observed between On1_conv vs. CC_dig and CC_dig vs. On1_dig.

Conclusions

Based on the RMS deviations, the conventional method is significantly more accurate at both implant and platform levels in the case of an in vitro edentulous lower jaw model. The RMS deviations of the implant analogs are smaller on the platform level with both conventional and digital methods.

Introduction

In many clinical cases, anatomical conditions such as an atrophied alveolar ridge do not allow insertion of normal diameter implants. At this point, narrow dental implants may provide an effective option to avoid complex surgical treatments. The aim of this trial was to evaluate long-term survival, prosthetic and biological complications, and OHRQoL for two-piece narrow dental implants supporting overdentures with Locator-attachments.

Methods

Twenty-five patients with edentulous mandibles received four narrow dental implants and retained dentures with Locator attachments. Following successful implantation, immediate loading of anterior implants with Locator attachments was performed, while posterior implants underwent a conventional healing procedure. Follow-up examinations included documentation of implant and denture-related complications, modified gingiva index, modified plaque index, OHIP-G, and radiographic measurements of bone loss.

Results

Up to 9 years after restoration, 18 patients with 72 implants were available for the follow-up. During the observation period, one implant was lost in the immediate loading group. Implant survival was 98% and 100%. The outcomes of mPI and mGI for the 18 patients hardly differed between the groups. During the observation period, 136 prosthetic complications occurred. Scores for the different OHIP-G domains at the last follow-ups were stable over the years.

Conclusions

Throughout an extended period of observation, we found stable implant survival rates, good maintenance of oral hygiene, and manageable prosthetic complications. The OHRQoL was satisfying over the years, suggesting that this treatment option could be favorable for older individuals.

Trial Registration

https://drks.de/search/en/trial/DRKS00005497