International journal of oral implantology (Berlin, Germany)最新文献

Purpose: Aspergillosis is a common cause of fungal maxillary sinusitis that is often asymptomatic and detected only incidentally on imaging. It may be triggered by spores entering the maxillary sinus through the natural ostium, often following the dislocation of foreign bodies, for example root canal filling or augmentation materials. This retrospective study aimed to evaluate a standardised treatment for maxillary sinus aspergillosis followed by implant-prosthetic rehabilitation.

Materials and methods: Eleven immunocompetent patients with maxillary sinus aspergillosis were included in the present study. Maxillary sinus surgery was performed via a bone lid under local anaesthesia and intravenous sedation. The aspergilloma was removed completely and the diagnosis was confirmed by histopathology. Sinus disinfection consisted of irrigation with hydrogen peroxide (3%) and saline solution, followed by photodynamic decontamination. Three months postoperatively, a new CBCT scan was taken to confirm the absence of any pathology in the sinus. Sinus floor elevation and bone augmentation were then performed following a clear protocol. Implants were placed, whenever possible, simultaneously or after 3 months and exposed after another 3 months. The definitive prosthetic restoration followed 6 to 8 weeks postoperatively.

Results: The surgical procedures went without complications, and all patients were successfully restored. After 3 to 10 years (mean 6.8 ± 1.7 years), all inserted implants were still in place and presented with no inflammation, and with pocket depths below 5 mm (3.1 ± 0.9 mm). Postoperative radiographs showed no recurrence of any sinus pathology.

Conclusion: The present treatment protocol proved to be efficient in managing infection and defect reconstruction. Throughout the 3- to 10-year follow-up period, neither recurrences nor complications presented, affirming the reliability of the protocol.

Purpose: To evaluate the accuracy of guided implant placement using surgical guides with or without metallic sleeves through a systematic review and meta-analysis.

Materials and methods: A comprehensive search was conducted on PubMed, Scopus and Web of Science up to 2025, identifying in vivo and in vitro studies comparing static surgical guides with and without metallic sleeves. Studies reporting angular, horizontal or vertical deviations between planned and actual implant positions were included. Data were extracted and analysed using standardised mean differences, with heterogeneity assessed via the I² index and Cochran Q test.

Results: Four studies met the inclusion criteria: three in vitro and one in vivo randomised clinical trial, totalling 90 implants. Meta-analysis showed no statistically significant differences between sleeveless and sleeved guides in terms of angular deviation (standardised mean difference 0.18; 95% confidence interval -0.24 to 0.59; P = 0.402) or horizontal deviation (standardised mean difference -0.23; 95% confidence interval -0.70 to 0.24; P = 0.340). All studies demonstrated low heterogeneity (I² = 0%).

Conclusions: Clinical evidence comparing sleeveless and sleeved surgical guides remains very limited. Current data, mainly derived from in vitro studies and one small randomised clinical trial, suggest that both guide types may offer comparable accuracy; however, these findings should be interpreted with caution, and further high-quality clinical studies are required to validate these preliminary results and establish their applicability in different clinical scenarios.

Purpose: To evaluate and compare the accuracy of implant placement measured by using CBCT or intraoral scanning in computer-assisted implant surgery in terms of angular, coronal, apical and depth deviations between planned and actual implant position.

Methods: A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and registered in the International Prospective Register of Systematic Reviews database (CRD420250648755). The population, intervention, comparison, outcomes and study design and study type question addressed the accuracy of implant placement surface scanning versus CBCT in in vitro and in vivo studies on computer-assisted implant surgery. The literature was searched using the PubMed, Scopus and Web of Science databases up to 2025. Studies reporting quantitative data on angular, coronal, apical and signed depth deviations were included. Risk of bias was assessed using the Quality Assessment Tool for In Vitro Studies, Risk of Bias In Non-randomised Studies of Interventions tool and Cochrane Risk of Bias Tool. Meta-analyses were conducted using standardised mean differences, heterogeneity was assessed with I2 and forest plots were generated.

Results: Eight studies were included. The meta-analysis showed no statistically significant differences in angular deviation (standardised mean difference 0.76 degrees, P = 0.2315) or apical deviation (standardised mean difference 0 mm, P = 0.9820) between CBCT and intraoral scanning. Intraoral scanning demonstrated lower coronal deviation (standardised mean difference -0.21 mm, P = 0.0435) and a trend towards reduced depth deviation (standardised mean difference -0.40 mm, P = 0.0620). Intraoral scanning also exhibited lower variability across studies. Risk of bias was low in in vitro studies and moderate to high in most in vivo studies.

Conclusion: Most existing studies rely on pre- and postoperative CBCT imaging, whereas intraoral scanning-based methods remain underexplored. Preliminary evidence suggests that intraoral scanning-based analyses may offer higher accuracy than CBCT, although the differences are not statistically significant. When deciding between intraoral scanning and CBCT, clinicians should consider clinical practicality, including equipment availability and radiation exposure.

Purpose: The present systematic review and meta-analysis evaluates the effect of a special treatment procedure that avoids the repeated change of implant abutments (one-abutment one-time concept, study group) on implant survival and peri-implant bone level stability compared to the standard procedure (control group).

Materials and methods: The National Center for Biotechnology Information database (PubMed) was searched systematically using preselected search terms. Randomised clinical control trials were extracted that were conducted no more than 10 years previously at the time (2012 to 2022), comparing two treatment approaches (study group vs control group) in single-tooth implant replacement over a minimum observation period of 12 months. A meta-analysis was then performed to compare the implant survival rate and marginal bone loss between the study and control groups.

Results: Ten studies met the inclusion criteria and were included in the subsequent meta-analysis, in which a total of 753 implants were placed in 573 patients. On average, 55.8 patients were included per study and 75.3 implants were placed. The cumulative survival rate of the implants was 99.34%. When comparing the subgroups, the survival rate in the study group was 99.43%, whereas in the control group with multiple changes it was 99.25%. The difference was only marginally statistically significant and there was slightly less bone resorption in the study group compared to the control group (P = 0.0518).

Conclusion: The one-abutment one-time concept leads to less bone resorption on implants; however, due to the marginal statistical significance and the low influence on implant survival, further studies involving a larger number of patients need to be carried out to evaluate the clinical relevance.

Purpose: To evaluate changes in implant stability quotient values of hydrophilic tissue-level implants over time, and to investigate the influence of local factors on variations in these values.

Methods: Fifty tapered, self-tapping, tissue-level implants with a hydrophilic surface were placed and monitored for 12 months. Implant stability quotient values were recorded at the time of insertion (T0) and monthly thereafter for 12 months. All implants were restored with screw-retained restorations 2 months after placement. A repeated measures analysis of variance was used to evaluate the trends in implant stability quotient values over time. A multiple linear regression model was employed to determine the impact of various factors on changes in implant stability quotient values.

Results: Implant stability quotient values decreased from T0 to T1, although this reduction was not statistically significant (P = 0.28). The greatest decrease was observed in implants with initially high implant stability quotient values at T0 (P 0.05). Values increased significantly at each subsequent time point (P 0.001). A significant time effect was noted between immediate and delayed placement protocols (P 0.05), with immediate implants demonstrating lower initial implant stability quotient values but a steeper increase over time. Implants placed in the mandible and wider implants in molar sites showed higher implant stability quotient values compared to those placed in the maxilla and narrower implants (mandible vs maxilla P 0.05; wide molar vs regular premolar P 0.05). Insertion torque was positively correlated with implant stability quotient values at T0 (P 0.001).

Conclusions: The lowest implant stability quotient value was recorded 1 month after implant placement, and then increased consistently throughout the study period without reaching a plateau. Implants placed immediately showed a steeper improvement in implant stability quotient values.

Conflict-of-interest statement: The authors declare there are no conflicts of interest relating to this study.

Background: Dental rehabilitation is considered challenging to achieve whenever composite scapulo-dorsal free flaps are used to reconstruct medium-to-large maxillary defects due to the fact that bone quality and quantity may be low, which may preclude placement of conventional dental implants. In such cases, current options for dental rehabilitation include printed patient-specific subperiosteal implants or zygomatic implants.

Methods: The authors report three cases of maxillary tumour resections that led to medium-to-large defects reconstructed using composite scapulo-dorsal free flaps. Secondary zygomatic implants were perforated through the composite scapulo-dorsal flap more than 12 months after primary reconstruction. Initial loading with removable dental prostheses took place at the time of zygomatic implant placement, followed by secondary non-removable prosthesis placement.

Results: Adequate dental rehabilitation was achieved in all three cases, with an implant survival rate of 100% and no apparent complications after a follow-up period of more than 24 months.

Conclusion: The technique described in the present paper shows promising results in achieving adequate dental rehabilitation in cases with composite scapulo-dorsal free flaps for reconstruction of medium-to-large maxillary defects and could be used as part of the dental rehabilitation strategy, especially in cases where dental prostheses have failed or removable prostheses cannot be used.

Conflict-of-interest statement: The authors declare there are no conflicts of interest relating to this study.

Background: Certain 3D interrelationships between adjacent implants can potentially predispose to prosthetic and biological complications.

Materials and methods: Patient records with adjacent dental implants were assessed to evaluate the effects of vertical, horizontal and angulation interrelationships between splinted compared to non-splinted implant restorations on the occurrence of biological and prosthetic complications. Data on patient- and implant-related variables were collected at baseline (T1) during prosthesis placement and at the last follow-up appointment (T2).

Results: The study included 227 patients with 508 implants and a mean follow-up period of 6.7 ± 6.5 years. No significant difference in implant survival was observed between the groups (97.3% for splinted adjacent implant restorations and 98.4% for non-splinted adjacent implant restorations). Implant success, defined as the absence of any biological or prosthetic complications, was relatively low (56.8% for non-splinted adjacent implant restorations and 62.1% for splinted adjacent implant restorations), with no significant inter-group differences (odds ratio 0.80; P = 0.415). Patients with splinted adjacent implant restorations demonstrated a significantly higher likelihood of biological complications than those with non-splinted adjacent implant restorations (24.1% vs 12.6%, respectively; odds ratio 2.21; P = 0.028) but a notably lower risk of prosthetic complications (19% vs 33.3%, respectively; odds ratio 0.47; P = 0.015). Survival and success rates were consistent across both groups at both patient and implant levels. Generally, certain 3D interrelationships were linked to biological complications in the splinted adjacent implant restoration group and prosthetic complications in the non-splinted adjacent implant restoration group. With regard to marginal bone loss according to implant location, the middle implant was found to have increased marginal bone loss compared to its mesial or distal counterpart (P = 0.013)Conclusion: Certain 3D relationships were found to exacerbate prosthetic complications in non-splinted adjacent implant restorations and biological complications in splinted adjacent implant restorations. Implants with either type of restoration exhibited comparable survival and success rates.

Conflict-of-interest statement: The authors declare there are no conflicts of interest relating to this study.