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

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: 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.

Purpose: To compare the accuracy of static guided surgery using a pilot drill guide and dynamic guided surgery for dental implant placement.

Materials and methods: Partially edentulous adult patients requiring implant placement were randomly assigned to either the static guided surgery group using a pilot drill guide or the dynamic guided surgery group. Digital implant planning was conducted using intraoral scans and CBCT with planning software to determine the optimal prosthetic position. Postoperative CBCT scans were taken to compare with the plan and assess platform, apex, vertical and angular deviations from the planned implant positions.

Results: A total of 25 implants were placed. Mean deviations at the implant platform were 1.17 ± 0.75 mm for the static guided surgery group and 1.17 ± 0.71 mm for the dynamic guided surgery group, with no significant differences (P = 0.983). Apical deviations were 2.39 ± 1.22 mm for the static guided surgery group and 1.75 ± 0.59 mm for the dynamic guided surgery group, with no significant differences (P = 0.112). Vertical deviations were 0.79 ± 0.50 mm for the static guided surgery group and 0.61 ± 0.51 mm for the dynamic guided surgery group (P = 0.403). Significant differences were found in angular deviations, with the static guided surgery group showing 10.9 ± 5.63 degrees and the dynamic guided surgery group showing 4.72 ± 2.63 degrees (P = 0.002). Independent variables such as sex, age, implant location, arch and implant size did not significantly influence accuracy.

Conclusion: Both static and dynamic guided surgery offer comparable precision in implant placement, with dynamic guided surgery providing superior angular accuracy. Further studies with larger sample sizes are recommended to validate these findings.

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

Purpose: To present a novel digital workflow (the Columbus Digital Bridge Protocol) for immediately loaded full-arch rehabilitations, integrating digital technologies throughout diagnostic, surgical and prosthetic phases, with a focus on the application of intraoral photogrammetry scanning.

Materials and methods: The workflow presented in this article, successfully implemented in 14 patients, includes standardised clinical steps: digital diagnostic planning through matching of facial scans and CBCT data, surgical placement of four implants following tooth extraction, immediate post-surgical intraoral photogrammetry scanning using a three-step procedure (i.e., soft tissue registration, application of scan flags, final matching), and delivery of a 3D printed prototype followed by the final restoration.

Results: The preliminary results demonstrate that the Columbus Digital Bridge Protocol represents a promising novel digital workflow for immediate loading of full-arch implant rehabilitations. The protocol achieved optimal accuracy in prosthetic fit without requiring additional scans, plaster impressions or major prosthetic intraoral adjustments.

Conclusions: The present novel digital protocol may offer clinicians a predictable and efficient method for delivering immediately loaded full-arch rehabilitations while overcoming the traditional challenges associated with post-surgical impressions and ensuring passive prosthetic fit. The integration of photogrammetry with intraoral scanning technology appears to provide accurate implant position recording and soft tissue registration within a fully digital workflow including the simplified possibility of pre-/post-surgical overlapping to register the maxillomandibular relation.

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

Introduction: Autogenous bone grafting in oral surgery poses significant challenges, particularly in maintaining long-term bone stability. Osteoimmunology, which emphasises the role played by the immune system in bone formation and resorption, has gained attention for improving graft success rates. Azithromycin, a macrolide antibiotic, exhibits immunomodulatory properties, whereas platelet-rich fibrin contains growth factors that promote bone healing.

Methods: The present retrospective study analysed 275 patients treated between 2014 and 2023 at a primary care centre in Paris, France. The inclusion criteria required patients to be aged over 18 years and to have undergone autogenous bone grafting using the split bone block technique. Three antibiotic regimens were compared: the standard of care, standard of care combined with platelet-rich fibrin, and standard of care combined with platelet-rich fibrin and azithromycin. The primary outcome was the occurrence of bone resorption or locoregional complications within a 4-month follow-up period.

Results: The overall success rate was 75.3%, with major bone resorption observed in 24.7% of cases. Multivariate analysis identified penicillin allergy (P 0.01) and posterior bone defects (maxilla and mandible, P = 0.02 and P = 0.001, respectively), as predictors significantly associated with higher failure rates. In contrast, the combination of platelet-rich fibrin and azithromycin improved outcomes significantly (adjusted odds ratio 8.38, P 0.001).

Conclusion: The combination of platelet-rich fibrin and azithromycin markedly enhanced the success of autogenous bone grafts, likely due to the immunomodulatory effects of azithromycin on the receptor activator of nuclear factor NF-κB ligand pathway. These findings support further investigation into this approach, particularly guided bone regeneration.

Purpose: Ceramic implants are gradually becoming an alternative to standard titanium implants; however, there is still a lack of scientific data on the former. Thus, the present study was conducted to assess the clinical and microbiological performance of a two-piece ceramic implant system after a mean follow-up period of 2 years.

Materials and methods: A total of 17 patients from a collective of 21 from a private dental practice that met the inclusion criteria received 32 two-piece ceramic implants (CERALOG, BioHorizons Camlog, Basel, Switzerland). The implants were restored with single crowns or three-unit fixed partial dentures. Implant survival, probing pocket depth, bleeding on probing, mucosal recession/creeping, keratinised mucosa width, Papilla Presence Index, peri-implant marginal bone level and microbiological contamination were evaluated after a mean loading period of 24 months (range 12 to 41 months).

Results: All implants survived and were suitable for retaining prostheses. Probing pocket depth of 3.7 mm ± 0.7 mm and bleeding on probing on 84% of implants were recorded. Sufficient keratinised mucosa width (6.6 ± 2.9 mm) was observed with no mucosal recession/creeping. The Papilla Presence Index varied between 0 and 4 with a mean value of 1.70 ± 1.07. Mean marginal bone loss was 1.2 ± 0.9 mm. Microbiological investigation revealed no statistically significant difference in the total number of bacteria between teeth and implants (P = 0.2278); however, probing pocket depth > 4 mm proved to be a significant predictor for an increased number of bacteria (P 0.001).

Conclusion: Within the limitations of the present study, the investigated two-piece ceramic implant system achieved fully satisfying functional and microbiological results. Interpretation of the clinical, radiographic and microbiological results cannot support the hypothesis that ceramic implants are less affected by peri-implant disease.