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

Purpose: To investigate various cleaning protocols employed to enable the reuse of healing abutments in the past decade.

Materials and methods: The review followed the guidelines set out in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, with guidance from the Cochrane Collaboration Handbook. Electronic searching and handsearching were performed using the National Library of Medicine (MEDLINE via PubMed) and the Cochrane Central Register of Controlled Trials from January 2010 to July 2022, respectively. Studies published in English were evaluated. Two independent examiners conducted the search and the review process. The risk of bias of the included studies was evaluated.

Results: In total, 178 articles were evaluated for review, but only 15 of them were selected for full-text reading. Regarding cleaning efficacy, chemical decontamination using sodium hypochlorite produced better results than laser and mechanical decontamination with airflow. Similar efficacy was found between chemical and electrochemical decontamination. Combined use of chemical and electrochemical decontamination protocols demonstrated the greatest efficacy. Chemical and electrochemical decontamination methods were found to achieve better outcomes in preserving the surface properties of decontaminated healing abutments than laser and mechanical methods.

Conclusion: The present review found that combined decontamination protocols (chemical, electrochemical processing and autoclave treatment) are favourable for obtaining healing abutments with optimally cleaned surfaces. Moreover, healing abutments located in an area that is difficult to access can be cleaned without affecting the surface properties. This information could benefit researchers and clinicians when multiple-use healing abutments are considered.

Purpose: The root membrane technique was designed to preserve the buccal portion of the root in situ, preventing postextraction bundle bone loss and overlying soft tissue recession. Nevertheless, maintenance of the aesthetic gingival architecture around two or multiple adjacent implants, particularly in the anterior maxilla, remains a challenge, notably regarding the gingival contour and the interimplant papillae. The present study aimed to evaluate the clinical, aesthetic and radiographic outcomes for immediate adjacent implants placed using the root membrane technique in the anterior maxilla in a sample with a 5- to 9-year follow-up.

Materials and methods: A retrospective clinical study was designed using the medical records of two private dental practices. A total of 40 patients who were treated using the root membrane technique for at least two adjacent implants and single-crown restorations between January 2010 and February 2019 were selected (100 implants). The clinical and radiographic data were analysed to assess implant survival/success, marginal bone loss and the pink aesthetic score.

Results: The cumulative survival rate after a mean follow-up period of 81.5 ± 30.5 months was 99.0% (implant-based) and 97.5% (patient-based), respectively. Between 1 and 5 years (n = 99), the mean marginal bone loss changed from 0.39 ± 0.07 mm to 0.36 ± 0.07 mm and subsequently to 0.37 ± 0.07 mm at the 7-year follow-up (n = 71) and 0.33 ± 0.07 mm at the 9-year follow-up (n = 14). The improvement from 1 year was significant at all the follow-up time points (P = 0.000). The mean global pink aesthetic score increased from baseline (11.33 ± 1.03) to 3 months after placement of the final restoration (11.73 ± 0.95) and the final observation (12.01 ± 0.87). This was a significant increase (P = 0.000 baseline to 3 months, 3 months to final observation and baseline to final observation).

Conclusions: In this non-controlled retrospective study, adjacent implants placed using the root membrane technique achieved a satisfactory survival and success rate. The variation in marginal bone loss showed a significant positive trend from 1 year to 5 and 7 years. The overall pink aesthetic scores improved significantly between sequential observation periods.

Conflict-of-interest statement: Dr Leitão-Almeida receives personal fees (for sponsored lectures) and non-financial support from MegaGen (Daegu, South Korea) outside of the submitted work; the other authors declare no conflicts of interests relating to this study.

The following amendments are made to the published article: Int J Oral Implantol 2022;15(3):265-274; PMID: 36082660; First published 9 September 2022.

The aim of the present study was to generate an international and multidisciplinary consensus on the clinical management of implant protrusion into the maxillary sinuses and nasal fossae. A total of 31 experts participated, 23 of whom were experts in implantology (periodontologists, maxillofacial surgeons and implantologists), 6 were otolaryngologists and 2 were radiologists. All the participants were informed of the current scientific knowledge on the topic based on a systematic search of the literature. A list of statements was created and divided into three surveys: one for all participants, one for implant providers and radiologists and one for otolaryngologists and radiologists. A consensus was reached on 15 out of 17 statements. According to the participants, osseointegrated implants protruding radiographically into the maxillary sinus or nasal fossae require as much monitoring and maintenance as implants fully covered by bone. In the event of symptoms of sinusitis, collaboration between implant providers and otolaryngologists is required. Implant removal should be considered only after pharmacological and surgical management of sinusitis have failed.

Purpose: To prove that a fully digital workflow, even for registration of the maxillomandibular relationship, can be employed to produce implant-supported overdentures and demonstrate that CAD/CAM techniques can be used to mill permanent implant-supported overdentures from polymethylmethacrylate discs, using polyetheretherketone as the sliding mechanism.

Materials and methods: An edentulous 64-year-old woman received six implants in the maxilla after a bone augmentation procedure and two implants in the mandible. Five months after implant placement, intraoral scans were taken of her original complete dentures, of each prosthesis individually, and of both in centric relation, and another was taken of both edentulous arches, including the scan bodies. Along with facial photographs, sufficient digital data were gathered to design and mill titanium bars, polyetheretherketone female parts and a trial implant-supported overdenture. The tooth positions and colour were discussed with the patient using Smile Design software (3Shape, Copenhagen, Denmark). In the second session, the bars and trial implant-supported overdenture were inserted and checked, and in the third session, the final implant-supported overdentures were inserted.

Results: The milled titanium bar exhibited a passive fit, as did the implant-supported overdentures. After 1 year, no prosthetic complications were noted; the measured pockets were all less than 4 mm in depth. On a visual analogue scale from 0 to 10, with 0 being the worst and 10 being the best, the patient awarded a score of 9 for her satisfaction with the implant-supported overdentures.

Conclusion: A fully digital workflow enables the production of robust wear-resistant implant-supported overdentures milled from polymethylmethacrylate, using polyetheretherketone female parts as the sliding mechanism, in just three clinical sessions.

Peri-implantitis is an infectious disease that leads to progressive bone loss. Surgical therapy has been advocated as a way of halting its progression and re-establishing peri-implant health. One of the most challenging but crucial tasks in the management of peri-implantitis is biofilm removal to achieve reosseointegration and promote the reduction of peri-implant pockets. A wide variety of strategies have been used for implant surface decontamination. Mechanical means have been demonstrated to be effective in eliminating calculus deposits and residual debris; however, the presence of undercuts and the grooves and porosities along the roughened implant surface make it difficult to achieve an aseptic surface. In conjunction with mechanical measures, use of chemical adjuncts has been advocated to dilute bacterial concentrations, destroy the bacteria's organic components and eliminate endotoxins. Pharmacological adjuncts have also been recommended to diminish the bacterial load. Other strategies, such as use of lasers, implantoplasty and electrolysis, have been suggested for implant surface decontamination to promote predictable clinical and radiographic outcomes.

Purpose: To evaluate the clinical performance of zirconia bars with distal extensions supporting mandibular implant overdentures based on biological and prosthodontic outcomes.

Materials and methods: Fifteen edentulous patients (seven women and eight men) were included in a pilot study. Each patient received two interforaminal implants and a mandibular implant overdenture supported by a CAD/CAM zirconia bar with distal extensions, giving a total of 30 implants. The bar design, biological outcomes (implant survival and peri-implant conditions), peri-implant bone level changes recorded on a panoramic radiograph and prosthodontic maintenance (bar fracture and maintenance of the attachment system) were assessed at a 1-year follow-up.

Results: After 1 year, all 15 zirconia bars with their corresponding prostheses and implants were successfully in situ with no prosthodontic maintenance required and no biological complications. One patient showed moderate mucosal hyperplasia around the bar. The peri-implant radiographic measurements revealed a stable marginal bone level, with a mean of 0.20 ± 0.67 mm. The mean total length of the bar segments was 41.9 mm (range 35.0 to 51.0 mm), 8.6 mm (range 7.2 to 10.6 mm) of which came from the length of the distal extension, resulting in a mean increase in rigid support of 71% (range 60% to 99%). The mean distal bar connector area was 9.7 mm2 (range 6.8 to 18.7 mm2).

Conclusion: Zirconia bars with distal extensions for implant overdentures appear to be a reliable option for the prosthodontic rehabilitation of edentulous mandibles. A survival rate of 100% was observed for implants, bars and prostheses, with stable peri-implant bone levels, no biological complications and a low risk of prosthodontic maintenance being required.

Purpose: Titanium bases are used frequently in daily practice for bonding to CAD/CAM abutments or crowns. Due to intimate contact between the adhesive gap of the titanium-base abutment and the peri-implant bone, the physical and chemical characteristics of the bonding material, or the gap itself, may affect peri-implant inflammatory reactions. The present study therefore aimed to examine the long-term effects of individualised abutments bonded to titanium bases on peri-implant health.

Materials and methods: A total of 24 patients, each with one test and one control abutment, participated in the present prospective, single-blind, randomised controlled clinical trial. The test abutments were CAD/CAM titanium abutments bonded to titanium bases. As the control abutments were individualised, one-piece CAD/CAM titanium abutments were used. Clinical and radiographic parameters were assessed at abutment insertion and then on a yearly basis over the following 5 years.

Results: No significant differences in marginal bone level were observed between the titanium-base and one-piece abutments at any of the follow-up time points; however, when intragroup marginal bone levels were compared to the baseline values, significant differences were found at several follow-up time points. Intergroup differences were only found to be significant for pocket depth at the 4- (P = 0.006) and 5-year follow-ups (P = 0.024), favouring titanium-base abutments.

Conclusions: Within the limitations of the present study, it appears that the peri-implant tissues of this specific patient cohort responded to titanium-base abutments in a rather similar manner to one-piece abutments over a 5-year period; however, no definitive conclusions can be drawn due to the low power of the present study.