Clinical implant dentistry and related research最新文献

Objective: This cross-sectional study aimed to investigate the salivary profile of inflammatory mediators in individuals with periodontal and peri-implant disease as compared to individuals with periodontal and peri-implant health.

Materials and methods: Saliva samples were collected from 155 participants (mean age 63.3 ± 11.4 years), comprising individuals with periodontal and peri-implant health (N = 41), gingivitis and/or mucositis (N = 18), and periodontitis and/or peri-implantitis (N = 96). Samples were analyzed using multiplex-immunoassay panel consisting of inflammatory mediators in the tumor necrosis factor (TNF), interferon (IFN), interleukin (IL) superfamily, and matrix metalloproteinases.

Results: The levels of B-cell activating factor (BAFF), sIL-6Rβ, IFN-β, and sIL-6Rα, sTNFR1, and Pentraxin-3 were significantly higher in patients with periodontitis and/or peri-implantitis compared to healthy subjects. Furthermore, among the investigated inflammatory mediators, Pentraxin-3 exhibited the highest diagnostic potential (AUC = 0.74) for distinguishing between subjects with periodontitis and/or peri-implantitis and healthy individuals.

Conclusions: Our findings demonstrated elevated salivary levels of BAFF, sIL-6Rβ, IFN-β, sIL-6Rα, sTNF-R1, and Pentraxin-3 in individuals with periodontitis and/or peri-implantitis in comparison to periodontal and peri-implant healthy controls.

Objective: The study evaluates three biologically active substances with known bone-inductive potential on previously decontaminated titanium (Ti) discs.

Material and methods: Rough and smooth Ti surfaces were contaminated with a multispecies biofilm and cleaned with a chitosan brush. Discs were treated either with injectable-platelet-rich fibrin (i-PRF), advanced platelet-rich fibrin (A-PRF+), or enamel matrix derivatives (EMDs) before osteoblast seeding.

Results: Biocompatibility, adhesion, migration, and gene expression of runt-related transcription factor 2 (RUNX2), collagen Type I Alpha 2 (COL1a2), alkaline phosphatase (ALP), osteocalcin (OC), and osteonectin (ON) were performed. All the tested biologic agents similarly increased cell viability. Specifically, osteoblasts seeded over i-PRF and EMD-treated surfaces showed improvement in adhesion and migration and significantly increased ALP, OC, ON, RUNX-2, and COL1a2 mRNA levels up to 2.8 fold (p < 0.05) with no differences between Ti surfaces.

Conclusions: i-PRF and EMD possess beneficial bioactive properties that enhance tissue healing and promote regeneration on thoroughly sterilized surfaces. Biologically active materials may hold the potential to influence the process of implant re-osseointegration, which warrants more research since sterilization of the affected surfaces under clinical conditions is still not reliably possible and remains one of the greatest challenges.

Objectives: To compare patients' satisfaction and oral health-related quality of life (OHRQoL) in edentulous patients treated by All-on-4 and All-on-6 implant-supported fixed prostheses rehabilitation over 3-7 years.

Methods: All patients (n = 125) were divided into short-term (3-5 years, n = 71) and long-term (5-7 years, n = 54) follow-up groups. Patients' satisfaction was examined in a cross-sectional survey. OHRQoL and psychological impact were evaluated using the Oral Health Impact Profile (OHIP). Comparison of All-on-4 and All-on-6, including OHIP values, satisfaction scores, treatment duration and complications, were analyzed using the Chi-square test and the Mann-Whitney U test. Potential influence of patient-related factors on patient-reported outcome measures (PROMs) were analyzed via the Mann-Whitney U test, the Kruskal-Wallis test and multiple regression analyses. Power calculation was conducted in R Studio.

Results: Both All-on-4 and All-on-6 follow-up groups showed high scores in total satisfaction and PROMs, including chewing comfort, aesthetics, cleanability, and stability, with no significant difference (p > 0.05). Meanwhile, no significant differences were observed in the OHIP scores between two groups in both follow-up durations (p > 0.05). However, in patients with 3-5 years follow-up, All-on-4 group had significantly lower phonetic satisfaction scores than All-on-6 group (p < 0.05). Additionally, during both follow-up periods, All-on-4 patients exhibited notably superior psychological effect in contrast to All-on-6 patients (p < 0.05).

Conclusions: Edentulous patients treated by four or six implant-supported fixed prostheses showed same high satisfaction in oral health-related quality of life in both 3-5 years and 5-7 years follow-ups.

Objective: Soft tissue seal around implants ensures stable osseointegration and a long-term survival of dental implants. Different surface modification and decontamination for implant abutments were endorsed in order to improve peri-implant soft tissue healing, such as laser, plasma spray, acid etching, and steaming. The aim of this study was to evaluate the response of peri-implant soft tissue to titanium abutments treated with Erbium-doped: Yttrium-Aluminum-Garnet (Er:YAG) laser versus plasma spray.

Methods: Twenty-four patients who required implant placement in the maxillary arch participated in this study. Patients were divided into three groups, abutments treated with Er:YAG laser versus cold plasma spray and untreated abutments. Fourteen days following the implant abutment insertion, soft tissue peri-implant biopsies were taken for histological, histochemical, and immunohistochemical evaluation. Scanning electron microscopy was done for the abutments; plaque index (PI) and gingival index (GI) were assessed 14 days and 3 months following final restoration.

Results: Regarding the histological results, the least mean inflammatory cell count was in the plasma group (174.09 ± 40.67), followed by the laser group (654.27 ± 85.95) and the control group (852.00 ± 117.98), with statistically significant differences between them. The mean area fraction of collagen fibers showed the highest value in the plasma group (9.73 ± 1.91), followed by the laser group (3.25 ± 0.49), while the lowest value was found in the control group (1.17 ± 0.51). The immunohistochemical expression of E-cadherin was significantly higher and uniformly distributed in the plasma group (42.4 ± 11.2%) followed by the laser group (15.4 ± 4.07%) and the control group (6.8 ± 1.7%). SEM analysis of healing abutments showed fibroblast-like cells, which were more developed with dense fibers in the plasma group; laser group fibers showed fewer and more delicate fibers than the plasma group, while no fibers were detected in the control group.

Conclusion: Within the limitations of this feasibility study, the present data concluded that plasma spray and Erbium: YAG laser can be used for abutment surface treatment to achieve better peri-implant soft tissue healing. Clinically and histologically, plasma spray showed a better effect on the peri-implant soft tissues by reducing the inflammatory reaction, promoting collagen fiber formation, higher fibroblast-like cell attachment, and upregulating E-cadherin expression than Erbium: YAG laser and control groups.

Introduction: This retrospective study aimed to evaluate peri-implant marginal bone loss (MBL) and prosthetic complications between two types of locator attachments in two implant-supported mandibular overdentures.

Material and method: From the archived records, information about patients who had two implants inserted utilizing two different types of locator attachments into the interforaminal region between November 2019 and December 2023 was obtained. Overall, 60 patients (Total = 120 implants) from the archive records of the Prosthodontics Department, Faculty of Dentistry, Mansoura University, with ages ranging from 40 to 60 (mean age 50), were included in the study. Group I (control): Overall, 30 patients who would be delivered mandibular implant overdenture using conventional locator attachments. Group II (study): Overall, 30 patients who would be delivered mandibular implant overdenture using RTx locator attachments. After the placement of the mandibular overdenture (T0), 6 months (T6), 12 months (T12), and 3 years (T3) later, the marginal bone loss (MBL) was assessed. Prosthetic complications were evaluated for both groups 3 years after prosthetic delivery.

Result: A statistically significant increase (p = 0.000) was found in MBL scores at all observation times between both groups. Group II showed a statistical increase in MBL than Group I. For prosthetic complications, no significant difference was found between both groups. Group II showed more matrix wear than Group I however, it was not statistically significant (p = 0.60).

Conclusion: Within the limitation of this study, we can conclude the following: Both types of locator attachment (conventional and RTx locator) can be used clinically with no preference concerning the frequency of prosthetic complications. From the MBL perspective, conventional locators are more favorable than RTx locators.

Objectives: This study evaluates the clinical performance of implants with hydrophilic surface and two different macrostructures: cylindrical with perforating triangular threads (CT) and cylindrical-tapered with the association of square and condensing and perforating triangular threads (TST).

Materials and methods: This was a multicenter split-mouth, simple-blinded, randomized, and controlled trial. Thirty patients with edentulous mandible received two CT and two TST implants. Primary stability was determined by insertion torque and resonance frequency analysis (RFA). Implants were loaded with full fixed-arch prostheses within 24 h after insertion. Clinical parameters (visible plaque index, marginal bleeding index; bleeding on probing; probing depth; and clinical attachment level) and the RFA were assessed at 2, 6, 12, and 24 months after implant loading. Marginal bone level changes were measured by comparison of standardized radiographs taken on the day of implant placement and 6, 12, and 24 months thereafter.

Results: Twenty-eight patients completed the 2-year follow-up. The survival rates were 99.16% for CT implants and 100% for TST implants. One CT implant was lost until the 2 months follow-up. No significant differences were found between the two implant types for marginal bone level changes (CT 0.34 [0.24; 0.55 mm]; 0.33 [0.18; 0.55 mm]; 0.41 [0.12; 0.7 mm] vs TST 0.36 [0.14; 0.74 mm]; 0.33 [0.23; 0.63 mm]; 0.30 [0.20; 0.64 mm] at 6, 12, and 24 months, respectively) and other clinical parameters.

Conclusion: The macrostructure of the implants had no influence on survival rate, primary and secondary stability, marginal bone level changes, and peri-implant clinical parameters outcomes. Both implants can be predictably used for immediate loading of full-arch mandibular prostheses.

Osseodensification is a novel approach that has significantly advanced the field of implant dentistry, particularly in the context of transcrestal maxillary sinus floor elevation. This technique involves the use of specially designed burs that compact and densify bone along the osteotomy walls, thereby enhancing implant primary stability and facilitating osseointegration in low-density bone. This article reviews the historical evolution of implant site preparation, and the biomechanical, histological, and clinical evidence of osseodensification with a special focus on its application in sinus floor augmentation. The integration of this technique into contemporary practice represents a paradigm shift, offering a minimally invasive and efficient solution for addressing the challenges of posterior maxilla, with improved patient-reported outcomes and low complication rate. Three different protocols for sinus lift and implant placement using osseodensification burs are proposed based on available literature, and risk factors for Schneiderian membrane perforation based on residual bone height are discussed, along with implant-related outcomes and patient-reported outcome measures. The potential for osseodensification to become a standard practice in sinus floor augmentation is emphasized, highlighting key aspects such as surgical protocol and patient selection.

Objectives: This study aimed to develop an artificial intelligence (AI)-based deep learning model for the detection and numbering of dental implants in panoramic radiographs. The novelty of this model lies in its ability to both detect and number implants, offering improvements in clinical decision support for dental implantology.

Materials and methods: A retrospective dataset of 32 585 panoramic radiographs, collected from patients at Sivas Cumhuriyet University between 2014 and 2024, was utilized. Two deep-learning models were trained using the YOLOv8 algorithm. The first model classified the regions of the jaw to number the teeth and identify implant regions, while the second model performed implant segmentation. Performance metrics including precision, recall, and F1-score were used to evaluate the model's effectiveness.

Results: The implant segmentation model achieved a precision of 91.4%, recall of 90.5%, and an F1-score of 93.1%. For the implant-numbering task, precision ranged from 0.94 to 0.981, recall from 0.895 to 0.956, and F1-scores from 0.917 to 0.966 across various jaw regions. The analysis revealed that implants were most frequently located in the maxillary posterior region.

Conclusions: The AI model demonstrated high accuracy in detecting and numbering dental implants in panoramic radiographs. This technology offers the potential to reduce clinicians' workload and improve diagnostic accuracy in dental implantology. Further validation across more diverse datasets is recommended to enhance its clinical applicability.

Clinical relevance: This AI model could revolutionize dental implant detection and classification, providing fast, objective analyses to support clinical decision-making in dental practices.

Background: Sinus floor elevation is one of the predictable techniques for augmentation of vertically deficient posterior maxillary alveolar ridges. Several biomaterials were reported to be successful for sinus augmentation, including xenografts and hydroxyapatite. The aim of this study was to compare the quality and quantity of generated bone using xenografts versus nanohydroxyapatite in sinus augmentation.

Methodology: Twenty-four patients/sinuses were randomly assigned into two groups; in the control group, patients underwent sinus floor elevation and augmentation using deproteinized bovine bone (DBB), whereas in the study group, the sinus was augmented using nanohydroxy-apatite bone (NHA). For each patient, the amount of bone height was assessed preoperatively, immediately postoperatively, and 6 months postoperatively. Furthermore, the quality of the newly formed bone was assessed via histological and histomorphometric analyses after 6 months postoperatively.

Results: Both biomaterials showed a good level of consolidation. In the study group, the mean bone height after 6 months was 11.72 ± 1.24 compared to 12.01 ± 1.16 mm in the control group which was not statistically significant (p > 0.05). The mean bone area percent of newly formed bone was 29.84% ± 6.7% for NHA group and 34.73 ± 7.9 for DBB group. Moreover, the mean percent of residual grafting material was 32.43% ± 11.53% for NHA group compared to 30.43% ± 8.27% for DBB group. Histologically, there was no significant difference between both groups regarding different parameters (p > 0.05).

Conclusion: The two-stage sinus floor augmentation using NHA and DBB revealed no statistically significant difference regarding both the quality and the quantity of the regenerated bone. Studies with larger samples and longer follow up are recommended.

Trial registration: ClinicalTrials.gov identifier: NCT03184857.