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Osteoinductively Functionalized 3D-Printed Scaffold for Vertical Bone Augmentation in Beagle Dogs. 用于比格犬垂直骨增量的骨诱导功能化三维打印支架
Pub Date : 2024-10-31 DOI: 10.1111/cid.13408
Ting Wang, Gaoli Xu, Chuankai Zhang, Tymour Forouzanfar, Junwei Liang, Yulei Pan, Chenxi Shen, Gang Wu, Haiyan Lin

Objective: To evaluate the efficacy of 3D-printed scaffolds that were osteoinductively functionalized with a bone morphogenetic protein 2 (BMP-2)-incorporated biomimetic calcium phosphate particles (BMP-2-inc. BpNcCaP)/hyaluronic acid (HA) composite gel in vertical bone augmentation in beagle dogs.

Materials and methods: Four Beagle dogs were used in this study. Three months after the extraction of 1st, 2nd, 3rd, and 4th premolars at both sides of the lower jaws of Beagle dogs, one or two critical-size vertical bone defects (4 mm vertical bone defect without buccal and lingual bone) on each side were surgically created. The defects were randomly subjected to the following groups: (1) Control (without bone-defect-filling materials); (2) 3D scaffold; (3) BMP2-inc. BpNcCaP/HA-functionalized 3D scaffold. Six weeks post-surgery, samples were harvested and subjected to micro-CT and histomorphometric analyses.

Results: The struts of the BMP2-inc. BpNcCaP/HA-func. 3D scaffold were covered by a thick layer of cemented irregular particles with an average pore size at 327 ± 27 μm. The BpNcCaP/HA-func. 3D scaffold group bore significantly higher bone volume, bone volume fraction, trabecular number, trabecular thickness, bone mineral density, connectivity density, and bone volumes in three directions (mesiodistal, buccolingual, and apicocoronal) when compared with the groups of Control and 3D scaffold. Moreover, the BMP2-inc. BpNcCaP/HA-func. 3D scaffold group bore significantly lower trabecular separation and exhibited significantly higher bone-to-scaffold contact percentage and newly formed bone area percentage within pores in comparison with 3D scaffold.

Conclusions: BMP2-inc. BpNcCaP/HA-func. 3D scaffold dramatically enhanced vertical alveolar bone augmentation, which suggests a promising application potential of BMP2-inc. BpNcCaP/HA-func. 3D scaffold in dental clinic.

目的评估骨形态发生蛋白 2(BMP-2)-纳入生物仿生磷酸钙颗粒(BMP-2-inc. BpNcCaP)/透明质酸(HA)复合凝胶的骨诱导功能化三维打印支架在比格犬垂直骨增量中的疗效:本研究使用了四只比格犬。在比格犬下颌两侧的第 1、2、3 和 4 颗前臼齿拔除三个月后,通过手术在两侧各创建一个或两个临界大小的垂直骨缺损(4 毫米垂直骨缺损,不含颊舌骨)。缺陷随机分为以下几组:(1)对照组(无骨缺陷填充材料);(2)三维支架;(3)BMP2-inc. BpNcCaP/HA 功能化三维支架。手术后六周,采集样本并进行显微 CT 和组织形态学分析:结果:BMP2-inc.结果:BMP2-inc.BpNcCaP/HA-func.三维支架的支柱被一层厚厚的胶结不规则颗粒覆盖,平均孔径为 327 ± 27 μm。BpNcCaP/HA-func.与对照组和三维支架组相比,BpNcCaP/HA-func.三维支架组的骨量、骨量分数、骨小梁数、骨小梁厚度、骨矿物质密度、连接密度和三个方向(中轴、颊舌和心尖)的骨量均明显增加。此外,BMP2-inc. BpNcCaP/HA-func.此外,与三维支架相比,BMP2-inc. BpNcCaP/HA-func:结论:BMP2-inc.结论:BMP2-inc. BpNcCaP/HA-func.三维支架在牙科临床中的应用潜力。
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引用次数: 0
Two Stage Sinus Lifting Using Nanohydroxyapatite Particles Versus Deproteinized Bovine Bone: Randomized Clinical Trial. 使用纳米羟基磷灰石颗粒与去蛋白牛骨的两阶段窦提升术:随机临床试验。
Pub Date : 2024-10-31 DOI: 10.1111/cid.13410
Mahmoud Nour, Mohamed Shawky, Rofaida A Abaas, Maha Hakam, Mohammed Atef

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.

背景:上颌窦底抬高术是一种可预测的上颌后牙槽脊垂直缺损增高技术。据报道,有几种生物材料可成功用于上颌窦增高,包括异种移植物和羟基磷灰石。本研究旨在比较在上颌窦增量术中使用异种移植物和纳米羟基磷灰石生成骨的质量和数量:将 24 名患者/窦随机分为两组:对照组患者使用去蛋白牛骨(DBB)进行窦底抬高和增量,而研究组患者使用纳米羟基磷灰石骨(NHA)进行窦增量。对每位患者的术前、术后即刻和术后 6 个月的骨高度进行了评估。此外,术后 6 个月后,还通过组织学和组织形态计量学分析评估了新形成骨的质量:结果:两种生物材料都显示出良好的巩固性。研究组 6 个月后的平均骨高为(11.72 ± 1.24)毫米,对照组为(12.01 ± 1.16)毫米,差异无统计学意义(P > 0.05)。新形成骨的平均骨面积百分比,NHA 组为 29.84% ± 6.7%,DBB 组为 34.73 ± 7.9%。此外,NHA 组残留移植材料的平均百分比为 32.43% ± 11.53%,而 DBB 组为 30.43% ± 8.27%。从组织学角度看,两组在不同参数上无明显差异(P > 0.05):结论:使用 NHA 和 DBB 进行的两阶段窦底增量术在再生骨的质量和数量方面均无统计学意义上的显著差异。建议进行样本更大、随访时间更长的研究:试验注册:ClinicalTrials.gov identifier:NCT03184857.
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引用次数: 0
Minimally Invasive Sinus Augmentation: A Systematic Review. 微创鼻窦增生:系统回顾
Pub Date : 2024-10-30 DOI: 10.1111/cid.13403
Benyapha Sirinirund, Amanda B Rodriguez Betancourt, Riccardo Scaini, Yu-Chang Wu, Hsun-Liang Chan

Aim: Technology improvement and a better understanding of sinus anatomy and wound healing in the past decade have allowed the development of minimally invasive surgical techniques. This systematic review focused on identifying and describing these techniques for vertical and lateral sinus augmentation (VSA and LSA).

Materials and methods: Electronic and hand search were conducted to screen the literature published from January 2003 to May 2024. The selected studies had to include detailed techniques for minimally invasive SA. Data extraction included the study types, sample size, technique/instrument details, and outcome measurements.

Results: A total of 36 articles (27 VSA, 8 LSA with an additional 1 article included both procedures) with 2732 sinus augmentation met the inclusion criteria. Minimally invasive VSA includes the use of modified rotary instruments with stopper, balloon, hydraulic pressure, digital planning, endoscope, and operating microscope. These techniques aim for conservative flap reflection, precise sinus window preparation, and/or controlled sinus membrane elevation. Most of the selected studies (n = 15) did not report the incidence of sinus membrane perforation.

Conclusion: Within the limitations of this review, minimally invasive VSA and LSA achieved sufficient sinus augmentation and implant success with the potential advantages of reduced surgical complications and morbidity. Comparative studies with defined outcomes are encouraged to further validate these useful minimally invasive techniques for SA.

目的:过去十年中,随着技术的进步以及对鼻窦解剖和伤口愈合的深入了解,微创手术技术得以发展。本系统性综述的重点是识别和描述这些用于垂直和侧向鼻窦增大术(VSA 和 LSA)的技术:材料和方法:通过电子和手工检索筛选了 2003 年 1 月至 2024 年 5 月期间发表的文献。所选研究必须包含微创鼻窦增容的详细技术。数据提取包括研究类型、样本大小、技术/器械细节和结果测量:共有 36 篇文章(27 篇 VSA,8 篇 LSA,另有 1 篇文章同时包含两种手术),2732 个鼻窦增大术符合纳入标准。微创 VSA 包括使用带有塞子、球囊、液压、数字规划、内窥镜和手术显微镜的改良旋转器械。这些技术旨在实现保守的皮瓣反射、精确的窦窗准备和/或可控的窦膜抬高。大多数所选研究(n = 15)未报告窦膜穿孔的发生率:在本综述的局限性范围内,微创 VSA 和 LSA 达到了足够的窦增量和植入成功率,并具有减少手术并发症和发病率的潜在优势。我们鼓励开展具有明确结果的比较研究,以进一步验证这些有用的微创技术。
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引用次数: 0
Preclinical Investigation on the Effect of Collagen Matrix With Polydeoxyribonucleotide at Buccally Positioned Implants. 胶原蛋白基质与聚脱氧核苷酸对颊部植入物影响的临床前研究
Pub Date : 2024-10-27 DOI: 10.1111/cid.13411
Chang-Hoon Kim, Ji-Youn Hong, SeungIl Shin, Seung-Yun Shin, Jong-Hyuk Chung, Daniel S Thoma, Hyun-Chang Lim

Objectives: The objective of this study is to investigate the effect of collagen matrix with polydeoxyribonucleotide (PDRN) at two concentrations on keratinized tissue (KT) regeneration for buccally positioned implants in canines.

Methods: Four implants were placed in the edentulous mandible of five dogs simultaneously with KT removal. The implants were positioned buccally with respect to the ridge crest. After 2 months, KT augmentation was performed applying the following treatment modalities:(1) free gingival graft (FGG), (2) xenogeneic collagen matrix (XCM), (3) XCM loaded with 2 mg/mL PDRN (PDRN2), and (4) XCM loaded with 4 mg/mL PDRN (PDRN4). All animals were sacrificed 3 months later. Outcomes included clinical (KT height) and histomorphometric measurements (KT height/length, level of the mucosa, mucosal thickness, supracrestal soft tissue height).

Results: Clinical and histomorphometric KT formation at 3 months was greatest in groups with FGG (4.70 ± 1.00/3.94 ± 0.93 mm) and PDRN2 (4.85 ± 1.43/3.95 ± 0.87 mm). Group PDRN2 (1.87 ± 1.50 mm) showed a higher marginal mucosal level with respect to the implant platform compared to other groups (range: 0.57 ± 0.97-0.69 ± 1.14 mm). All groups presented a soft tissue thickness of < 2 mm on the buccal aspect of the implants.

Conclusions: Based on the limitations of this pilot preclinical study, XCM with 2 mg/mL of PDRN demonstrated a potential for KT augmentation.

研究目的本研究旨在探讨两种浓度的聚脱氧核苷酸(PDRN)胶原基质对犬颊侧种植体角化组织(KT)再生的影响:在切除 KT 的同时,在五只犬的无牙下颌植入了四个种植体。种植体的颊侧位置与牙脊嵴相关。2 个月后,采用以下治疗方式进行 KT 增量:(1) 游离牙龈移植 (FGG);(2) 异种胶原基质 (XCM);(3) 含有 2 毫克/毫升 PDRN 的 XCM (PDRN2);(4) 含有 4 毫克/毫升 PDRN 的 XCM (PDRN4)。所有动物均在 3 个月后处死。结果包括临床(KT 高度)和组织形态测量(KT 高度/长度、粘膜水平、粘膜厚度、上软组织高度):3个月时,临床和组织形态测量的KT形成在FGG组(4.70 ± 1.00/3.94 ± 0.93 mm)和PDRN2组(4.85 ± 1.43/3.95 ± 0.87 mm)最大。与其他组相比,PDRN2 组(1.87 ± 1.50 mm)与种植体平台的边缘粘膜水平更高(范围:0.57 ± 0.97-0.69 ± 1.14 mm)。所有组的软组织厚度均符合结论:基于这项临床前试验研究的局限性,含有 2 毫克/毫升 PDRN 的 XCM 显示出了 KT 增量的潜力。
{"title":"Preclinical Investigation on the Effect of Collagen Matrix With Polydeoxyribonucleotide at Buccally Positioned Implants.","authors":"Chang-Hoon Kim, Ji-Youn Hong, SeungIl Shin, Seung-Yun Shin, Jong-Hyuk Chung, Daniel S Thoma, Hyun-Chang Lim","doi":"10.1111/cid.13411","DOIUrl":"https://doi.org/10.1111/cid.13411","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to investigate the effect of collagen matrix with polydeoxyribonucleotide (PDRN) at two concentrations on keratinized tissue (KT) regeneration for buccally positioned implants in canines.</p><p><strong>Methods: </strong>Four implants were placed in the edentulous mandible of five dogs simultaneously with KT removal. The implants were positioned buccally with respect to the ridge crest. After 2 months, KT augmentation was performed applying the following treatment modalities:(1) free gingival graft (FGG), (2) xenogeneic collagen matrix (XCM), (3) XCM loaded with 2 mg/mL PDRN (PDRN2), and (4) XCM loaded with 4 mg/mL PDRN (PDRN4). All animals were sacrificed 3 months later. Outcomes included clinical (KT height) and histomorphometric measurements (KT height/length, level of the mucosa, mucosal thickness, supracrestal soft tissue height).</p><p><strong>Results: </strong>Clinical and histomorphometric KT formation at 3 months was greatest in groups with FGG (4.70 ± 1.00/3.94 ± 0.93 mm) and PDRN2 (4.85 ± 1.43/3.95 ± 0.87 mm). Group PDRN2 (1.87 ± 1.50 mm) showed a higher marginal mucosal level with respect to the implant platform compared to other groups (range: 0.57 ± 0.97-0.69 ± 1.14 mm). All groups presented a soft tissue thickness of < 2 mm on the buccal aspect of the implants.</p><p><strong>Conclusions: </strong>Based on the limitations of this pilot preclinical study, XCM with 2 mg/mL of PDRN demonstrated a potential for KT augmentation.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of i-PRF, A-PRF+, and EMD on Osteogenic Potential of Osteoblasts on Titanium. i-PRF、A-PRF+ 和 EMD 对钛上成骨细胞成骨潜能的影响
Pub Date : 2024-10-22 DOI: 10.1111/cid.13406
Liza Lima Ramenzoni, Jothi Varghese, Patrick Roger Schmidlin, Shubhankar Mehrotra

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.

研究目的本研究评估了三种已知具有骨诱导潜能的生物活性物质在先前净化过的钛盘(Ti)上的作用:粗糙和光滑的钛表面被多菌种生物膜污染,并用壳聚糖刷进行清洁。在成骨细胞播种前,用可注射的富血小板纤维蛋白(i-PRF)、高级富血小板纤维蛋白(A-PRF+)或釉基质衍生物(EMDs)处理钛盘:结果:对生物相容性、粘附性、迁移性以及runt相关转录因子2(RUNX2)、Ⅰ型胶原蛋白α2(COL1a2)、碱性磷酸酶(ALP)、骨钙素(OC)和骨连蛋白(ON)的基因表达进行了研究。所有测试的生物制剂都同样提高了细胞活力。具体而言,在 i-PRF 和 EMD 处理过的表面上播种的成骨细胞显示出粘附性和迁移性的改善,ALP、OC、ON、RUNX-2 和 COL1a2 mRNA 水平显著增加达 2.8 倍(p 结论:i-PRF 和 EMD 具有有益的生物活性特性,可增强组织愈合并促进彻底灭菌表面的再生。生物活性材料可能会影响种植体的再骨结合过程,这需要进行更多的研究,因为在临床条件下对受影响表面进行消毒仍然是不可靠的,也是最大的挑战之一。
{"title":"Effects of i-PRF, A-PRF+, and EMD on Osteogenic Potential of Osteoblasts on Titanium.","authors":"Liza Lima Ramenzoni, Jothi Varghese, Patrick Roger Schmidlin, Shubhankar Mehrotra","doi":"10.1111/cid.13406","DOIUrl":"https://doi.org/10.1111/cid.13406","url":null,"abstract":"<p><strong>Objective: </strong>The study evaluates three biologically active substances with known bone-inductive potential on previously decontaminated titanium (Ti) discs.</p><p><strong>Material and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Indications and Outcomes of Sinus Floor Augmentation With Bone Substitutes: An Evidence-Based Review. 使用骨替代物进行窦底增高术的临床适应症和疗效:基于证据的综述
Pub Date : 2024-10-17 DOI: 10.1111/cid.13400
Muhammad H A Saleh, Hamoun Sabri, Natalia Di Pietro, Luca Comuzzi, Nicolas C Geurs, Layal Bou Semaan, Adriano Piattelli
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引用次数: 0
Soft tissue response to titanium healing abutments treated by Er: YAG laser or plasma spray: A randomized controlled feasibility clinical study with SEM and histological analysis. 用 Er: YAG 激光或等离子喷涂处理钛愈合基台的软组织反应:采用扫描电镜和组织学分析的随机对照可行性临床研究。
Pub Date : 2024-10-15 DOI: 10.1111/cid.13373
Dalia Yossri, Nevine H Kheir El Din, Nermeen Sami Afifi, Doaa Adel-Khattab

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.

目的:种植体周围软组织的密封可确保稳定的骨结合和种植体的长期存活。为了改善种植体周围软组织愈合,人们对种植基台进行了不同的表面改良和净化处理,如激光、等离子喷射、酸蚀和蒸气。本研究的目的是评估种植体周围软组织对掺铒钇铝基台处理过的钛基台的反应:方法:24名需要在上颌牙弓植入种植体的患者参与了这项研究。患者被分为三组,即使用 Er:YAG 激光与冷等离子喷涂处理过的基台和未处理过的基台。种植体基台植入 14 天后,取种植体周围软组织活检,进行组织学、组织化学和免疫组化评估。对基台进行扫描电子显微镜检查;在最终修复后 14 天和 3 个月分别评估菌斑指数(PI)和牙龈指数(GI):在组织学结果方面,等离子组的平均炎症细胞数最少(174.09 ± 40.67),其次是激光组(654.27 ± 85.95)和对照组(852.00 ± 117.98),它们之间的差异有统计学意义。胶原纤维的平均面积分数显示,血浆组最高(9.73 ± 1.91),其次是激光组(3.25 ± 0.49),而对照组最低(1.17 ± 0.51)。E-cadherin的免疫组化表达在血浆组(42.4 ± 11.2%)明显较高且分布均匀,其次是激光组(15.4 ± 4.07%)和对照组(6.8 ± 1.7%)。对愈合基台的扫描电镜分析显示,等离子组的成纤维细胞更发达,纤维更致密;激光组的纤维比等离子组更少、更细,而对照组未检测到纤维:结论:在本可行性研究的限制条件下,本研究数据得出结论,等离子体喷射和铒:结论:在本可行性研究的限制条件下,本研究数据得出结论,等离子喷涂和铒:YAG 激光可用于基台表面处理,以实现更好的种植体周围软组织愈合。从临床和组织学角度来看,等离子喷剂对种植体周围软组织的作用更好,与铒:YAG 激光组和对照组相比,等离子喷剂能减轻炎症反应,促进胶原纤维形成,提高成纤维细胞的附着力,上调 E-cadherin 的表达:YAG 激光组和对照组。
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引用次数: 0
Exploring the Learning Curve of Dental Implant Placement Using a Task-Autonomous Robotic System Among Young Dentists From Different Specialties-A Pilot Module Study. 探索来自不同专业的年轻牙科医生使用任务自主型机器人系统进行牙科种植体植入的学习曲线--试点模块研究
Pub Date : 2024-10-15 DOI: 10.1111/cid.13402
Minjie Zhuang, Jinyan Chen, Baoxin Tao, Meisha Gul, Feng Wang, Yiqun Wu

Background: The learning curve effect of dynamic computer-assisted implant surgery (D-CAIS) was observed among inexperienced novice surgeons. The learning curves can provide valuable information for novice surgeons and valid comparisons between new and conventional techniques. Recently, robotic computer-assisted implant surgery (R-CAIS) has shown promise as a novel dental implant surgical technique for both partially and edentulous patients. However, its learning curve remains unknown.

Purpose: The aim of this study was to explore the learning curve of dental implant placement surgery with a task-autonomous robotic system among young dentists with different specialties.

Methods and materials: Four young dentists (mean age: 25.3 ± 1.5 years at the beginning of their first attempt) with equal representation of males and females and with different specialties participated in this study. None of the participants had prior experience in R-CAIS. Each operator placed eight implants over eight attempts using a semi-active task-autonomous robotic system. Among the eight implants, four were straight lateral incisor implants, and four were 30°-tilted premolar implants. The implants were placed in each dental quadrant of the maxillary and mandibular jaw modules. The operation time was recorded. Coronal, apical, and angular deviations between the planned and actual sites of implant placement were measured by merging preoperative and postoperative cone-beam computed tomography (CBCT) scans. The data were analyzed with repeated-measures ANOVA (α = 0.05).

Results: The mean time for implant placement was associated with the number of attempts (p < 0.01). The time taken for the second attempt was significantly shorter than that of the first attempt (33.26 vs. 30.47 min; p < 0.001) then it plateaued. Three-dimensional (3D) angular (p = 0.31), coronal deviation (p = 0.26), and apical deviation (p = 0.06) did not differ significantly among attempts. The mean values and standard deviations of 3D coronal deviation, 3D apical deviation, and 3D angular deviation were 0.71 ± 0.31 mm, 0.72 ± 0.30 mm, and 0.94 ± 0.58°, respectively. Neither the position of the jaw (p > 0.59) nor the tilt angle of the implant (straight or 30°-tilted, p > 0.85) was related to implant placement accuracy.

Conclusions: Dentists quickly learned the basic workflow of R-CAIS and thus facilitated the clinicians in the mastery of implant placement on edentulous jaw modules, leading to a comparable operating speed and high precision. Moreover, the accuracy of placement of straight and tilted implants in both the maxilla and mandible with R-CAIS was satisfactory.

背景:在缺乏经验的外科医生中观察到了动态计算机辅助种植手术(D-CAIS)的学习曲线效应。学习曲线可以为新手外科医生提供有价值的信息,并对新技术和传统技术进行有效比较。最近,机器人计算机辅助种植手术(R-CAIS)作为一种新型牙科种植手术技术,在部分无牙颌和无牙颌患者中的应用前景广阔。目的:本研究旨在探讨不同专业的年轻牙医在使用任务自主机器人系统进行牙科种植手术时的学习曲线:四名年轻牙医(首次尝试时的平均年龄为 25.3 ± 1.5 岁)参加了本研究,男女比例相同,专业各异。所有参与者均无 R-CAIS 经验。每位操作者使用半主动任务自主机器人系统进行了八次植入。八颗种植体中,四颗是直侧切牙种植体,四颗是30°倾斜前磨牙种植体。种植体分别植入上颌和下颌模块的每个牙象限。手术时间均有记录。通过合并术前和术后的锥束计算机断层扫描(CBCT),测量了计划植入和实际植入位置之间的冠状、根尖和角度偏差。数据采用重复测量方差分析(α = 0.05):结果:种植体植入的平均时间与尝试的次数有关(p 0.59),种植体的倾斜角度(直角或30°倾斜角,p > 0.85)也与种植体植入的准确性无关:牙医很快就学会了 R-CAIS 的基本工作流程,从而帮助临床医生掌握了在无牙颌模块上植入种植体的方法,从而实现了相当的操作速度和高精度。此外,使用 R-CAIS 在上颌和下颌植入直线和倾斜种植体的精确度也令人满意。
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引用次数: 0
Maintenance Costs, Time, and Efforts Following Implant Therapy With Fixed Restorations Over an Observation Period of 10 Years: A Randomized Controlled Clinical Trial. 观察期为 10 年的固定修复体种植治疗后的维护成本、时间和工作量:随机对照临床试验。
Pub Date : 2024-10-13 DOI: 10.1111/cid.13405
Miha Pirc, Naida Gadzo, Marc Balmer, Nadja Naenni, Ronald E Jung, Daniel S Thoma

Objectives: To assess the costs and efforts of maintenance therapy following implant treatment with fixed restoration over an observation period of 10 years.

Material and methods: This randomized controlled clinical trial included 64 patients who were randomly assigned to receive one of two implant systems (AST or STM) and fixed restoration. Patients were included in a regular maintenance program and were examined at loading, 1, 3, 5, 8, and 10 years. Outcome measures included technical and biological complications, time, efforts, and costs to resolve them.

Results: A total of 97 implants were placed in 64 patients (AST: 54, STM: 43). Patient recall rates at 5 and 10 years were 89% and 67%. In general, technical complications were resolved within one to two appointments (mean = 1.5), and biological complications required a mean of 1.3 appointments. The overall regular maintenance time for the period of 10 years amounted to 77 min per year. Technical complications occurred in 39.5% of the patients, with screw-loosening being the most common one (43.4% of all complications). The most time-consuming technical complication was abutment fracture (94 min ± 68), followed by screw fracture (84 min ± 38). The prevalence of peri-implant mucositis on the patient level was 30.2%, and it was 9.3% for peri-implantitis. The average annual maintenance costs amounted to 9% of the initial cost of the implant treatment over the period of 10 years.

Conclusions: Additional regular maintenance costs and costs due to the treatment of potential complications have to be taken into consideration when placing dental implants. The majority of technical complications could be resolved within one appointment, whereas the time needed to treat biological complications varied between one and three appointments for peri-implantitis.

目的评估使用固定修复体进行种植治疗后,在10年观察期内的维护治疗成本和工作量:这项随机对照临床试验包括 64 名患者,他们被随机分配到两种种植系统(AST 或 STM)和固定修复体中的一种。患者被纳入定期维护计划,并在装模、1、3、5、8 和 10 年时接受检查。结果测量包括技术和生物学并发症,以及解决这些并发症所需的时间、精力和费用:64名患者共植入了97颗种植体(AST:54颗,STM:43颗)。患者在 5 年和 10 年后的召回率分别为 89% 和 67%。一般来说,技术并发症可在一到两次就诊(平均=1.5次)内解决,生物并发症平均需要1.3次就诊。10年间,每年定期维护的总时间为77分钟。39.5%的患者出现了技术并发症,其中最常见的是螺钉松动(占所有并发症的43.4%)。最耗时的技术并发症是基台断裂(94 分钟 ± 68),其次是螺钉断裂(84 分钟 ± 38)。患者种植体周围粘膜炎的发病率为30.2%,种植体周围炎的发病率为9.3%。10年间,每年的平均维护费用占种植治疗初始费用的9%:结论:在种植牙时,必须考虑到额外的定期维护成本和治疗潜在并发症的成本。大多数技术并发症都可以在一次就诊中得到解决,而对于种植体周围炎,治疗生物并发症所需的时间则从一次到三次不等。
{"title":"Maintenance Costs, Time, and Efforts Following Implant Therapy With Fixed Restorations Over an Observation Period of 10 Years: A Randomized Controlled Clinical Trial.","authors":"Miha Pirc, Naida Gadzo, Marc Balmer, Nadja Naenni, Ronald E Jung, Daniel S Thoma","doi":"10.1111/cid.13405","DOIUrl":"https://doi.org/10.1111/cid.13405","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the costs and efforts of maintenance therapy following implant treatment with fixed restoration over an observation period of 10 years.</p><p><strong>Material and methods: </strong>This randomized controlled clinical trial included 64 patients who were randomly assigned to receive one of two implant systems (AST or STM) and fixed restoration. Patients were included in a regular maintenance program and were examined at loading, 1, 3, 5, 8, and 10 years. Outcome measures included technical and biological complications, time, efforts, and costs to resolve them.</p><p><strong>Results: </strong>A total of 97 implants were placed in 64 patients (AST: 54, STM: 43). Patient recall rates at 5 and 10 years were 89% and 67%. In general, technical complications were resolved within one to two appointments (mean = 1.5), and biological complications required a mean of 1.3 appointments. The overall regular maintenance time for the period of 10 years amounted to 77 min per year. Technical complications occurred in 39.5% of the patients, with screw-loosening being the most common one (43.4% of all complications). The most time-consuming technical complication was abutment fracture (94 min ± 68), followed by screw fracture (84 min ± 38). The prevalence of peri-implant mucositis on the patient level was 30.2%, and it was 9.3% for peri-implantitis. The average annual maintenance costs amounted to 9% of the initial cost of the implant treatment over the period of 10 years.</p><p><strong>Conclusions: </strong>Additional regular maintenance costs and costs due to the treatment of potential complications have to be taken into consideration when placing dental implants. The majority of technical complications could be resolved within one appointment, whereas the time needed to treat biological complications varied between one and three appointments for peri-implantitis.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A retrospective study on patient satisfaction and Oral Health-Related Quality of Life with fixed 4- or 6-implant supported prostheses over 3-7 years. 一项回顾性研究,研究对象为使用固定式 4 或 6 种植体支持修复体 3-7 年的患者满意度和与口腔健康相关的生活质量。
Pub Date : 2024-10-11 DOI: 10.1111/cid.13394
Wenjia Chen, Yi Zhou, Lijiao Pang, Rui Pu, Fuming He, Haiping Yang

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.

目的比较接受All-on-4和All-on-6种植体支持固定义齿修复治疗3-7年的无牙患者的满意度和口腔健康相关生活质量(OHRQoL):将所有患者(125 人)分为短期(3-5 年,71 人)和长期(5-7 年,54 人)随访组。通过横断面调查了解患者的满意度。使用口腔健康影响档案(OHIP)评估了患者的 OHRQoL 和心理影响。采用Chi-square检验和Mann-Whitney U检验分析了All-on-4和All-on-6的比较,包括OHIP值、满意度评分、治疗时间和并发症。通过 Mann-Whitney U 检验、Kruskal-Wallis 检验和多元回归分析,分析了患者相关因素对患者报告结果指标(PROMs)的潜在影响。功率计算在 R Studio 中进行:结果:All-on-4和All-on-6随访组在总满意度和PROMs(包括咀嚼舒适度、美观度、清洁度和稳定性)方面的得分都很高,差异无显著性(P>0.05)。同时,两组患者在随访期间的 OHIP 评分也无明显差异(P > 0.05)。然而,在随访 3-5 年的患者中,All-on-4 组的语音满意度评分明显低于 All-on-6 组(P 结论:All-on-4 组的语音满意度评分明显高于 All-on-6 组):接受四颗或六颗种植体支持固定义齿治疗的无牙颌患者在3-5年和5-7年的随访中对口腔健康相关生活质量的满意度都很高。
{"title":"A retrospective study on patient satisfaction and Oral Health-Related Quality of Life with fixed 4- or 6-implant supported prostheses over 3-7 years.","authors":"Wenjia Chen, Yi Zhou, Lijiao Pang, Rui Pu, Fuming He, Haiping Yang","doi":"10.1111/cid.13394","DOIUrl":"10.1111/cid.13394","url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Clinical implant dentistry and related research
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