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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。
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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":null,"pages":null},"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
Prevention and management of intra-operative complications in maxillary sinus augmentation: A review. 上颌窦隆起术中并发症的预防和处理:综述。
Pub Date : 2024-10-08 DOI: 10.1111/cid.13397
Pascal Valentini, Claudio Stacchi

Maxillary sinus floor elevation is usually performed in two different ways: the lateral approach involves the creation of a bony window on the maxillary sinus lateral wall, providing direct access to the sinus cavity for membrane elevation and subsequent graft placement, and the transcrestal approach is considered less invasive. The aim of this article is to describe, based on the literature, how to anticipate, avoid, and manage the intraoperative complications that can occur with both approaches. For both approaches, the most common complication is the sinus membrane perforation. For the lateral approach, an average frequency ranging from 15.7% to 23.1% is reported, but because of the better visibility, their management will be easier compared to the transcrestal approach. Mean perforation rate reported for the transcrestal approach is lower (3.1%-6.4%), but it should be noted that a significant number of perforations cannot be detected and managed given the blind nature of this technique. Anatomical parameters such as sinus width and buccal wall thickness may be a risk factor for one approach and not the other. As it is impossible to assess the resistance of the Schneiderian membrane, the transcrestal approach is more likely to lead to infectious complications in the event of perforation. Others, such as the risk of vascular damage, are encountered only with the lateral approach, which can be prevented easily by dissecting the alveolo-antral artery. For both approaches, prevention is essential and consists in analyzing the anatomy, mastering the surgical technique, and collaborating with the ENT to manage the essentially infectious consequences of intraoperative complications.

上颌窦底抬高术通常有两种不同的方法:外侧入路是在上颌窦外侧壁上开一个骨窗,使患者可以直接进入窦腔进行骨膜抬高和随后的移植物置入;而经鼻骨入路被认为是创伤较小的入路。本文旨在根据文献介绍如何预测、避免和处理这两种方法可能出现的术中并发症。这两种方法最常见的并发症都是窦膜穿孔。据报道,外侧入路的平均穿孔率为 15.7% 到 23.1%,但由于可视性更好,与经蝶入路相比,处理起来更容易。据报道,经嵴入路的平均穿孔率较低(3.1%-6.4%),但需要注意的是,由于该技术的盲目性,大量穿孔无法被发现和处理。鼻窦宽度和颊壁厚度等解剖参数可能是一种方法而非另一种方法的风险因素。由于无法评估施奈德膜的阻力,一旦发生穿孔,经骨途径更有可能导致感染性并发症。其他的并发症,如血管损伤的风险,只有侧方入路才会遇到,而剖开肺泡-腹腔动脉就可以轻松避免。对这两种方法而言,预防都是至关重要的,包括分析解剖结构、掌握手术技巧,以及与耳鼻喉科医生合作处理术中并发症可能造成的感染后果。
{"title":"Prevention and management of intra-operative complications in maxillary sinus augmentation: A review.","authors":"Pascal Valentini, Claudio Stacchi","doi":"10.1111/cid.13397","DOIUrl":"https://doi.org/10.1111/cid.13397","url":null,"abstract":"<p><p>Maxillary sinus floor elevation is usually performed in two different ways: the lateral approach involves the creation of a bony window on the maxillary sinus lateral wall, providing direct access to the sinus cavity for membrane elevation and subsequent graft placement, and the transcrestal approach is considered less invasive. The aim of this article is to describe, based on the literature, how to anticipate, avoid, and manage the intraoperative complications that can occur with both approaches. For both approaches, the most common complication is the sinus membrane perforation. For the lateral approach, an average frequency ranging from 15.7% to 23.1% is reported, but because of the better visibility, their management will be easier compared to the transcrestal approach. Mean perforation rate reported for the transcrestal approach is lower (3.1%-6.4%), but it should be noted that a significant number of perforations cannot be detected and managed given the blind nature of this technique. Anatomical parameters such as sinus width and buccal wall thickness may be a risk factor for one approach and not the other. As it is impossible to assess the resistance of the Schneiderian membrane, the transcrestal approach is more likely to lead to infectious complications in the event of perforation. Others, such as the risk of vascular damage, are encountered only with the lateral approach, which can be prevented easily by dissecting the alveolo-antral artery. For both approaches, prevention is essential and consists in analyzing the anatomy, mastering the surgical technique, and collaborating with the ENT to manage the essentially infectious consequences of intraoperative complications.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396018","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
Full-arch prostheses supported by implants with different macrostructures: A multicenter randomized controlled trial. 由不同宏观结构种植体支撑的全牙弓修复体:多中心随机对照试验
Pub Date : 2024-10-03 DOI: 10.1111/cid.13392
Ana Carolina Monachini Marcantonio, Guilherme José Pimentel Lopes de Oliveira, Paulo Afonso Tassi, João Paulo Lavagnoli Manfrinato, Bruno Segnini, Raphael Ferreira de Souza Bezerra Araújo, Larissa Carvalho Trojan, Flávia Noemy Gasparini Kiatake Fontão, Ivete Aparecida de Mattias Sartori, Elisa Mattias Sartori, Luis Eduardo Marques Padovan, Daniela Leal Zandim-Barcelos, Elcio Marcantonio

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.

研究目的本研究评估了具有亲水性表面和两种不同大体结构的种植体的临床表现:带有穿孔三角螺纹的圆柱形种植体(CT)和带有方形螺纹和凝结穿孔三角螺纹的圆柱锥形种植体(TST):这是一项多中心分口、单盲、随机对照试验。30 名下颌无牙患者分别接受了两个 CT 和两个 TST 种植体。通过插入扭矩和共振频率分析(RFA)确定种植体的基本稳定性。种植体植入后 24 小时内装入全固定拱形义齿。在种植体植入后的 2、6、12 和 24 个月对临床参数(可见斑块指数、边缘出血指数、探诊出血、探诊深度和临床附着水平)和共振频率分析进行评估。通过比较种植体植入当天及其后 6、12 和 24 个月的标准化 X 光片,测量边缘骨水平的变化:结果:28 名患者完成了为期两年的随访。CT 种植体的存活率为 99.16%,TST 种植体的存活率为 100%。一个 CT 种植体在 2 个月的随访中丢失。两种种植体在边缘骨水平变化(6、12和24个月时分别为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])和其他临床参数方面无明显差异:结论:种植体的宏观结构对存活率、主要和次要稳定性、边缘骨水平变化和种植体周围临床参数结果没有影响。这两种种植体均可用于下颌全拱修复体的即刻加载。
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引用次数: 0
Ultrasonography-Guided Dental Implant Surgery: A Feasibility Study. 超声波引导下的植牙手术:可行性研究
Pub Date : 2024-10-03 DOI: 10.1111/cid.13401
Paolo Nava, Hamoun Sabri, Javier Calatrava, Jacob Zimmer, Zhaozhao Chen, Junying Li, Hom-Lay Wang

Objective: To evaluate the feasibility of ultrasound-image-based computer-assisted implant planning and placement.

Materials and methods: Intraoral scans, cone-beam computerized tomography (CBCT), and ultrasound (US) scans with a custom positioning device were acquired in nine patients. Prosthetic-driven surgical guides were planned and fabricated based on ultrasound images and intraoral scans. Implants were then placed. Postoperative implant position was obtained intra-surgically by intraoral scan. Aside from the ultrasound-based plan, conventional implant planning was performed by the same operator on a pre-surgical CBCT for comparison. Linear deviations between ultrasound and CBCT-planned implant positions were measured and compared with the intra-surgical implant position, and the position deviations between two consecutive plannings were performed on the same CBCT by the same operator. The linear deviation between the 3D scan surface of the edentulous region and the ultrasonographic soft tissue profile segmentation was also assessed with reverse-engineering software. Means, standard deviations, and root mean square differences (RMSD) were calculated for every variable.

Results: All the ultrasound-planned implants were successfully placed, and no complications were recorded. The mean deviations in angles, shoulders, and apexes were 5.27 ± 1.75° (RMSD: 5.53°), 0.92 ± 0.26 mm (RMSD: 0.95 mm), and 1.41 ± 0.61 mm (RMSD: 1.53 mm), respectively, between the US and CBCT-planned implants; 2.63 ± 0.43° (RMSD: 2.66°), 1.16 ± 0.30 mm (RMSD: 1.19 mm), and 1.26 ± 0.27 mm (RMSD: 1.28 mm) between the planned implant and intra-surgically recorded positions; and 2.90 ± 1.36° (RMSD: 3.18°), 0.65 ± 0.27 mm (RMSD: 0.70 mm), and 0.99 ± 0.37 mm (RMSD: 1.05 mm) between two consecutive CBCTs planning performed by the same operator. The mean deviation between the 3D surfaces of model scans and ultrasound-derived soft tissue profile in the edentulous area was 0.19 ± 0.08 mm.

Conclusions: Ultrasound-guided implant surgery represents a feasible non-ionizing alternative to conventional static guided implant surgical protocols for implant placement in sites with favorable characteristics.

目的:评估基于超声波图像的计算机辅助种植规划和植入的可行性:评估基于超声图像的计算机辅助种植规划和植入的可行性:对九名患者进行口内扫描、锥束计算机断层扫描(CBCT)和使用定制定位装置的超声波(US)扫描。根据超声波图像和口内扫描结果,规划并制作了修复体驱动的手术导板。然后植入种植体。术后种植体的位置在术中通过口内扫描获得。除了基于超声波的规划外,同一操作者还在手术前的 CBCT 上进行了常规种植规划,以进行比较。测量超声和 CBCT 规划的种植体位置之间的线性偏差,并与手术中的种植体位置进行比较。此外,还使用逆向工程软件评估了缺牙区三维扫描表面与超声软组织轮廓分割之间的线性偏差。计算每个变量的平均值、标准差和均方根差(RMSD):结果:所有超声规划的种植体均成功植入,无并发症记录。美国和 CBCT 计划种植体的角度、肩部和顶点的平均偏差分别为 5.27 ± 1.75°(RMSD:5.53°)、0.92 ± 0.26 mm(RMSD:0.95 mm)和 1.41 ± 0.61 mm(RMSD:1.53 mm);CBCT 计划种植体的角度、肩部和顶点的平均偏差分别为 2.63 ± 0.43°(RMSD:2.66°)、1.16 ± 0.30 mm(RMSD:1.19 mm)和 1.26 ± 0.27 mm(RMSD:1.28 mm);同一操作者进行的两次连续 CBCT 规划之间的偏差分别为 2.90 ± 1.36°(RMSD:3.18°)、0.65 ± 0.27 mm(RMSD:0.70 mm)和 0.99 ± 0.37 mm(RMSD:1.05 mm)。模型扫描的三维表面与超声波得出的缺牙区软组织轮廓之间的平均偏差为 0.19 ± 0.08 毫米:结论:超声引导种植手术是一种可行的非电离种植手术方案,可替代传统的静态引导种植手术方案,在具有良好特征的部位植入种植体。
{"title":"Ultrasonography-Guided Dental Implant Surgery: A Feasibility Study.","authors":"Paolo Nava, Hamoun Sabri, Javier Calatrava, Jacob Zimmer, Zhaozhao Chen, Junying Li, Hom-Lay Wang","doi":"10.1111/cid.13401","DOIUrl":"https://doi.org/10.1111/cid.13401","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility of ultrasound-image-based computer-assisted implant planning and placement.</p><p><strong>Materials and methods: </strong>Intraoral scans, cone-beam computerized tomography (CBCT), and ultrasound (US) scans with a custom positioning device were acquired in nine patients. Prosthetic-driven surgical guides were planned and fabricated based on ultrasound images and intraoral scans. Implants were then placed. Postoperative implant position was obtained intra-surgically by intraoral scan. Aside from the ultrasound-based plan, conventional implant planning was performed by the same operator on a pre-surgical CBCT for comparison. Linear deviations between ultrasound and CBCT-planned implant positions were measured and compared with the intra-surgical implant position, and the position deviations between two consecutive plannings were performed on the same CBCT by the same operator. The linear deviation between the 3D scan surface of the edentulous region and the ultrasonographic soft tissue profile segmentation was also assessed with reverse-engineering software. Means, standard deviations, and root mean square differences (RMSD) were calculated for every variable.</p><p><strong>Results: </strong>All the ultrasound-planned implants were successfully placed, and no complications were recorded. The mean deviations in angles, shoulders, and apexes were 5.27 ± 1.75° (RMSD: 5.53°), 0.92 ± 0.26 mm (RMSD: 0.95 mm), and 1.41 ± 0.61 mm (RMSD: 1.53 mm), respectively, between the US and CBCT-planned implants; 2.63 ± 0.43° (RMSD: 2.66°), 1.16 ± 0.30 mm (RMSD: 1.19 mm), and 1.26 ± 0.27 mm (RMSD: 1.28 mm) between the planned implant and intra-surgically recorded positions; and 2.90 ± 1.36° (RMSD: 3.18°), 0.65 ± 0.27 mm (RMSD: 0.70 mm), and 0.99 ± 0.37 mm (RMSD: 1.05 mm) between two consecutive CBCTs planning performed by the same operator. The mean deviation between the 3D surfaces of model scans and ultrasound-derived soft tissue profile in the edentulous area was 0.19 ± 0.08 mm.</p><p><strong>Conclusions: </strong>Ultrasound-guided implant surgery represents a feasible non-ionizing alternative to conventional static guided implant surgical protocols for implant placement in sites with favorable characteristics.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373818","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
Osseodensification technique in crestal maxillary sinus elevation-A narrative review. 上颌窦骨嵴抬高术中的骨增生技术--综述。
Pub Date : 2024-10-01 DOI: 10.1111/cid.13399
João Gaspar, Ziv Mazor, Estevam A Bonfante

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.

骨质增生是一种新型方法,它极大地推动了种植牙领域的发展,尤其是在上颌窦底经骨隆起的情况下。该技术使用专门设计的车针,沿截骨壁压实骨质并使其致密,从而增强种植体的初期稳定性,促进低密度骨质的骨结合。本文回顾了种植部位准备的历史演变,以及骨质增生的生物力学、组织学和临床证据,并特别关注其在上颌窦底增量术中的应用。将这种技术融入当代实践代表着一种范式的转变,它为解决上颌后部的难题提供了一种微创、高效的解决方案,并改善了患者报告的结果和较低的并发症发生率。根据现有文献,我们提出了三种不同的上颌窦提升术和使用骨强化车针植入种植体的方案,并根据残余骨高度讨论了施奈德膜穿孔的风险因素,以及与种植体相关的结果和患者报告的结果测量。强调了骨增量术成为上颌窦底增量术标准做法的潜力,并突出了手术方案和患者选择等关键方面。
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引用次数: 0
Retrospective study on the clinical and radiographic outcomes of 2.8 mm diameter implants supporting fixed prostheses up to 11 years. 对支持固定义齿的 2.8 毫米直径种植体长达 11 年的临床和放射学效果的回顾性研究。
Pub Date : 2024-09-30 DOI: 10.1111/cid.13395
Lianyi Xu, Yue Ma, Xijin Du, Ying Qing, Yingguang Cao, Xiaojuan Sun, Reinhilde Jacobs, Ke Song

Objectives: This study aimed to report the clinical and radiographic results of 2.8 mm two-piece narrow diameter implant (NDI) supporting fixed restorations.

Materials and methods: Clinical and radiographic data of 54 NDIs in 32 patients were retrospectively assessed after 2 to 11 (mean 8.17) years of follow-up. Clinical and radiographic measurements were taken. Survival rate, implant and prosthesis failure, pink aesthetic scores (PES), white aesthetic scores (WES), bleeding on probing (BOP), probing depth (PD), marginal bone loss (MBL), and mechanical and biological complications were evaluated.

Results: An implant failed during the follow-up period, resulting in a cumulative survival rate of 98.15% at the implant level and 96.88% in the patient. The total mean values of PES and WES for 2.8 mm NDIs were 7.09 ± 1.15 (range: 3.33-9.00) and 7.42 ± 1.03 (range: 3.67-9.33). The prevalence of sites with positive BOP was 38.14 ± 29.77%. The mean PD value was 2.46 ± 0.62 mm. The average MBL was 1.15 ± 0.74 mm (range: 0.25-4.03 mm). No implant or abutment fracture was detected. A veneer chipping was present in one patient, and a loose crown appeared in another patient. Two implants (3.7%) and two patients (6.3%) were diagnosed with peri-implantitis.

Conclusion: Within the limitation of the study, the results indicate that the use of two-piece 2.8 mm NDI for the fixed prosthetic rehabilitation of edentulous regions with reduced interdental and/or buccal-lingual width is viable.

研究目的本研究旨在报告 2.8 毫米两件式窄直径种植体(NDI)支持固定修复体的临床和放射学结果:对 32 名患者的 54 个 NDI 的临床和放射学数据进行了回顾性评估,随访时间为 2 至 11 年(平均 8.17 年)。进行了临床和放射学测量。对存活率、种植体和修复体失败率、粉色美学评分(PES)、白色美学评分(WES)、探诊出血(BOP)、探诊深度(PD)、边缘骨质流失(MBL)以及机械和生物并发症进行了评估:随访期间有一颗种植体失败,种植体的累积存活率为 98.15%,患者的累积存活率为 96.88%。2.8 mm NDI 的 PES 和 WES 总平均值分别为 7.09 ± 1.15(范围:3.33-9.00)和 7.42 ± 1.03(范围:3.67-9.33)。BOP阳性部位的发生率为 38.14 ± 29.77%。平均 PD 值为 2.46 ± 0.62 毫米。平均 MBL 为 1.15 ± 0.74 毫米(范围:0.25-4.03 毫米)。未发现种植体或基台断裂。一名患者的贴面出现崩裂,另一名患者的牙冠出现松动。两名种植体(3.7%)和两名患者(6.3%)被诊断为种植体周围炎:研究结果表明,在牙间和/或颊舌宽度减小的无牙颌区域,使用两片式 2.8 毫米 NDI 进行固定修复是可行的。
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引用次数: 0
Fully digital versus conventional workflow: Are removable complete overdentures equally good? A randomized crossover trial. 全数字化与传统工作流程:可摘全口覆盖义齿的效果是否一样好?随机交叉试验。
Pub Date : 2024-09-30 DOI: 10.1111/cid.13398
Thomas Van de Winkel, Frans Delfos, Olleke van der Heijden, Ewald Bronkhorst, Luc Verhamme, Gert Meijer

Introduction: Implant-supported removable complete overdentures (IODs) are a common treatment in case of edentulism and malfunctioning of the conventional denture. Manufacturing IODs in a conventional way (C-IODs) is time-consuming, but in a digital workflow, this can be done in three sessions. Digitally produced IODs (3D-IODs) are also more advantageous than C-IODs because lost or broken 3D-IODs can be swiftly reproduced as the digital design is always available.

Purpose: To prove in a non-inferiority study, with a margin of 0.3 point per Oral Health Impact Profile-20 (OHIP-20) question, that IODs made according to a fully digital workflow (3D-IODs), function as good as C-IODs with respect to patient-reported outcome measures (PROMs).

Materials and methods: This randomized crossover study included 36 fully edentulous patients who showed extreme resorption of the maxillary alveolar process, making denture retention difficult. After a maxillary bone augmentation and the installation of 4-6 implants, each patient wore both types of IOD for 1 year each, with the order reversed in two subsets of patients. The 3D-IODs and C-IODs were fabricated in advance for both jaws (at least two mandibular implants were already present). The OHIP-20 survey was performed at baseline, after 1 year (before the IOD switch), and after 2 years to determine patient satisfaction scores using a visual analog scale (VAS). The general health status was assessed using the Short Form (SF-36) questionnaire.

Results: Regarding the PROMs, patients preferred the 3D-IOD: the improvement on the overall OHIP scale (0-4), expressed as a mean, was 0.26 points greater than for the C-IOD (p < 0.001). This applied also to the VAS scale (1-100) with an increase of 7.37 points (p < 0.001). Regarding the SF-36 scale, only for the item "emotional well-being," the 3D-IOD scored significantly better (p = 0.033).

Conclusion: Compared with conventionally fabricated C-IODs, fully digitally produced 3D-IODs resulted in significantly higher OHIP-20 and satisfaction scores.

导言:种植体支持的可摘全口覆盖义齿(IOD)是一种常见的治疗方法,用于治疗缺牙症和传统义齿的故障。用传统方法(C-IODs)制作 IODs 非常耗时,但在数字化工作流程中,只需三次就能完成。数字制作的 IOD(3D-IOD)也比 C-IOD 更具优势,因为丢失或损坏的 3D-IOD 可以快速复制,因为数字设计始终可用。目的:在一项非劣效性研究中,以每个口腔健康影响档案-20(OHIP-20)问题 0.3 分的差值证明,根据全数字工作流程制作的 IOD(3D-IOD)在患者报告结果测量(PROM)方面与 C-IOD 一样好:这项随机交叉研究包括 36 名完全无牙颌的患者,他们的上颌骨牙槽突极度吸收,导致义齿难以固位。在进行上颌骨增量手术并安装 4-6 个种植体后,每位患者分别佩戴两种类型的 IOD 1 年,其中两组患者的佩戴顺序相反。3D-IOD和C-IOD是事先为两个下颌制作的(至少已有两个下颌种植体)。分别在基线期、1年后(IOD转换前)和2年后进行OHIP-20调查,使用视觉模拟量表(VAS)确定患者的满意度。一般健康状况采用简表(SF-36)问卷进行评估:结果:在PROMs方面,患者更倾向于3D-IOD:OHIP总评分(0-4分)的平均值比C-IOD高出0.26分(p 结论:与传统的C-IOD相比,3D-IOD的患者满意度更高:与传统制作的 C-IOD 相比,全数字化制作的 3D-IOD 的 OHIP-20 和满意度评分明显更高。
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引用次数: 0
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Clinical implant dentistry and related research
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