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Comparative analysis of dental implant placement accuracy: Semi-active robotic versus free-hand techniques: A randomized controlled clinical trial. 牙科种植体植入准确性的比较分析:半主动机器人与徒手技术:随机对照临床试验
Pub Date : 2024-08-19 DOI: 10.1111/cid.13375
Fan Yang, Jianping Chen, Ruijue Cao, Qingwei Tang, Haiyan Liu, Yuchen Zheng, BeiLei Liu, Min Huang, Zhenshi Wang, Yude Ding, Linhong Wang

Background: Robot-assisted implant surgery has emerged as a novel digital technology, and the accuracy need further assessment.

Purpose: This study aimed to compare the accuracy of single dental implant placement between a novel semi-active robot-assisted implant surgery (RAIS) method and the conventional free-hand implant surgery (FHIS) method through a multicenter, randomized controlled clinical trial.

Materials and methods: Patients requiring single dental implant placement were recruited and randomized into RAIS and FHIS group. Deviations at the platform, apex, and angle between the planned and final implant positions were assessed in both groups. Additionally, the evaluation of instrument and surgical complications was examined.

Results: A total of 140 patients (median age: 35.35 ± 12.55 years; 43 males, 97 females) with 140 implants from four different research centers were included, with 70 patients (70 implants) in the RAIS group and 70 patients (70 implants) in the FHIS group. In the RAIS and FHIS groups, the median platform deviations were 0.76 ± 0.36 mm and 1.48 ± 0.93 mm, respectively (p < 0.001); median apex deviations were 0.85 ± 0.48 mm and 2.14 ± 1.25 mm, respectively (p < 0.001); and median angular deviations were 2.05 ± 1.33° and 7.36 ± 4.67°, respectively (p < 0.001). Similar significant difference also presented between RAIS and FHIS group in platform vertical/horizontal deviation, apex vertical/horizontal deviation. Additionally, implants with self-tapping characteristics exhibited significantly larger deviations compared with those without self-tapping characteristics in the RAIS group. Both RAIS and FHIS methods demonstrated comparable morbidity and safety pre- and post-operation.

Conclusions: The results indicated that the RAIS method demonstrated superior accuracy in single dental implant placement compared with the FHIS method. Specifically, RAIS exhibited significantly smaller deviations in platform, apex, and angular positions, as well as platform and apex vertical/horizontal deviations. This clinical trial was not registered prior to participant recruitment and randomization. https://www.chictr.org.cn/showproj.html?proj=195045.

背景:目的:本研究旨在通过一项多中心、随机对照临床试验,比较新型半主动机器人辅助种植手术(RAIS)方法与传统徒手种植手术(FHIS)方法在单颗牙种植体植入方面的准确性:招募并随机分为 RAIS 组和 FHIS 组。对两组患者计划种植体位置和最终种植体位置之间的平台、顶点和角度偏差进行评估。此外,还对器械和手术并发症进行了评估:共有来自四个不同研究中心的 140 位患者(中位年龄:35.35 ± 12.55 岁;43 位男性,97 位女性)接受了 140 个种植体,其中 RAIS 组和 FHIS 组分别有 70 位患者(70 个种植体)和 70 位患者(70 个种植体)。RAIS 组和 FHIS 组的平台偏差中位数分别为 0.76 ± 0.36 毫米和 1.48 ± 0.93 毫米(P 结论:RAIS 和 FHIS 组的平台偏差中位数分别为 0.76 ± 0.36 毫米和 1.48 ± 0.93 毫米:结果表明,与 FHIS 方法相比,RAIS 方法在单颗牙种植体植入方面表现出更高的准确性。具体而言,RAIS 在平台、顶点和角度位置的偏差,以及平台和顶点的垂直/水平偏差方面都明显较小。该临床试验在参与者招募和随机化之前没有注册。https://www.chictr.org.cn/showproj.html?proj=195045。
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引用次数: 0
Effect of immediate all-digital restoration of single posterior implants: The SafetyCrown concept on patient-reported outcome measures, accuracy, and treatment time-A randomized clinical trial. 单一后牙种植体即刻全数字化修复的效果:SafetyCrown概念对患者报告结果、准确性和治疗时间的影响--随机临床试验。
Pub Date : 2024-08-19 DOI: 10.1111/cid.13374
Lukas Waltenberger, Sven Reich, Marcel Zwahlen, Stefan Wolfart

Objective: The SafetyCrown workflow facilitates the immediate restoration of posterior single sites with the one-abutment/one-time concept. This randomized clinical trial aimed to assess the direct effect of immediate restoration on dental patient-reported outcomes (dPROs), feasibility, implant accuracy, and time.

Materials and methods: Participants with a single posterior edentulous site for late implant placement underwent optical impressions, shade selection, and cone beam computed tomography. After virtual treatment planning, they were randomized into the test group and the control group. For the test group, individual definitive hybrid abutments were prefabricated. The next step was a fully guided surgery with printed guides. After the implant was placed using guided surgery, the abutment was inserted. A chairside CAD/CAM workflow was used to provide the patient with a provisional restoration. Implants in the control group were left submerged to heal. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-G14, and dPRO was measured using a 10-item visual analog scale (VAS) questionnaire. Additional measurements of implant accuracy and time were performed. Follow-up was performed 7 to 10 days after implant placement.

Results: Thirty-nine participants with 45 restorations were included (test group: 23, control: 22). Immediate restoration was successful in 21 out of 23 implants (91.3%) in the test group. Both groups exhibited decreased OHRQoL without significant intergroup differences, while patient satisfaction was high overall. Test group participants perceived higher benefits and satisfaction with immediate loading than participants in the control group. Implant accuracy averaged 0.60 mm at the shoulder and 0.95 mm at the apex. Operative time was longer in the immediate loading group (61.9 min) than in the control group (32.1 min) (p < 0.001).

Conclusions: Considering the limitations, the immediate restoration of late placed posterior implants using the described workflow proved feasible in 21 out of 23 cases. Both groups achieved high patient satisfaction with no differences in OHRQoL during the first week. Patients who received immediate loading rated the benefits very highly and were satisfied with the provisional restoration during the healing period.

目的:安全冠(SafetyCrown)工作流程以一次修复/一次性理念促进了后牙单个部位的即刻修复。这项随机临床试验旨在评估即刻修复对牙科患者报告结果(dPROs)、可行性、种植体准确性和时间的直接影响:材料和方法: 参与者有一个后部缺牙部位,需要晚期种植体植入,他们接受了光学印模、色调选择和锥形束计算机断层扫描。虚拟治疗规划后,他们被随机分为试验组和对照组。对于试验组,预制了单个确定性混合基台。下一步是使用打印导板进行全引导手术。使用引导手术植入种植体后,再插入基台。采用椅旁 CAD/CAM 工作流程为患者提供临时修复体。对照组的种植体则浸泡在水中等待愈合。口腔健康相关生活质量(OHRQoL)采用OHIP-G14进行评估,dPRO采用10项视觉模拟量表(VAS)问卷进行测量。此外,还对种植体的准确性和时间进行了测量。种植体植入后 7 到 10 天进行随访:39名参与者共进行了45次修复(试验组:23次,对照组:22次)。测试组的 23 个种植体中有 21 个(91.3%)成功进行了即刻修复。两组患者的 OHRQoL 都有所下降,但组间差异不大,患者的满意度总体较高。与对照组相比,试验组患者对即刻种植的益处和满意度更高。种植体精确度在肩部平均为 0.60 毫米,在顶点平均为 0.95 毫米。即刻加载组的手术时间(61.9 分钟)长于对照组(32.1 分钟)(p 结论:即刻加载组的手术时间(61.9 分钟)长于对照组(32.1 分钟):考虑到手术的局限性,在 23 个病例中,有 21 个病例采用了所述的工作流程,证明对晚期植入的后部种植体进行即刻修复是可行的。两组患者的满意度都很高,第一周的 OHRQoL 没有差异。接受即刻加载的患者对其益处评价很高,并对愈合期间的临时修复表示满意。
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引用次数: 0
Alveolar ridge preservation and its impact on marginal bone level changes around dental implants: A retrospective, cohort comparative study. 牙槽嵴保留及其对种植牙周围边缘骨水平变化的影响:一项回顾性队列比较研究。
Pub Date : 2024-08-19 DOI: 10.1111/cid.13379
Chiara Cinquini, Rossana Izzetti, Annamaria Porreca, Giovanna Iezzi, Marco Nisi, Antonio Barone

Objectives: This retrospective study compared the outcomes of implants placed in alveolar ridge preservation (ARP) treated sites with those in spontaneously healed (SH) sites.

Materials and methods: The study included patients presenting with one implant placed in an ARP-treated socket and one in an SH site. The primary outcome was the comparison of Marginal Bone Level Changes (MBLC). Statistical analysis was performed to identify factors influencing MBLC, including age, gender, smoking, parafunctional habits, and prosthetic emergence angle.

Results: Of these, 28 patients (23 females, 82.1%) were included in this analysis. Sockets in the SH group were classified as type I, whereas type II sockets were more common in the ARP group. The SH group exhibited significantly higher MBLC than the ARP group (p = 0.032), with values, respectively, of 1.00 [0.25; 1.62] and 0.40 [0.00; 1.00] mm. Among all evaluated parameters, the performance of ARP was the only factor significantly affecting MBLC (β = -0.72, SE: 0.32, p = 0.026). Age, gender, smoking, parafunctional habits, and prosthetic emergence angle did not significantly affect MBLC.

Conclusions: The study shows the potential role of ARP in maintaining stable marginal bone levels around implants. In our sample, ARP significantly reduced MBLC compared with spontaneous healing, highlighting its possible impact in clinical practice for better peri-implant bone stability.

目的:这是一项回顾性研究:这项回顾性研究比较了将种植体植入牙槽嵴保留(ARP)治疗部位和植入自愈合(SH)部位的效果:研究对象包括将一颗种植体植入 ARP 处理过的牙槽窝和一颗种植体植入自愈合牙槽窝的患者。主要结果是边缘骨水平变化(MBLC)的比较。通过统计分析确定影响边缘骨水平变化的因素,包括年龄、性别、吸烟、辅助功能习惯和修复体出现角度:本次分析共纳入了 28 名患者(23 名女性,82.1%)。SH组患者的基台被归类为I型,而ARP组患者中II型基台更为常见。SH 组的 MBLC 值明显高于 ARP 组(p = 0.032),分别为 1.00 [0.25; 1.62] mm 和 0.40 [0.00; 1.00] mm。在所有评估参数中,ARP 的性能是唯一显著影响 MBLC 的因素(β = -0.72,SE:0.32,p = 0.026)。年龄、性别、吸烟、辅助功能习惯和假体出现角度对 MBLC 没有明显影响:研究表明,ARP 在维持种植体周围稳定的边缘骨水平方面具有潜在作用。在我们的样本中,与自发愈合相比,ARP 明显降低了 MBLC,突出了其在临床实践中对提高种植体周围骨稳定性的可能影响。
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引用次数: 0
Intracellular infection of Cutibacterium acnes in macrophages of extensive peri-implantitis lesions: A clinical case series. 广泛种植体周围炎病变巨噬细胞中的痤疮杆菌胞内感染:临床病例系列。
Pub Date : 2024-08-13 DOI: 10.1111/cid.13367
Jin-Young Park, Dawool Han, Yuan Park, Eunae Sandra Cho, Jong In Yook, Jung-Seok Lee

Cutibacterium acnes is a facultative anaerobic, gram-positive rod, and a commensal bacterium of the body surface including oral cavity. A causal relationship between C. acnes and chronic granulomatous diseases, such as sarcoidosis and orthopedic implant-associated infections, has been previously reported. Typically, C. acnes has been observed inside macrophages, allowing evasion of host immunity, and triggering a persistent inflammatory response. However, such findings have not been reported in peri-implantitis lesions. In this case series, we collected inflamed tissues from extensive peri-implantitis lesions of eight patients. Out of the eight samples, seven tested positive for the 16 s rRNA gene of C. acnes by polymerase chain reaction, and six were positive by immunohistochemistry. Immunohistochemical staining revealed the presence of C. acnes in the cytoplasm of macrophages, suggesting a role in lesion formation. This finding may enhance our understanding of the pathophysiology of persistent peri-implantitis lesions and provide implications for future therapy.

痤疮丙酸杆菌是一种兼性厌氧革兰阳性杆菌,是包括口腔在内的体表共生细菌。痤疮丙酸杆菌与肉样瘤病和骨科植入物相关感染等慢性肉芽肿疾病之间存在因果关系。通常情况下,痤疮丙酸杆菌存在于巨噬细胞内,可以逃避宿主免疫,并引发持续的炎症反应。然而,在种植体周围炎病变中还没有此类发现的报道。在本病例系列中,我们从八名患者的广泛种植体周围炎病变中采集了炎性组织。在这 8 份样本中,7 份样本的痤疮丙酸杆菌 16 s rRNA 基因聚合酶链反应检测呈阳性,6 份样本的免疫组化检测呈阳性。免疫组化染色显示,巨噬细胞的细胞质中存在痤疮丙酸杆菌,这表明痤疮丙酸杆菌在病变形成过程中发挥了作用。这一发现可能会加深我们对持久性种植体周围炎病变的病理生理学的理解,并为今后的治疗提供借鉴。
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引用次数: 0
Assessment of the application of a novel three-dimension printing individualized titanium mesh in alveolar bone augmentation: A retrospective study. 评估新型三维打印个性化钛网在牙槽骨增量中的应用:回顾性研究。
Pub Date : 2024-08-12 DOI: 10.1111/cid.13372
Chang Liu, Jinmeng Li, Shuo Zhang, Hanyu Xiao, Yanying Wang, Jian Zhang

Objective: To assess the clinical and radiographic outcomes of alveolar ridge augmentation using a novel three-dimensional printed individualized titanium mesh (3D-PITM) for guided bone regeneration (GBR).

Materials and methods: Preoperative cone-beam computed tomography (CBCT) was used to evaluate alveolar ridge defects, followed by augmentation with high-porosity 3D-PITM featuring circular and spindle-shaped pores. Postoperative CBCT scans were taken immediately and after 6 months of healing. These scans were compared with preoperative scans to calculate changes in bone volume, height, and width, along with the corresponding resorption rates. A statistical analysis of the results was then conducted.

Results: A total of 21 patients participated in the study, involving alveolar ridge augmentation at 38 implant sites. After 6 months of healing, the average bone augmentation volume of 21 patients remained at 489.71 ± 252.53 mm3, with a resorption rate of 16.05% ± 8.07%. For 38 implant sites, the average vertical bone increment was 3.63 ± 2.29 mm, with a resorption rate of 17.55% ± 15.10%. The horizontal bone increment at the designed implant platform was 4.43 ± 1.85 mm, with a resorption rate of 25.26% ± 15.73%. The horizontal bone increment 2 mm below the platform was 5.50 ± 2.48 mm, with a resorption rate of 16.03% ± 9.57%. The main complication was exposure to 3D-PITM, which occurred at a rate of 15.79%.

Conclusion: The novel 3D-PITM used in GBR resulted in predictable bone augmentation. Moderate over-augmentation in the design, proper soft tissue management, and rigorous follow-ups are beneficial for reducing the graft resorption and the incidence of exposure.

目的评估使用新型三维打印个性化钛网(3D-PITM)进行引导骨再生(GBR)的牙槽嵴增量术的临床和放射学效果:术前使用锥形束计算机断层扫描(CBCT)评估牙槽嵴缺损情况,然后使用具有圆形和纺锤形孔隙的高孔隙三维钛网进行增量。术后立即进行 CBCT 扫描,并在愈合 6 个月后进行扫描。将这些扫描结果与术前扫描结果进行比较,以计算骨量、骨高和骨宽的变化以及相应的吸收率。然后对结果进行统计分析:共有 21 名患者参与了研究,涉及 38 个种植部位的牙槽嵴增量。经过 6 个月的愈合后,21 位患者的平均骨增量仍为 489.71 ± 252.53 mm3,吸收率为 16.05% ± 8.07%。38 个种植部位的平均垂直骨增量为 3.63 ± 2.29 mm,吸收率为 17.55% ± 15.10%。设计种植平台的水平骨增量为 4.43 ± 1.85 毫米,吸收率为 25.26% ± 15.73%。平台下方 2 毫米处的水平骨增量为 5.50 ± 2.48 毫米,吸收率为 16.03% ± 9.57%。主要并发症是 3D-PITM 暴露,发生率为 15.79%:结论:在 GBR 中使用的新型 3D-PITM 可实现可预测的骨增量。设计中的适度过度增量、适当的软组织管理和严格的随访有利于减少移植物吸收和暴露的发生。
{"title":"Assessment of the application of a novel three-dimension printing individualized titanium mesh in alveolar bone augmentation: A retrospective study.","authors":"Chang Liu, Jinmeng Li, Shuo Zhang, Hanyu Xiao, Yanying Wang, Jian Zhang","doi":"10.1111/cid.13372","DOIUrl":"https://doi.org/10.1111/cid.13372","url":null,"abstract":"<p><strong>Objective: </strong>To assess the clinical and radiographic outcomes of alveolar ridge augmentation using a novel three-dimensional printed individualized titanium mesh (3D-PITM) for guided bone regeneration (GBR).</p><p><strong>Materials and methods: </strong>Preoperative cone-beam computed tomography (CBCT) was used to evaluate alveolar ridge defects, followed by augmentation with high-porosity 3D-PITM featuring circular and spindle-shaped pores. Postoperative CBCT scans were taken immediately and after 6 months of healing. These scans were compared with preoperative scans to calculate changes in bone volume, height, and width, along with the corresponding resorption rates. A statistical analysis of the results was then conducted.</p><p><strong>Results: </strong>A total of 21 patients participated in the study, involving alveolar ridge augmentation at 38 implant sites. After 6 months of healing, the average bone augmentation volume of 21 patients remained at 489.71 ± 252.53 mm<sup>3</sup>, with a resorption rate of 16.05% ± 8.07%. For 38 implant sites, the average vertical bone increment was 3.63 ± 2.29 mm, with a resorption rate of 17.55% ± 15.10%. The horizontal bone increment at the designed implant platform was 4.43 ± 1.85 mm, with a resorption rate of 25.26% ± 15.73%. The horizontal bone increment 2 mm below the platform was 5.50 ± 2.48 mm, with a resorption rate of 16.03% ± 9.57%. The main complication was exposure to 3D-PITM, which occurred at a rate of 15.79%.</p><p><strong>Conclusion: </strong>The novel 3D-PITM used in GBR resulted in predictable bone augmentation. Moderate over-augmentation in the design, proper soft tissue management, and rigorous follow-ups are beneficial for reducing the graft resorption and the incidence of exposure.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972467","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
3D surface defect map for assessing buccolingual profile of single tooth gaps following alveolar ridge preservation. 三维表面缺陷图,用于评估牙槽嵴保留后单齿隙的颊舌侧轮廓。
Pub Date : 2024-08-11 DOI: 10.1111/cid.13377
Leonardo Mancini, Shayan Barootchi, Miha Pirc, Enrico Marchetti, Ronald E Jung, Lorenzo Tavelli, Daniel S Thoma

Aim: A new, non-invasive approach suggests using single intraoral optical scanning to analyze the ridge profile of single-tooth gaps following alveolar ridge preservation in the absence of a baseline scan. This method involves creating a three-dimensional (3D) surface map to identify and assess contour changes and ridge profiles based on the adjacent teeth.

Materials and methods: The present study was designed as a cross-sectional pilot analysis on a convenience sample of patients undergoing alveolar ridge preservation. Intraoral optical scans were taken on 23 patients, capturing data from 30 edentulous sites. The digital models were then imported into an image analysis software for a 3D surface defect map analysis performed by one examiner. This analysis characterized the buccolingual profile of the single tooth gap relative to the adjacent teeth. 10 linear divergence points, spaced 0.5 mm apart in a corona-apical direction, were identified at the midfacial aspect of the sites. Based on these points the sites were plotted and grouped in three different buccolingual profiles (linear, concave, and convex). Clinical parameters including Keratinized mucosa Width (KMW), and soft tissue phenotype with Colorvue biotype probes were also recorded.

Results: Three different buccolingual patterns (linear, convex, and concave) were identified. Seven sites exhibited a linear profile, 10 sites displayed a concave shape, and 13 showed a convex profile. The linear profile had surface discrepancies similar to the neighboring teeth. In contrast, the convex profile revealed mid-buccal discrepancy localized only at the crestal aspect, while the concave had an extended divergence ranging from 1 to 5 mm below the soft tissue margin. Univariate and multiple logistic regression analyses did not reveal any statistically significant variables influencing profilometric analysis; however, when combining phenotype and KMW, thick phenotypes demonstrated a higher proportion of concavity (OR = 4.83) compared to thin ones, suggesting a significant trend. With every 1 mm of increase in KMW, the probability of showing a concavity decreased (p = 0.057).

Conclusion: A 3D surface defect map represents a useful tool for objectively quantifying ridge defects and profiles by assessing profilometric and surface differences compared to adjacent dentition using a single intraoral scan. This method also indicates that KMW may play a critical role in preventing concavity defects. The 3D defect map can guide decision-making during soft tissue augmentation procedures by emphasizing the specific location of the defect and providing more detailed insights into its localization. These parameters can enable the tailoring of flap management and soft tissue grafting strategies to address the patient's individual needs.

目的:一种新的、非侵入性的方法建议在没有基线扫描的情况下,使用单次口腔内光学扫描来分析牙槽嵴保留后单牙间隙的牙嵴轮廓。这种方法包括创建一个三维(3D)表面图,根据邻牙识别和评估轮廓变化和牙脊轮廓:本研究旨在对接受牙槽嵴保留治疗的患者样本进行横断面试验分析。对 23 名患者进行了口内光学扫描,采集了 30 个缺牙部位的数据。然后将数字模型导入图像分析软件,由一名检查人员进行三维表面缺陷图分析。该分析描述了单个牙缝相对于邻牙的颊舌侧轮廓。在这些部位的面中部确定了 10 个线性分歧点,这些点在冠尖方向上的间距为 0.5 毫米。根据这些点将这些部位绘制成三种不同的颊舌侧剖面图(线形、凹形和凸形)。临床参数包括角化粘膜宽度(KMW)和使用 Colorvue 生物型探针的软组织表型:结果:确定了三种不同的颊舌形态(线形、凸形和凹形)。7 个部位呈现线形轮廓,10 个部位呈现凹形轮廓,13 个部位呈现凸形轮廓。线形轮廓的表面差异与邻近牙齿相似。相比之下,凸面轮廓显示的颊中部差异仅局限于嵴的一面,而凹面轮廓的差异则扩大到软组织边缘以下 1 到 5 毫米的范围。单变量和多重逻辑回归分析没有发现任何对轮廓测量分析有显著统计学影响的变量;但是,当结合表型和 KMW 时,厚的表型比薄的表型显示出更高的凹陷比例(OR = 4.83),这表明了一个显著的趋势。KMW 每增加 1 毫米,出现凹陷的概率就会降低(p = 0.057):三维表面缺损图是一种有用的工具,可通过口内扫描评估与邻牙相比的轮廓和表面差异,从而客观量化牙脊缺损和轮廓。这种方法还表明,KMW 可在预防凹陷缺陷方面发挥关键作用。三维缺损图通过强调缺损的具体位置并提供更详细的定位信息,可以指导软组织增量手术的决策。这些参数可以帮助定制皮瓣管理和软组织移植策略,以满足患者的个性化需求。
{"title":"3D surface defect map for assessing buccolingual profile of single tooth gaps following alveolar ridge preservation.","authors":"Leonardo Mancini, Shayan Barootchi, Miha Pirc, Enrico Marchetti, Ronald E Jung, Lorenzo Tavelli, Daniel S Thoma","doi":"10.1111/cid.13377","DOIUrl":"https://doi.org/10.1111/cid.13377","url":null,"abstract":"<p><strong>Aim: </strong>A new, non-invasive approach suggests using single intraoral optical scanning to analyze the ridge profile of single-tooth gaps following alveolar ridge preservation in the absence of a baseline scan. This method involves creating a three-dimensional (3D) surface map to identify and assess contour changes and ridge profiles based on the adjacent teeth.</p><p><strong>Materials and methods: </strong>The present study was designed as a cross-sectional pilot analysis on a convenience sample of patients undergoing alveolar ridge preservation. Intraoral optical scans were taken on 23 patients, capturing data from 30 edentulous sites. The digital models were then imported into an image analysis software for a 3D surface defect map analysis performed by one examiner. This analysis characterized the buccolingual profile of the single tooth gap relative to the adjacent teeth. 10 linear divergence points, spaced 0.5 mm apart in a corona-apical direction, were identified at the midfacial aspect of the sites. Based on these points the sites were plotted and grouped in three different buccolingual profiles (linear, concave, and convex). Clinical parameters including Keratinized mucosa Width (KMW), and soft tissue phenotype with Colorvue biotype probes were also recorded.</p><p><strong>Results: </strong>Three different buccolingual patterns (linear, convex, and concave) were identified. Seven sites exhibited a linear profile, 10 sites displayed a concave shape, and 13 showed a convex profile. The linear profile had surface discrepancies similar to the neighboring teeth. In contrast, the convex profile revealed mid-buccal discrepancy localized only at the crestal aspect, while the concave had an extended divergence ranging from 1 to 5 mm below the soft tissue margin. Univariate and multiple logistic regression analyses did not reveal any statistically significant variables influencing profilometric analysis; however, when combining phenotype and KMW, thick phenotypes demonstrated a higher proportion of concavity (OR = 4.83) compared to thin ones, suggesting a significant trend. With every 1 mm of increase in KMW, the probability of showing a concavity decreased (p = 0.057).</p><p><strong>Conclusion: </strong>A 3D surface defect map represents a useful tool for objectively quantifying ridge defects and profiles by assessing profilometric and surface differences compared to adjacent dentition using a single intraoral scan. This method also indicates that KMW may play a critical role in preventing concavity defects. The 3D defect map can guide decision-making during soft tissue augmentation procedures by emphasizing the specific location of the defect and providing more detailed insights into its localization. These parameters can enable the tailoring of flap management and soft tissue grafting strategies to address the patient's individual needs.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918337","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 efficacy of two vertical soft tissue augmentation techniques for peri-implant crestal bone level stability: A randomized clinical trial. 两种垂直软组织增量技术对稳定种植体周围牙槽骨水平的临床疗效:随机临床试验。
Pub Date : 2024-08-11 DOI: 10.1111/cid.13365
Algirdas Puisys, Egle Vindasiute-Narbute, Dainius Razukevicius, Samuel Akhondi, German O Gallucci, Ignacio Pedrinaci

Objectives: This study aimed to compare the efficacy of two techniques-acellular dermal matrix (ADM) grafting and tenting technique (TT)-for soft tissue height (STH) augmentation simultaneous to implant placement to minimize peri-implant crestal bone level (CBL) changes.

Methods: Forty patients with a healed single mandibular posterior edentulous site with a thin soft tissue phenotype were enrolled. Twenty patients received simultaneously to implant placement ADM grafting, while the others received submerged healing abutment (TT). Clinical peri-implant soft tissue height and radiographic CBL changes were measured at restoration delivery and 1-year follow-up.

Results: Both techniques effectively increased soft tissue thickness, resulting in a final average STH of 3.4 ± 0.5 mm after augmentation. On average, soft tissue increased by 1.6 ± 0.5 mm in group ADM and by 1.8 ± 0.4 mm in group TT after augmentation. In Group ADM, mesial CBL decreased from 0.4 ± 0.3 mm to 0.1 ± 0.2 mm, and distal CBL decreased from 0.5 ± 0.3 mm to 0.2 ± 0.3 mm over 1 year. In Group TT, mesial CBL remained stable at 0.3 ± 0.2 mm, while distal CBL reduced slightly from 0.5 ± 0.5 mm to 0.3 ± 0.2 mm. Both groups showed minimal changes in CBL, indicating great stability (pmesial = 0.003, pdistal = 0.004). TT was particularly effective in preventing mesial bone loss (pmesial = 0.019). The mesial CBL changes significantly differed between groups (p = 0.019), and not significantly at distal sites (p = 0.944). Neither treatment exhibited significant bone remodeling below the implant shoulder.

Conclusion: This study suggests that both techniques were successful in STH augmentation, and they may effectively reduce peri-implant crestal bone level changes, with TT being slightly superior. TT was more prone to post-surgical complications. This RCT was not registered before participant recruitment and randomization.

研究目的本研究旨在比较两种技术--细胞外基质(ADM)移植和帐篷技术(TT)--在植入种植体的同时增加软组织高度(STH)以减少种植体周围骨嵴水平(CBL)变化的效果:方法:40 位下颌后方缺牙部位愈合且软组织表型较薄的患者入选。20名患者在种植体植入的同时接受了ADM移植,其他患者则接受了浸没式愈合基台(TT)。在修复体交付和 1 年随访时测量临床种植体周围软组织高度和 CBL 影像学变化:结果:两种技术都有效地增加了软组织厚度,增高后的最终平均STH为3.4 ± 0.5 mm。增量后,ADM 组软组织平均增加了 1.6 ± 0.5 毫米,TT 组平均增加了 1.8 ± 0.4 毫米。在 ADM 组中,CBL 中线在 1 年内从 0.4 ± 0.3 mm 下降到 0.1 ± 0.2 mm,CBL 远端从 0.5 ± 0.3 mm 下降到 0.2 ± 0.3 mm。在 TT 组中,中轴 CBL 保持稳定,为 0.3 ± 0.2 毫米,而远轴 CBL 略有下降,从 0.5 ± 0.5 毫米降至 0.3 ± 0.2 毫米。两组的 CBL 变化都很小,这表明其稳定性很好(pmesial = 0.003,pdistal = 0.004)。TT 在防止中轴骨质流失方面尤为有效(pmesial = 0.019)。各组间 CBL 的中线变化有明显差异(p = 0.019),远端则无明显差异(p = 0.944)。两种治疗方法都没有显示出种植体肩部以下有明显的骨重塑:本研究表明,这两种技术在 STH 增量中都是成功的,它们可以有效地减少种植体周围的骨水平变化,其中 TT 稍胜一筹。TT更容易出现术后并发症。该研究在参与者招募和随机分配前未进行注册。
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引用次数: 0
Iliac crest vertical block grafts -placing outside or inside the bone contour: A cohort study. 髂嵴垂直块移植--置于骨轮廓外还是骨轮廓内?一项队列研究。
Pub Date : 2024-08-08 DOI: 10.1111/cid.13370
Christian Mertens, Christopher Büsch, Oliver Ristow, Jürgen Hoffmann, Hom-Lay Wang, Korbinian Jochen Hoffmann

Objective and aim: Challenging defect configurations and dimensions arise from severe, localized vertical alveolar ridge defects caused by trauma or prior surgery. This study aims to analyze three-dimensional bone gain, assess marginal bone stability in such defect configurations, and evaluate the impact of grafting outside the bone contour on the overall outcome, with a focus on iliac crest block grafts as a valid treatment option.

Materials and methods: The prospective cohort study evaluated patients who required vertical block grafting due to localized bone defects in the maxilla or mandible and who had received iliac grafts. Three-dimensional bone gain was analyzed using cone beam computed tomography (CBCT) after 3 months of bone healing for each treated site and implant position. A comparison between bone grafts inside and outside the bone contour was conducted. Marginal bone stability was measured using intraoral radiographs during routine annual follow-up visits.

Results: Seventy patients with 89 treated sites were evaluated. After 3 months of graft healing, the mean vertical bone gain was 11.03 ± 3.54 mm, the mean horizontal bone gain was 7.18 ± 2.00 mm, and the mean graft length was 28.19 ± 11.01 mm. A total of 217 implants were placed in the augmented regions. On implant level, a mean vertical bone gain of 10.44 ± 3.44 mm and a mean horizontal bone gain of 6.54 ± 1.86 mm were measured. Over a 43-month observation period, mesial and distal marginal bone loss averaged 0.44 ± 0.92 mm and 0.49 ± 1.05 mm, respectively. Eight implants were diagnosed with periimplantitis, resulting in the loss of four implants, while no early implant losses were reported.

Conclusion: Within the limitations of this study, vertical bone grafts with iliac crest block grafts were found to be a dependable treatment option for dental implant placement, and placing block grafts outside the bone contour did not lead to inferior outcomes.

目的和宗旨:由于外伤或之前的手术造成的严重、局部垂直牙槽嵴缺损,其缺损结构和尺寸具有挑战性。本研究旨在分析三维骨增量,评估此类缺损构型的边缘骨稳定性,并评估骨轮廓外移植对整体效果的影响,重点是将髂嵴块状移植作为一种有效的治疗方案:这项前瞻性队列研究评估了因上颌骨或下颌骨局部骨缺损而需要进行垂直块状移植,并接受过髂骨移植的患者。在每个治疗部位和种植体位置的骨愈合 3 个月后,使用锥形束计算机断层扫描(CBCT)分析了三维骨增量。对骨轮廓内外的植骨进行了比较。在每年的例行随访中,使用口内X光片测量边缘骨的稳定性:对 70 名患者的 89 个治疗部位进行了评估。移植骨愈合 3 个月后,垂直骨增量平均为 11.03 ± 3.54 毫米,水平骨增量平均为 7.18 ± 2.00 毫米,移植骨长度平均为 28.19 ± 11.01 毫米。在增量区域共植入了 217 个种植体。在种植体水平上,垂直骨增量平均为(10.44 ± 3.44)毫米,水平骨增量平均为(6.54 ± 1.86)毫米。在 43 个月的观察期内,中轴和远轴边缘骨量损失平均分别为 0.44 ± 0.92 毫米和 0.49 ± 1.05 毫米。8颗种植体被诊断为种植体周围炎,导致4颗种植体脱落,但没有早期种植体脱落的报告:结论:在本研究的局限性范围内,发现垂直骨移植与髂嵴块移植是种植牙的可靠治疗方案,在骨轮廓外放置块移植不会导致较差的结果。
{"title":"Iliac crest vertical block grafts -placing outside or inside the bone contour: A cohort study.","authors":"Christian Mertens, Christopher Büsch, Oliver Ristow, Jürgen Hoffmann, Hom-Lay Wang, Korbinian Jochen Hoffmann","doi":"10.1111/cid.13370","DOIUrl":"https://doi.org/10.1111/cid.13370","url":null,"abstract":"<p><strong>Objective and aim: </strong>Challenging defect configurations and dimensions arise from severe, localized vertical alveolar ridge defects caused by trauma or prior surgery. This study aims to analyze three-dimensional bone gain, assess marginal bone stability in such defect configurations, and evaluate the impact of grafting outside the bone contour on the overall outcome, with a focus on iliac crest block grafts as a valid treatment option.</p><p><strong>Materials and methods: </strong>The prospective cohort study evaluated patients who required vertical block grafting due to localized bone defects in the maxilla or mandible and who had received iliac grafts. Three-dimensional bone gain was analyzed using cone beam computed tomography (CBCT) after 3 months of bone healing for each treated site and implant position. A comparison between bone grafts inside and outside the bone contour was conducted. Marginal bone stability was measured using intraoral radiographs during routine annual follow-up visits.</p><p><strong>Results: </strong>Seventy patients with 89 treated sites were evaluated. After 3 months of graft healing, the mean vertical bone gain was 11.03 ± 3.54 mm, the mean horizontal bone gain was 7.18 ± 2.00 mm, and the mean graft length was 28.19 ± 11.01 mm. A total of 217 implants were placed in the augmented regions. On implant level, a mean vertical bone gain of 10.44 ± 3.44 mm and a mean horizontal bone gain of 6.54 ± 1.86 mm were measured. Over a 43-month observation period, mesial and distal marginal bone loss averaged 0.44 ± 0.92 mm and 0.49 ± 1.05 mm, respectively. Eight implants were diagnosed with periimplantitis, resulting in the loss of four implants, while no early implant losses were reported.</p><p><strong>Conclusion: </strong>Within the limitations of this study, vertical bone grafts with iliac crest block grafts were found to be a dependable treatment option for dental implant placement, and placing block grafts outside the bone contour did not lead to inferior outcomes.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908620","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}
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Clinical implant dentistry and related research
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