DOI: 10.11607/jomi.10937, PubMed-ID: 3917832123. Aug. 2024,Seiten: 1-20, Sprache: EnglischPadovezi, Iloéia Pontes Domingues Daher / Peruzzo, Daiane / Fernandes, Juliana Campos Hasse / Fernandes, Gustavo Vicentis Oliveira / Joly, Júlio CésarObjective: The goal of this observational study was to evaluate the occurrence, incidence rate, and esthetic impact of facial growth in adult patients subjected to rehabilitation with single implants on the anterior maxillary region (pre-maxilla), specifically in the central incisors, to evaluate the influence of time on changes in the incisal level. Methods: Patients who received single implants in #11 or #21 (A.D.A. #8 or #9), with age greater than nineteen years old on the date they received the implant and with the presence of adjacent teeth, were included. As exclusion criteria: implants with less than five years of installation, implants adjacent to dental elements that have undergone some anatomical change in the incisal area due to restorations, fractures, or excessive wear; rehabilitation with implants in both central upper incisors. Standardized pictures were obtained to evaluate the presence and incidence of incisal linear changes. All rehabilitation followed the same standard of reconstruction and received the same incisal level of the homologous and adjacent tooth in order to mimicry and achieve the best esthetic for the patient. Thus, in T0, the incisal level difference between the crown and the adjacent tooth was zero; any modification in the incisal levels, from 1.0 mm of difference, was registered. It was considered 1.0 mm as the cutoff mark because this number permits easy observation of any difference, either by professional or patient. The data obtained were analyzed and correlated statistically. Results: A total of 56 patients/implants were included (aged between 23 and 63; an average of 40.79 ± 12.25); incisal level alteration between teeth and implants was found, leading to an incidence rate of 19.6% of patients. The study had an average follow-up of 10.7 ± 3.37 years. All implants evaluated had stability and healthy peri-implant tissue condition throughout the follow-up, with a 100% survival rate. There was no statistically significant prevalence of incisal level changes between males (19%) and females (20%) (p=0.238); there was an incidence of 41.7% in the group between 20 and 30 years old, 13.3% between 30 and 40 years old, 23.7% between 40 and 50 years old, and 6.3% in the group over 50 years old was found, but with no statistically significant differences (p=0.118) among different age groups. Similarly, no statistically significant difference was observed (p=0.262) comparing the number of clinical cases in each subgroup with and without change in the incisal level. Conclusion: It was possible to conclude that the changes in the incisal level in maxillary anterior crowns retained by single implants in the adult patient were presented in 19.6% of the cases evaluated. This prevalence was not influenced by gender or age group; however, it was observed more often in dental implant cases with longer follow-ups.
Schlagwörter: Facial growth, Anterior single implant, Esthetic, Incisal level
DOI: 10.11607/jomi.11069, PubMed-ID: 3917832323. Aug. 2024,Seiten: 1-23, Sprache: EnglischEmam, Marwa / Keilig, Ludger / Bourauel, ChristophPurpose: This in vitro study aimed to compare by finite element analysis the stress distribution created in restoration components and the bone-implant interface by the effect of different abutment and crown esthetic material combinations. Materials and Methods: A model of an implant in the maxillary central incisor region was generated. 5 materials with varying moduli of elasticity (E) and 6 combinations were used for the crown and abutment to generate 6 models. The models’ abutment/crown materials were as follows: PEEK / lithium disilicate, PEEK / composite resin, hybrid ceramics / lithium disilicate, hybrid ceramics / hybrid ceramics, PEEK / hybrid ceramics, zirconia / lithium disilicate. A static load of 500 N was applied and structural analysis was started. von Mises (mvM) and principal stress values on the bone-implant interface and (mvM) values for cement lines, and restorative materials were evaluated separately. Results: All models had the same (mvM) distribution in the bone implant interface. Models with abutments having higher (E) values (zirconia and hybrid ceramics) showed lower (mvM) distribution in crowns and overlying cement than abutments with lower (E) values (PEEK). The model PEEK/composite showed the highest (mvM) in the crown and underlying cement while the model zirconia/lithium disilicate showed the lowest. Conclusions: Higher (E) values abutments showed better stress distribution compared to those with low (E) values. Clinical relevance: Restoring anterior dental implants with abutment materials having high (E) values is more successful than materials with low (E) values. PEEK abutment and composite crown showed significantly high stress in the cement between crown and abutment which might be a cause of debonding. PEEK abutments and composite crowns are not recommended for definitive hybrid abutments and crowns.
Schlagwörter: dental implants, finite element method, high-performance polymer PEEK, zirconia, lithium disilicate, hybrid ceramics
DOI: 10.11607/jomi.10956, PubMed-ID: 3917250016. Aug. 2024,Seiten: 1-22, Sprache: EnglischAsik, Batuhan / Ayyildiz, Berceste Guler / Terzioglu, Busra / Eken, SeymaPurpose: This study aimed to evaluate the relationship between risk profile assessments of dental implants that have been in function for at least two-year and peri-implant marginal bone loss during the follow-up period using the Implant Disease Risk Assessment Diagram. Material and Methods: A total of 70 patients and 170 implants who had been functionally loaded for at least two years and who attended follow-up sessions were included in the study. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing, clinical attachment level (CAL), and peri-implant modified plaque index, modified bleeding index, PD, keratinized mucosal width (KMW), CAL and GR were recorded. According to the IDRA risk diagram, participants and dental implants were divided into low, moderate, and high-risk groups. Marginal bone level (MBL) was measured on periapical radiographs obtained at functional loading (T0) and at the last follow-up session (T1), and mesial and distal marginal bone level changes (ΔMBL) were calculated as T1-T0. Results: A statistically significant correlation was found between the periodontitis history and periodontitis susceptibility and IDRA classification at the patient-level. Full-mouth GI, PD, and BOP were found to be statistically higher in the high-risk IDRA group. No statistically significant result was found between the mesial and distal ΔMBL between the IDRA risk groups.Conclusions: In this study, IDRA risk level increased especially by periodontitis susceptibility and periodontitis history, but no significant difference was found between risk groups in terms of ΔMBL.
Schlagwörter: periodontal disease; staging and grading; risk factors; disease susceptibility; periimplantitis, risk assessment
DOI: 10.11607/jomi.11103, PubMed-ID: 3917243716. Aug. 2024,Seiten: 1-20, Sprache: EnglischCinquini, Chiara / Parisi, Ester / Baldi, Niccolò / Miccoli, Mario / Alfonsi, Fortunato / Barone, AntonioPurpose: Immediate implant placement is a reliable solution to replace hopeless teeth, but this procedure may be associated to an increased risk of soft tissue complications in case of thin biotype. The use of tissue-level implants with a convergent transmucosal profile has been advocated to increase space for soft tissue, contributing to improve their stability and esthetics. The aim of this retrospective study was to evaluate the esthetic outcomes and the Patient-Reported Outcome Measures (PROMs) of immediately placed implants with a convergent transmucosal profile. Materials and methods: This single-cohort, monocentric, retrospective clinical study was conducted on patients treated with an immediately placed implant in the esthetic zone (from premolar to premolar). All the eligible patients were recalled for a clinical and radiographic follow-up visit. Results: This study included 20 patients (8 males, 12 females) with an average age of 55.5± 6.8 years, who received 20 implants, with a mean follow-up of 46.5± 15.3 months. At the time of follow-up, immediately placed implants showed a mean Marginal Bone Loss of 0.42± 0.49 mm, and a statistically significant improvement of the esthetic parameters from baseline to the last available follow-up; in particular, Pink and White esthetic scores (p=.001) and Papilla Index at mesial and distal sites (p<.001). All the patients reported a high satisfaction (VAS>9) both from esthetic and functional point of view. Conclusion: Immediately placed implants with convergent transmucosal profile in the esthetic zone showed good clinical and esthetic outcomes, with stable results over time.
Schlagwörter: Immediate placement, prostheses, cohort study, tissue-level
DOI: 10.11607/jomi.11081, PubMed-ID: 3917235816. Aug. 2024,Seiten: 1-24, Sprache: EnglischKondo, Yusuke / Masaki, Chihiro / Hata, Kentaro / Oda, Masafumi / Morimoto, Yasuhiro / Hosokawa, RyujiPurpose: This study aimed to investigate the associations between the concentrations of bone turnover markers and maxillary and mandibular cancellous Hounsfield units to determine whether bone turnover marker assessments are effective for preoperative examinations for implant treatment. Materials and Methods: The study included 94 patients (37 males and 57 females) with a mean age of 62.0±11.9 years. Spearman's rank correlation and multivariate linear regression coefficients were used to determine the associations between the bone turnover markers and maxillary and mandibular cancellous Hounsfield units. Results: Multivariate bias correction showed that the concentrations of bone-specific alkaline phosphatase, procollagen type I N-terminal propeptide, and deoxypyridinoline were negatively associated with the maxillary Hounsfield units. The concentration of undercarboxylated osteocalcin tended to be negatively associated with the maxillary Hounsfield units but not significantly. The concentrations of deoxypyridinoline and tartrateresistant acid phosphatase 5b were significantly negatively associated, and the concentrations of bone-specific alkaline phosphatase and procollagen type I N-terminal propeptide only tended to be negatively associated with the mandibular Hounsfield units. Conclusion: Several bone formation and resorption markers were negatively correlated with the maxillary and mandibular Hounsfield units. BTM measurement is effective for preoperative examination for implant treatment.
DOI: 10.11607/jomi.10417, PubMed-ID: 3917230716. Aug. 2024,Seiten: 1-21, Sprache: EnglischRajan, Gunaseelan / Ramesh, Ashwini Obla / Saravanakumar, Mariappan / Balachandran, Anand / Krishnamurthy, Srinivasan / Natarajarathinam, GowriPrimary failure of eruption (PFE) is a rare non-syndromic condition in which non-ankylosed teeth fail to erupt fully or partially due to malfunction of the eruption mechanism. 3 young patients are presented in this article with features consistent with a diagnosis of primary failure of eruption. The features of this condition are described together with different modalities of treatment planning for such patients. Zygoma implants as a new approach in the treatment of patients with primary failure of eruption requiring full mouth rehabilitation is discussed.
DOI: 10.11607/jomi.11045, PubMed-ID: 391213719. Aug. 2024,Seiten: 1-28, Sprache: EnglischSampaio, Douglas / Klein, Gustavo Batista Grolli / Cortelli, Sheila Cavalca / Rosa, Jorge Luiz / Vieira, Giovani Souza / de Lima Romeiro, RogérioAim: To assess the roughness and hydrophilicity of nine types of dental implant surfaces, while also examining the presence of contaminants carbon and oxygen on these surfaces. Furthermore, the study investigated potential correlations between these characteristics across the analyzed surfaces. Materials and Methods: The surfaces analyzed were as follows: MI: machined (turned), Implacil implant; TOI: blasted with titanium oxide, Implacil implant; TOAEI: blasted with titanium oxide and acid-etched, Implacil implant; ZAED: blasted with zirconia and acid-etched, DSP implant; CPD: coated with calcium phosphate, DSP implant; XD: subjected to an experimental treatment (patent pending), DSP implant; DAEHAS: double acid-etched and activated with hydroxyapatite nano-crystals, SIN implant; DAES: double acid-etched, SIN implant; and AMP: untreated surface of the Plenum implant, produced by additive manufacturing. Four and five disc-shaped specimens were used in the hydrophilicity and roughness assessments, respectively. Roughness was evaluated by optical profilometry and scanning electron microscopy; hydrophilicity was determined using the sessile-drop technique; and the chemical analysis was performed using X-ray photoelectron spectroscopy. The Kruskal- Wallis, Mann-Whitney, and Spearman correlation tests were employed to analyze the data (p < 0.10). Results: Significant differences were observed among the analyzed surfaces in terms of both roughness and hydrophilicity (p < 0.001). The surface exhibiting the highest roughness was AMP, whereas the greatest hydrophilicity was exhibited by CPD. Correlations between roughness and hydrophobicity were observed for MI (r = 0.936, p = 0.009), ZAED (r = 0.957, p = 0.004), and DAES (r = 0.964, p = 0.005). The carbon concentration observed on the CPD surface was lower than that observed on the other surfaces, whereas the oxygen concentrations were similar. No correlations were observed between the presence of contaminants and the roughness or hydrophilicity characteristics. Conclusion: Roughness and hydrophilicity values exhibited considerable variation among the tested surfaces. Aside from the CPD surface, comparable concentrations of carbon and oxygen were detected. Although correlations between roughness and hydrophilicity were observed only for the ZAED, DAES, and MI surfaces, these correlations were inadequate to establish a causal relationship between the two surface characteristics.
Schlagwörter: Dental implants; Wettability; Osseointegration; Surface properties; Cell adhesion
DOI: 10.11607/jomi.11036, PubMed-ID: 391213619. Aug. 2024,Seiten: 1-21, Sprache: EnglischKim, Heon-Young / Song, Ju-Dong / Jang, Il-Seok / Kim, Sun-Jong / Kim, Jin-WooPurpose: The osseointegration in dental implants is greatly affected by various surface properties, such as chemistry, texture, and overall cleanliness. This study aimed to investigate the impact of mineral oil lubricants used in rotary instruments on osseointegration within rabbit tibiae, with a specific focus on potential contamination from dental handpices. Materials and Methods: Twelve New Zealand rabbits were included in this study, each receiving two implants in each tibia, resulting in a total of 48 implants across the study. Groups were organized based on the time until euthanasia and the degree of implant contamination. Three contamination levels were defined: the first group received implants without any lubricant in the handpiece (control group); the second group received implants with handpices managed as recommended; the third group had implants placed using fixtures pre-soaked in lubricant. These groups were further subdivided based on euthanization periods of two and four weeks. We measured and analyzed both the removal torque and the bone-implant contact. Results: We observed a non-significant inverse correlation between the severity of fixture contamination and removal torque. However, there was a significant reduction in bone-implant contact associated with higher contamination levels, particularly after four weeks. Conclusions: Even brief exposure to lubricants from handpieces can jeopardize the osseointegration of implants in bone. Therefore, it is imperative to implement thorough procedures for lubricant removal post-application and to employ precise cleaning and suction during implant drilling and placement to minimize residual oil on the implant surface.
Schlagwörter: Dental implant, osseointegration, lubricant, surface contamination
DOI: 10.11607/jomi.11062, PubMed-ID: 391213609. Aug. 2024,Seiten: 1-21, Sprache: EnglischHerzberg, Ran / Slutzkey, Gil / Raz, Perry / Rayyan, Fatma / Beitlitum, IlanPurpose: To evaluate the efficacy of vertical guided bone regeneration (GBR) in the mandible utilizing a non-resorbable membrane and a bone graft combination of autogenous bone chips, and high-temperature processed (HTP) xenograft, through CT scans and microCT analysis. Materials and Methods: Patients underwent vertical ridge augmentation procedures prior to implant placement. The surgical procedure included flap elevation and placement of a bone graft comprising a 1:1 combination of autogenous posterior mandible-derived bone chips, and HTP xenograft graft particles covered with a d-PTFE membrane trimmed to suit the 3D shape of the bone defect. This was fastened securely with titanium screws and pins, and a layer of native collagen membrane. Post-operative complications and ridge measurements were assessed. Pre bone augmentation and pre implant placement bone parameters were obtained from CT scans. Biopsy specimens collected during implantation were examined by microCT. Results: All 13 study procedures were successful without any complications. The results revealed average vertical and horizontal bone gains of 3.35 mm and 5.15 mm respectively. A total of 33 implants were successfully placed in the augmented areas, without the need for further bone augmentation. MicroCT analysis revealed 48% bone, 15% filler material, and 37% non-calcified tissue in the augmented region compared to 65% bone, 3% filler material, and 32% non-calcified tissue in the pristine bone. Conclusions: A mixture of autogenous bone and HTP xenograft, covered with a d-PTFE membrane and a layer of native collagen membrane is effective for vertical GBR.
Schlagwörter: vertical guided bone regeneration, microCT, xenograft, d-PTFE, GBR
DOI: 10.11607/jomi.10948, PubMed-ID: 390932911. Aug. 2024,Seiten: 1-20, Sprache: EnglischAboelkhier, Mohammed / Ghazy, Mohamed / Al-Zordk, WalidPurpose: The purpose of this in vitro study was to evaluate the effect of titanium base height on torque loss of monolithic zirconia, lithium disilicate, and polymer-infiltrated ceramic hybrid- abutment restorations for offset placed implant. Materials and methods: Forty-two hybrid- abutment restorations supported by offset placed implants (diameter: 4.2 mm; length: 10 mm) were divided into 6 groups: short titanium base and zirconia (SZ), long titanium base and zirconia (LZ), short titanium base and lithium disilicate (SE), long titanium base and lithium disilicate (LE), short titanium base and polymer-infiltrated ceramic (SP), and long titanium base and polymer-infiltrated ceramic (LP). An adhesive resin cement was used to bond the restoration to the titanium base. The restoration was secured with titanium screw tightened to 30 Ncm by using a calibrated torque meter device. The specimens were exposed to thermocycling (5000 cycles at 5°C to 55°C), then cyclic loaded (120 000 cycles/50 N/1.6 Hz), where the load was placed vertically in mesial fossa of the restoration. After the loosening torque value of the abutment screw was measured by the torque meter device, the torque loss and its percentage were calculated. Two-way ANOVA, one-way ANOVA, and post hoc Tukey tests were used for statistical analysis of the data (α=.05). Results: The 2-way ANOVA test showed significant differences in loosening torque, torque loss and percentage of torque loss across the restorative material (P<.001), no significant difference across the height of titanium base (P=.213) and no significant interaction (P=.845) between restorative material and height of titanium base. Regarding the restoration type, 1-way ANOVA test showed significant difference (F ratio=15.95, P<.001) in torque loss between groups. The mean torque loss value with monolithic zirconia was significantly higher than with lithium disilicate (P=.039) and polymer-infiltrated ceramic (P<.001), respectively. Between the lithium disilicate and polymer-infiltrated ceramic, a significant difference (P=.013) was also found. Conclusion: The restorative material had a major effect on the torque maintenance in hybrid-abutment-restoration supported by offset placed implant, while the titanium base abutment height had no influence on it. Compared to lithium disilicate and polymer-infiltrated ceramic materials, monolithic zirconia induced higher torque loss when used as hybrid-abutment-restoration.
Schlagwörter: torque loss, implant, titanium base, ceramic, abutment height
DOI: 10.11607/jomi.11003, PubMed-ID: 390932901. Aug. 2024,Seiten: 1-25, Sprache: EnglischAbraham, Mariá P. / Fabris, Douglas / Souza, Júlio C. M. / Henriques, BrunoPurpose: The objective of this study was to examine how the saline and acidic environment affects the mechanical integrity of narrow single-body titanium implants for oral rehabilitation. Materials and methods: Thirty titanium-base alloy implants with 2.5 mm diameter were placed into a polyacetal holder and coupled to a stainless-steel prosthetic cap for fatigue testing in three different environments, as follows: dry air; saline solution (pH at 7.6); and lactic acid solution (pH at 3.4). The fracture surfaces were analyzed using a Scanning Electron Microscope (SEM). Also, finite element analysis was carried out to estimate the maximum von Mises stresses. Results: The fatigue resistance was higher in the group tested in dry air (60%), followed by saline solution (30%) and lactic acid (10%). Regardless of the environment, fracture occurred at the same region of the failed specimens in line with the highest stress concentration spots, according to the finite element analysis. SEM analyses revealed two distinct failure regions, both with the presence of fatigue streaks: fatigue and overload. A high incidence of secondary cracks was also noticed on the specimens exposed to the solutions. Conclusions: The present study revealed that both saline and acidic solutions significantly affect the fatigue resistance of narrow dental implants. Critical regions of the narrow implants were also susceptible to cracks and plastic deformation that should be taken into consideration in planning for oral rehabilitation.
Schlagwörter: extra narrow implants; fatigue; corrosion; saline solution, failure analysis.
DOI: 10.11607/jomi.11060, PubMed-ID: 390932921. Aug. 2024,Seiten: 1-13, Sprache: EnglischAkhondi, Samuel / Pala, Kevser / Pedrinaci, Ignacio / Gallucci, German O.This technical note serves as a practical guide for clinicians aiming to provide solutions to optimize the precision of static computer-assisted implant surgery (sCAIS) and the success of implant placement in free-end situations. Five methods are introduced for enhancing surgical guide stabilization and improving the accuracy of implant placements in situations lacking stabilizing adjacent teeth. Techniques include the use of keratinized soft tissues, implant-borne stabilizers, lateral fixation pins, transitional implants, and digital bone segmentation for guide support. Each method is evaluated for its potential to address the specific challenges faced in sCAIS, aiming to contribute to the field through practical solutions for clinicians.
DOI: 10.11607/jomi.11010, PubMed-ID: 390932931. Aug. 2024,Seiten: 1-21, Sprache: EnglischLi, Zhen / Yun Yang, MM / Meng Yang, MBBS / Xin Tong, MMObjective: To observe and analyse patients with dental implant fracture and explore the factors influencing the fracture with the aim of providing reference for physicians’ clinical work. Methods: The clinical data of 19 patients with dental implant fracture who visited the Department of Implantology of our hospital between 2007 and 2019 were retrospectively observed and analysed, and the fracture’s influencing factors (e.g. the fracted implant site, implant diameter and connection mode, upper prosthetic method and fracture site) were analysed and investigated. Results: The fractured implants comprised 12 Straumann implants (5 fractured at the smooth dental neck and 7 atop the central screws), 5 Bego implants (4 fractured at the smooth dental neck and 1 atop the central screw), 3 Lifecore implants fractured atop the central screws and 1 Anthogyr implant fractured atop the central screw. Of the 19 patients, 6 had anterior dental implant fracture, and 13 had posterior dental implant fracture (21 fractured implants in total). Maxillary anterior dental implant fracture was observed in 6 patients (8 implants), maxillary posterior implant fracture was observed in 3 patients (3 implants), and mandibular posterior dental implant fracture was observed in 10 patients (10 implants). Conclusions: A good implant system design, appropriate implant diameter and reasonable upper prosthetic method are key to maintaining long-term stability of a dental implant.
Schlagwörter: Dental implant; implant fracture; implant diameter; Cantilever fixed bridge
DOI: 10.11607/jomi.11005, PubMed-ID: 390932891. Aug. 2024,Seiten: 1-26, Sprache: EnglischKeskin, Aynil / Kayssoun, AmmarPurpose: This study was designed to evaluate the influence of utilizing Polyetheretherketone (PEEK) coping and three different dental restorative materials in the success of tooth and implant-supported fixed partial dentures (TISFPD) in the maxillary posterior region, under static loading by 3-Dimensional Finite Element Analysis (3D FEA). Materials and Methods: Six 3D FEA models were designed assuming the extraction of maxillary first and second molars. Bone, implant, abutment, PEEK coping, second premolar, periodontal ligament (PDL) and six 3-unit TISFPD with different restorative materials [Porcelain-Fused-to-Metal (PFM), PEEK-Composite (PC), Monolithic Zirconia (MZ)] were modeled. Then, PEEK copings were modeled to be cemented onto the implants as a double-crown system for the first three groups (PFMPEEK, PCPEEK and MZPEEK) whereas, the next three groups (PFM, PC, MZ) excluded a PEEK coping in their designs. The prostheses were loaded twice, vertically and obliquely. From the determined points, 250 N for vertical loading (0o to the long axis) and 200 N for the oblique loading (30o to the long axis) were applied. Von Mises tension, maximum and minimum principal tension value criterias were analyzed. Results: Regardless of the material used for suprastructure, the maximum average stress was reduced by using PEEK coping. Considering the maximum stress distribution, PC appeared to have the highest stresses on the cortical bone, implant and screw. Additionally, the von Mises stresses formed in the PDL for each model were lower when PEEK coping was included in the design of the TISFPD, reducing the risk of intrusion. Conclusions: The stress distribution was positively affected by the PEEK coping in TISFPD design, reducing bone resorption and failure. This elastic material used generated lower stresses in the bone and implant, while no significant effect was found on stresses around natural teeth.
Schlagwörter: Tooth-implant; PEEK; FEA; Stress distribution; Static loading
DOI: 10.11607/jomi.11039, PubMed-ID: 3894116828. Juni 2024,Seiten: 1-24, Sprache: EnglischGehrke, Peter / Pietruska, Maria Julia / Korth, Anissa / Schöttler, Tanja / Jenatschke, Rafaela / Fischer, Carsten / Sader, Robert / Weigl, PaulPurpose: To retrospectively evaluate the long-term clinical, technical, biological, and esthetic outcomes of implant supported single zirconia crowns (ISCs) intraorally cemented to Ti-base hybrid-abutments up to 16 years after placement. Materials and Methods: A total of 63 ISCs (Xive S, Camlog Screw Line, Replace Select TC NP, Branemark MK II, and 3i Osseotite) were evaluated in 36 patients at two different centers. Original Ti-bases were selected and zirconia meso structures and zirconia crowns were designed using CAD/CAM software and then milled from partially stabilized zirconia blocks. After the meso structures were cemented extraorally onto the Ti-bases, the ceramic crowns were intraorally luted to the hybrid abutments. The Ti-base ISC restorations were followed up for up to 16 years, and their clinical, biological, and esthetic outcomes were recorded at distinct time points (T1; T2) at three-year intervals. Results: 36 patients (18 men, 18 women) received 32 ISCs in the anterior region and 31 in the posterior region of the maxilla and mandible. The mean follow-up of the Ti-base ISCs was 6.93 ± 2.60 years. The mean follow-up of the implants amounted to 8.11 ± 3.26 years. No implants were lost during follow-up, resulting in a cumulative implant survival rate of 100%. Abutment screw loosening was observed in two ISCs after one year in service. The overall cumulative restorative survival rate of the Ti-base restorations reached thus 96.83%. At T2 follow-up 24% of the ISCs exhibited an increase in PD despite maintaining clinically healthy peri-implant tissue. An 11% increase in BOP and a 3.17% decrease in PI were recorded. Despite spectrophotometrically measured ΔE values indicating visible discoloration of some restorations and their peri-implant soft tissue, a low incidence of esthetic complications was observed with an average PES/WES score of ≥ 12. No correlation was found between PES (R = -0.25; p = 0.27) and WES (R = -0.18; p = 0.43) scores and digital shade determination. Conclusions: The results of the present retrospective, multicenter, cohort study indicate satisfactory clinical outcomes for intraorally cemented single zirconia crowns (ISCs) supported by Ti-base hybrid abutments. An overall esthetic superiority of Ti-base ISCs could not be confirmed.
Schlagwörter: retrospective trial, titanium base, zirconia, two-piece hybrid abutment, implant-supported single crown.
DOI: 10.11607/jomi.11008, PubMed-ID: 3894116728. Juni 2024,Seiten: 1-20, Sprache: EnglischPaternò Holtzman, L / Solderer, A / Malpassi, C / Palattella, PDespite high rates of success for dental implants, implant failure due to several causes may require explantation. In the present retrospective study, implants removed between 2000 and 2022 have been registered and the cause of removal has been established. All implants were removed by a single operator (PPM) in the department of Oral Surgery of the George Eastman Dental Hospital in Rome, Italy. Characteristics of removed implants such as implant surface, morphology (bone versus tissue level implants), type of restoration (fixed versus removable), in the case of fixed restorations, mode of retention (cement versus screw-retained), location of the implant (maxillary versus mandibular arch) were recorded. Furthermore, patient-level characteristics were also recorded (systemic health conditions and medications taken, smoking habits and previous history of periodontitis). In total, 381 implants in 381 patients were removed in the 20-year time-span. The most frequent cause of removal was peri-implantitis (82.4% of implants), followed by implant malposition and loss of osteointegration. The survival time was not affected by the cause of removal, while bone level implants had a longer survival time versus tissue level implants. Maxillary implants had a higher prevalence of peri-implantitis compared to mandibular implants.
DOI: 10.11607/jomi.10909, PubMed-ID: 3894116628. Juni 2024,Seiten: 1-20, Sprache: EnglischKoutouzis, Theofilos / Bembey, Kanika / Sofos, StavrosPurpose: To evaluate the effect of osteotomy preparation technique and implant diameter on primary stability and bone-implant interface of short implants (6mm), when placed in bone with high degree of cancellous content. Material and method: 90 short (S) implants (6 mm) divided in nine groups based on width (Narrow 4.2 mm, Regular 4.8 mm, Wide 5.4 mm) (N,R,W) and osteotomy preparation (Standard, Osteotome, Osseodensification) (ST, OT, OD) and placed in porcine tibia plateau bone samples: Group SN-ST; Group SN-OT; Group SN-OD; Group SRST; Group SR-OT; Group SR-OD; Group SW-ST; Group SW-OT and Group SW-OD. Insertion torque and Implant Stability Quotient (ISQ) were measured. Four implants from each group SNST, SN-OT, SN-OD were evaluated histomorphometrically. Results: Insertion torque was significantly higher for implants of Group SW-OD compared to Group SW-ST (50.00 ±14.14 Ncm vs 28.00 ±10.85 Ncm, p= 0.005) and Group SW-OT compared to Group SW-ST (46.87 ±17.10 Ncm vs 28.00 ±10.85 Ncm, p=0.026). Insertion torque was significantly higher for implants of Group SW-OD compared to Group SN-OD (50.00 ±14.14 Ncm vs 31.5 ±15.82 Ncm, p=0.04). No significant differences were observed for the percentage of bone, marrow space and connective tissue in contact to the implant surface between studied groups. Conclusion: Osteotomy preparation technique at sites with high degree of cancellous content can influence the implant insertion torque for short and wide implants (5.4x6mm). Implant width can influence the insertion torque of short implants placed with the osseodensification technique.
Schlagwörter: Osseodensification, osteotome, stability, implants, histology, bone
DOI: 10.11607/jomi.10998, PubMed-ID: 3894116528. Juni 2024,Seiten: 1-24, Sprache: EnglischLevy-Bohbot, A. / Bertolus, C. / Durin-Touati-Sandler, A. / Gellée, T.Purpose: As the population gets older, the prevalence of complete or partial tooth loss is increasing, significantly impacting people's quality of life. Scientific research demonstrates that implant-fixed complete dentures offer high levels of satisfaction. In certain cases, tooth loss can lead to significant bone atrophy, necessitating pre-implant bone reconstruction. We conducted a retrospective cohort study involving 43 arches, including or not bone grafts, rehabilitated using a stackable guided approach, which included an immediate loading protocol. The primary outcome measure was the survival rate of the implant at 4 months. Material and methods: The digital workflow helps the design of the provisional prothesis before the implant surgery, which will be loaded immediately after the implant's placement. The stacked guides integrate both surgical and prosthetic considerations into a digital workflow. Result: A total of 284 implants were placed. After a 4-month follow-up period, 10 implants (3.5%) exhibited no osseointegration and were subsequently replaced, resulting in an overall success rate of 96.5%. After 1 year of follow-up, a prosthetic success rate of 100% was observed, with all patients being able to progress to the stages for the permanent fixed dentures. Conclusion: Our findings support the use of this protocol for all patients, whether they require bone grafts or not. However, a long-term follow-up is essential for a comprehensive evaluation of these treatment outcomes.
Schlagwörter: Complete edentulouComputer-guided surgery, Immediate loading , Stackable guide, Full Arch rehabilitation, Autologous Bone graft.
DOI: 10.11607/jomi.10939, PubMed-ID: 3894116428. Juni 2024,Seiten: 1-19, Sprache: EnglischLiang, Liang / Zhao, Yaoyu / Ye, Zhitong / Gao, Zhan / Ma, Ziqi / Yan, Qi / Shi, BinObjective: To evaluate multiple risk factors of peri-implant bone loss. Materials and Methods: A case-control study was conducted on patients who had received dental implants treatment from January 2018 to December 2021. Implants with bone loss were included in the case group, and implants with no bone loss were included in the control group. Risk factors including history of periodontitis, abutment connection type, implant surface, diameter, location, three-dimensional position, opposing dentition, adjacent teeth, prosthetic type, retention type and custom abutment were evaluated. A multivariate logistic regression model was used to evaluate these risk factors, providing corresponding odds ratios (ORs) with 95% confidence intervals (CIs). Results: A total of 776 implants in 479 patients were included in the analysis. The number of implants in the case group and the control group were 84 and 692, respectively. Cement-retained prostheses (OR=2.439, 95%CI=1.241-4.795) and nonplatform switch design (OR=2.055, 95%CI=1.167-3.619) were identified as weak risk factors. Horizontal deviation (OR=4.177, 95%CI=2.265-7.703) was a moderate risk factor. Vertical deviation (OR=10.107, 95%CI=5.280-19.347) and implants located in the mandibular molar region (OR=10.427, 95%CI=1.176-92.461) were considered high risk factors. Conclusion: Implants in the molar region, cement retained, non-platform switch design, and poor three-dimensional implant positioning are identified as significant risk factors for peri-implant bone loss.
Schlagwörter: Peri-implant bone loss, dental implants, abutment design, logistic regression
DOI: 10.11607/jomi.10885, PubMed-ID: 3894117028. Juni 2024,Seiten: 1-23, Sprache: EnglischMalak, Ahmad Al / El Masri, Yasmina / El Masri, Jad / Issawi, Hassan Al / Salameh, Pascale / Aoun, GeorgesObjectives: Several anatomical and histological limitations can complicate implant placement, angulated implant positioning appeared to compensate these limitations. However several studies suggested a higher rate of marginal bone loss and implant failure regarding tilted implants in comparison with conventional implant. Therefore this umbrella review aims to summarize and analyze all the evidence available concerning marginal bone loss and implant failure between tilted and axial implants. Methods: An electronic literature search was conducted, without any language restrictions and only systematic reviews with meta-analysis or meta-analysis studies were included. The outcomes assessed in this review were implant failure and marginal bone loss in mm. Relative risks (RRs) and the differences of the mean (MD) were calculated with 95% confidence intervals (CIs) regarding implant failure and marginal bone loss respectively. Results: in total 8 studies were included, based on the short-term results, a non-significant mean difference (MD=0.00; 95% Cl; -0.01-0.02; p-value = 0.75) was recorded between tilted and axial implants supporting full-arch dentures, meanwhile a significant mean difference was recorded on a 3 years and long term follow-up reached (MD= 0.08 95% Cl = 0.05-0.11; p value<0.00001)) and (MD= 0.18; 95% Cl= 0.15-0.20; p value< 0.00001) respectively, and an insignificant difference was observed between tilted and axial implants regarding implant failure (RR=1.02; 95% Cl=0.85-1.23; p value= 0.81) Conclusion: this review based on high and moderated quality studies with low risk of bias demonstrated no significant outcome was observed between tilted implants supporting full-arch or fixed partial denture and axial implants regarding implant failure.
Schlagwörter: Tilted implant; Axial implant; Dental implant; Marginal bone loss; Implant failure
DOI: 10.11607/jomi.11037, PubMed-ID: 3894116328. Juni 2024,Seiten: 1-18, Sprache: EnglischCorbella, Stefano / Taschieri, SilvioPurpose. There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The purpose of the study was to explore the comparative efficacy of using two different drilling protocols using burs with different design for preparing implant sites, by evaluating radiographic and clinical outcomes. Materials and Methods. The present randomized controlled clinical trial with an allocation ratio of 1:1 was carried on in two private practice offices by two experienced surgeons and researchers. In the control group the surgeons followed the protocol with standard straight burs while in the test group they used step burs. In both groups the patients received the same type of implants and prosthesis. The primary outcome was the marginal bone resorption one year after the prosthetic placement. Results. In the study were included and treated a total of 60 subjects (86 implants). At the one-year follow-up were screened 54 subjects (74 implants), and 50 at the 2-year follow-up (69 implants). This study showed no evidence of a difference in bone resorption, which increased significantly over time, between the two groups. Conclusions. Both clinical parameters and patientcentered outcomes revealed no difference between the two protocols of implant site preparation with two different drill shape.
Schlagwörter: Dental implant, bone surgery, osteotomy, implant bur design, marginal bone resorption, success rate, quality of life.
DOI: 10.11607/jomi.11002, PubMed-ID: 3894117128. Juni 2024,Seiten: 1-15, Sprache: EnglischWadhwani, Chandur PK / Albrektsson, Tomas / Schoenbaum, Todd R. / Chung, Kwok-HungPurpose: To investigate residual debris within internal features of new “as received” dental implants. Materials and Methods: A total of 15 new dental implants representing various dental implant brands were obtained in sealed containers from the manufacturers. Batch numbers and implant types were documented. In a controlled setting, implants were carefully unpacked, and their internal aspects were visually examined. Further analysis involved light microscopy imaging to document and photograph any foreign material. The internal aspect of the implants were sampled with both an endodontic paper cone and a fine bristle brush swab. These were inserted into the implant, rotated three times, then removed and examined under a microscope at 30x magnification. Post sampling some of the brushes/swabs were washed with alcohol to remove debris that could be further examined under magnification. Results: Inspection of the implants without magnification revealed no visible foreign materials. However, under light microscopy (x10 and x30), all 15 implants exhibited small black particles at various internal sites, including connections, threads, and deep within screw channels. Swabs evaluated at magnification detected what appeared to be metal particles in all 15 implants, ranging from distinct metal shards to smaller particles. Conclusion: This study suggests that implant manufacturers have not effectively removed all machining debris from within implant bodies, potentially producing prosthetic and clinical complications.
DOI: 10.11607/jomi.10954, PubMed-ID: 3894116928. Juni 2024,Seiten: 1-17, Sprache: EnglischEdiboğlu, Engin / Akdeniz, Sıdıka Sinem / Beyler, EsraPurpose: The aim of this study is to examine the stresses on the peri-implant bone under occlusal forces of 30% Carbon fiber reinforced PEEK (Cfr-PEEK) and 60% Cfr-PEEK materials that can be used as an alternative to titanium dental implants by finite element analysis. Materials and Methods: Single-tooth implants of 30% Cfr-PEEK, 60% Cfr-PEEK and titanium were modeled in each of the maxillary anterior, maxilla posterior, mandibular posterior regions. As a result of the applied vertical and oblique forces; Von Misses stress, maximum principal stress and minimum principal stress values and stress distributions in the implant, cortical bone and spongious bone in each of the models were examined. Results: 30% Cfr-PEEK implants stress in the surrounding bone was higher than titanium and 60% Cfr-PEEK implants. The 60% Cfr-PEEK material displayed lower stress distribution on both cortical and spongious peri-implant bone in all models. Conclusion: Titanium and 60% Cfr- PEEK implants exhibited biomechanically similar behavior and these implants conducted stresses to bone more homogeneous than the 30% Cfr-PEEK implants. Overall, oblique forces had more destructive effect than vertical forces and denser bone structure showed better stress distribution against incoming forces. For the routine use of Cfr-PEEK material as dental implant material; animal and long-term clinical studies are needed.
Schlagwörter: Carbon fiber reinforced PEEK, Finite element analysis, Dental implant
DOI: 10.11607/jomi.10921, PubMed-ID: 3886946413. Juni 2024,Seiten: 1-21, Sprache: EnglischGelpi, Federico / Alberti, Christian / De Santis, Daniele / Bevilacqua, Marco / Mellone, Federica / Tealdo, TizianoPurpose: Severe anterior maxillary atrophy offers few implant-supported rehabilitation solutions to Quad Zygoma characterized by a wide anterior cantilever. One of the possible alternatives to consider before the quad zygoma is the extra-long nasal/trans-nasal implant placement. This retrospective multicentric study shows the predictability of nasal/transnasal implant placement in patients affected by severe anterior maxilla atrophy, with residual anatomical features that indicate this surgery. This specific remote anchorage can often be safely involved in immediate loading with other remote anchorages, such as zygoma and pterygoid implants. In this rehabilitation, it’s mandatory to reduce the instability of the frameworks and mechanical stress that could unfavorably affect the implant's prognosis due to the overloading derived from anterior bending. Materials and Methods: In this retrospective multicentric study, 52 nasal or trans-nasal implants were inserted in 31 atrophic anterior maxillas (Cawood and Howell's class V-VI). All implants were successful after the healing period; even if 27 nasal implants reached an insertional torque equal to or greater than 50 n/cm2, the threshold value estimated to be able to support an immediate load. Result: All 52 implants were successful, so the proportion of success was 100%, with a 97.5% one-sided confidence interval of 88.8-100%. The success rate is achieved only if at least two of the following criteria are met: 1) a greater torque than 50 Ncm as a minimum sufficient condition to plan immediate loading; 2) after a healing period of 16 weeks, the secondary stability is clinically and radiographically evaluated to exclude possible coronal bone resorption: this condition allows the successive prosthetic finalization; 3) the possibility of carrying out a full arch rehabilitation with minimal anterior spread. Insertion torque was <50 Newton centimeters (Ncm) in 14 patients (45%) and 50 Ncm in 17 (55%). Mechanical load was delayed in the former and immediate in the latter. The proportion of torque <50 Ncm was higher in men than in women (69% versus 28%, p=0.033). Immediate torque was not significantly affected by age. Conclusion: Although the sample is not extremely numerically significant, it conveys a clear and significant clinical, surgical indication as never before in the literature; we can state that nasal/trans nasal implants have been very useful in reducing the anterior cantilever and overcoming the anatomical limitations affecting conventional Quad Zygoma.
Schlagwörter: nasal implants, zygomatic implants, pterygoid implants, anterior cantilever prostheses, severe atrophy
DOI: 10.11607/jomi.11017, PubMed-ID: 3882008631. Mai 2024,Seiten: 1-31, Sprache: EnglischRajanna, Harshitha / Chaudhry, Kirti / Pandey, Akhilesh Kumar / Somvanshi, Shradha / Singh, Surjit / Kumar, Pravin / Chugh, AnkitaPurpose: The successful osseointegration around immediate implants requires high
quality and quantity of osteogenesis around them. The role of magnesium as a boneenhancing
mineral, and as an adjunctive analgesic has been well documented in
orthopedic literature. However, there is a paucity of literature in its role in successful
osseointegration around immediate implants. This randomized controlled trial sought to
assess the promising impact of magnesium on osseointegration by examining various
aspects of implant stability, correlating them with serum bone markers, and establishing
a foundation for future research on its potential as a potent analgesic. Materials and
Methods: Immediate implant placement was done after the extraction of the indicated
mandibular molar tooth, and all the patients were segregated into 2 groups (Placebo-
Lactose, and Magnesium citrate). Bone regenerate in the peri-implant area was assessed
radiographically immediate post-operatively, on the 6th week and 12 weeks. Implant
stability was measured immediate post-operatively, at the 4th week and 12th week.
Serum parameters were procured pre-operatively and post-operatively for serum
calcium, serum alkaline phosphatase (ALP), and serum parathyroid hormone at the 8th
week, and serum vitamin D3 levels preoperatively. Results: 54 immediate implants
placed showed the demographics and baseline serum, clinical, and radiographic
parameters were comparable in both groups. Analysis of Implant Stability Quotient at
12th week showed statistically significant difference in intervention group both on
intergroup and intragroup analysis. Radiodensity measurement showed a statistically
significant difference in both intragroup and intergroup analysis in the intervention
group at the 6th and 12th week. In bone gap analysis, the difference in mean change in
the horizontal bone gap (HG) at 6 weeks was non-significant while the difference in
HG at the 12th week was significant in the intervention group. On intragroup analysis,
mean change HG at 6 weeks and 12 weeks both were significant only in intervention
group. Intergroup analysis of vertical bone gap (VG) 12 and VG 12-0 (mean difference
in the vertical bone gap from 12th week-day 0) showed a statistically significant
difference in the intervention group. On intragroup analysis, VG 12 was significantly
better in the intervention group. On serum analysis, ALP post-operatively was found to
be significantly raised (P=0.013) in intervention group. Numerical rating Scale (NRS)
analysis showed a significant decrease in post-op day 5 and 7, (P=0.017) and (P=0.002)
respectively. Conclusion: The oral magnesium citrate supplementation after immediate
implant placement helps in enhancing the stability of the immediate implants, along
with improved radiodensity around them which was found to be statistically significant.
It also helps in reducing the horizontal, and vertical gap around the implant and has
significant analgesic potential.
Schlagwörter: Immediate implant; Magnesium citrate; Implant stability quotient; Analgesia; Osseointegration
DOI: 10.11607/10974, PubMed-ID: 3882008531. Mai 2024,Seiten: 1-22, Sprache: EnglischFrancescato, Olívia / Souza Rodrigues, Ismael Noan / Douglas de Oliveira, Dhelfeson Willya / Moreira, Allyson Nogueira / Magalhães, Cláudia Silami / Lages, Frederico SantosPurpose: Compare Neodent Zi® zirconia implants' insertion torque (IT) and removal torque (RT) with
Neodent Alvim® titanium. Measure the maximum torque supported by the zirconia implant until its
fracture (MT) and the maximum torque sustained by the assembler of this implant (MTA) until its
fracture. Material and Methods: In this in-vitro study twenty four implants were used. Two groups of
implants with the same macrogeometry and from the same manufacturer were compared, Zirconia
(n=12) and Titanium (n=12). Implant bed preparations were completed in bovine ribs following a
standardized drilling protocol. Then, the insertion torque (IT), removal torque (RT), maximum torque
to fracture (MT) and maximum torque to fracture of the assembler (MTA) were completed using a
calibrated torque meter. Data was presented using descriptive statistics including means, standard
deviations (SD), medians, and quartiles. The Shapiro-Wilk test was used to verify data normality and
the Wilcoxon test was used to evaluate differences between groups. Statistical significance was
established as p < 0.05. Results: Zirconia implants showed: IT 89.33 ± 31.18 Ncm and RT 84.89 ±
32.92 Ncm. Titanium implants showed: IT 77.58 ± 28.96 Ncm and RT 76.75 ± 31.29 Ncm without
significant differences (p>0.05). In relation to fracture under rotational force, the zirconia implants
fractured at 106.17 ± 22.54 Ncm, and the implant assembly fractured at 84.00 ±13.14 Ncm.
Conclusion: Neodent Zi® implants showed stability but lower fracture torque than Alvim® titanium.
As the fracture values of the assembler were significantly lower than the fracture values of the zirconia
implants, it can be stated that, as recommended by the manufacturer, they act as a safety measure
during installation.
Schlagwörter: Biomechanical phenomena, fracture strength, Y-TZP ceramic.
DOI: 10.11607/jomi.10943, PubMed-ID: 3878813724. Mai 2024,Seiten: 1-30, Sprache: EnglischManuela Lopes da Silva, Laura / Carvalho Correia, Francisco Diogo / Campos Felino, António / Da Silva Braga, Ana Cristina / Lobo de Faria e Almeida, Ricardo Manuel CasaleiroPurpose – Compare the morphometric results of immediate implants (Type 1C) with a
cylindrical (conventional) or triangular neck, in the anterior region of the maxilla,
during 6 months of osseointegration. Materials and Methods – Prospective randomized
clinical trial with a sample of 20 individuals randomly assigned to each group (10
triangular neck implants and 10 cylindrical neck implants). Consecutively direct
measurements were performed: before (T-1) and after tooth extraction (T0), after
implant placement (T1), after 1 month of the submerged implant healing (T2), when
placing the healing abutment (T3), after placing the definitive crown (T3), and after 6
months of osseointegration (T4). Results – A significant difference between T1 and T3
in the buccal cortical thickness was identified (0.49Å}0.86mm). Although there was a
significant increase in the buccal cortical thickness in both implants, this increase was
greater for the triangular neck implants (cylindrical shape: 0.08Å}0.59 vs. triangular neck
0.90Å}0.91mm). It was also observed that implants placed below the buccal bone crest
(í-1mm) promote less vertical buccal bone loss than implants placed Ñ-1mm at crest
level (-0.65Å}0.52mm vs. -1.42Å}0.86mm). This observation needs to be further
investigated in additional studies. Conclusions – The triangular neck implants present an
increase in the cortical buccal thickness compared to the cylindrical implants. However,
this increase does not fully compensate the remodulation after tooth loss.
Schlagwörter: dental implants, dental implant placement, single tooth, endosseous implant, esthetics, immediate dental implant placement.
DOI: 10.11607/jomi.10910, PubMed-ID: 3878813424. Mai 2024,Seiten: 1-33, Sprache: EnglischPilloni, Andrea / Marini, Lorenzo / Gagliano, Nicoletta / Dellavia, Claudia / Pellegrini, Gaia / Henin, Dolaji / Zeza, Blerina / Rojas, Mariana AndreaPurpose: To evaluate the response of human peri-implant soft tissue (PIST) on different healing
abutment materials 24 hours after positioning, by assessing the expression of genes related to the
early connective tissue wound healing response. Materials and Methods: Experimental abutments of
4 different materials (A): grade 4 titanium, (B) grade 5 titanium, (C) zirconia and (D) PEEK, were
mounted on installed implants in 5 patients, four different abutments each. Before implant
placement, a gingival biopsy (control-CT) was obtained using a 2 mm diameter punch (T0). After
24 hours (T24), PIST biopsies were collected using a specifically designed custom-made cutting
device. Real-time PCR was performed to analyze the expression of the following genes: COL-I,
COL-III, MMP-1, TIMP-1,TGF-b1, FN, ITGA4, ITGA5, ITGB1, RAC-1, COL-IV, aSMA, IL-6
and CXCL-1. Results: Gene expression analysis showed some differences between CT and
abutment of different materials, although no significant differences were detected comparing the
experimental groups. COL-I was significantly down-regulated in groups A and C compared to CT.
MMP-1 and TIMP-1 increased in all the experimental groups, although at a lower extent in group
A. FN, RAC-1, COL-IV and aSMA were down-regulated, especially in group A, in which CXCL-1
and IL-6 showed the lowest expression. Conclusions: The results of grade 4 titanium and zirconia
abutments seem to be promising, since a lower expression of genes related with inflammation,
myofibroblasts activation and ECM remodeling was observed when compared with grade 5
titanium and PEEK, without triggering a pro-fibrotic response in the early phases of PIST repair.
Schlagwörter: gene expression analysis, PEEK, peri-implant soft tissue, titanium, zirconia, wound healing
DOI: 10.11607/jomi.10506, PubMed-ID: 3878813524. Mai 2024,Seiten: 1-27, Sprache: EnglischOzbay, Deniz / Tunc, Samet / Uraz Çörekci, Ahu / Guler Ayyildiz, Berceste / Cula, SerpilPurpose: The study aimed to evaluate the clinical and radiographic results of simultaneous implant placements using transcrestal sinus floor elevation (TSFE) with and without enamel matrix derivative (EMD) application. Material and Methods: Twenty-four patients were randomly assigned into two groups: EMD+TSFE Group was defined as (n=13 patients, 20 implants) TSFE with EMD application, and TSFE Group was defined as (n=11 patients, 20 implants) TSFE without EMD application. The patients recalled at 3- (T3) and 12- (T12) months after surgery. The residual bone height (RBH), implant protrusion length (IPL), peri-implant sinus bone level (SBL), endo-sinus bone gain (ESBG), and implant stability (ISQ) were measured. Multivariable regressions were performed for the groups. Results: The ESBG was 3.72±0.85 mm in the EMD+TSFE group and, was 3.10±0.05 mm in the TSFE group at T3 and there were statistically significant differences. (p<0.05). However, there were no statistically significant differences in ESBG at T12 between the groups. (p>0.05) ISQ values did not show a statistical difference between the groups at T1 and T3, but in the TSFE+EMD group, it showed a statistical increase at T3 in the intra-group evaluation compared to the TSFE group. Conclusion: In this study, it can be mentioned that the use of EMD in TSFE operations is effective in new bone formation in the apical part of the implant during the early healing period, but in the long term, no significant difference was shown between cases in which EMD was used or not in terms of new bone formation and primary and secondary stabilization. The study was submitted at ClinicalTrials.com; the clinical trial number is ###.
Schlagwörter: maxillary sinus, regeneration, dental implant, resonance frequency analysis
DOI: 10.11607/jomi.10924, PubMed-ID: 3878813624. Mai 2024,Seiten: 1-33, Sprache: EnglischLiu, Han-Pang / Yien Chiam, Sieu / Wang, Hom-LayPurpose: The objective of this systematic review and meta-analysis was to examine the impact of
titanium base supported single implant restorations on peri-implant conditions. Materials and
Methods: Six randomized controlled trials (RCTs), comprising a total of 274 implants that met the
inclusion criteria, were chosen for data analysis. A random effects model was employed for the metaanalysis.
Results: Data from this study revealed that the Ti-base group exhibited a slightly but
statistically significant increase in peri-implant marginal bone loss (difference in means = 0.088, 95%
confidence interval = 0.003 to 0.17, p = 0.041) compared to the one-piece-abutment group. These
effects were consistent in the subgroup analysis of regular-threaded implants comparing to the microthreaded
subgroup. However, no significant differences were observed between the Ti-base group and
the abutment group concerning probing depth (PD), bleeding on probing (BOP), and the risk of
prosthetic-related complications. Conclusions: The utilization of Ti-base in single-implant supported
restoration is associated with a slight increase in peri-implant marginal bone loss, while other periimplant
health parameters show no significant correlation. Therefore, to determine the impact of Tibase
on peri-implant condition of single implant-supported restoration is insufficient based on the
findings of this meta-analysis.
DOI: 10.11607/jomi.10799, PubMed-ID: 3875838117. Mai 2024,Seiten: 1-17, Sprache: EnglischSchallenberger, Verônica / Maracci, Lucas Machado / Barbieri Ortigara, Gabriela / Serpa, Geraldo Fagundes / Salatino Liedke, GabrielaPurpose: This study assessed the accuracy of linear measurements and dental implant selection
performed in a smartphone application compared to a computer software. Materials and
methods: Forty-four DICOM files from partially edentulous patients in the posterior region of
the mandible were evaluated by three trained and calibrated examiners. Images were analyzed
using three visualization methods: cross-sectional view (CScr) and coronal (CSco) plane using
the CS 3D Imaging software, and coronal (DRco) plane using the DroidRender smartphone
application. For the purpose of standardization, measurements of bone width and height were
taken in the edentulous posterior region of the mandible, 10 mm posterior to the mental foramen.
Dental implant selection was made according to Straumann® Standard implant catalog
2022/2023. Linear measurements were compared using the ANOVA test for repeated
measurements and implant selection was compared using the Friedman test. Statistical analysis
was performed using the SPSS software, considering a significance level of 5%. Results: Linear
measurements showed a statistically significant difference for bone width (p = 0.030), but not for
height (p = 0.685). The choice of implant was not influenced by the visualization method (p =
0.614). Conclusion: It is possible to suggest the use of smartphone applications as an additional
diagnostic tool for DICOM evaluation and dental implant planning in the posterior region of the
mandible. Smartphone applications allow an assessment not limited to 2D images or to static
environments. Therefore, information exchange and diagnostic opinion in emergency situations
may be facilitated.
Schlagwörter: Dental Implants; Clinical Decision-Making; Cone-Beam Computed Tomography; Smartphone.
DOI: 10.11607/jomi.10882, PubMed-ID: 3875838217. Mai 2024,Seiten: 1-15, Sprache: EnglischSezer, Taygun / Yılmaz, Erkan / Esim, EmirPurpose: The purpose of this study was to analyze the effect of scanning modes on the accuracy
of the Trios for full-arch digital implant impressions. Materials and Methods: The trueness and
precision of the intraoral scanning mode (IOSM) and the intraoral edentulous scanning mode
(IOEM) of the Trios were evaluated in three edentulous models, each featuring 4, 6, and 8
implant analogues. Reference scanning data were obtained by scanning each model with a
desktop scanner. Each model was scanned 10 times using the IOSM and IOEM modes of the
Trios to establish the test groups. The scan bodies in the test and reference scans were isolated
and exported in the reverse engineering program. The scan bodies in each group were
superimposed with the corresponding reference scan (trueness) or with each other (precision).
The overall 3D deviation between the aligned scan bodies was computed by the root-meansquare
(RMS) values. Results: As a result of the trueness and precision evaluation, no significant
difference was found between scanning modes in any of the models. When comparing models,
the 8-implant model showed significantly lower trueness than the 4-implant model. However, it
also exhibited significantly higher precision when compared to both the 4-implant and 6-implant
models. There were no significant differences in other pairwise comparisons between the
models. Conclusion: Trueness and precision values were similar between the IOSM and IOEM
groups across all the models. An increase in the number of implants in complete edentulous
arches may have a negative impact on digital impression accuracy.
Schlagwörter: Scanning mode, digital implant impression, intraoral scanner, full-arch
DOI: 10.11607/jomi.10895, PubMed-ID: 3875838017. Mai 2024,Sprache: EnglischTalwar, Aditya / Bhat, Shweta R. / Duggal, Isha / Kontham, RakeshObjective: The present study aimed to compare and quantify the surface changes seen in two
most commonly used orthodontic miniscrew implants (MSI) materials; titanium and stainless
steel after their clinical use. Methods: 40 MSIs (20 titanium and 20 stainless steel) were retrieved
from the maxillary arch of 20 subjects (13 females and 7 males) in the age group of 18 – 27 years
(mean age=22.4 ± 3.83 years) after their intended use. 40 (20 titanium and 20 stainless steel) asreceived
MSIs were used as control. All the MSIs were analyzed under a Scanning Electron
Microscope (SEM) for the characterization of their morphological condition (blunting of tip,
surface defects and corrosion). Furthermore, Energy Dispersive X-ray (EDX) microanalysis was
carried out to study the changes in surface characterization. Results: When imaged using SEM, as-received
Titanium and Stainless Steel MSIs demonstrated a relatively smooth surface with no surface defects. However,
the retrieved titanium and stainless-steel implants showed increased surface defects (both corrosion and
cracks) with the difference being statistically significant. The retrieved Titanium MSIs (115.31±24.38μm)
showed 4 times more blunting compared to the retrieved Stainless-steel MSIs (29.74±8.56 μm), with the latter
showing 2-3 times more surface corrosion. Conclusion: Clinical usage had pronounced effects on both
Titanium and Stainless steel MSI alloys in terms of changes in the surface characteristics. While stainless steel
MSIs are more susceptible to surface corrosion, Titanium MSIs exhibit greater alterations in the form of
tipblunting and cracks in screw threads.
DOI: 10.11607/jomi.10890, PubMed-ID: 3872804710. Mai 2024,Seiten: 1-23, Sprache: EnglischAlsabeeha, Nabeel H.M. / Amir-Rad, Fatemeh / Ma, Sunyoung / Shah, Maanas / Hannawi, Haifa / Tawse-Smith, Andrew / Duncan, Warwick J. / Baqain, Zaid H. / Atieh, Momen A.The replacement of missing teeth with implant-supported prostheses has become a standard
treatment option with reliable long-term outcomes in various clinical indications.1–6 The
implant-supported single crowns, in particular, presented the most favorable outcome with a
survival rate of 89.5% to 96% over a 10-year period.5,6 A notable prosthetic maintenance
requirement, however, was reported irrespective of the prosthetic material used for the crown
construction.1,7 Metal-ceramic restorations have been considered the gold standard when replacing single
or multiple missing teeth with implant-supported fixed dental prostheses.8 A systematic
review of 4363 metal-ceramic implant-supported single crowns in the anterior and posterior
region reported an impressive survival rate of 98.3% over five years.9 Yet, the biologic and
prosthetic complications associated with these restorations were substantial with a rate of
13.5%. In the posterior region, a recent systematic review of short-term randomized
controlled trials10 reported a survival rate of 99.1% for metal-ceramic implant-supported
single crowns. The reported prosthetic complications, mainly ceramic chipping, were also
notable with an incidence rate of 7.6%.mIn recent years, the introduction of high-strength all-ceramic materials
as well as digitaldesign and manufacturing processes, has allowed faster fabrication of more esthetic and
cost effective restorations.11 Zirconia-based fixed dental prostheses on teeth and implants are now
increasingly used and show 5-year cumulative survival rates of 89.4 to 100%.12 These
restorations are typically made up of a zirconia framework that is veneered with a layer of
glass ceramic to impart translucency for enhanced esthetics.13 However, chipping of the
ceramic layer has been a lingering issue, shifting the attention toward the use of full anatomic
monolithic zirconia restorations.14,15 Replacement of missing teeth with dental implants in posterior ridges with
limited bone width can be surgically challenging and the notion of narrow diameter implants has been
suggested.16,17 These implants were thought to offer potential advantages in terms of costeffectiveness
and surgical morbidity.18,19 The literature, however, remains controversial on
treatment outcomes with narrow diameter implants, particularly in posterior sites.19–21
When single tooth replacement with monolithic zirconia implant-supported single
crowns in posterior sites are considered, only short to medium-term outcomes are
available.22–26 The survival rates and clinical performances reported in these studies were
variable. Crown survival rates between 84% and 100% were demonstrated over an
observation time of one to three years, while the prosthetic complications were between 0%
to 14%. In three studies,22,23,25 standard diameter titanium implants were used in premolar and
molar sites to support the single crowns. The remaining two studies by Mühlemann et al.
(2020) and Zumstein et al. (2023) reported the one-year and three-year outcomes,
respectively, of the same cohort. In these studies, narrow titanium-zirconium (TiZr) implants
of 3.3 mm diameter were exclusively utilized in molar sites. The implant and crown survival
rates reported at one and three years were 97.4% and 84%, respectively. The lower survival
rate observed in the report of Zumstein et al. (2023) resulted from fracture of five implants
and the subsequent loss of their respective crowns. Aside from these two reports, no other
information on the outcomes of monolithic zirconia single crowns supported by narrow
diameter TiZr implants in posterior sites are available.
The validity of this treatment, therefore, needs further investigation with well-designed
clinical trials. Hence, a randomized controlled trial was undertaken to assess various implant,
prosthetic, and patient-reported outcomes of monolithic zirconia single crowns supported by
either narrow or standard diameter titanium-zirconium (TiZr) implants in posterior sites. The
present report focuses on the one-year prosthetic results.
DOI: 10.11607/jomi.10947, PubMed-ID: 3872814710. Mai 2024,Seiten: 1-25, Sprache: EnglischAltieri, Federica / Cassetta, MicheleReducing crestal bone loss (CBL) around implants allows for soft tissue stability and long-term
success. The aim of the present study was to evaluate the extent of CBL in implants placed with
the implant shoulder at the equi-crestal level and 2 mm below the alveolar ridge at 2, 12, 36, and
60 months. A split-mouth randomized controlled clinical trial was conducted by selecting
subjects with Kennedy Class IV partial edentulism of the lower jaw. Two implants were inserted,
of equal length and diameter, one equi-crestal and the other sub-crestal, in the site corresponding
to the lateral incisor. Intraoral periapical radiographs with Rinn centering devices were
performed at the time of implant insertion (T0), at 2 (T1), 12 (T2), 36 (T3), and 60 months (T4).
Descriptive statistics and the T-test were used, setting the significance to P⩽ 0.05. Twenty-five
subjects were recruited, with a mean age of 65 years (SD 9.88, range 42-82). No subject dropped
out. A total of 50 implants were inserted, 25 at crestal and 25 sub-crest level. At the 60-month
follow-up, no implant or prosthetic failure was recorded. An average loss of -0.81 mm was
recorded in the crestal implant group (n.25; SD: 0.40; max-min: -1.6 – -0.1) while in the implants
positioned below the crest the average CBL was -0.87mm (n.25; SD: 0.41; max-min: -2 – -0.2);
however, the higher CBL in the sub-crestal implant group was not statistically significant
(P=0.65). Comparing the mean CBL values of the two groups at the various follow-ups, a greater
crestal bone resorption was recorded in sub-crest implants between T0 and T1 (-0.25 vs -0.1) and
between T1 and T2 (-0.39 vs -0.23), while in subsequent follow-ups a greater, statistically
significant (P=0.01), crestal bone loss was recorded in ridge implants between T3 and T4 (-0.05
vs -0.18). Over time, therefore, the extent of CBL seems to be reduced in implants placed below
the crest, with bone retention above the implant shoulder. Ultimately, although the position of
the implant shoulder relative to the crestal ridge doesn’t affect the CBL, sub-crestal placement is
recommended in order to reduce the risk of exposure of the rough surface of the implant.
Schlagwörter: crestal bone loss, dental implant-abutment design, microthreads, Morse-taper connection, dental radiography, dental implant platform switching, sub-bone level.
DOI: 10.11607/jomi.10965, PubMed-ID: 3872814610. Mai 2024,Seiten: 1-25, Sprache: EnglischBerberi, Antoine N.Purpose: To evaluate, within a period of 5 years, the bone level in mesial, distal, palatal, and
buccal areas around scalloped shape implants immediately placed and loaded with temporary
crowns fixed on final prefabricated abutments, and also to evaluate the thickness of buccal
bone. Materials and Methods: 18 implants were inserted and loaded immediately using
computer-assisted design/computer-assisted manufacturing technology on 18 patients to replace
single tooth in the esthetic part of the maxilla. The marginal bone level across the scalloped
implant neck was measured mesially and distally using intraoral standardized radiographs after
crown fixations and 1, 3, and 5 years later. Cone beam computed tomography para-axial cuts
images were used to measure bone level buccally and palatally from the implant neck to the
implant-to bone contact after 5 years of loading and to evaluate the thickness of the buccal bone
at the implant neck and 4 mm apically, immediately after implant placement and 5 years later.
Results: All implants were assessed clinically and radiologically after 5 years. No implant
failure was recorded, and the average marginal bone variation on mesial and distal sites was
0.114 ± 0.135 mm at crown cementation, 0.239 ± 0.158 mm 1 year later, 0.233 ± 0.182 mm 3
years later, and 0.180 ± 0.182 mm 5 years later. Our findings indicate that at T0, the average
thickness of the buccal bone was 2.27 mm at implant neck M0 (ranging from 1.9 to 2.4) and
2.33 mm at 4 mm apically to the implant neck M1 (ranging from 1.9 mm to 2.9 mm). By T4,
the mean had decreased to 1.94 mm at M0 (with a range of 1.7 mm to 2.3 mm) and 2.14 mm at
M1 (with a range of 1.8 mm to 2.4 mm). After 5 years the mean changes at buccal and palatal
bone for all implants were +0.187 ± 0.52 mm and +0.06 ± 0.38 mm respectively.
Minor prosthetic problems were observed over the five years: incisal ceramic chipping
occurred in two crowns, and two crowns were replaced for esthetic reasons after one year. No
loosening of crowns or abutments was reported. Conclusions: Scalloped neck implants
demonstrated a comparable behavior to regular neck implants with similar designs in an
immediate implantation and temporization protocol over a five-year period.
Schlagwörter: immediate implantation, immediate loading, maxilla, scalloped neck, marginal bone level, buccal bone thickness, CAD/CAM.
DOI: 10.11607/jomi.10877, PubMed-ID: 3872814510. Mai 2024,Seiten: 1-28, Sprache: EnglischChi, Chih-Ching / Shen, Yen-Wen Shen / Hsu, Jui-Ting / Fuh, Lih-Jyh / Huang, Heng-LiPurpose: Finite element analysis and an in vitro experiment were employed to investigate the
loading effects of angled abutments, comparing various customized angled abutments derived
from the average angle of incisors in patients with a commercial 15°∆ angled abutment, on both
the implant and surrounding bone. Methods: Four customized angled abutment models (21.9°∆,
24.15°∆, 20.22°∆, 33°∆) were developed using cone-beam computed tomography (CBCT) images of
incisor inclination from various age groups of patients. 3D maxillary bone models were created
from CBCT images of four individual patients. Finite element analysis and in-vitro strain gauge
experiments were conducted, applying 100N or 50N of axial or oblique force, to assess the
differences in stress/strain between the customized and the commercial 15°∆ angled abutments in
both the implants and surrounding bone. Results: Under axial loading, the stress values in the
dental implant and surrounding bone were elevated due to the relatively higher angles of the
customized angled abutments (21.9°∆, 24.15°∆, 20.22°∆, 33°∆) when compared to the commercial 15°∆
angled abutment; however, under oblique loading the commercial 15°∆angled abutment exhibited
higher stress values in both the implant and surrounding bone. For in vitro experiment, there is
no statically difference in bone strain between the customized (21.9°∆) and the commercial 15°∆
angled abutments in axial loading. Nevertheless, in oblique loading using a commercial 15°∆
angled abutment induced the higher bone strains. Conclusion: Customized angled abutments
offer lower stress/strain under oblique loads but higher stress/strain under axial loads compared
to commercial ones. Therefore, in the design and application of angled abutments, careful
consideration of the occlusal load direction is paramount for achieving biomechanical success of
dental implant.
Schlagwörter: maxillary incisor region; immediate implant placement; customized angled abutments; finite element analysis; in-vitro strain gauge experiment.
DOI: 10.11607/jomi.10777, PubMed-ID: 3872814410. Mai 2024,Seiten: 1-16, Sprache: EnglischÇoban, Elif / Altay, BerkanIntroduction: Patients may have high expectations regarding dental implants based on the source
of their information, which can lead to challenges in clinical communication. This study aims to
evaluate the quality of responses provided by Chat Generative Pre-trained Transformer
(ChatGPT, OpenAI, USA), an artificial intelligence program, to patient questions in the field of
dental implantology. Materials and Methods: This study was prospectively designed as a crosssectional
study. Frequently asked questions by patients about general information on dental
implantology (Part 1) and dental implant brands (Part 2) were posed to the ChatGPT program.
Responses were independently assessed by oral and maxillofacial surgeons (Group 1: n=10),
periodontologists (Group 2: n=10), prosthodontists (Group 3: n=10), and general dentists (Group
4: n=10) using the Global Quality Scale (GSQ). Results: There were a total of 60 questions, with
30 questions in each part. Participants in the study were evenly distributed by gender (50%
female, 50% male) with a mean age of 32.6±4.07 years. The mean years of experience were
8.2±3.12 years. There were no significant differences in mean age, gender, and years of
experience among the groups (p>0.05). The overall mean GSQ score was 3.87±0.29. Part 1 had a
mean score of 3.9±0.35, and Part 2 had a mean score of 3.85±0.29, with no statistically
significant difference (p>0.05). Conclusion: The artificial intelligence platform may contribute to
the additional education of patients in the field of dental implantology and aid in understanding
treatment procedures. However, it is concerning that ChatGPT may exhibit bias regarding dental
implant brands, which could impact patient guidance.
DOI: 10.11607/jomi.10703, PubMed-ID: 3872814310. Mai 2024,Seiten: 1-20, Sprache: EnglischHaim, Tal / Omer, Cohen / Fatma, Rayyan / Pokhojaev, Ariel / Sarig, Rachel / Perry, Raz / Beitlitum, IlanNatural Coral Particles (NCPs) are a suitable scaffold material for Guided Bone Regeneration
(GBR) procedures; it combines the placement of a bone substitute supporting a barrier
membrane. Due to increasing sea pollution and the declarations of endangered coral species
(KYOTO 1997), they are no longer suitable for the medical industry. Novel domestic corals have
been grown under controlled conditions to produce cultivated coral graft (CCG) material. This
study aimed to evaluate a new CCG in an in vivo experimental GBR procedure. The calvarias of
8 rabbits were surgically exposed, and circular defects 8 mm in diameter were prepared. One
defect was filled with CCG particles (experimental group); the contralateral defect (control
group) was spontaneously filled by blood clot. The defects were covered with a collagen
membrane. Animals were euthanized after 8 weeks. Histological observations of the defects
showed similar bone growth patterns in both experimental and control osteotomies. In the
experimental defects, no traces of coral particles were observed. Histometric analysis showed
denser bone in the pristine zone (65-66%) than in the peripheral zone for both the control (50%)
and experimental defects (31%) (P= NS). The new bone percentage was reduced from the
peripheral zone toward the middle and the center of the defect (31%, 32% and 27%,
respectively) as the distance from the peripheral pristine bone borders increased. The existing
data support the complete degradation of CCG as space-maintaining scaffold for GBR
procedures.
Schlagwörter: coral, graft, animal study, GBR, bone, rabbit.
DOI: 10.11607/jomi.10912, PubMed-ID: 3872814810. Mai 2024,Seiten: 1-27, Sprache: EnglischKim, Ji Hye / Goh, Mi-Seon / Song, Ju-Hyup / Chang, MoontaekPurpose: This study aimed to assess the alteration in keratinized mucosa (KM) dimensions in
the early healing period after implant placement, and the influence of variables obtained during
implant surgery on KM alteration. Materials and Methods: Study participants were consecutively
recruited from patients who had received implants following a non-submerged surgical protocol.
The implant had to be installed in the extraction socket that had healed for more than 6 months
without any soft or hard tissue augmentation. Keratinized mucosa width (KMW), keratinized
mucosa thickness (KMT), soft tissue level (STL), and probing pocket depth (PPD) were
measured at implant placement and 3 and 6 months after implant surgery. The influence of
variables obtained during implant surgery on the 6-month KMW alteration was assessed. Results:
A total of 66 implants in 55 patients who completed the follow-up examination after 6 months
were included in this study. KMW, KMT, and STL significantly decreased at 3- and 6-months
examination by 0.7–1.2 mm. KMW was reduced by 24.6%. Mesial PPD significantly increased
between the 3- and 6-months follow-up. In the multivariate generalized estimating estimations
analysis, the implant diameter negatively influenced the 6-month KMW alteration, but the KMW
at implant surgery positively influenced the 6-month KMW alteration. Conclusions: The KMW
decreased significantly at 3 and 6 months after implant placement. If the initial KMW was wider,
the KMW was reduced more at 6 months after implant placement. Therefore, it is important to
carefully monitor KMW alterations during the early healing period to ensure optimal esthetics
and peri-implant tissue health.
Schlagwörter: mucous membrane, dental implants, wound healing, humans, prospective studies
DOI: 10.11607/jomi.10606, PubMed-ID: 387173483. Mai 2024,Seiten: 1-23, Sprache: EnglischXu, Weiwei / Chen, Yen-Wei / Nagatomo, Kanako / Liu, Yifeng / Zhou, Jihai / Shen, I.Y.Purpose: This experimental study investigated how well implant stability quotient (ISQ)
represents resonance frequency. Benchtop experiments on standardized samples, mimicking a
premolar section of a mandible, were conducted to correlate an ISQ value and a resonance
frequency to synthetic bone density and an incremental insertion torque. A frequency spectrum
analysis was performed to check the validity of the resonance frequency analysis (RFA).
Materials and Methods: Branemark Mk III implants with dimensions ∅4 Å~ 11.5 mm were placed
in Sawbones test models of five different densities (40, 30, 40/20, 20, 15 PCF). An incremental
insertion torque was recorded during implant placement. To perform stability measurements, the
test models were clamped partially in a vise (unclamped volume 10 Å~ 20 Å~ 34 mm). A
MultiPeg was attached onto the implants, and a Penguin RFA measured ISQ. Simultaneously,
motion of the MultiPeg was monitored via a laser Doppler vibrometer and processed by a
spectrum analyzer to obtain the resonance frequency. Tightness of the clamp was adjusted to
vary the resonance frequency. A statistical analysis produced a linear correlation coefficient 𝑅
among the measured ISQ, resonance frequency, and incremental insertion torque.
Results: The resonance frequency had high correlation to the incremental insertion torque (𝑅 =
0.978), confirming the validity of using RFA for this study. Measured ISQ data were scattered
and had low correlation to the resonance frequency (𝑅 = 0.214) as well as the incremental
insertion torque (𝑅 = −0.386). The spectrum analysis revealed simultaneous presence of
multiple resonance frequencies. Conclusions: For the designed benchtop tests, resonance
frequency does indicate implant stability in view of Sawbones density and incremental insertion
torque. ISQ measurements, however, do not correlate well to the resonance frequency, and may
not reflect the stability when multiple resonance frequencies are present simultaneously.
Schlagwörter: dental implants, stability, Implant Stability Quotient (ISQ), resonance frequency analysis.
DOI: 10.11607/jomi.10898, PubMed-ID: 387173493. Mai 2024,Seiten: 1-16, Sprache: EnglischSchmitz, Johannes H. / Valenti, Marco / Valenti, Alessandro / Cortellini, Davide / Canale, AngeloStatement of Problem: Data on the clinical performance of monolithic Zirconia screw-retained
crowns on external hexagon implants fabricated from digital scans through a cast-free, fully
digital workflow is lacking and needs to be included. Purpose: This retrospective multicentric
study aimed to evaluate the real-life clinical results of monolithic Zirconia screw-retained crowns
without the interposition of a Ti-base on external hexagon implants fabricated from intraoral
scans and a cast-free approach in private practices. Materials and Methods: Single external hex
implant fixtures were restored with monolithic zirconia crowns without the interposition of a Tibase.
The crowns were directly screwed on external hexagonal implant connections with a castfree,
fully digital workflow. Data were analyzed using descriptive statistics and the Kaplan–
Meier test. Between September 2022 and March 2023, the California Dental Association
modified criteria were adopted for clinical evaluation after recalling all patients. Results: A total
of 304 single tooth restorations in the maxillary and mandibular posterior regions fabricated
between July 2014 and July 2022 in 252 patients (120 males and 132 females, mean age 53.6
years, SD 23.3). Seven crowns were excluded because of patient dropout. The most common
minor technical complications were screw loosening (3 crowns) and loss of the screw-access
hole filling (3 crowns). Four failures included two implant failures with mobility and two
fractured crowns. No screw or implant fractures were recorded. The overall cumulative survival
rate was 98.6% and the average success rate (crowns experiencing no failures or complications)
was 96.0%. The mean overall survival time was 101.3 months (standard error, 0.847; 95%
confidence interval for the mean, 99.67-102.99). The overall survival probability was 87.9% up
to 97 months. Conclusions: With careful case selection and comprehensive periodontal
maintenance program, single crowns directly screwed onto an external hexagon platform have
shown to have excellent survival and success (complication-free) rates, comparable to available
data regarding single crowns with a metal implant- prosthetic interface.
DOI: 10.11607/jomi.10843, PubMed-ID: 387173503. Mai 2024,Seiten: 1-29, Sprache: EnglischParpaiola, Andrea / Toia, Marco / Norton, Michael / Bacci, Christian / Todaro, Claudia / Rodriguez y Baena, Ruggero / Lupi, Saturnino MarcoBackground: The use of ceramic-coated patient-specific CAD/CAM titanium abutments
represents a therapeutic option for the rehabilitation of single tooth. The utilization of highly
customized abutments enables the accurate three-dimensional positioning of the prosthetic
emergence. This study evaluates the clinical performance of implant-prosthetic rehabilitations
carried out using ceramic-coated CAD/CAM titanium abutments. Materials and methods: Thirty
implants were placed in thirty patients and rehabilitated with thirty single crowns attached to
CAD/CAM titanium abutments. A conventional procedure was applied, with implant placement
after post-extraction socket healing and prosthetic restoration after implant healing. Implants of
lengths ranging from 6-15 mm and widths of 3.6, 4.2, and 4.8 mm were used in this study. At the
time of prosthesis delivery (T0), after two years (T1), and after five years (T2), plaque (PI) and
bleeding (BoP) indices, probing depths (PPD), marginal bone levels (MBL), and PES/WES were
evaluated for each implant. Results: No patient dropped out of the study during the follow-up
period. All thirty implants were clinically successful at five years post-prosthesis delivery
(survival rate: 100%) and showed no signs of peri-implant infection. Peri-implant soft tissues
were in good health (BoP at T2: 0% in 73% of patients; 25% in 13% of patients; 50% in 10% of
patients; and 75% in 3% of patients). The mean PPD was 2.05±0.56 mm at T0, 1.992±0.6 mm at
T1, and 1.867±0.439 mm at T2. The mean MBL at T0 was 0.413±0.440 mm, at T1 was
0.306±0.388 mm, and at T2 was 0.263±0.368 mm. The mean PES, WES, and PES/WES indices,
7.43±1.04, 7.57±0.82, and 15.00±1.17, respectively, indicate good integration of soft tissues,
satisfactory aesthetics, and an overall positive outcome. Conclusions: The success rates,
maintenance of marginal bone levels, and periodontal and aesthetic indices suggest the validity
of implant-prosthetic rehabilitations with CAD/CAM abutments in cases of single crowns.
Schlagwörter: Implant-prosthetic rehabilitation; CAD/CAM abutments; Single crowns; Clinical performance; Peri-implant soft tissues
DOI: 10.11607/jomi.10601, PubMed-ID: 387173513. Mai 2024,Seiten: 1-24, Sprache: EnglischÖztürk, Mevlude Elif / Özkan, YaşarPurpose: Following tooth extraction, the healing process comprises bone resorption and soft
tissue contraction, which have the potential to obstruct the optimal placement of implants,
causing both functional and aesthetic limitations. This study is aimed at assessing the healing
process of the extraction socket and the dimensional changes that occur after alveolar ridge
preservation, utilizing a polylactide-co-glycolide scaffold (PLGA). Materials and method: The
present study involved the extraction of 28 teeth from 14 patients. The total number of sockets
was 28, which were divided into two groups consisting of 14 study and 14 control sockets. The
study group (SG) was subjected to socket preservation with PLGA scaffold while the control
group (CG) was left for spontaneous healing. Measurements were taken before and after the
operation, with cone beam computed tomographies (CBCT) being conducted at both the baseline
and 4-month intervals. Samples for histological examination were obtained via trephine core
biopsy and the implants were subsequently placed. Results: According to the histologic analyses,
the PLGA scaffold was resorbed within four months. CBCT imaging revealed a decrease in the
horizontal dimension of the crest at three distinct coronoapical levels in the SG, measuring
2.05±1.05 mm at -1 mm, 1.51±0.89 mm at -3 mm, and 0.92±0.7 mm at -5 mm level. The CG
showed readings of 1.22±1 at -1 mm, 0.92±0.67 at -3 mm, and 0.73±0.69 at -5 mm levels. In
comparison to CG, SG showed a significant reduction in horizontal losses at the -1 mm level.
Vertical dimension of the crest decreased by 1.64±1.11 mm on the buccal bone height, 1.56±1.08
mm on lingual bone height in SG; in the CG, the buccal and lingual bone height had mean values
of 2.08±1.44 mm and 1.73±1.27 mm, respectively. There was no significant statistical difference
observed in the vertical losses between the groups. Conclusions: Following a period of 4 months,
it can be concluded that the PLGA scaffold was completely resorbed. Based on CBCT
measurements, it was observed that horizontal resorption was lower than CG at the -1 mm
coronal level.
Schlagwörter: alveolar bone resorption, socket preservation, polylactide-co-glicolide acid, cone beam computer tomography
DOI: 10.11607/jomi.10789, PubMed-ID: 387173553. Mai 2024,Seiten: 1-23, Sprache: EnglischFelicita, A. Sumathi / Maheshwari, T.N. UmaObjective: To determine the change in the sagittal and vertical position of the mini-implant
placed in the maxilla during distal movement of the entire maxillary dentition. Materials and
Methods: Twenty eight mini-implants, fourteen on each side were evaluated in young healthy
patients in the age group of 15 years to 25 years. Distal movement of the entire maxillary arch
was performed with 1.2 mm x 8 mm stainless steel mini-implants on 0.018” x 0.025” stainless
steel wire. CBCT were taken at the start of (T1) and at the end of six months (T2) of distal
movement of the maxillary teeth. The vertical and sagittal angulation of the mini-implant was
measured at T1 and T2. The linear distance between the mini-implant and the alveolar crest, the
maxillary sinus, the maxillary second premolar and the maxillary first permanent molar were
measured. The change in angulation and the linear displacement of the mini-implant were
evaluated in the vertical and sagittal plane. Wilcoxon signed rank test was performed to
determine if there was a statistically significant change in the position of the mini-implant.
Results: Vertically, there was a significant change in the linear distance between the miniimplant
and the alveolar crest on the right side (p≤.006) and the mini-implant and the maxillary
sinus on the left side (p≤.003). Sagittally, there was a statistically significant rotation of the miniimplant
occlusally (left side p≤.004 and right side p≤.002). The head and tip of the mini-implant
were displaced towards the maxillary second premolar and away from the maxillary first
permanent molar respectively. There was a significant relative displacement of the mini-implant
anteriorly away from the maxillary first permanent molar (left side p≤.026 and right side
p≤.041)and closer to the maxillary second premolar (left side: p≤..011 and right side: p≤.002).
Conclusions: There was a statistically and clinically significant rotation of the mini-implant in
the vertical and sagittal direction during distal movement of the entire maxillary teeth. The
linear displacement of the mini-implant was more pronounced in the sagittal direction compared
to the vertical direction.
Schlagwörter: Keywords: mini-implant; distal movement; vertical, sagittal; displacement, cohort study
DOI: 10.11607/jomi.10907, PubMed-ID: 387173543. Mai 2024,Seiten: 1-29, Sprache: EnglischAng, Kai Yuit / Quek, Christopher / Kong Fei, Frank Lee / Seetoh, Yoong Liang / Tan, Li Wen / Choon Tan, Keson BengPurpose: One-size implant-abutment (OSIA) connection systems have been developed for
simplicity of clinical use and for a range of implant diameters. The aim of this in vitro study was
to investigate the rotational load fatigue performance of different implant diameters and
abutment platforms of an OSIA connection system. Methodology: Narrow, regular and wide
diameter implants were tested with Regular Base (RB/WB) abutments of an OSIA system
(Straumann. BLX). Wide diameter implants were also tested with Wide Base (WB) abutments.
This resulted in 4 test groups (n=5): N-RB/WB (Narrow, 3.5mm, RB/WB abutment), R-RB/WB
(Regular, 4.0mm, RB/WB abutment), W-RB/WB (Wide, 5.0mm, RB/WB abutment) and W-WB
(Wide, 5.0mm, WB abutment). A rotational load fatigue machine applied a sinusoidally varying
stress at an angle of 45o, producing an effective bending moment of 35Ncm at a frequency of 10
Hz in air at 20 oC. The number of cycles to failure was recorded. Results were evaluated using
ANOVA. Failed specimens were examined with SEM to evaluate the failure mode. Pristine
specimens were sectioned to examine the implant-abutment connection. Results: All specimens
in the 3 test groups with RB/WB abutments failed within the range of 558,750 cycles to
4,497,619 cycles, while the W-WB test group reached the upper limit of 5 million cycles without
failure. Significant difference was found between abutment platforms (P < .001). There were no
significant differences found for implant diameters (P =.857). However, with increasing implant
diameter, implant fracture was less common and the location of failure was more coronal and
consistently at the level of the implant platform for the abutment, and at the screw neck.
Conclusions: For wide diameter implants, WB abutments exhibited a superior fatigue
performance than RB/WB abutments, and would be preferred in situations of high mechanical
risk. Increasing implant diameter, when used with RB/WB abutments, did not improve fatigue
performance due to the one-size prosthetic connection, but failures were less catastrophic, and
coronally located, which may be advantageous in managing failures.
Schlagwörter: Keywords: Failure Analysis, Load Fatigue, Implant-abutment Connection, Implant Fracture
DOI: 10.11607/jomi.10957, PubMed-ID: 3865713324. Apr. 2024,Seiten: 1-32, Sprache: EnglischKomatsu, Keiji / Matsuura, Takanori / Ogawa, TakahiroPurpose: The formation of a biological seal between implant abutments and the surrounding soft tissue is a preventive strategy against peri-implantitis. The aim of this study is to test the hypothesis that surfaces of prosthetic implant abutments treated with vacuum ultraviolet (VUV) light enhance the growth and function of human gingival fibroblasts. Materials and methods: Implant abutments were treated with 172 nm VUV light for one minute. Untreated abutments were subjected as controls. Their surface properties were characterized using SEM, contact angle measurements, and chemical composition analysis. Human gingival fibroblasts were cultured on both untreated and VUV-treated abutments to evaluate cell attachment, proliferation, distribution, and collagen production. Cell detachment assays were also performed under various mechanical and chemical stimuli. Results: After VUV treatment, implant abutments demonstrated a notable transition from hydrophobic to hydrophilic wettability. Surface element analysis revealed a considerable reduction in surface carbon and increases in oxygen and titanium elements on the VUV-treated surfaces. On day 1 of culture, 3.9 times more fibroblasts attached on VUV-treated abutments than on untreated control abutments. Fibroblastic proliferation increased 1.9-3.1 times on VUV-treated abutments, along with a significant improvement in the distribution of populating cells. Collagen production on VUV-treated abutments increased by 1.5-1.7 times. While untreated abutment surfaces showed voids and limited spread of collagen deposition, dense and full coverage of collagen was observed on VUV-treated abutments, with a great contrast in the challenging axial surface zone. Cell retention against mechanical and chemical detaching stimuli was increased 11.3 and 4.3 times, respectively, by VUV treatment. Conclusion: Treatment of implant abutments with VUV light for one minute resulted in a reduction of surface carbon and a transformation of the surface from hydrophobic to hydrophilic. This led to enhanced attachment, proliferation, and retention of human gingival fibroblasts, along with nearly complete collagen coverage on implant abutments. These in vitro results indicate the promising potential of utilizing VUV photofunctionalized implant abutments to enhance soft tissue reaction and sealing mechanisms.
Schlagwörter: ultraviolet light; implant abutment; gingival fibroblasts; soft tissue attachment; photofunctionalization
DOI: 10.11607/jomi.10655, PubMed-ID: 386073575. Apr. 2024,Seiten: 1-19, Sprache: EnglischUnsal, Gokce / Caglar, Alper / Tural, Mine / Orhan, Metin / Alkan, OzerPurpose: The purpose of this study was to evaluate the dimensional accuracy of implant
impressions obtained using different tray types and techniques. Materials and Methods: A
partially dentate maxillary Kennedy Class II model was created as a reference model through
three-dimensional (3D) printing. Then, 4.3-mm diameter implant analogs were placed at the
first premolar, first molar, and second molar regions. Five types of trays–metal and plastic
stock trays and custom trays fabricated using liquid crystal display (LCD), fused deposition
modeling (FDM), and urethane dimethacrylate (UDMA) resin–were used to create
impressions. Open- and closed-tray techniques were also compared. In total, 150 impressions
were obtained. The reference model and impressions were scanned using a laboratory scanner.
The positional and angular deviations of implants with different tray types and techniques
were evaluated using the superimposition method. Results: There was no statistically
significant difference (P>0.05) between the impression accuracy with the different tray types
and impression techniques. The angular deviations with plastic and UDMA trays were greater
than those with metal, FDM, and LCD trays. Angular deviation at the second molar by using
closed trays was greater than that using open plastic trays. The highest and lowest positional
deviation were observed at the first molar implant with an open plastic tray impression (mean:
62.46 ± standard deviation: 28.54 μm) and a closed LCD tray impression (36.59 ± 29.93 μm).
The greatest angular deviation was observed with an open FDM tray impression at the first
premolar implant (0.067 ± 0.024°), and the lowest angular deviation was observed with a
closed metal stock tray impression at the second molar implant (0.039 ± 0.025°). Statistical
differences were detected using Mann–Whitney U tests for pair groups and the Kruskal–
Wallis test for groups with more than three comparisons (P>0.05). Conclusion: Plastic and
metal stock trays or conventional and 3D-printed custom trays can be used to obtain implant
impressions for maxillary partially edentulous arches with similar dimensional accuracy. The
five tray types and two techniques may be safely used to obtain impressions of partially
edentulous maxillary arches with three implants.
Schlagwörter: Keywords: implant, deviation, accuracy, 3D, impression
DOI: 10.11607/jomi.10690, PubMed-ID: 386073535. Apr. 2024,Seiten: 1-37, Sprache: EnglischAl-Tarawneh, Sandra K. / Thalji, Ghadeer / Fernandez Lozada, Mariana / Waia, Dalia / Cooper, Lyndon F.Objective: To explore the effect of adding an allogenic soft tissue graft at time of single implant
placement using a fully digital workflow for single implant placement and restoration without
making either analog or digital impressions.
Materials and methods: A prospective randomized clinical study was performed enrolling thirtynine
participants requiring single tooth implant randomized into (+ graft) group which received
an allogenic dermal graft at the time of implant placement (n=19), or (- graft) group (n=20). A
fully digital surgical and restorative protocol was implemented. Intraoral scans were taken before
implant placement (T0), at time of final crown delivery (T1) and at one-year post placement
(T2). Intraoral scans were aligned using Geomagic Control X 2020 software), linear and
volumetric changes in buccal tissues were measured at T0, T1 and T2. Implant survival, probing
depths, and complications were recorded. Participants were asked to complete an OHIP-14
survey at T0 and T2. Marginal bone levels were measured at T0 and T2 on peri-apical x-rays.
Results: 39 participants completed surgery and restoration in incisor, canine, premolar and molar
positions. Two early failures were recorded in central incisor positions (95% survival). Crown
delivery without complication from the digital workflow (impressionless) was achieved for
36/39 of cases (92%) with implant depth control being implicated as the chief challenge. Thirtyseven
participants attended the one-year follow-up visit. Both groups showed gain in buccal
tissues thickness without significant differences between the two groups for both linear and
volumetric measurements (P>0.05). Soft tissue grafting was associated with minimal added
morbidity. The interproximal marginal bone changes recorded were -0.16mm mesial and -
0.12mm distal for the graft group and -0.01mm mesial and -0.11mm distal for the non-graft
group (p=0.07 for mesial and 0.83 for distal). OHIP score was significantly reduced at T2
compared to T0 (P=0.003) for the entire cohort.
Conclusions: The augmentation of alveolar mucosa on the buccal aspect of single tooth implants
is associated with clinically favorable outcomes. A fully digital workflow has been validated to
permit crown delivery on CAD/CAM abutments without implant impressions.
Schlagwörter: Keywords: single implant, soft tissue graft, allograft, digital, marginal bone loss
DOI: 10.11607/jomi.10615, PubMed-ID: 386073545. Apr. 2024,Seiten: 1-25, Sprache: EnglischCardoso, José Maria / Ribeiro, Ana Clara / Proença, Luís / Noronha, Susana / Castro Alves, RicardoPurpose: The aim of this study was to investigate whether genetic variations in cytokine genes
involved in the pathogenesis of peri-implantitis, could be associated with its occurrence, an issue
that remains controversial and may vary according to the population evaluated.
Material and Methods: A cross-sectional analytical study was carried out on 102 Portuguese
Caucasian individuals divided into two groups: 43 individuals with peri-implantitis and 59
individuals with peri-implant health. Samples from the buccal mucosa were obtained and genetic
analysis was performed using the real-time polymerase chain reaction (PCR) technique for IL-1A
and IL-1B and using PCR and restriction fragment length polymorphism analysis for IL-1RN.
Results: The IL-1A -889 C/T polymorphism showed a higher prevalence of the less common
allele (T allele) in cases of peri-implantitis than in healthy cases (27.9% vs 16.9%, respectively),
but without statistical significance (p = 0.060). For the IL-1B +3954 C/T and IL-1RN (variable
number of tandem repeats) polymorphisms, the analysis revealed that the allele and genotype
frequencies did not differ significantly between groups. There was a significant association
between a history of periodontitis and peri-implantitis (p = 0.020).
Conclusions: The genetic polymorphisms evaluated had no influence on the occurrence of periimplantitis
in the population studied. Further research into genetic variations in different
populations is needed to elucidate the role of genetic factors in the onset and progression of periimplant
disease.
Schlagwörter: Keywords:dental implants, peri-implantitis, interleukin-1 receptor antagonist protein, interleukin-1, genetic polymorphisms.
DOI: 10.11607/jomi.10734, PubMed-ID: 386073555. Apr. 2024,Seiten: 1-19, Sprache: EnglischDemir, Esin / Özel, Gülsüm / İnan, Özgür / Dolanmaz, DoğanPurpose: The aim of this study is to evaluate and compare patient satisfaction levels in
edentulous patients treated with different configurations of implant supported prosthesis.
Also, the effect of previous prosthesis experience before implant treatment on patient
satisfaction was investigated.
Materials and Methods: A study population of 142 patients was identified. Patients
seperated into four treatment types. Group 1 comprised 43 patients treated with implant
supported overdenture for mandible and conventional complete denture for maxilla while
group 2 comprised 32 patients treated with implant supported overdentures for maxilla and
mandible. Group 3 comprised 26 patients treated implant supported overdenture for mandible
and fixed prosthesis for maxilla. Group 4 comprised 41 patients treated with implant
supported maxillomandibular fixed restorations. A questionnaire consisting of specific issues
about masticatory performance, pronunciation, comfort, social ability were used to evaluate
treatment outcomes.
Results: The patients in group 4 were significantly more satisfied regarding masticatory
performance than other treatment modalities. VAS scores of Group 3 and group 4 regarding
comfort and social ability were similar while scores of these two groups were significantly
higher than that of group 1 and 2. The patients who used conventional removable prosthesis
before implant treatment were more satisfied with their implant supported prosthesis
regarding social ability.(p=.03)
Conclusion: It was found that treatment design of that implant supported fixed prosthesis on
maxilla and implant overdenture on mandible provided comparable level of satisfaction with
maxillomandibular fixed prosthesis for edentulous patients. Implant supported fixed
prosthesis for maxilla and implant supported overdenture for mandible served as a practical
alternative to satisfy patients especially in patients with mandibular atrophy who would
demand extensive surgeries for maxillomandibular fixed prosthesis. Satisfaction level of
implant supported overdenture was not superior to conventional prosthesis for maxilla.
Previous removable prosthesis experience may influence social comfort of patients.
DOI: 10.11607/jomi.10723, PubMed-ID: 386073615. Apr. 2024,Seiten: 1-27, Sprache: EnglischGuarnieri, Renzo / Testarelli, Luca / Galindo-Moreno, Pablo / Del Fabbro, Massimo / Testori, TizianoObjectives: The aim of this narrative review is to describe the emerging evidence concerning
etiological factors and pathophysiological mechanisms involved in peri-implant inflammatory
diseases.
Material and Methods: An electronic search for articles published until November 2022 was
conducted in MEDLINE by three independent reviewers to identify manuscripts reporting data on
etiological factors and pathophysiological mechanisms associated with peri-implant diseases.
Results: Current evidence suggests that peri-implant mucositis and peri-implantitis are
inflammatory conditions linked to a microbial challenge. However, in recent years, there has been
increasing evidence indicating that certain peri-implant inflammatory conditions may not be
primarily related to biofilm-mediated infectious processes but rather to other biological
mechanisms, such as a foreign body response.
Conclusion: The current evidence, not only in the dental literature, opens new avenues for a more
complex interpretation of the etiopathogenetic factors involved in peri-implant diseases. A better
understanding of various factors related to the host response, including dysbiosis mechanisms
associated with changes in microbiota composition, is necessary for a more precise physiopathological
characterization of these diseases.
Schlagwörter: Keywords: dental implant; peri-implant diseases; foreign body response; microbial biofilm; periimplant Infection.
DOI: 10.11607/jomi.10600, PubMed-ID: 386073625. Apr. 2024,Seiten: 1-30, Sprache: EnglischMourão, Elisa Ribeiro Sá Tscherbakowski / Nascimento, Polianne Alves Mendes / Mauad de Abreu, Fernando Antônio / Cosso, Mauricio Greco / De Araújo Silva, Vânia Eloisa / Zenóbio, Elton GonçalvesPurpose: The purpose of this systematic review was to assess histological and imaging outcomes
related to new bone formation around implants, inserted simultaneously with sinus
augmentation, comparing different types of grafts. Materials and Methods: Systematic Review
was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-
Analysis (PRISMA), and the Cochrane Handbook for Systematic Reviews of Interventions.
LILACS/BVS, Medline/PubMed, Cochrane Library and Embase databases, including gray
literature and manual investigation, were searched to identify clinical trials reporting human
histological and imaging data of bone formation around implants, inserted into the maxillary
sinus at the same moment of the elevation and augmentation procedure, using several materials.
Study selection, risk of bias (Rob 2.0 or ROBINS I), quality of evidence (GRADE), and data
collection were performed by two independent reviewers. Results: Of the 1101 potentially
eligible articles, 44 were retrieved, 12 were assessed for eligibility and 5 were included in this
systematic review (4 randomized and one controlled clinical trials). As a result, 130 grafted
sinuses with 179 installed implants in 103 patients, aged between 24 and 79 years and followed
up from 6 to 15 months, were analyzed. The heterogeneity between studies did not allow the data
to be combined for meta-analyses. All graft materials proved to be viable options for the
intervention. The use of BCP was related to higher bone-to-implant contact. Conclusion: All the
assessed grafts are viable options for the intervention addressed. The use of some material is
justified to maintain the sinus volume and allow bone formation in the apical site of implants
under the sinus membrane. Longer chair time and the morbidity of the donor site should be
considered when choosing autogenous bone. Synthetic biphasic materials can be selected for this
intervention due to superior values of %BIC when compared to DBB.
Schlagwörter: Key words: maxillary sinus augmentation, simultaneous implant, graft materials, bone neoformation, systematic review
DOI: 10.11607/jomi.10683, PubMed-ID: 386073585. Apr. 2024,Seiten: 1-14, Sprache: EnglischStumpel, Lambert J. / Bedrossian, Edmond A. / Revilla-León, MartaA technique for virtually planning single implant by combining an intraoral digital scan, an opensource
computer-aided design software program, bone sounding, and 2-dimensional radiographic
imaging is described. The surgical implant guide is fabricated by using additive manufacturing
technologies. Furthermore, the surgical implant guide positioned in the patient’s mouth is used to
radiographically verify the estimated mesio-distal implant angulation before proceeding with the
surgical intervention and modified, if necessary. When a cone bean computed tomography scan
is not available, this technique eases implant planning procedures and minimize possible surgical
complications.
Schlagwörter: Keywords: 3D printing; additive manufacturing; computer-aided design; surgical implant guide; computer-aided implant planning
DOI: 10.11607/jomi.10820, PubMed-ID: 3849879018. März 2024,Seiten: 1-27, Sprache: EnglischAmengual, Luis / Brañes, Manuel / Marchesani, Francisco / Parada, Leopold / Jara, Maria Constanza / Albrektsson, TomasPurpose: To evaluate the feasibility of reversing a primary failure through therapeutic mechanical stimulation induced by transcutaneous application of acoustic waves (ESWT) in the peri-implant tissues. Materials and Μethods: This clinical report evaluates the outcome of a new protocol proposed to treat a primary failure (loosened oral implant); application of three cycles of ESWT, once session per week for 3 consecutive weeks, with an equivalent positive energy of 0,18 mJ/mm² (therapeutic dose: 2000 impulses/ 8Hz/ 4.0 bar). Standardized intraoral radiographs, Cone Beam Computed Tomography (CBCT), Implant Stability Quotient (ISQ) and clinical evaluations were performed. Results: It was possible to verify a progressive increase in the ISQ value after the ESWT protocol; 17 (initial), 46 (after two months) and 68 (after four months), which led to successful implant prosthetic rehabilitation (35 N/cm measured). Our evaluation at 6 years of follow-up confirms that the new bone-implant interface is preserved and ESWT as a safe non-invasive treatment. Conclusion: In the context of the new dynamic model of osseointegration, the Foreign Body Equilibrium (FBE), this represents the first report of a host-Implant equilibrium re-established after an early failure process. However, it is necessary to perform studies to determine both the medical device and the most effective therapeutic range for clinical applications of this technology in oral implantology.
Schlagwörter: ESWT, primary failure, case report, osseointegration, oral implant, osteoimmunology
DOI: 10.11607/jomi.10823, PubMed-ID: 3849878918. März 2024,Sprache: EnglischGehrke, Sergio Alexandre / Júnior, Jaime Aramburú / Treichel, Tiago Luis Eirles / da Costa, Eleani Maria / Scarano, Antonio / Júnior, Nilton De Bortoli / Fernandes, Gustavo Vicentis Oliveira / De Aza, Piedad N.Purpose: The aim of the present animal study was to examine the impact of two implant designs
that promote different insertion torque values on implant stability and evaluate, histomorphometrically,
the bone healing for immediate implant placement in fresh sockets.
Materials and Methods: Twelve female sheep (35.0±5.0kg) and 48 conical Morse-taper dental
implants divided into two groups (n = 24 per group): G1 group, where the implants present
a design that can provide high insertion torque values; and G2 group, where the implants
present a design that can provide low insertion torque values. Both had the same surface
treatment, and dimensions (4.0 mm in diameter and 10 mm in length). The first two posterior
teeth (both sides) were extracted carefully. Sequentially, there were osteotomies in the mesial
socket of each molar tooth. The final implant position was 2 mm below the buccal bone crest
level. On the right side, implants of the G1 were placed anteriorly, followed by implants of
the G2; and, on the left side, it was the reverse. A digital torquemeter was used to measure the
maximum final insertion torque value (f-IT). The initial implant stability quotient (ISQ) was
measured immediately after the implant insertion (T0) and immediately after the euthanasia
and removing the mandibles with the implants. The animals were euthanized (n=6 animals/
time) at 21 days (T1) and 35 days (T2). The t-test was used to compare statistical differences
for each intragroup parameter analyzed. Pearson's correlation was used to analyze possible
correlations: f-IT and BIC%, f-IT and ISQ, and ISQ and %BIC.
Results: Regarding the insertion torque, the G1 presented higher values than the G2, with a
statistically significant difference (p<0.0001). The ISQ mean values were higher in the B-L
direction than those obtained for M-D for both groups. %BIC measurements showed higher
values in samples from G2 than G1 at both times and in both directions. New bone, medullary
spaces, and collagen matrix had statistical differences between the groups at each evaluation
time.
Conclusion: Using implants with a modified macrogeometry plays a significant role in implant
stability and the healing process of bone tissue around the implant. It is important for
clinicians to carefully consider implant macrogeometry when planning dental implant surgery
to achieve optimal implant stability and successful osseointegration, mainly in cases of immediate
implant placement.
Schlagwörter: dental implants, macrogeometry, pre-clinical study, histomorphometry.
DOI: 10.11607/jomi.10798, PubMed-ID: 3849880318. März 2024,Sprache: EnglischHarutyunyan, Liza / Lieuw, Kayla / Yang, Bryan / Lee, Eric / Yeh, Yu-Ting / Chen, Hsuan-Hung / Lin, Guo-HaoPurpose: The aim of this systematic review and meta-analysis is to analyze the risk of dental
implant failure for patients who had a history of anti-depressant use. Materials and methods: An
electronic search was performed up to June 2023 in three databases, including
PubMed/MEDLINE, Web of Science and Cochrane Central Register of Controlled Trials with
data on comparison of implant failure rate for patients with and without the use of antidepressants
were included. Meta-analyses for the risk ratio of implant failure rate at the patient
level and implant level were performed. Results: Eleven clinical studies were selected for
inclusion in this review. The meta-analyses showed a risk ratio of 2.44 (95% confidence
interval= 1.75 to 3.39, p< 0.0001) and 2.44 (95% CI= 1.73 to 3.46, p< 0.0001) for the implant
failure at the patient level and implant level, respectively. The comparisons presented a low
heterogeneity for the patient-level analysis and a moderate heterogeneity for the implant-level
analysis among the pooled studies. Subgroup analyses also revealed that patients who received
only selective serotonin reuptake inhibitors (SSRIs) or SSRIs with other type of anti-depressants
had a higher risk of implant failure than those who were not on any anti-depressants.
Conclusions: The current review demonstrates the use of anti-depressants, such as SSRIs, may
increase the risk of dental implant failure at both patient level and implant level. Although
limited evidence suggests that a certain type of SSRI (sertraline) may have more influence on
implant failure than other SSRIs, future studies are needed to warrant this finding.
Schlagwörter: dental implants, antidepressive agents, selective serotonin reuptake inhibitors, systematic review
DOI: 10.11607/jomi.10625, PubMed-ID: 3849878818. März 2024,Sprache: EnglischLiu, Ying / He, Fengxiao / Zhao, Yaoyu / Sun, Quan / Xia, Haibin / Xia, Dahong / Bai, YiObjective: This systematic review aimed to compare the influence of immediate and
non-immediate loading protocols on overdentures retained by reduced-diameter
implants(≦3.5mm).
Methods: Electronic databases, including MEDLINE (via PubMed), Embase and the
Cochrane Central Register of Controlled Trials were searched for randomized
controlled trials (RCTs) comparing clinical outcomes of immediately and nonimmediately
loaded reduced-diameter implants supported overdentures. The risk of
bias within and across the studies and the certainty of evidence were assessed by RoB
2.0 and GRADE, respectively. Sensitivity analysis was performed by eliminating
studies at high risk of bias, and repeating the data synthesis employing the randomeffect
model. Subgroup analyses were conducted based on the implant diameter and
the length of follow-up.
Results: Six RCTs with 255 patients were included in this systematic review. The
meta-analyses found similar implant survival rates between immediate and nonimmediate
loaded implants in mini implant (RR=0.98; 95% CI=0.95, 1.01; p=0.12)
and narrow implant subgroups (RR=0.99, 95% CI=0.94, 1.03, p =0.56), as well as in
short-term (RR=0.98, 95% CI=0.97, 1.00, p =0.11) and long-term (RR=0.97, 95%
CI=0.93, 1.01, p =0.09) follow-up subgroups. Additionally, marginal bone loss (MBL)
showed no statistically significant difference between the loading protocols in the
subgroup of long-term follow-up (MD=0.03; 95%CI=-0.16, 0.23; p=0.74). Three
RCTs investigating peri-implant parameters found relatively higher modified plaque
index and probing depth in reduced-diameter implant under immediate loading.
Conclusion: Compared with non-immediate loading, the immediately loading
protocol can achieve comparable survival rates and MBL in reduced-diameter implant
retained overdentures.
Schlagwörter: reduced-diameter implant, immediate loading, conventional loading, loading protocol, implant-retained overdenture
DOI: 10.11607/jomi.10749, PubMed-ID: 3849878718. März 2024,Sprache: EnglischNtovas, Panagiotis / Soundia, Maria / Karveleas, Ilias / Ladia, Ourania / Tarnow, Dennis / Papazoglou, EfstratiosObjectives: To investigate the influence of a single infrapositioned ankylosed tooth or implant
supported restoration, in smile attractiveness. Material and methods: A series of 48 digital
modified images, simulating a varying degree of infraposition(from 0.25 to 2.0 mm, with a
step of 0.25 mm), was created for each one of the maxillary anterior tooth, by altering the
full-portrait image of a smiling male adult, in medium and high smile lines. For the model
with the high smile line, also a series of 24 digital modified images simulating infraposition
of a single anterior tooth with a restored incisal edge was created. Smile attractiveness for
each one of the images was evaluated from 160 participants (80 dentists and 80 laypersons),
implementing a visual analog scale. Results: For the images with the high smile line, an infraposition
≥ 0.25mm in central incisor’s region and ≥ 0.5mm in the region of the lateral incisor
or the canine, had a negative effect on the perceived smile attractiveness both for the dentists
and the laypersons. Regarding the medium smile line, an infraposition ≥ 0.5mm in central
and lateral incisor’s region, had a negative effect on the perceived smile attractiveness for
both groups of observers. In the area of the canine, infraposition ≥ 0.5mm for the dentists and
≥ 0.75mm for the laypersons, had a negative impact on the smile attractiveness. Conclusions:
Even a minor infraposition of a single maxillary anterior ankylosed tooth or implant supported
restoration, can reduce the perceived attractiveness of the face. Infraposition in canine’s
area can be better tolerated in a medium, compared to a high smile line. In patients
with a high smile line prosthetic intervention in order to restore the incisal edge of an infrapositioned
tooth, without to harmonize the gingival contour, can be beneficial for the lateral incisor,
ineffective for the central incisor and unfavorable for the canine.
Schlagwörter: implant submersion, infraocclusion, ankylosed tooth, craniofacial growth, smile esthetics
DOI: 10.11607/jomi.10593, PubMed-ID: 3849878618. März 2024,Sprache: EnglischRibeiro, Anne Kaline Claudino / Veríssimo, Aretha Heitor / Lemos, Luisa Madeira / Bezerra, Aliane da Silva / de Almeida, Érika Oliveira / Carreiro, Adriana da Fonte PortoSingle implants are a predictable treatment, and immediate loading can be an option with
acceptable survival rates. Clinical and patient-centered outcomes comparing immediate and
delayed protocol of single implants are unclear. The purpose of this study was to assess
complications, satisfaction, and quality of life of patients rehabilitated with delayed and
immediate loading single crowns. An electronic search was conducted in
PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase databases up to
February 2023. Only prospective studies, randomized and non-randomized clinical trials
comparing immediate and delayed loading were included. For the quantitative analysis,
dichotomous and continuous variables were evaluated with a 95% confidence interval. A total
of 20 studies were evaluated. No statistically significant difference between protocols was
observed: satisfaction (I2: 0%; P = 0.42), quality of life (I2: 0 %; P = 0.05), biological
complications (I2: 9%; P = 0.17) mechanical complications (I2: 58%; P = 0.84), and survival
rate (I2: 0%; P = 0.38). Subgroup analysis showed significant differences only for marginal
bone loss when immediate implants were placed in the mandible (IÇ: 15%; P = 0.01) and
posterior zone (I2: 0%; P = 0.001). Complications and patient-centered outcomes for
immediate single-implant crowns were comparable to delayed loading. Scientific evidence
showed no significant difference between loading protocols for survival rates. Although
several factors could interfere with the complication events, implant failures, and marginal
bone loss, the subgroup analysis evidenced that only immediate implants placed in the
posterior mandible zone had higher statistically significant mean marginal bone loss.
Schlagwörter: immediate dental implant loading, implant-supported dental prosthesis, patient satisfaction, quality of life, survival rate
DOI: 10.11607/jomi.10809, PubMed-ID: 3849878518. März 2024,Sprache: EnglischYounes, Ibrahim Abazar / Able, Francine Badin / De Moraes, Kely Cristina / Sartori, Ivete Aparecida de MattiasPurpose: This study aimed to identify the technical complications associated with maxillary
complete-arch implant-supported fixed prostheses (ISFPs) and to evaluate the survival rates of
both implants and prostheses. Additionally, we sought to analyze the impact of the presence of
cantilevers, the type of prosthetic abutment, and the number of implants on the occurrence of
complications. Materials and Methods: Data were obtained from standardized clinical
assessments carried out in a single appointment by two calibrated professionals using
information from dental records. Results: The sample consisted of 64 patients rehabilitated with
ISFPs classified as hybrid prostheses (metal-resin). The survival rate for implants was 98.6%
after 1 to 12 years (5.2 years ± 36.6 months) and was 100% for the prostheses after a follow-up
period of 12 to 144 months (mean 48.1 ± 33.94 months). The most frequent complications were
occlusal wear (82.8% of patients) and loosening of prosthetic screws (16.6%) and abutments
(8.1%). Screw loosening frequency was significantly greater in 30-degree abutments compared
with straight abutments (P=0.008), but no significant difference was found between 17-degree
and 30-degree abutments. Prostheses with a higher occurrence of screw loosening had a greater
average CL/AP spread ratios (0.9 0.5). In addition, abutments installed on distal implants were
more likely to loosen (P<0.001). The absence of mutually protected occlusion did not
significantly influence the loosening of screws and prosthetic abutments. Conclusions: Implantsupported
fixed maxillary complete-arch rehabilitations have high survival rates but are subject
to technical complications.
Schlagwörter: dental implants, maxillary edentulism, mechanical outcomes, screw loosening, follow-up
DOI: 0.11607/jomi.10810, PubMed-ID: 3849878418. März 2024,Sprache: EnglischSrimaneekarn, Natchalee / Arayapisit, Tawepong / Booncharoensombat, Supisara / Nanayon, Tirakorn / Choterungruangkorn, Navin / Kunavisarut, Chatchai / Nakaparksin, PranaiPurpose: Determining the esthetic success of single-tooth implant restorations (STIR) requires an
objective tool such as one devised by Belser et al., 2009 - pink esthetic scores and white esthetic
scores (PES/WES). This study aimed to utilized PES/WES to establish threshold scores based on
(1) detectability and (2) acceptability of a STIR by lay person perception, (3) to study the
difference in the ability of laypeople and dentists in detecting the presence of STIR, and (4) to
study the pink and white deficiencies in relation to the detectability of the presence of STIR.
Materials and Methods: A total of 38 calibrated photographs of STIR in the anterior region were
scored with PES/WES by 3 prosthodontists. Next, 100 laypeople and 60 dentists were instructed
to identify the STIR among the anterior teeth and provide reasoning behind the identification
(based on pink and white esthetic criteria). The acceptance of the STIR was recorded. Receiver
Operating Characteristics (ROC) analysis was utilized to determine the threshold scores. Results:
At the PES/WES score of 17, 71% of laypeople could not correctly identify the STIR, and at the
PES/WES score of 12, 80% of laypeople accepted the implant. Out of 3,800 occasions, laypeople
correctly identified the STIR 1,770 (46.58%) of those occasions. Among the correctly identified
STIR, 751 (42.43%) of those occasions were identified with pink deficiencies and 1019
(57.57%) of those occasions were with white deficiencies. Out of 2,280 occasions, dentists
correctly identified STIR 1869 (81.98%) of those occasions. Conclusions: The PES/WES score
of 12 indicates the clinically acceptable threshold, while the score of 17 indicates the detectable
threshold for an exceptional esthetic outcome. Laypeople tend to accept the implant despite its
detectability. For both laypeople and dentists, root convexity/soft tissue color and texture are the
most focused criteria of PES/WES, followed by overall white deficiencies that remain
influential. Compared to laypeople, dentists tend to have a higher ability to detect STIR.
Schlagwörter: pink esthetic scores, white esthetic scores, single-tooth implant restorations, implant esthetic
DOI: 10.11607/jomi.10852, PubMed-ID: 3849878318. März 2024,Sprache: EnglischFeng, Xi / Wang, Haicheng / Weng, Yuteng / Chen, Yongliang / Huang, Jie / Wang, ZuolinPurpose: To explore the contribution of paired-related homeobox 1-positive cells to the
implant-induced osseointegration process in adult alveolar bone and the potential underlying
mechanisms. Materials and Methods: Cre recombinase-induced lineage tracing and cell
ablation were conducted in a murine dental implant model. Scratch and transwell assays were
used to assess MC3T3-E1 cell migration after paired-related homeobox 1 overexpression.
Single-cell RNA sequencing were applied to identify potential genes involved in pairedrelated
homeobox 1-positive cells-driven osteogenesis. Results: Paired-related homeobox 1-
positive cells were observed to accumulate in the peri-implant area in a time-dependent
manner. The number of these cells were found to reach its maximum on day 14.
Osseointegration in mice were noticeably impaired after ablation of paired-related homeobox
1-positive cells. Further, it was discovered that paired-related homeobox 1 promotes MC3T3-
E1 cell migration, a process which is indispensable for sound healing of peri-implant tissue.
Finally, Semaphorin 3C was detected exclusively and abundantly expressed by paired-related
homeobox 1-positive cells. Knockdown of semaphorin 3C in paired-related homeobox 1-
positive cells significantly weakened their osteogenic potential. Conclusion: Our data suggest
that paired-related homeobox 1-positive cells contribute to the osseointegration process under
stress stimulation and semaphorin 3C may play a critical role in paired-related homeobox 1-
positive cell-driven osteogenesis. Paired-related homeobox 1 could significantly promote
MC3T3-E1 cell migration.
Schlagwörter: paired-related homeobox 1-positive cells, osseointegration, alveolar bone, semaphorin 3C
DOI: 10.11607/jomi.10754, PubMed-ID: 384572648. März 2024,Sprache: EnglischIida, Takahisa / Miki, Michihide / Ferri, Mauro / Guzon, Fernando M. Muñoz / Cesaretti, Gianfranco / Botticelli, DanieleBackground: After tooth extraction, a physiological shrinkage of the alveolar ridge occurs.
Applying a buccal overbuilding some months before tooth extraction may create a stiffer hard
tissue that might protect the alveolar crest from resorption. Hence, the aim of this experiment
was to evaluate the dimensional changes in the alveolar crest after buccal overbuilding
performed before tooth extraction. Materials and Methods: At the test sites, an alveolar crest
overbuilding was performed on the buccal aspect of the distal root of the third premolar using
xenograft covered with a collagen membrane. No treatment was applied at the control sites. After
3 months, the distal roots of both third premolars were extracted and implants were immediately
installed into the alveolus allowing a non-submerged healing. After 3 months, biopsies were
collected. Results: At the histological analyses, no statistically significant differences in hard
tissue dimensions were found. The buccal bone plate at the test sites presented a tendency of
higher resorption compared to the control sites. However, if the contribution of the residues of
biomaterial was considered, a higher volumetric gain was registered at the test than at the control
sites. Conclusions: The buccal overbuilding performed before tooth extraction did not contribute
to the preservation of the alveolar crest dimensions after extraction. This could be due to failure
to incorporate the graft into the newly formed bone.
DOI: 10.11607/jomi.10787, PubMed-ID: 3839444223. Feb. 2024,Seiten: 1-16, Sprache: EnglischFonseca, Catarina Mendes / da Fonseca, Patrícia Alexandra Barroso / Quezada, Margarida Martins / Marques, Tiago / Montero, Javier / Morton, Dean / Correia, AndréPurpose: This study aimed to assess the accuracy and precision of prosthetically-driven
implant placement achieved through static computer-aided implant surgery. The primary
objective was to analyze the linear and angular deviations of dental implants in patients
treated at a university dental clinic. Various types of surgical techniques and templates
were utilized to optimize implant positioning. Materials and Methods: A total of fiftythree
dental implants were included in this study. The implants were positioned using
either tooth-supported templates or tooth-tissue-supported templates with fixation pins.
Two distinct guided surgery approaches were used, these being pilot drill guided and
fully guided. Three-dimensional (3D) data from the implant planning phase was
superimposed with the 3D data from the final implant positions using the ‘Treatment
Evaluation’ tool within CoDiagnostix. implant planning software (Straumann AG).
This enabled the automatic calculation of deviations in implant placement accuracy.
Results: Average angular deviation observed was 3.90 degrees. For linear deviations,
the mean 3D deviation at the most coronal point of the implants was 1.04 mm, while at
the implant apex it was 1.56 mm. Conclusion: This research demonstrates the
feasibility of a digital workflow for guided implant surgery, offering a promising
treatment option. Nonetheless, it is important to note that deviations do occur, with the
apical region of the implant being the most affected area. Care should be taken,
particularly in cases of limited bone availability.
DOI: 10.11607/jomi.10859, PubMed-ID: 3839443923. Feb. 2024,Sprache: EnglischHamada, Takumi / Gonda, Tomoya / Murase, Kohei / Maeda, Yoshinobu / Ikebe, KazunoriPurpose: The purpose of this study was to examine the mechanical influence of
edentulous mandibular morphology on peri-implant bone in implant prosthetics by
finite element analysis. Materials and Methods: Computed tomographic data from 25
patients with edentulous mandibles were selected and the radius of mandibular
curvature and the height of the mandible at the midline were measured in order to
clarify the morphological characteristics of the mandible. From the measurement, two
patients with the smallest and largest radii of the mandible were selected. Two types of
three-dimensional finite element models consisting of the edentulous mandible (small
and large radius), superstructure (a cantilever bridge), implants, and abutments were
created. Four implants were inserted between the right and left mental foramina. The
upper surface of the mandibular condyle was constrained, and a vertical load of 100 N
was applied on the occlusal surface of the right first molar. Three-dimensional finite
element analysis of each model was performed to examine the mechanical influence of
the edentulous mandibular morphology on the peri-implant bone. Results: Measurement
of mandibular morphology in CT images indicated that the lower the mandibular height
was, the larger was the radius of the anterior mandibular curvature. Finite element
analysis revealed that a higher equivalent stress was generated in the peri-implant bone
of the model with a larger radius of curvature than that of the model with a smaller
radius of curvature. The highest equivalent stress in the mandible was generated in the
distal margin of the peri-implant bone posterior to the loaded side of the large radius of
curvature model. Conclusions: The mandibular morphology had a mechanical influence
on the peri-implant bone.
DOI: 10.11607/jomi.10803, PubMed-ID: 3839444023. Feb. 2024,Sprache: EnglischOhayon, Laurent / del Fabbro, MassimoPurpose: Maxillary sinus floor augmentation is a safe and predictable technique used to increase
bone volume under sinus cavity for implant placement in atrophic posterior maxilla before
implant placement. Despite conflicting results concerning the new bone formation rates with or
without a barrier membrane, the benefits of using a collagen membrane to cover the lateral bone
window has been demonstrated, in order to prevent bone substitute particles dislodgement that
may occur from the sinus cavity through the sinus antrostomy towards the oral mucosa, and to
significantly reduce the postoperative swelling and pain reactions. The purpose of this case series
is to present a sling suture technique used to stabilize the collagen membrane against the lateral
bone window so as to improve the bone substitute stability inside the sinus cavity. Materials and
Methods: Maxillary sinus floor augmentation with lateral approach using sling suture technique
to maintain the collagen membrane against the lateral bone window was performed in 17 patients
(8 women/ 9 men, mean age: 58.2 years). Postoperative cone-beam computed tomography
(CBCT) images up to 6-month follow-up were performed to control the bone graft stability at the
level of the lateral antrostomy. The clinical postoperative pain and swelling were assessed
through a Visual Analogue Scale (VAS) questionnaire from level 1 (low), level 5 (acceptable), to
level 10 (high) at one week postoperative. Results: No bone substitute displacement was
observed for all clinical cases on the CBCT images at 6-month postoperative. The pain and
swelling level observed at one-week post operative were significantly low (respectively
1.6±1.0/2.1± 0.9). Conclusions: Within the limits of this case series, the use of sling suture
technique to maintain the barrier membrane at the level of the lateral bone window in case of
maxillary sinus floor augmentation with lateral approach surgery revealed to be a predictable
protocol to prevent bone substitute displacement outside the sinus cavity.
DOI: 10.11607/jomi.10780, PubMed-ID: 3839444123. Feb. 2024,Sprache: EnglischReinedahl, David / Galli, Silvia / Albrektsson, Tomas / Tengvall, Penni / Wennerberg, AnnPurpose: Marginal bone resorption (MBR) around oral implants may sometimes be a selflimiting
condition due to balancing immunological reactions against the utilized materials,
rather than a progressive bacterial infection. Contrary to previous assumptions from ligature
induced experimental peri-implantitis studies, our recent 8-week experiment showed that
marginal ligatures per se trigger an inflammatory immune response, resulting in bone
resorption around implants in absence of a plaque. The present study aims to investigate
whether this inflammatory/immunological reaction attenuates or progresses toward implant
failure after a longer healing time, 12 weeks. Materials and Methods: Sterile silk ligatures
were placed around the top of titanium (Ti) implants and compressed against the femoral
cortical bone plate of 6 rabbits. A non-ligated implant was used as control. After 12 weeks of
submerged healing, ground sections of implants and surrounding tissues were investigated
with light microscopy. The marginal soft tissues were also analyzed using selected qPCR
markers. Results: Histologically, the ligatures were outlined by immune cells, including
multinucleated giant cells (MNGC), with adjacent fibrous encapsulation and resorbed
peripheral bone that contrasted from the osseointegrated non-ligated control implants. The
difference in expression of qPCR markers was not significant, but >2-fold upregulation of
markers CD11b, IL1b, ARG1, NCF1, CD4 and >2-fold downregulation of CD8 indicated a
mild, focal inflammatory/immune response against the ligatures compared to controls, with
upregulation of M1 and M2 macrophages, neutrophils and helper T-cells and downregulation
of killer T cells. Further, the bone formation markers OC and ALPL were >2 fold down
regulated, consistent with the lack of osseointegration of the ligatures, compared to control
implants. Conclusions: Marginal silk ligatures per se trigger an inflammatory/immune
response and aseptic bone resorption around oral implants. Compared to our previous 8-week
study, the inflammatory reaction against the silk appears to attenuate with time, with only a
mild persisting inflammation that may block osseointegration and instead maintains a fibrous
tissue encapsulation type reaction. This may explain why traditional ligature experiments
have required regular exchange of ligatures in order for the bone resorption to progress.
DOI: 10.11607/jomi.10745, PubMed-ID: 3835890815. Feb. 2024,Sprache: EnglischChao, Denny / Komatsu, Keiji / Matsuura, Takanori / Cheng, James / Stavrou, Stella C. / Jayanetti, Jay / Chang, Ting-Ling / Ogawa, TakahiroPurpose: Laser-created titanium surface topographies enhance soft tissue attachment and implant
stability. However, knowledge about the underlying mechanisms governing the tissue-level
reaction is lacking. The objective of this study was to examine the behavior and function of
human gingival fibroblasts growing on healing abutments with or without laser-textured
topography. Materials and methods: Human primary gingival connective tissue fibroblasts were
cultured on healing abutments with machined or laser-textured (Laser-Lok, BioHorizons)
surfaces. Cellular and molecular responses were evaluated by cell density assay (WST-1),
fluorescence microscopy, qRT-PCR, and detachment test. Results: The machined surface showed
mono-directional traces and scratches from milling, whereas the laser-textured surface showed a
distinct morphology consisting of mono-directional meso-scale channels (15 μm pitch) and
woven, oblique micro-ridges formed within the channel. There were no differences in initial
fibroblast attachment, subsequent fibroblast proliferation, nor collagen production between the
machined and laser-textured surfaces. Fibroblasts growing on laser-textured surface spread
mono-directionally along the meso-channels, while cells growing on machined surfaces spread
randomly. Fibroblasts on laser-textured surfaces were 1.8-times more resistant to detachment
than those on machined surfaces. An adhesive glycoprotein (fibronectin) and trans-membrane
adhesion linker gene (integrin beta-1) were upregulated on laser-textured surfaces. Conclusions:
The increased fibroblast retention, uniform growth, increased transcription of cell adhesion
proteins compellingly explain the enhanced tissue-level response to laser-created, hybrid textured
titanium surfaces. These results provide a cellular and molecular rationale for the tissue
reaction to this unique surface and support its extended use from implant fixtures and healing
abutments to diverse prosthetic components where enhanced soft tissue responses would be
desirable.
Schlagwörter: Laser-Lok, microchannels, abutments, implant, soft tissue attachment, laser-textured
DOI: 10.11607/jomi.10612, PubMed-ID: 3838196713. Feb. 2024,Sprache: EnglischZierden, Karina / Reich, Sarah Marie / Vogler, Jonas Helmut Adrian / Wöstmann, Bernd / Rehmann, PeterPurpose: This retrospective clinical follow-up study assesses double-crown retained implanttooth-
supported removable partial dentures (DCR-ITSRPDs) survival, evaluates abutment
survival and identifies first aftercare measures. Materials and Methods: The influence of various
factors on the survival of the DCR-ITSRPDs and the abutments were observed in this
retrospective clinical follow-up study using Kaplan-Meier estimate. In addition, the first occurred
aftercare measure per prosthesis was evaluated. Results: 47 DCR-ITSRPDs were investigated
(mean observation: 4.3 ± 3.8 years; max. 14.3 years) out of which three (6.4%) had to be
replaced. The 5- and 10- year survival probability for DCR-ITSRPDs was 100% and 75%. A total
of 297 abutments (120 natural teeth and 177 dental implants) were observed, of which 22 (7.4%;
6 teeth and 16 implants) failed. The 5- and 10-year survival probability for teeth was 90.2% and
for dental implants 90.4% and 76.3%. Conclusion: DCR-ITSRPDs are a successful and durable
treatment option for patients with substantially reduced residual dentitions. Both, prostheses and
abutments show good survival times after 5- and 10-years in function. The patient associated
factors tested showed no influence on the survival of DCR-ITSRPs and abutments. Peri implant
infection was the decisive factor for abutment loss, therefore, regular dental prophylaxis and
examinations are of major importance.
Schlagwörter: removable dental prosthesis, double crown, dental implants, tooth-implant supported, survival
DOI: 10.11607/jomi.10759, PubMed-ID: 3838196813. Feb. 2024,Seiten: 1-22, Sprache: EnglischYonezawa, Daichi / Apaza Alccayhuaman, Karol Alí / Iezzi, Giovanna / Piattelli, Adriano / Ferri, Mauro / Boticelli, DanielePurpose: To evaluate the influence of immediate loading on osseointegration and bone density of
implants installed in a healed alveolar bone crest and supporting single crowns. Materials and
Methods: Two solid titanium transmucosal mini-screws were inserted in the distal regions of the
mandible in 14 patients. One mini-implant was immediately functionally loaded, whereas the other was
left unloaded. After two months of healing, biopsies were retrieved and new bone, old bone, and total
bone (new and old bone) were assessed. Results: Histological examination was performed on biopsies
This peer-reviewed, accepted manuscript will undergo final editing and production prior to print publication.
from 12 patients (n=12). New bone-to-implant contact percentage (BIC%) was 40.3 ± 16.8 % and 55.1
± 19.1 % (p=0.043) at the unloaded and loaded sites, respectively, while the total BIC% was 44.9 ±
17.0 % and 59.5 ± 18.8 %, respectively (p=0.034). The new bone density was 45.9 ± 11.6 % and 45.9 ±
16.7 % in the unloaded and loaded implants, respectively (p=0.622). Conclusions: Immediate loading
positively affected bone apposition on the implant surface, while no effect on bone density was
observed after 2 months of healing.
Schlagwörter: immediate dental implant loading, implant supported prosthesis, clinical trial, osseointegration, biopsy
DOI: 10.11607/jomi.10862, PubMed-ID: 3835011413. Feb. 2024,Seiten: 1-26, Sprache: EnglischMistretta, Lauren / Delgado-Ruiz, Rafael / Romanos, Georgios E.Purpose: This in-vitro study aims to investigate whether the wettability of two zirconia implant
disk surfaces is affected by glycine and erythritol air-polishing, using saline, bovine serum
albumin, bovine thrombin, and bovine artificial blood as the testing mediums. Materials and
Methods: Zirconia disks were provided by two implant companies: SDS. (Swiss Dental
Solutions, Plymouth, MA, USA) (n=6) and Patent. (Zircon Medical AG, Altendorf,
Switzerland) (n=6). Surface parameters (Sa, Sz, Sdr, Ssk, Sku, and Spd) were measured to
determine their initial surface roughness. Air-polishing was completed using glycine or erythritol
powders using the AIRFLOW. PERIO device (Manufactured by Electro Medical Systems
(EMS)). The wettability of the disk surfaces was evaluated by the contact angle analysis applied
on treated and untreated disks using four wetting solutions, saline, bovine serum albumin (BSA),
bovine thrombin, and bovine artificial blood. In total, 720 contact angle measurements were
completed with n=30 per group. Statistical analysis was performed using the one-way analysis of
variance and post-hoc Tukey HSD test. Results: The results indicate SDS. has a greater
wettability than Patent. before and after air-polishing. The wettability of surfaces treated with
glycine was hydrophobic in some cases. Erythritol increased the surface wettability of zirconia
disks compared to glycine. BSA and bovine artificial blood had lower contact angles than saline
and bovine thrombin for both untreated disks. Conclusions: The initial wettability of zirconia
disks differs between manufacturers, and air-polishing with erythritol powder increases the
wettability of zirconia implant disks for saline, bovine serum, bovine thrombin, and bovine
artificial blood.
Schlagwörter: contact angle, erythritol, glycine, wettability, zirconia
DOI: 10.11607/jomi.10741, PubMed-ID: 3835011113. Feb. 2024,Sprache: EnglischMaheshwaran, K. S. / Banu R., Fathima / Kumar V., Anand / Mohamed, KasimBackground: Simvastatin (SMV), a lipid lowering drug, can modulate the process of bone regeneration at the molecular and cellular levels. Its effect on the osseointegration of implants has been studied extensively on animals with assuring results with limited research on human subjects.
Aim: To estimate the effect of simvastatin gel in the osseointegration of dental implants using bone scintigraphy,
Materials and Methods: 20 participants with missing mandibular first molars and D2 type bone were assigned equally to Group A receiving 1.2% simvastatin and Group B receiving Placebo gels during the placement of implants. The participants were subjected to bone scintigraphy to determine the osteoblastic activity at baseline, 30th day and 90th day after implant placement.
Results: Group A revealed a significant increase in osteoblastic activity between baseline, day 30 and 90 (P<.05) with a higher mean of 100.06±21.644% on day 30. Group B revealed a significant increase in osteoblastic activity only between baseline and day 30, and baseline and day 90 (P<.05) whereas there was no difference between day 30 and 90 (P>.05) with a higher mean of 79.20±18.255% on day 30. Bivariate analysis at different time periods revealed a significant difference between groups A and B on day 30.
Conclusion: Implants placed with 1.2% simvastatin gel showed enhanced osteoblastic activity on the fourth week of implant placement, indicating faster rate of osseointegration at an early stage.
Schlagwörter: Simvastatin, Osseointegration, Osteoblastic activity
DOI: 10.11607/jomi.10839, PubMed-ID: 3835011213. Feb. 2024,Sprache: EnglischKhiabani, Kazem / Nourbakhshian, Farzaneh / Amirzade-Iranaq, Mohammad HoseinPurpose: To investigate the effect of lateral sinus floor elevation (LSFE) on sinus membrane
(SM) thickness and sinus health in mucosa thickness less and more than 5 mm. Materials and
Methods: LSFE was performed in a prospective controlled clinical trial on two groups with less
than and more than 5 mm (group A & B) SM thickness and followed for 6 months. Using
preoperative and 6-month postoperative CBCT and clinical evaluation, SM thickness changes
(primary outcome variable), sinus health, augmented bone height, and length (augmentation
adequacy), membrane–related variables, and operation time were measured. Results: Forty
unilateral sinus augmentations (A:20, B:20) with simultaneous installation of 52 fixtures were
performed on 40 subjects (72.5% males, mean age of 48.8±7.6). The mean preoperative and 6-
month SM thicknesses in group A and group B were 1.4±0.9 and 1.3±0.6 mm, and 6.8±1.0 and
3.4±1.7 mm, respectively. The mean postoperative SM thickness significantly decreased
(P<0.001) only in group B. The mean SM thickness changes also revealed a noticeable
difference between the two groups (P<0.001). Augmentation adequacy and membrane
perforation rate were similar in both groups. Clinical and radiographic rhinosinusitis was not
detected in any of the patients. Bleeding during separation and resistance to elevation in group B
were significantly higher than in group A (P=0.003, P=0.001). Surgical time in group B (12.08 ±
8.26 minutes) was longer than in group A (8.64 ± 3.70 minutes), without reaching a significant
level (P=0.097). Conclusions: LSFE in thickened mucosa (≤10 mm) and thinner mucosa (≤5
mm) does not cause abnormal changes in the sinus membrane and sinus health. LSFE in
thickened mucosa results in adequate sinus augmentation. Thickened SM also shows a
significant thickness reduction. The thickened membrane does not appear to be a
contraindication to SFE.
Schlagwörter: Sinus floor elevation, Schneiderian membrane, sinus membrane, mucosal thickness, ostium patency
DOI: 10.11607/jomi.10672, PubMed-ID: 3834984713. Feb. 2024,Seiten: 1-37, Sprache: EnglischSirawuttipong, Chayanan / Palanuwech, MaliPurpose: To investigate the esthetic outcomes based on the color differences in zirconia of
varying thickness, resin cement color, and types of titanium implant surface treatments.
Materials and Methods: Twenty-eight HTMZ specimens were arranged into four groups based
on zirconia thickness: 1.0, 1.5, 2.0, and 2.5 mm (n=7). Each group was tested using two resin
cement colors (n=7) (clear and opaque) in combination with six surface-treated titanium groups
(n=7): untreated titanium (UT), anodization (AN), 50-μm alumina airborne-particle abrasion
followed by AN (SBAN), AN followed by 50-μm alumina airborne-particle abrasion (ANSB),
95% hydrofluoric acid followed by AN (HFAN), and AN followed by 95% hydrofluoric acid
(ANHF) for the 48 experimental groups, and using composite resin (n=7) (A2D) for the four
control groups. All the specimens were measured using a spectrophotometer and subsequently
compared with composite resin (control) with the corresponding zirconia thickness to establish
the color differences. A color difference of <2.7 was considered clinically acceptable. The data
obtained were statistically analyzed using the analysis of variance and post hoc test (p=0.05).
Results: Zirconia thickness, resin cement color, and type of titanium implant surface treatment
significantly affected the observed color differences (p<0.05). When using 2.5-mm HTMZ with
clear resin cement on AN, UT, SBAN, HFAN, and ANSB, the mean color differences obtained
were below the clinically acceptable values. However, when using 2.5-mm HTMZ with clear
resin cement on AN, UT, and SBAN, the 95% confidence intervals of color differences obtained
were below the clinically acceptable values. Conclusions: HTMZ with a minimum thickness of
2.5 mm and clear resin cement on AN, UT, and SBAN groups potentially result in acceptable
color matching with 95% confidence intervals.
Schlagwörter: anodize, cement, ceramic, color, spectrophotometer, zirconia
DOI: 10.11607/jomi.10731, PubMed-ID: 3829001530. Jan. 2024,Sprache: EnglischRiachi, Emile / Juodzbalys, Gintaras / Maciuliene, DaivaPurpose: The objective of this systematic review is to assess the impact of implant placemen at different periods on the aesthetic and clinical outcomes, in the aesthetic zone. Material and Methods: Literature screening was conducted in PubMed, ScienceDirect and Cochrane library databases. Relevant articles were chosen according to selection criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data was collected from studies published from 2017-2022 in English. Results: Nine articles were included, where a total of 495 implants were placed, from which 250 were immediate, 109 early, and 136 delayed. Immediate implants showed no statistical difference in Pink Esthetic Score (PES) contrasted to delayed implants. Immediate implants showed significantly higher PES in comparison to early implants (MD= -0.76 with 95% CI= -1.50 to -0.02; P=0.04). The probing depth (PD) was considerably greater in the immediate implants when compared to delayed (MD= -0.62 with 95% CI= -1.05 to -0.18; P=0.005), and the plaque index (PI) was statistically greater in early implants compared to immediate implants (MD= 0.15 with 95% CI= 0.11 to 0.19; P<0.00001). All other soft tissue outcomes showed equal results. The marginal bone level (MBL) loss was statistically higher in early implants compared to immediate implants (MD= 0.09 with 95% CI= 0.02 to 0.16; P=0.02). Conclusions: immediate implants had significantly superior PES, marginal bone loss, and plaque index results when compared to early implants. The probing depth was significantly higher in the immediate group compared to the delayed group. All other outcomes showed no significant difference between the three implant groups. It is important to highlight the limitations of this review such as the small number of studies included and the few reports on aesthetic indices.
Schlagwörter: dental implant; endosseous dental implant therapy; dental implantation, endosseous; esthetics, dental.
DOI: 10.11607/jomi.10703, PubMed-ID: 3826093423. Jan. 2024,Sprache: EnglischTal, Haim / Cohen, Omer / Rayyan, Fatma / Pokhojaev, Ariel / Sarig, Rachel / Raz, Perry / Beitlitum, IlanNatural Coral Particles (NCPs) are a suitable scaffold material for Guided Bone Regeneration (GBR) procedures; it combines the placement of a bone substitute supporting a barrier membrane. Due to increasing sea pollution and the declarations of endangered coral species (KYOTO 1997), they are no longer suitable for the medical industry. Novel domestic corals have been grown under controlled conditions to produce cultivated coral graft (CCG) material. This study aimed to evaluate a new CCG in an in vivo experimental GBR procedure. The calvarias of 8 rabbits were surgically exposed, and circular defects 8 mm in diameter were prepared. One defect was filled with CCG particles (experimental group); the contralateral defect (control group) was spontaneously filled by blood clot. The defects were covered with a collagen membrane. Animals were euthanized after 8 weeks. Histological observations of the defects showed similar bone growth patterns in both experimental and control osteotomies. In the experimental defects, no traces of coral particles were observed. Histometric analysis showed denser bone in the pristine zone (65-66%) than in the peripheral zone for both the control (50%) and experimental defects (31%) (P= NS). The new bone percentage was reduced from the peripheral zone toward the middle and the center of the defect (31%, 32% and 27%, respectively) as the distance from the peripheral pristine bone borders increased. The existing data support the complete degradation of CCG as space-maintaining scaffold for GBR procedures.
Schlagwörter: coral, graft, animal study, GBR, bone, rabbit
DOI: 10.11607/jomi.10656, PubMed-ID: 379392378. Nov. 2023,Seiten: 1-21, Sprache: EnglischMarchand, Laurent / Cornish, David / Mojon, Philippe / Sailer, Irena / Worni, AndreasPurpose: to measure the surface temperature distribution after CO2-laser heating of titanium dental implants using different power settings, application intervals and irradiation times. Materials and methods: 10 tissue-level-type titanium implants (Camlog Screw-line Promote Plus 4.3mm x 11mm) were embedded (Epofix, Struers ApS, Copenhagen, Denmark) and irradiated with a carbon-dioxide-laser (Denta II, Lutronic Corporation, Fremont, USA) with a wavelength of 10.6µm and at power levels of 4watts (group 1), 6watts (group 2), 8watts (group 3) and 10watts (group 4). A continuous beam mode (setting I) and non-continuous beam modes with 5second (setting II) and 10second (setting III) pause intervals were used. For each setting, a total irradiation time of 50seconds was used and repeated 10 times. The temperature was measured using external thermocouples (Testo SE & Co. KGaA, Lenzkirch, Germany) in contact with the implant surface at implant shoulder, middle and apex. A linear regression model was used to analyse the data (p = 0.05). Results: Setting I demonstrated the most rapid increase in implant surface temperature in all three test sites as well as the greatest total temperature at 50 seconds of irradiation time. The greater the pause interval (settings II and III) during the 50 seconds of irradiation, the lower the rate of temperature increase as well as the total temperature in all three test sites and with all power levels. The average temperature difference between the apex and shoulder site was significant for test setting III for all groups, but not for any groups in settings I and II. Conclusion: Heating the internal aspect of a dental implant with a CO2-laser produces different temperature distribution profiles depending on the laser power level and the application interval. Laser-beam irradiation leads to a temperature gradient which is greatest at the implant apex and smallest at the implant shoulder.
DOI: 10.11607/jomi.10560, PubMed-ID: 379392428. Nov. 2023,Seiten: 1-25, Sprache: EnglischWen, Shih-Cheng / Sabri, Hamoun / Dastouri, EbrahimAim: This report stems from a homogeneous patient cohort from two similarly designed prospective controlled studies in the same center on surgical reconstructive treatment of peri-implantitis. The aim of this re-analysis study was exploring prognostic factors associated with surgical outcomes. Materials and methods: Individual patient data of both studies were gathered. The initial study employed a submerged healing approach via primary wound closure with implant supra-structure removal and complete coverage of grafted sites. The second study employed a non-submerged healing protocol in which healing abutments were kept in place and the implant was not fully submerged. Both studies measured all outcomes at similar timepoints throughout 1 year, to include clinical and radiographic defect fill (DF and RDF), reduction of pocket depth (PDR) and bleeding on probing (BOP). Multi-level regression was used for statistical assessment of outcomes, relative to the impact of site-/local-, surgical- and patient-related variables. Results: Overall, 59 implants (30 in submerged and 29 in the non-submerged group) were treated. A statistically significant higher DF (on average 0.9 mm higher), RDF (1.7 mm) and PDR (1.3 mm) were observed when a submerged reconstructive approach was performed, whereas BOP reduction was similar. After controlling for treatment (submerged/non-submerged), there were no other significant associations with patient- (age, gender, smoking, prior periodontitis etc.), or implant-related (previous prosthesis type, arch, KTW, etc.) factors. Conclusion: Within its limitations, we conclude that a submerged reconstructive approach for surgical management of peri-implantitis leads to significantly enhanced clinical and radiographic outcomes when compared to a non-submerged approach.
DOI: 10.11607/jomi.10731, PubMed-ID: 382900158. Nov. 2023,Seiten: 1-43, Sprache: EnglischRiachi, Emile / Juodzbalys, Ginataras / Maciuliene, DaivaPurpose: The objective of this systematic review is to assess the impact of implant placemen at different periods on the aesthetic and clinical outcomes, in the aesthetic zone. Material and Methods: Literature screening was conducted in PubMed, ScienceDirect and Cochrane library databases. Relevant articles were chosen according to selection criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data was collected from studies published from 2017-2022 in English. Results: Nine articles were included, where a total of 495 implants were placed, from which 250 were immediate, 109 early, and 136 delayed. Immediate implants showed no statistical difference in Pink Esthetic Score (PES) contrasted to delayed implants. Immediate implants showed significantly higher PES in comparison to early implants (MD= -0.76 with 95% CI= -1.50 to -0.02; P=0.04). The probing depth (PD) was considerably greater in the immediate implants when compared to delayed (MD= -0.62 with 95% CI= -1.05 to -0.18; P=0.005), and the plaque index (PI) was statistically greater in early implants compared to immediate implants (MD= 0.15 with 95% CI= 0.11 to 0.19; P<0.00001). All other soft tissue outcomes showed equal results. The marginal bone level (MBL) loss was statistically higher in early implants compared to immediate implants (MD= 0.09 with 95% CI= 0.02 to 0.16; P=0.02). Conclusion: immediate implants had significantly superior PES, marginal bone loss, and plaque index results when compared to early implants. The probing depth was significantly higher in the immediate group compared to the delayed group. All other outcomes showed no significant difference between the three implant groups. It is important to highlight the limitations of this review such as the small number of studies included and the few reports on aesthetic indices.
DOI: 10.11607/jomi.10553, PubMed-ID: 379392388. Nov. 2023,Seiten: 1-36, Sprache: EnglischMendes, Vivian Viveiros / Martins, Felipe V. / de Santana, Carolina Miller Mattos / de Santana, Ronaldo BarcellosBackground: The clinical use of bioactive substances, such as growth factors, have significantly increased, however, potential regenerative effects derived from the addition of different growth factors to bone substitutes on maxillary sinus floor augmentation (MSA) procedures is still controversial. This systematic review (SR) aimed at answering the following question: “Do recombinant, purified and concentrated growth factors enhance the regenerative potential of particulate bone graft substitutes in maxillary sinus floor augmentation?”. Methods: Human studies comparing histomorphometric data of the outcomes of interest new bone formation, residual graft material, and fibrous tissue ratio following MSA procedures employing particulate bone grafts/substitutes in combination or not with growth factors were retrieved from PubMed/MEDLINE, Web of Science, Cochrane and Scopus online databases and complemented with a hand search. Controlled studies published in English up to December 2022 and reporting on histomorphometric data expressed as percent volume of the outcomes of interest were considered. Risk of bias was assessed, and a meta-analysis (MA) was performed to investigate the effects of supplementary growth factors on new bone formation, remaining graft particles and fibrous tissue ratio. Results: Data of 613 samples from 477 patients reported in 22 publications were included. MA showed PRP or PRF resulted in 49% more new bone formation than in areas in control groups (P=0.004), and those areas supplemented with growth factors presented 57% less residual graft particles after healing (P<0.0001). A significant (P=0.03) 1.85-fold increase in connective tissue formation was noted in areas treated with rhBMP after healing. Conclusion: The MA provided evidence that selective supplementary growth factors may enhance new bone formation and accelerate particulate graft turnover, while rhBMP may significantly increase connective tissue formation in MSA procedures in humans.
DOI: 10.11607/jomi.10597, PubMed-ID: 379108351. Nov. 2023,Seiten: 1-17, Sprache: EnglischDegidi, Marco / Daprile, GiuseppePurpose: The primary aim of this study is to evaluate the correspondence between an Artificial Intelligence driven new tool prediction and the clinician’s evaluation in the immediate loading suitability of curves recorded during implant insertion in an in vitro test. The secondary aim is to analyse peak insertion torque (pIT) and variable torque work (VTW) values of the implants used for the in vitro study. Material and methods: The study was performed on artificial bone blocks of solid rigid polyurethane without cortical layer with four different densities. Five types of implants with different macrogeometries were used. A total of 140 implants (7 implants of each type in the four polyurethane blocks) were inserted. Immediately after implant placement the insertion curves were classified by the operator as suitable or non-suitable for immediate loading. In a second moment the same curves were analyzed by the new AIT that classified them as belonging to YES or NO class. For each implant pIT and VTW were also recorded. Results: The correspondence between surgeon and AIT evaluation was 99,3% with only one false-negative reported by the algorithm analysis. The sensitivity resulted 98.95%, the specificity 100%, positive predictive value 100% and negative predictive value 97.8%. Mean pIT of the whole sample was 34.19 + 19.43 Ncm while mean VTW was 2266.89 + 1993.73 Ncm. Statistically significant differences were found between implant systems in the whole sample and when divided by polyurethane block density. Conclusions: AIT showed a high level of accuracy in the prediction of immediate loading suitability of insertion curves examined. All the implants used in the in vitro test were able to reach good levels of primary stability, excluding when inserted in the less dense polyurethane block. Clinical studies conducted in larger samples and with more surgeons involved are necessary to confirm these results.
DOI: 10.11607/jomi.10651, PubMed-ID: 379108391. Nov. 2023,Seiten: 1-42, Sprache: EnglischAbreu, Orlando Jose / Estepa, Araceli Valverde / Naqvi, Afsar Raza / Nares, Salvador / Narvekar, AniruddhPurpose: Dental implant manufacturers recommend healing abutments (HA) be used for single-patient use; however, reuse on multiple patients following decontamination and sterilization is common. This study aims to evaluate four decontamination strategies utilizing enzymatic agents, available in most clinical settings, to determine the level to which biomaterial can be removed in a group of previously used HA (uHA). Secondly, to determine the degree to which the decontaminated HA are capable of inducing an inflammatory response in-vitro compared to new, never used HA. Materials and Methods: Fifty HA were collected following 2-4 weeks of intraoral use and distributed randomly into 5 test groups (Group A-E; n = 10/group). Group A: Enzymatic cleaner foam + Autoclave; Group B: Ultrasonic bath with enzymatic cleaner + Autoclave; Group C: Prophy jet + Enzymatic cleaner foam + Autoclave; Group D: Prophy jet + ultrasonic bath with enzymatic cleaner + Autoclave; Group E: Prophy jet + Autoclave. Ten new, sterile HA served as controls (Group “Control”). Residual protein concentration was determined by a Micro BCA protein assay while HA from each group were stained with Phloxine B and macroscopically examined for the presence of debris. To examine the inflammatory potential, human primary macrophages were exposed to HA and supernatant levels of 9 cytokines/chemokines profiles were analyzed using a multiplex bead assay. Results: All test groups presented with differences in the degree of visual decontamination compared to Controls, with Groups D and E displaying the most effective surface debris removaland reduced protein concentration. Of the detoxification strategies, Groups D and E removed the greatest biomaterial while least effective was Group A. However, compared to Controls, multiplex assays revealed high levels of inflammatory cytokine secretion up to 5 days from all Test Groups (A-E) irrespective of the decontamination method used. Conclusion: Our study found that compared to new, never used HA, decontamination of uHA utilizing enzymatic cleaners failed to reestablish inert HA surfaces and prevent an inflammatory immune response in-vitro. Clinicians should not reuse HA even after attempts to decontaminate and sterilize HA surfaces.
DOI: 10.11607/jomi.10592, PubMed-ID: 379108321. Nov. 2023,Seiten: 1-17, Sprache: EnglischKlass, Dmitriy / Price, Albert / DiBattista, Massimo / Dibart, Serge / Kernitsky, JeremyPurpose: To quantify the clinical accuracy of a robotically assisted implant guidance system in partially edentulous patients without the use of postoperative cone-beam radiography. Materials and Methods: A total of 10 implants (7 patients) were placed in partially edentulous patients utilizing robotically assisted implant guidance system. Following the implant placement a intraoral scan was performed to register the implant position after attaching a scan body. The virtual plan and the postoperative intraoral scan with the scan bodies were exported as STL files, superimposed and discrepancies were analyzed using Geomagic Control X software. Positional deviations were measured between the midpoint of the platform and apex of the planned and achieved implant positions. Results: Seven of the 10 samples in this study were defined as fully robotically dynamically guided, while 3 were partially robotically guided. For the fully robotic dynamically guided group the mean deviation at the midpoint of the restorative platform of the implant, the apex of the implant, the top of the scanbody, and the mean angular deviation were 1.31mm (SD0.46mm), 1.58mm (SD0.61mm), 1.11mm (SD0.57mm), and 2.34 degrees (SD1.71º), respectively. While for the partially robotic dynamically guided cases it was 1.31mm (SD0.49mm), 1.45mm (SD0.3mm), 1.74mm (SD0.47mm), and 3.75 degrees (SD2.53º). Eight out of the 10 implants (irrespective of full or partial guidance) showed a buccal displacement. Conclusion: Robotic surgery offers a level of accuracy similar to fully guided implant placement, without the need for a physical template, and allowing for changes in the surgical plan at any time. The analytical method described in this study is an effective and radiation free quality control tool that can be used in implant dentistry as well as in other areas of dental research dentistry.
DOI: 10.11607/jomi.10613, PubMed-ID: 379108331. Nov. 2023,Seiten: 1-24, Sprache: EnglischHassan, Manal / Shawky, Mohamed / Gibaly, Amr / Fattouh, Hesham / Atef, MohammedIntroduction: Different surgical procedures have been proposed to achieve successful horizontal ridge reconstruction of the anterior maxilla, most of these procedures require complex surgical stages with morbidity and are time-consuming. Aim: The purpose of this study is to evaluate the efficacy of using a customized xenograft shell with a 1:1 mixture of particulates xenograft and autogenous bone for the reconstruction of horizontally deficient anterior maxillary alveolar ridges. Methods: Cone beam computed tomography (CBCT) images of the atrophic maxilla of eight patients were acquired and generated into 3D models. The data were transferred to a 3D printer and solid models were fabricated. During the surgery, the xenograft blocks were manually sliced and customized on the 3D printed models and fixed then the gap was augmented with a 1:1 xenograft autograft mixture. Results: Clinical assessment showed no adverse effects. However, one patient exhibited wound dehiscence. The mean difference between the preoperative and the six months postoperative showed a net average bone gain by 4.06 mm at 2 mm from the crest and 4.34 mm at 5 mm from the crest, which was statistically significant. On the other hand, a statistically significant graft resorption by 1.41 mm and 2.19 mm at 2 and 5 mm from the crest was found when the mean difference between the immediate and the six months postoperative was calculated. Conclusions: Within the limitations of the study, the use of xenograft shells as a barrier for maxillary alveolar ridge reconstruction is predictable technique however, further investigations regarding the required time for graft consolidation is required.
DOI: 10.11607/jomi.10758, PubMed-ID: 379108281. Nov. 2023,Seiten: 1-22, Sprache: EnglischJoshi, Vinayak M. / Kandaswamy, EswarDental implants are an established treatment options for varying edentulous conditions and has grown in popularity since the 1990’s. This increased clinical application has evidenced a parallel increase in dental implant related research. The objective of this paper was to perform a comprehensive bibliometric analysis of five dental implantology journals from 1991-2023. Materials and Methods: We performed a search in the ISI Web of Science database between 1991 and 2023 in 5 journals with a focus on dental implantology: Clinical Oral Implant Research, Clinical Implant Dentistry and Related Research, Implant Dentistry, International Journal of Oral and Maxillofacial Implants, and International Journal of Oral Implantology. Results marked as correction, retraction notices, retracted articles, meeting abstract, withdrawn publications were removed from the analysis. The time period analyzed was divided into 4 decades: 1991-2000, 2001-2010, 2011-2020, 2021-2023. Additionally, the top 100 cited papers were also exported separately. Authors and countries with most publications were tabulated from the Web of Science database. VOS Viewer software was used to create network maps of keywords and title word occurrences for each of the time periods. Histcite software was used to analyze number of publications and citation counts. Results: Network maps of keywords and title word occurrences suggested an early focus on osseointegration and titanium implants between 1991-2000. Publications between 2001-2010 saw a focus on in-vivo studies, implant surface and peri-implantitis. Publications post 2011 saw a focus on bone regeneration, complications and zygomatic implants. USA ranked highest in total number of publications in all time periods analyzed. Conclusions: Within the limitations of the study, we reported a comprehensive bibliometric analysis from 1990-2023. We identified trends in keywords and titles of dental implant publications in these journals which mirrored the trends seen in clinical practice.
DOI: 10.11607/jomi.10595, PubMed-ID: 379108301. Nov. 2023,Seiten: 1-25, Sprache: EnglischKaraoğlu, Öykü / Nemli, Seçil Karakoca / Bal, Bilge Turhan / Güngör, Merve BankoğluPurpose: The purpose of the study is to investigate the screw loosening and fracture resistance of different hybrid abutment crown restorations after thermomechanical aging. Materials and Methods: Restorations were produced from zirconia, lithium disilicate, and hybrid ceramics with CAD-CAM system (n=10). Restorations and titanium bases (Tibases) were cemented and the abutment screws were torqued to 30 Ncm. They were retorqued after 10 minutes, and removal torque values (RTV) were measured. When 250000 and 500000 cycles of thermomechanical aging were completed, the RTVs were measured again and removal torque loss (RTL) ratios were calculated. The specimens were subjected to fracture resistance test after 750000 cycles of thermomechanical aging. The load at failure was recorded as the fracture resistance (N). The results were statistically analyzed (α=0.05). Results: Aging was effective on the RTVs and RTL ratios (P<0.001). The highest RTV was observed before aging; however, the RTVs significantly decreased and RTL ratios significantly increased after aging (P<0.05). The fracture resistance values significantly differed among the ceramic materials. All lithium disilicate and hybrid ceramic specimens showed restoration fracture, while most of the zirconia specimens were displayed Tibase related failure. Conclusion: Hybrid abutment crowns made of zirconia, lithium disilicate, and hybrid ceramics can withstand the average occlusal forces in the molar region; however ceramic type may affect the failure type. Retightening of the abutment screws after 10 minutes after first tightening and annually may be beneficial to prevent the adverse effects of screw loosening on the integrity of implant-abutment connection.
DOI: 10.11607/jomi.10598, PubMed-ID: 379108401. Nov. 2023,Seiten: 1-28, Sprache: EnglischKwan, Jan C. / Kwan, Norman H.Purpose. The purpose of this study is to compare the factors of taper, length, angle and number of vertical axial walls that affect the retentive strength of a cemented crown on a partially customizedhybrid abutment in the esthetic zone. Materials and Method. A total of 35 metal copings were used in this study divided into one group with 30 copings cemented to their corresponding 8° tapered abutment with lengths from 3 to 8 mm with 1 mm increments. The remaining five consisted of a standardized metal coping matching a hexagonal abutment with 3 mm vertical axial walls and the sequential removal of 1, 2, and 3 contiguous vertical axial walls. Dislodgment tests were performed for all copings in both groups. Maximum retentive forces were measured in kgF with a conversion factor of 9.807 N to 1 kgF. Results. At each tapered abutment length, the retentive strength increased proportionally and was significantly different from 31.67 ± SD 4.10 kgF to 67.68 ± SD 11.22 kgF, respectively [F (5,24) =20.46, p < 0.001]. An unmodified hexagonal abutment demonstrated the highest retentive strength of 70.15 ± SD 12.97 kgF. Sequential removal of 1, 2, and 3 contiguous vertical axial walls of the hexagonal abutment was 59.89 ± SD 10.06 kgF, 57.01 ± SD 9.62 kgF, and 55.99 ± SD 9.35 kgF, respectively with no significant difference (p > 0.05) in retentive strength. Conclusion. A partially customized abutment with vertical axial walls on one side and a profile reduction on the opposite side can provide comparable retention of cemented copings at 1/3 the length and 1/6 the surface area of an 8 mm high abutment with an 8° taper.
DOI: 10.11607/jomi.10700, PubMed-ID: 3786130420. Okt. 2023,Seiten: 1-36, Sprache: EnglischAri, Ilgin / Karaca, Çigdem / Er, Nuray / Ocak, MertPurpose: The aim of this study was to investigate the effects of membrane stabilization by suturing the sinus membrane and dental implant insertion on endo-sinus bone formation in lateral sinus lifting performed without grafting. Materials and Methods: Maxillary sinus lift surgery using the lateral approach was performed bilaterally in 30 New Zealand white rabbits. The maxillary sinus areas were divided into control and test groups. In the control group, a titanium screw was placed after sinus membrane elevation, while in the test group, the sinus membrane was sutured to the lateral walls and a titanium screw was placed in the center of the alveolar crest. The animals were sacrificed at 4 and 8 weeks. Samples were collected, and micro-computed tomography (micro-CT) analysis was performed. The volume of newly formed bone, percentage of osseointegration, sinus volume, residual bone height, and protrusion length of the implants were measured using micro-CT analysis. Results: The sinus volume, volume of newly formed bone, and percentage of osseointegration in the test group were significantly higher than those in the control group at 4 weeks (p = 0.01, p = 0.04, p = 0.02, respectively) While the volume of newly formed bone was 17.1 ± 3.08 mm3 in the control group, it was 26.9 ± 14.26 mm3 in the test group at 4 weeks. The volume of newly formed bone was significantly decreased from 26.9 ± 14.26 mm3 to 17 ± 3.66 mm3 at 8 weeks (p = 0.02). No significant difference in residual bone height was found at 4 and 8 weeks (p = 0.07). No significant difference in implant protrusion length was found between the control and test groups (p = 0.18). Protrusion length and new bone formation in the sinus showed a negative relationship (p = 0.01). Conclusion: Suturing the sinus membrane to the lateral sinus wall is an effective approach for increasing osseointegration, bone volume, and sinus volume in the short-term. A slow-absorbing suture material can be used to maintain sinus and bone volumes in the long-term.
DOI: 10.11607/jomi.9962, PubMed-ID: 376723956. Sept. 2023,Seiten: 1-9, Sprache: EnglischCiftci, Sezai / Ungor, Cem / Suleymanli, BayramPurpose: To examine the stresses caused by different All-on-4 surgical techniques—conventional, a combination of monocortical and bicortical, bicortical, and nasal floor elevation—on the implant and the surrounding bone using 3D finite element analysis (FEA). Materials and Methods: A 3D bone model of the atrophic maxilla was created based on CT imaging of the fully edentulous adult patient. All implants used in the models were 4 mm in diameter, and the length was 13 mm in the anterior and 15 mm in the posterior. Implants were applied to four different atrophic maxillary models with the All-on-4 technique: anterior and posterior monocortical implants in the first model, anterior monocortical and posterior bicortical in the second model, anterior and posterior bicortical in the third model, and anterior and posterior bicortical with nasal floor elevation in the fourth model. Eight linear analyses were performed by applying force from both vertical and 45-degree oblique directions to the four models prepared in our study. Results: When the cortical and cancellous bone around the anterior implants was examined, it was observed that the oblique and vertical loading conditions and the stresses around the implant were similar in all models. When the posterior implants were examined, model 1 (ie, anterior and posterior monocortical implants) showed the greatest oblique compression, vertical compression, and vertical tension forces. According to the Von Mises stress (VMS) analysis results for anterior and posterior implants, higher values were observed in model 1 compared to models 3 and 4 under oblique and vertical forces. It was observed that bicortical placement of the implants reduced the stresses on the bone and implant-abutment system but had no significant effect on the stress on the bar. Conclusions: According to the results of our study, in the All-on-4 technique, bicortical placement of the implants reduced the stresses on the bone and implant when the anatomical limitations allowed. In addition, nasal floor elevation can be applied in the atrophic maxilla in appropriate indications.
DOI: 10.11607/jomi.9952, PubMed-ID: 376723946. Sept. 2023,Seiten: 1-10, Sprache: EnglischWiesli, Matthias G. / Fankhauser-De Sousa, Sandra / Metzler, Philipp / Rohner, Dennis / Jaquiéry, ClaudePurpose: To assess the peri-implant and flap parameters of the prefabricated microvascular fibula flap and determine the dental implant survival rate. Materials and Methods: This retrospective study investigated a cohort of subjects who received prefabricated microvascular fibula flaps at two highly specialized tumor reconstruction centers. The subjects had all suffered atrophy or a large segmental defect of the jaws due to tumor resection or injury. Two independent surgeons determined the dental implant survival rate and assessed the peri-implant parameters and flap parameters during clinical follow-up. Results: In total, 41 subjects were treated with a prefabricated fibula flap between 1999 and 2012. Of these, 17 subjects (10 male, 7 female) with a total of 62 dental implants were examined. The other 24 subjects were unavailable for assessment and had to be excluded. Ten of the 62 dental implants (16.1%) had to be removed due to peri-implantitis before the follow-up assessment. Follow-up assessments were performed at intervals ranging from 2 to 12 years (mean: 7.2 years) after fibula flap transplantation. The dental implant survival rate was found to be 83.9%. A total of 208 dental surfaces were assessed. Overall, 96% of all surfaces had a pocket depth (PD) of ≤ 4 mm and 4% had a pocket depth of > 5 mm. An attachment level (AL) of 3 mm was measured in 48.5% of implants and ≥ 5 mm was measured in 15.9% of implants. Dental implants with a PD > 4 mm showed a significantly higher plaque index (PI) (75%; P = .0057), papillary bleeding index (PBI) (62.5%; P = .0094), and radiologic bone loss (P = .0014) compared to dental implants with a PD ≤ 4 mm. Conclusions: Reconstructive surgery using microvascular fibula flaps represents an alternative tool for oral rehabilitation in subjects suffering from a large segmental defect in the maxillary or mandibular bone compared to the conventional method. However, it appears that the different ossification processes that develop the fibula and the jawbones affect dental implant survival.
DOI: 10.11607/jomi.10364, PubMed-ID: 3734805622. Juni 2023,Seiten: 1-8, Sprache: EnglischPita, Afroditi / Thacker, Sejal / Sobue, Takanori / Gandhi, Vaibhav / Tadinada, AdityaPurpose: To compare the standard 360-degree CBCT acquisition protocol to the low dose 180-degree CBCT protocol for implant planning.
Materials and methods: Two groups of patients, each consisting of 35 patients, were included in the study. The first group was imaged with the conventional 360-degree CBCT protocol, and the second group was imaged with the low dose 180-degree CBCT protocol. The primary outcome of this study was the number of scans that needed to be repeated due to poor image quality. In addition, six secondary parameters were evaluated quantitatively and qualitatively.
Results: The results showed that there was no need to repeat any of the CBCT scans that were obtained in either group, which showed that 360-degree and 180-degree protocols had comparable image quality. As for the secondary parameters, the results showed that the evaluators were able to evaluate the six chosen parameters in a comparable manner.
Conclusion: The 180-degree low dose CBCT scan is a viable option for dental implant treatment planning in the posterior mandible as it provides comparable and adequate information regarding accuracy of measurements, identification of critical structures, evaluation of bone quality, and any pathology.
Schlagwörter: CBCT, implant planning, 180-degree, dental implant, ALARA, radiation, low-dose radiation, radiology
DOI: 10.11607/jomi.10321, PubMed-ID: 3767239627. März 2023,Seiten: 1-8, Sprache: EnglischBilge, Nebiha Hilal / Dagistanli, Sadettin / Karasu, Yerda Özkan / Orhan, KaanPurpose: To examine the changes of dentoalveolar structures and pathologies in the maxillary sinus before and after dental implant surgery alone or with direct vs indirect sinus lifting using CBCT images of the maxillary posterior region. Materials and Methods: Preoperative and postoperative CBCT images of 50 sinus sites and the alveolar bone around 83 implants in 28 patients were evaluated. Maxillary sinus pathologies were classified as mucosal thickening (MT), mucus retention cyst (MRC), polyp, and sinusitis before and after surgery. The changes after surgery were determined to be no change, reduction in pathology, or increase in pathology. Comparisons of pathology changes among the treatment groups were evaluated statistically with chi-square test, McNemar test, and Mann-Whitney U test. Results: Of the 50 sinuses evaluated for the presence of sinus pathology, 24 of 50 did not change postoperatively, the pathology increased in 10 sinuses, and the pathology decreased in 16. When the maxillary sinus regions were evaluated after indirect sinus lifting, direct sinus lifting, and in patients who had only implant surgery, there was no statistically significant difference between pathology distribution in terms of the procedure applied to the sinus (P > .05). However, in the maxillary sinuses with a pathology before implant placement were evaluated postoperatively, a statistically significant difference was found in favor of the presence of a change in pathology (ie, improvement or a decrease; P < .05). The maxillary sinuses without pathology before implant placement showed a statistically significant difference for no change; ie, continuation of the healthy state (P < .05). Conclusion: This study showed that surgical procedures could have a direct effect on the sinus membrane and maxillary sinus. Both the implant procedure and surgical approach may have an effect on maxillary sinus pathology, as well as an increase or decrease of the pathology. Hence, further studies with a longer-term follow-up should be performed to better understand the correlation between implant surgery and pathology.