Accuracy analysis of robotic-assisted immediate implant placement: A retrospective case series.

OBJECTIVES: This study aimed to investigate the accuracy of a robotic computer-assisted implant surgery (r-CAIS) for immediate implant placement. METHODS: Patients requiring immediate implant placement in the maxillary anterior region were enrolled for r-CAIS. Before surgery, the patients underwent a cone beam computed tomography (CBCT) scan with a positioning marker. Virtual implant placement position and drilling sequences were planned. Following spatial registration and calibration, the implants were placed with the robotic system under supervision. A postoperative CBCT was taken to control the actual implant positions. The DICOM data of the virtually planned and the actually placed implant were superimposed and registered through the accuracy verification software of the robotic system. The accuracy was calculated automatically. The deviation at the mesial-distal, labial-palatal, and apico-coronal directions were recorded. RESULTS: Fifteen patients with 20 implants were included. No adverse surgical events or postoperative complications were reported. The global platform, apex, and angular deviation were 0.75 ± 0.20 mm (95 % CI: 0.65 to 0.84 mm), 0.70 ± 0.27 mm (95 % CI: 0.57 to 0.82 mm), and 1.17 ± 0.73° (95 % CI: 0.83 to 1.51°), respectively. Moreover, the vertical platform and apex deviation were 0.50 ± 0.31 mm, (95 % CI: 0.35 to 0.64 mm) and 0.48 ± 0.32 mm, (95 % CI: 0.33 to 0.63 mm), respectively. All the placed implant positions were further labial and apical than the planned ones, respectively. CONCLUSIONS: High accuracy of immediate implant placement was achieved with the robotic system. CLINICAL SIGNIFICANCE: Our study provided evidence to support the potential of the robotic system in implant placement, even in challenging scenarios.

Accuracy of dynamic navigation compared to static surgical guides and the freehand approach in implant placement: a prospective clinical study.

BACKGROUND: Computer-guided implant surgery has improved the quality of implant treatment by facilitating the placement of implants in a more accurate manner. This study aimed to assess the accuracy of implant placement in a clinical setting using three techniques: dynamic navigation, static surgical guides, and freehand placement. We also investigated potential factors influencing accuracy to provide a comprehensive evaluation of each technique's advantages and disadvantages. MATERIALS AND METHODS: Ninety-four implants in 65 patients were included in this prospective study. Patients were randomly assigned to one of three groups: dynamic navigation, static surgical guides, or freehand placement. Implants were placed using a prosthetically oriented digital implant planning approach, and postoperative CBCT scans were superimposed on preoperative plans to measure accuracy. Seven deviation values were calculated, including angular, platform, and apical deviations. Demographic and consistency analyses were performed, along with one-way ANOVA and post-hoc tests for deviation values. RESULTS: The mean global platform, global apical, and angular deviations were 0.99 mm (SD 0.52), 1.14 mm (SD 0.56), and 3.66° (SD 1.64°) for the dynamic navigation group; 0.92 mm (SD 0.36), 1.06 mm (SD 0.47), and 2.52° (SD 1.18°) for the surgical guide group; and 1.36 mm (SD 0.62), 1.73 mm (SD 0.66), and 5.82° (SD 2.79°) for the freehand group. Both the dynamic navigation and surgical guide groups exhibited statistically significant differences in all values except depth deviations compared to the freehand group (p < 0.05), whereas only the angular deviation showed a significant difference between the dynamic navigation and surgical guide groups (p = 0.002). CONCLUSION: Our findings highlight the superior accuracy and consistency of dynamic navigation and static surgical guides compared to freehand placement in implant surgery. Dynamic navigation offers precision and flexibility. However, it comes with cost and convenience considerations. Future research should focus on improving its practicality. TRIAL REGISTRATION: This study was retrospectively registered at the Thai Clinical Trials Register-Medical Research Foundation of Thailand (MRF) with the TCTR identification number TCTR20230804001 on 04/08/2023. It was also conducted in accordance with the Declaration of Helsinki and approved by the institutional ethics committee at the Xian Jiaotong University Hospital of Stomatology, Xian, China (xjkqII[2021] No: 043). Written informed consent was obtained from all participants.

A Pilot Investigation Generating an Alternative Therapeutic Strategy Combining Deproteinized Bovine Bone and Gelatin Sponge for a Novel Implant Material in Sinus Floor Elevation Operation.

BACKGROUND Implant placement in the posterior maxilla is typically complicated by a shortage of bone. Gelatin sponge could be combined with an appropriate material to enhance mechanical strength and maintain stability of an implant. This study aimed to evaluate the clinical application of bone grafting with bovine bone mixed with gelatin sponge. MATERIAL AND METHODS Fifty-four patients were divided into a control group (deproteinized bovine bone, n=26) and a test group (deproteinized bovine bone combined with gelatin sponge, n=28). Implants were placed in patients simultaneously after surgery (operation). Cone-beam computed tomography examination was carried out immediately and 6 months after surgery. Space with grafting materials was measured with Mimics software (version 16.0). RESULTS No remarkable differences were found for simultaneous placement, height of residual bone, delayed placement, width of residual bone, graft volume immediately after surgery (V1), graft volume 6 months after surgery (V2), or volumetric change rate between the test group and the control group (P>0.05). Graft volume V2 was remarkably decreased compared with V1 in the control and test groups (P=0.01). There were no significant differences for bone height immediately after surgery (H1) and bone height at 6 months after surgery (H2) between the 2 groups. Bone height H2 was markedly decreased compared with H1 (P<0.05). At 1 year after implantation, there was 1 implant loss in the control group and 2 in the test group. The implant survival rate in the control group was 97.62% and 95.24% in the test group. CONCLUSIONS Absorbable gelatin sponge combined with bovine bone particles was an effective and economical material for use in routine sinus floor elevation surgery.

miR­144­3p inhibits tumor cell growth and invasion in oral squamous cell carcinoma through the downregulation of the oncogenic gene, EZH2.

Accumulating evidence demonstrates that microRNAs (miRNAs or miRs) play important roles in the development and progression of human malignancies, including oral squamous cell carcinoma (OSCC); however, the unique roles of miRNAs are not yet fully understood in OSCC. The present study aimed to identify novel miRNAs associated with OSCC and to elucidate their functions. Based on a microarray analysis, miR­144­3p was found to be one of the most significantly downregulated miRNAs in OSCC tissues. Its low expression was closely associated with tumor size, differentiation and lymph node metastasis. Functionally, miR­144­3p overexpression suppressed proliferation, promoted apoptosis, and suppressed the invasion and migration of OSCC cells. In addition, enhancer of zeste homolog 2 (EZH2), a well­known oncogene, was proven to be a direct target of miR­144­3p, and its protein expression was negatively regulated by miR­144­3p. Moreover, EZH2 expression was increased, and inversely correlated with the miR­144­3p level in OSCC tissues. Notably, EZH2 knockdown inhibited cell proliferation, promoted cell apoptosis, and suppressed the invasion and migration of OSCC cells, whereas EZH2 overexpression partially reversed the anticancer effects mediated by miR­144­3p overexpression. On the whole, the findings of the present study suggest that miR­144­3p functions as a tumor suppressor by targeting the EZH2 oncogene, and may thus be considered as a potential diagnostic and therapeutic target for OSCC.

Hsa_circ_0001742 promotes tongue squamous cell carcinoma progression via modulating miR-634 expression.

Recent studies indicated that circular RNAs (circRNAs) could play critical roles in the initiation and development of tumors, including tongue squamous cell carcinoma (TSCC). We aimed to investigate the roles and underlying mechanisms of hsa_circ_0001742 in TSCC. In the present study, results reported that the expression of hsa_circ_0001742 was obviously increased and correlated with TSCC patients with advanced clinical stage, lymph-node metastasis. In vitro function assays revealed that hsa_circ_0001742 inhibition decreased the proliferation, invasion, and epithelial-mesenchymal transition (EMT) processes of TSCC cells. Molecular mechanism demonstrated that hsa_circ_0001742 could directly bind to miR-634, which mediated the functions of hsa_circ_0001742 in TSCC tumorigenesis. Furthermore, RAB1A was a target of miR-634 and hsa_circ_0001742 modulated the expression of RAB1A through competitively binding to miR-634. Thus, our study showed that hsa_circ_0001742 could promote TSCC progression by targeting miR-634/RAB1A pathway.

Intraglandular Transplantation of Adipose-Derived Stem Cells for the Alleviation of Irradiation-Induced Parotid Gland Damage in Miniature Pigs.

PURPOSE: In a previous study, the authors verified the protective efficacy of adipose-derived stem cells (ADSCs) on the prevention of salivary gland (SG) damage induced by irradiation in mice. As a critical step before implementation in clinical practice, the present study investigated the protective effect of ADSCs in a miniature pig SG model, because miniature pigs share many characteristics with humans. MATERIALS AND METHODS: Third-passage autologous ADSCs at a concentration of 4 × 106 cells/mL were transplanted by intraglandular injection into parotid glands (PGs) immediately after local irradiation at a single dose of 20 Gy. The injection process was repeated twice a week for 6 consecutive weeks. At 12 weeks after irradiation, functional and histologic evaluations were performed by measuring salivary flow rate (SFR) and hematoxylin and eosin and periodic acid-Schiff staining. Immunohistochemical and transmission electron microscopic examinations also were conducted to evaluate amylase (AMY) production, microvessel density (MVD), and microstructural changes. RESULTS: The irradiated PGs showed remarkable decreases in SFR, AMY production, and MVD. However, transplantation of ADSCs alleviated irradiated PG morphology and function by preserving more functional acinar cells and increasing SFR and AMY production. In addition, greater MVD was observed in the ADSC-treated group than in the irradiated group. CONCLUSIONS: These results indicated that intraglandular transplantation of autologous ADSCs is an effective method to protect PGs against damage from irradiation in miniature pigs, which might have clinic application in the future.

Sinus floor elevation using osteotome technique without grafting materials: a 2-year retrospective study.

OBJECTIVE: The study aimed to assess the clinical results after osteotome technique to lift sinus floor, without graft materials in the residual bone height (RBH), below 8 mm. MATERIAL AND METHODS: Twenty-two patients aged from 19 to 70 years old in need of maxillary sinus floor augmentation were enrolled in this study. Preoperative and postoperative cone beam computerized tomography (CBCT) were taken to guide the surgery. Twenty-seven implants were inserted and followed clinically, another CBCT exam was taken at 6 months postoperatively. The diameter of the implants was 4.7 mm (SD 0.4 mm), the length was 10 mm (SD 1.0 mm). The average residual bone height was 6.7 mm (SD 1.2 mm). RESULTS: No implants were lost after the surgery and the 2 years follow-up. There was no obvious marginal bone loss during the 6 months follow-up verified by CBCT. The mean bone gain at the implant sites was 2.5 mm (SD 1.5 mm). CONCLUSION: The study verified the good and stable clinical result of the OSFE technique without using bone grafting materials when the RBH was only 4.1-8 mm.