An eight-year retrospective study on the clinical outcomes of laser surface-treated implants.

PURPOSE: To retrospectively evaluate peri-implant bone loss and health status associated with the long-term use of laser surface-treated implants. METHODS: For control study, total of 23 titanium ASTM F136 grade 23 implants were placed in the edentulous molar area of the mandible. When the Implant Stability Quotient (ISQ) ≥ 70 and insertion torque value (ITV) ≥ 35-50 Ncm at the insertion site, an immediate provisional restoration was connected to the implant within a week after surgery. The definitive restorations were placed 2 months after surgery for all implants. 13 implants were immediately loaded, while 10 implants were conventionally loaded. For comparative study, Radiographs were taken from third years for and then annually for the subsequent eight years to monitor marginal bone loss. RESULTS: After eight year of implant installation, the average change in vertical bone loss was 0.009 mm (P < 0.001), while the average change in horizontal bone loss 8 year after implant placement was 0.026 mm (P < 0.001). The mean marginal bone loss was < 0.2 mm on average. CONCLUSIONS: In this retrospective study, laser-treated implants exhibit a low rate of bone absorption around the implants.

Efficacy of Xenogeneic Collagen Matrices in Augmenting Peri-Implant Soft Tissue: A Systematic Review and Meta-Analysis.

BACKGROUND: Xenogenic collagen matrices (XCMs) are gaining popularity for soft tissue augmentation in dental implants; yet, gaps exist in our understanding of their comparative effectiveness. OBJECTIVE: This systematic review and meta-analysis focuses on studies that utilize soft tissue augmentation techniques for dental implants to improve keratinized mucosa width (KMW), soft tissue thickness (STT), and soft tissue volume (STV). We compared porcine collagen matrices with autogenous grafts when no bone grafts were utilized. MATERIALS AND METHODS: We searched databases such as PubMed, Scopus, and the Cochrane Central Register of Controlled Trials for randomized controlled trials and controlled clinical trials published between January 2013 and July 2023 that assessed the efficacy of XCM in peri-implant soft tissue augmentation. The primary outcome included KMW changes while the secondary outcome was STT/STV changes. Statistical analyses were conducted using a random- or fixed-effects model, and heterogeneity was assessed using I2 statistics. RESULTS: Nine studies were included in the qualitative analysis, and six were included in the meta-analysis. No significant intergroup differences were observed (p > 0.05), but a significant difference was observed in favor of KMW ≥ 2 mm. Heterogeneity among the studies varied at the 6- and 12-month follow-ups, with I2 values of 78% and 0%, respectively. The pooled mean difference between the XCM and autograft groups was -0.96 (-1.71 to -0.21), which shows that there was a larger increase in KMW in the autograft group compared with the XCM group (p < 0.05). CONCLUSIONS: Collagen matrices are less effective than autogenous grafts at increasing keratinized tissue and STT/STV, but the two techniques yield comparable aesthetic outcomes. Additional studies are necessary to better guide clinical practice and improve patient outcomes.

Five years of radiographic evaluation for the peri-implant bone changes of all-on-four implant prostheses constructed from different framework materials using different digital construction techniques.

BACKGROUND: There is insufficient evidence recommending a framework material and a CAD/CAM manufacturing technique for mandibular implant-supported prostheses. The study objective was to evaluate the clinical application of different materials and construction techniques used for mandibular All-on-4 prosthesis on circumferential peri-implant bony changes after 5 years. METHODS: Thirty-six male patients with all-on-4 mandibular implant-supported prostheses were recalled and divided into three groups. Group PK (patients with frameworks milled from PEEK blocks), Group PSM (patients with frameworks milled from soft metal blocks), and Group SLM (patients with frameworks constructed with additive manufacturing; selective laser melting). The circumferential bone level on all implant faces was assessed with a CBCT. Two-way repeated measures ANOVA was used to compare vertical bone loss (VBL) and horizontal bone loss (HBL) between different groups, implant positions, and observation times followed by Tukey's multiple comparisons. RESULTS: For all observation times, there was a significant difference in VBL between groups for both anterior and posterior implants (P < .001). For anterior implants, group PSM showed the lowest VBL while group PK showed the highest for anterior and posterior implants. For all groups, HBL significantly increased after 5 years for both anterior and posterior implants (P < .001). For anterior implants, group PSM showed the highest HBL. For posterior implants, group PK and SLM showed the highest. CONCLUSION: Within the study's limitations, mandibular implant-supported fixed frameworks fabricated with either milling from PEEK or soft metal blocks, or additive manufacturing (laser melting technology) exhibited significant vertical and horizontal bone height changes after 5 years. CLINICAL TRIAL REGISTRY NUMBER: (NCT06071689) (11/10/2023).

Hyoid displacement during swallowing function for completely edentulous subjects rehabilitated with mandibular implant retained overdenture.

BACKGROUND: Hyoid bone is attached to the mandible, tongue, larynx, temporal bone, and cervical spine via different types of muscles or ligaments. The tongue, mandible, and hyoid system play a crucial role in swallowing function. This within subject study aimed to evaluate the impact of mandibular implant overdentures on the displacement of the hyoid bones during the swallowing process. METHODS: Twenty five healthy edentulous subjects were selected for participating in the study. New complete dentures were constructed for all the participants. Subsequently two dental implants were inserted in the canine regions of the participant's mandibular arch. In order to retain the mandibular prosthesis in place, ball attachments were incorporated into the mandibular dentures to convert them into implant overdentures. Using 10 ml of thin liquid bolus, videofluoroscopy swallowing examination was performed in three different oral conditions: without complete dentures (WCD), with complete denture (CDs), and with a mandibular implant overdenture (IODs). ANOVA with Bonferroni test was used to analyze the data in order to determine how the hyoid displacement varied throughout different oral conditions. RESULTS: Compared to complete dentures, mandibular implant overdentures showed a significant decrease (P < 0.05) in both anterior hyoid displacement and duration of hyoid maximum anterior excursion (DOHMAE). However, there was a non-significant difference (P > 0.05) between the two oral circumstances in terms of superior hyoid displacement or duration for hyoid maximum elevation (DOHME). There is no penetration or aspiration for both complete denture and implant overdenture oral conditions. CONCLUSION: Implant retained overdentures have a positive effect on hyoid displacement during swallowing of thin liquid bolus consistency relative to conventional complete dentures. TRIAL REGISTRATION: Retrospectively registered (NCT06187181) 02/1/2024.

A forecasting model for suitable dental implantation in canine mandibular premolar region based on finite element analysis.

In recent years, dental implants have become a trend in the treatment of human patients with missing teeth, which may also be an acceptable method for companion animal dentistry. However, there is a gap challenge in determining appropriate implant sizes for different dog breeds and human. In this study, we utilized skull computed tomography data to create three-dimensional models of the mandibles of dogs in different sizes. Subsequently, implants of various sizes were designed and subjected to biomechanical finite element analysis to determine the optimal implant size. Regression models were developed, exploring the relationship between the average weight of dogs and the size of premolar implants. Our results illustrated that the regression equations for mean body weight (x, kg) and second premolar (PM2), third premolar (PM3), and fourth premolar (PM4) implant length (y, mm) in dogs were: y = 0.2785x + 7.8209, y = 0.2544x + 8.9285, and y = 0.2668x + 10.652, respectively; the premolar implant diameter (mm) y = 0.0454x + 3.3506, which may provide a reference for determine suitable clinical implant sizes for dogs.

Antral membrane balloon technique versus Densah bur in crestal sinus lift with simultaneous implant placement: a randomized clinical trial.

BACKGROUND: The posterior maxilla presents challenges for implant insertion because of the poor bone quality as well as the loss of vertical bone height. Indirect transcrestal sinus lift techniques are advised when a few millimeters of additional height are needed. This study aimed to evaluate the clinical and radiographic outcomes of antral membrane balloon technique versus Densah burs for transcrestal maxillary sinus lifting with simultaneous implant placement. MATERIALS AND METHODS: This randomized clinical trial was conducted on 22 patients received 32 dental implants for replacement of missed maxillary posterior teeth after crestal maxillary sinus lifting. The patients were randomly divided into two groups. Group 1, patients underwent crestal sinus floor elevation with simultaneous implant placement using antral membrane balloon technique. Group 2, patients underwent crestal sinus floor elevation with simultaneous implant placement using Densah burs. Patients were evaluated clinically and radiographically using cone beam computed tomography (CBCT) at regular time intervals immediately, 6 months and 12 months after surgery. All clinical and radiographic parameters were statistically analyzed. RESULTS: All dental implants were successful for 12 months of follow up. Regarding implant primary stability, there was a statistical significant difference between the study groups in favor of Densah group (P = 0.004), while there was no significant difference after 6 months (P = 0.07). Radiographically, balloon group showed a statistically significant immediate postoperative vertical bone height (P < 0.0001), and significant reduction in vertical bone height after 6 months (P < 0.0001). Densah group showed significant increase in bone density (P ≤ 0.05). CONCLUSION: Both techniques demonstrated successful clinical and radiographic outcomes for crestal sinus lift. The antral membrane balloon group demonstrated better immediate postoperative vertical bone gain, while Densah burs had higher implant primary stability and bone density. TRIAL REGISTRATION: This study was registered in Clinical-Trials.gov PRS ( https://register. CLINICALTRIALS: gov ) under identification number NCT05922592 on 28/06/2023.

Bacterial reduction and temperature increase of titanium dental implant models treated with a 445 nm diode laser: an in vitro study.

In this in vitro study, the use of a 445 nm diode laser was investigated for the decontamination of titanium dental implants. Different irradiation protocols and the effect of repetitive laser irradiation on temperature increase and decontamination efficacy were evaluated on titanium implant models. An automated setup was developed to realize a scanning procedure for a full surface irradiation to recapitulate a clinical treatment. Three irradiation parameter sets A (continuous wave, power 0.8 W, duty cycle (DC) 100%, and 5 s), B (pulsed mode, DC 50%, power 1.0 W, and 10 s), and C (pulsed mode, DC 10%, power 3.0 W, and 20 s) were used to treat the rods for up to ten consecutive scans. The resulting temperature increase was measured by a thermal imaging camera and the decontamination efficacy of the procedures was evaluated against Escherichia coli and Staphylococcus aureus, and correlated with the applied laser fluence. An implant's temperature increase of 10 °C was set as the limit accepted in literature to avoid thermal damage to the surrounding tissue in vivo. Repeated irradiation of the specimens resulted in a steady increase in temperature. Parameter sets A and B caused a temperature increase of 11.27 ± 0.81 °C and 9.90 ± 0.37 °C after five consecutive laser scans, respectively, while parameter set C resulted in a temperature increase of only 8.20 ± 0.53 °C after ten surface scans. The microbiological study showed that all irradiation parameter sets achieved a complete bacterial reduction (99.9999% or 6-log10) after ten consecutive scans, however only parameter set C did not exceed the temperature threshold. A 445 nm diode laser can be used to decontaminate dental titanium rods, and repeated laser irradiation of the contaminated areas increases the antimicrobial effect of the treatment; however, the correct choice of parameters is needed to provide adequate laser fluence while preventing an implant's temperature increase that could cause damage to the surrounding tissue.

Influence of titanium and titanium-zirconium alloy as implant materials on implant stability of maxillary implant retained overdenture: a randomized clinical trial.

BACKGROUND: Long-term success of implant restoration depends on many factors one of them is the sufficient implant stability which is lowered in compromised bone density sites such as the maxilla as it is categorized as type III & IV bone, so searching for a new innovation and updates in implant material and features is very mandatory. So, the aim of this study was to compare between two implant materials (roxolid and traditional titanium) on the primary and secondary stability of implant retained maxillary overdenture. METHODS: Eighteen completely edentulous patients were selected. All patients received maxillary implant-retained overdentures and lower complete dentures; patients were divided equally into two groups according to the type of implant materials. Group A received a total number of 36 implants made of roxolid material and Group B received a total number of 36 implants made of traditional titanium alloys. Implant stability was assessed using ostell device, the primary implant stability was measured at the day of implant installation however, secondary implant stability was measured after six weeks of implant placement. Paired t-test was used to compare between primary and secondary stability in the same group and an independent t-test was used to compare between the two groups with a significant level < 0.05. RESULTS: Independent t-test revealed a significant difference between the two groups with p -value = 0.0141 regarding primary stability and p-value < 0.001 regarding secondary stability, as roxolid implant group was statistically higher stability than titanium group in both. Paired t- test showed a statistically significant difference in roxolid implant group with p-value = 0.0122 however, there was non-statistically significant difference in titanium group with p-value = 0.636. Mann Whitney test showed a significant difference between the two groups regarding amount of change in stability with p value = 0.191. roxolid implant group showed a higher amount of change in stability than the titanium implant group. CONCLUSION: Within the limitation of this study, it could be concluded that: Roxolid implants showed promising results regarding primary and secondary stability compared to conventional Titanium implants and can be a better alternative in implant retained maxillary overdentures. TRIAL REGISTRATION: Retrospectively NCT06334770 at 26-3-2024.

Influence of prosthetic index structures and implant materials on stress distribution in implant restorations: a three-dimensional finite element analysis.

BACKGROUND: Mechanical complications affect the stability of implant restorations and are a key concern for clinicians, especially with the frequent introduction of new implant designs featuring various structures and materials. This study evaluated the effect of different prosthetic index structure types and implant materials on the stress distribution of implant restorations using both in silico and in vitro methods. METHODS: Four finite element analysis (FEA) models of implant restorations were created, incorporating two prosthetic index structures (cross-fit (CF) and torc-fit (TF)) and two implant materials (titanium and titanium-zirconium). A static load was applied to each group. An in vitro study using digital image correlation (DIC) with a research scenario identical to that of the FEA was conducted for validation. The primary strain, sensitivity index, and equivalent von Mises stress were used to evaluate the outcomes. RESULTS: Changing the implant material from titanium to titanium-zirconium did not significantly affect the stress distribution or maximum stress value of other components, except for the implant itself. In the CF group, implants with a lower elastic modulus increased the stress on the screw. The TF group showed better stress distribution on the abutment and a lower stress value on the screw. The TF group demonstrated similar sensitivity for all components. DIC analysis revealed significant differences between TF-TiZr and CF-Ti in terms of the maximum (P < 0.001) and minimum principal strains (P < 0.05) on the implants and the minimum principal strains on the investment materials in both groups (P < 0.001). CONCLUSIONS: Changes in the implant material significantly affected the maximum stress of the implant. The TF group exhibited better structural integrity and reliability.

In-house protocol for fully guided zygomatic implant surgery and prosthesis repositioning. A technical note

AIM: The present study aims to describe an in-house protocol for fully guided zygomatic implant surgery and prosthesis repositioning. MATERIALS AND METHODS: Four extramaxillary zygomatic dental implants (ZIs) were placed in one patient. The preoperative phase included digital planning, through which a surgical guide was designed and created. The analysis of the accuracy of guided surgery and the guided prosthesis repositioning was carried out by superimposing the digital planning with the final postsurgical implant positioning through CBCT. The radiologic evaluation included implant angular deviation, entrance and exit deviation, platform deviation, and apex apicocoronal and mesiodistal deviation. The prosthetic evaluation was performed in three directions: buccopalatal, apicocoronal, and mesiodistal. RESULTS: All the ZIs successfully osseointegrated after 3 months of healing, with no complications. The mean axial angular implant deviation was 0.52 ± 0.36 degrees, and the mean implant depth deviation was 0.47 ± 0.28 mm. The entrance and exit deviation of the implants was 0.74 ± 0.42 mm and 0.7 ± 0.43 mm, respectively. The virtual prosthesis was superimposed and compared with the standard tessellation language file of the provisional polymethyl methacrylate prosthesis at the level of the first molars and central incisors; the mean buccopalatal deviation was 0.6 ± 0.035 mm, the mean apicocoronal deviation was 0.65 ± 0.11 mm, and the mean mesiodistal deviation was 0.3 ± 0.07 mm. CONCLUSIONS: According to the results obtained in this first case of the present case series, careful and meticulous digital planning based on the correct prosthetic parameters can safely guide the performance of surgery.

UTILIZATION OF ARTIFICIAL INTELLIGENCE FOR PREDICTIVE MODELING IN DENTAL IMPLANTOLOGY.

Artificial intelligence (AI) is making waves in dentistry, with applications in predicting dental implant success. AI models analyze patient data (X-rays, medical history) to identify factors influencing implant viability. The aim is to identify existing research on the use of AI-based predictive models in dental implants. The following databases were searched: Web of Science, Scopus, Google Scholar, PubMed, and Cochrane Library, using the keywords "Artificial Intelligence," "Dentistry," "Implant," and "Success." The studies were reviewed qualitatively, as quantitative analysis was not feasible due to the lack of specific outcomes and the insufficient number of studies for comparison. Technology has presented dental implantology with many opportunities, and it is through artificial intelligence that it is advancing. AI is being applied to detect potential implant failure patients, prognosis osseointegration, improve implant design, and master planning and also for data analysis to predict early complications. Decision trees, random forests, Artificial Neural Networks (ANN), and Deep Learning (DL) improve diagnostics and treatment planning and introduce a powerful predictive model for a successful implant.

Post sterilization of intraoral scan body and the effect it has on the axes and distances between three adjacent implants: in-vitro study.

BACKGROUND: The purpose of this pilot in-vitro study was to assess the effect of sterilization on the intra-implant axis, inter-implant axis, intra-implant distance and inter-implant distance of three implants in a straight line by using laboratory scanner (LBS) versus intra-oral scanner (IOS) with intra-oral scan bodies (ISB). METHODS: A printed 3D model with three internal hex analogs in the positions 15#,16#,17# was used. Zirkonzhan (ZZ) intra-oral scan body (ISB), two-piece titanium was used. The ZZ ISBs were scanned by 7 Series dental wings (LBS) and 30 times by Primescan (IOS) pre sterilization and 30 times post sterilization. For each scan (pre and post) stereolithography (STL) file was created and a comparison between all the scans pre sterilization and post sterilization were superimposed on the laboratory scan by using a 3D analyzing software. A Kolmogorov-Smirnov test performed followed by Wilcoxon Signed Ranks tests. (p < 0.05) Results: Post sterilization of the ZZ ISB, the mean errors were significantly increased for the inter-implant distances (p < 0.0005), intra-implant distances 1,2,3 (p < 0.0005), intra-implant axis 1,3 (p < 0.0005) and inter-implant axes 13,23 (p < 0.05). In contrast, the mean errors for intra-implant axis 2 (p < 0.0005) and inter-implant axis 12 (p < 0.0005) were significantly reduced. CONCLUSIONS: ZZ ISB showed changes in all four parameters after sterilization. The middle ISB had the largest changes in mean error regarding all four parameters. Sterilization process may affect the three-dimensional (3D) structure of the ZZ ISB after three cycles. There is a lack in the literature in this field and there is a need for further studies to explore the effect of sterilization (multiple cycles) on different ISBs and for creating an approved guidelines regarding the amount of sterilization for each ISB in the industry.

Importance of local and systemic factors in preventing implant displacement in the mandibular body: a scoping review of existing literature.

BACKGROUND: The aim of this research was to analyse the current literature on displaced dental implants in the mandibular body, including local and systemic variables related to their cause, and to identify the most frequent location. METHODS: The study conducted a search of three databases (Pubmed, Scopus, and Web of Science) using specific index terms such as 'dental implant', 'displacement', 'dislocation', 'displaced', and 'mandible'. The analysis focused on the direction of displacement and the characteristics of the bone tissue (bone quality, density, and quantity) in cases where dental implants were displaced. RESULTS: A total of 371 articles were obtained. Thirteen of these articles were selected and read in full. To define bone quality, the Lekholm and Zarb classification, modified by Rosas et al., was used. The type II-B bone, which is characterized by thick cortical bone surrounding cancellous bone with extremely wide medullary spaces, presented the largest number of complications. Twenty-two cases were found in which the displacement direction was horizontal. Of these, four were displaced vestibularly, fourteen lingually, and four remained in the center. Additionally, 24 cases presented vertical displacement, with 12 displaced towards the inferior border of the mandible, 9 towards the middle or adjacent to the inferior dental nerve canal, and 3 above the inferior dental nerve canal. CONCLUSION: The accidental displacement of implants within the mandibular body is associated with various risk factors, including the characteristics of the bony trabeculum and the size of the medullary spaces. It is reasonable to suggest that only an adequate pre-surgical diagnostic evaluation, with the help of high-resolution tomographic images that allow a previous evaluation of these structures, will help to have better control over the other factors, thus minimizing the risk of displacement.

Long-Term Success in Dental Implant Revisions: A 31-Year Case Study of Alveolar Atrophy Management in an Elderly Woman.

BACKGROUND In the early 1980s, Brånemark described the use of cylindrical titanium dental implants integrated with bone. Since then, significant advances in dental implant technology have resulted in improved function and cosmetic appearance. This report describes an 87-year-old woman with a 31-year history of revision implant dentistry, initially for severe alveolar atrophy of the premolar and upper molar teeth. CASE REPORT In 1992, a severe alveolar atrophy of the upper premolar and molar areas was treated with the insertion of 4 fixtures in the frontal sector and a prosthesis superimposed anchored to the fixtures and with a rear support on the only surviving teeth. In 2004, the teeth were extracted and a distal support to the prosthesis was obtained with 2 fixtures in the maxillary tuberosity. In 2018, to eliminate the need for home removal of the prosthesis, 2 zygomatic fixtures were positioned and a fixed prosthesis was made. In 2023, at the last follow-up, satisfactory function and aesthetics of the prosthesis were reported and the bone levels at the fixtures appeared stable. CONCLUSIONS This report demonstrates the improvements in dental implant technology over more than 30 years in a single patient and highlights the importance of improved function and cosmetic appearance.

[Comparison of the application of micro-implant screw support and flat guide plate in the treatment of excessive deep overbite of lower anterior teeth].

PURPOSE: To compare and analyze the orthodontic effects of micro-implant screw support and flat guide plate on excessive deep overbite of lower anterior teeth. METHODS: Eighty-two patients with excessive deep overbite of the lower anterior teeth who were treated from January to December 2022 were selected and randomly divided into two groups (41 in each group) by random number table method. Both groups were treated with straight wire arch orthodontic technology, and the anterior teeth were supported by micro-implant screws (micro-implant screw group) and flat guide plates (flat guide plate group), respectively. The effect of upper anterior tooth compression, changes in occlusal plane, and apical absorption were compared between the two groups. SPSS 25.0 software package was used for statistical analysis. RESULTS: There were no significant changes in SNA angle, SNB angle, ANB angle, U1-PP, U6-PP, and L6-MP before and after treatment between the two groups (P＞0.05). L1-MP significantly increased in both groups after treatment than before treatment(P＜0.05). There was no significant difference in bite opening, Spee curve depth, U1 depression, L1 depression, U6 elongation, L6 elongation and occlusal opening time between the two groups before and after treatment(P＞0.05). The root apex absorption of the mandibular central incisors and lateral incisors in the micro-implant screw group was significantly lower than that in the flat guide plate group(P＜0.05), while there was no significant difference in root apex absorption between the two groups of canines(P＞0.05). CONCLUSIONS: Both micro-implant screw support and flat guide plate can effectively lower the mandibular anterior teeth in the treatment of deep overbite in adults, with good orthodontic effects. However, the latter can lead to increased root resorption.

Osseointegrative and antimicrobial properties of graphene oxide nano coated dental implants: A systematic review.

Introduction: Osseointegration stands as a pivotal concept within the realm of dental implants, signifying the intricate process through which a dental implant integrates with the adjoining bone tissue. Graphene oxide (GO) has been shown to promote osseointegration, the process by which the implant fuses with the surrounding bone. The objective of this study was to assess the osseointegrative and antimicrobial properties of GO nano coated dental implants. Methods: A systematic search was conducted using electronic databases (e.g., PubMed, Scopus, Web of Science) to identify relevant studies published. Inclusion criteria encompassed studies that evaluated the effects of GO nano coating on osseointegrative and antimicrobial characteristics of dental implants. Studies not written in English and published before 2012 were excluded. Results: The initial search yielded a total of 127 potential studies, of which six met the inclusion criteria and five were included in the review. These studies provided data on GO nano coated dental implants and their osseointegrative and antimicrobial properties. All the included studies showed moderate risk of bias. None of the studies provided information related to sample size calculation or sampling technique. Discussion: The findings from the included studies demonstrated that GO nano coating had a positive impact on osseointegrative properties of dental implants. Enhanced bone-implant contact and increased bone density were observed in animals and humans receiving GO nano coated implants. Furthermore, the antimicrobial properties of GO nano coating were found to inhibit bacterial colonization and biofilm formation on the implant surface, reducing the risk of implant-associated infections. Conclusion: The findings indicate that GO nano coating holds promise in enhancing the success rate and longevity of dental implants. However, more studies with larger sample sizes, are needed to further strengthen the evidence and determine the long-term effects of GO nano coated dental implants.

A new guide for enhancing dental implant placement: an in vitro assessment of accuracy.

This study aimed to design a new surgical guide for controlling the mesiodistal distance between implant osteotomies and adjacent teeth as well as the osteotomy depth in partially edentulous patients. The guide kit was designed with design software and milled with a CNC (computer numerical control) router. The guide consisted of 2 components-stoppers and crown guides-for determining the drilling depth and mesiodistal position, respectively. The stoppers were designed in 7.5-, 9.5-, and 11.5-mm lengths, and the crown guides were fabricated with outer diameters of 5.0, 6.0, 7.0, and 8.0 mm. The accuracy of the guide was assessed by preparing a total of 20 implant osteotomies in 4 partially edentulous models and comparing the dimensions of the actual osteotomies to the values that were predicted to occur with the use of the surgical guides. Osteotomies were prepared using the 7.5-mm stopper with either the 7.0- or 8.0-mm crown guide. Cone beam computed tomography (CBCT) was used to obtain images for analysis of osteotomy-tooth mesiodistal distances, which were predicted to be 3.0 or 5.5 mm, depending on position; interosteotomy mesiodistal distances, which were predicted to be 3.0 mm; and osteotomy depth, which was predicted to be 11.5 mm. A 1-sample t test was used to determine if there were significant differences between the predicted values and the measurements of the guided osteotomies on the CBCT images of the mandibular models, and an independent t test was conducted to compare the results of 3.0- and 5.5-mm osteotomy-tooth distances (α = 0.05). Differences between the predicted and actual values of the interosteotomy mesiodistal distance (P = 0.516) and osteotomy depth (P = 0.847) were not statistically significant. The actual osteotomy-tooth mesiodistal distances were significantly different from the predicted values of 3.0 (P = 0.000) and 5.5 mm (P = 0.001), with higher mean differences of 0.46 and 0.60 mm, respectively. The designed guide had a high accuracy in achieving optimal linear interosteotomy mesiodistal distances and osteotomy depths, and the obtained mean values were clinically acceptable.

Hybrid-resolution facial and dental scanning: a cost-effective approach to utilizing 3D facial data in anterior dental implant restoration.

As digital technology becomes more prevalent in the practice of dental medicine, methods to fully replace 2-dimensional photography and analog devices such as the facebow are still in their infancy. As more practices adopt 3-dimensional (3D) intraoral scanners, effective digital communication of the relationships between the teeth and the face becomes essential. With the high cost of intraoral scanners, the additional expense of a face scanner is not a feasible investment for many practices. This article explores a technique for meshing (lower resolution) facial data obtained from a smartphone-based scanner with high-resolution intraoral scan data. In this approach, the data from a free 3D scanning application on a smartphone and a traditional intraoral scanner are meshed so that high-resolution data are available for intraoral features and lower resolution data are used to capture the gross contours of the face. In this way, a hybrid-resolution composite scan that incorporates all of the data needed to simulate the face and accurately reproduce the teeth is generated without the cost of additional scanning equipment. This article defines a new term, the facial registration scan, for use alongside the familiar digital bite registration obtained with an intraoral scanner. To illustrate the clinical use of the hybrid-resolution scan concept, this article presents a case in which this method was used for the restoration of maxillary anterior implants.

Comparison of the efficacy of seven non-surgical methods combined with mechanical debridement in peri-implantitis and peri-implant mucositis: A network meta-analysis.

This network meta-analysis aims to compare the clinical efficacy of seven non-surgical therapies for peri-implant disease, including laser treatment, photobiomodulation therapy (PBMT), photodynamic therapy (PDT), systemic antibiotics (SA), probiotics, local antimicrobials (LA), and air-powder polishing (APP) combined with mechanical debridement (MD). We conducted searches in four electronic databases, namely PubMed, Embase, Web of Science, and The Cochrane Library, to identify randomized controlled trials of non-surgical treatments combined with MD for individuals (aged at least 18 years) diagnosed with peri-implantitis or peri-implant mucositis with a minimum of 3 months follow-up. The outcomes of the study were the reduction in pocket probing depth (PPD) and bleeding on probing (BoP), plaque index (PLI), clinical attachment level (CAL), and marginal bone loss (MBL). We employed a frequency random effects network meta-analysis model to combine the effect sizes of the trials using standardized mean difference (SMD) and 95% confidence intervals (CIs). Network meta-analyses include network plots, paired comparison forest plots, league tables, funnel plots, surface under the cumulative ranking area (SUCRA) plots, and sensitivity analysis plots. The results showed that, for peri-implantitis, PBMT +MD demonstrated the highest effect in improving PPD (SUCRA = 75.3%), SA +MD showed the highest effect in improving CAL (SUCRA = 87.4%, SMD = 2.20, and 95% CI: 0.38 to 4.02) and MBL (SUCRA = 99.9%, SMD = 3.92, and 95% CI. 2.90 to 4.93), compared to MD alone. For peri-implant mucositis, probiotics +MD demonstrated the highest effect in improving PPD (SUCRA = 100%) and PLI (SUCRA = 83.2%), SA +MD showed the highest effect in improving BoP (SUCRA = 88.1%, SMD = 0.77, and 95% CI: 0.27 to 1.28), compared to MD alone. Despite the ranking established by our study in the treatment of peri-implant disease, decisions should still be made with reference to the latest treatment guidelines. There is still a need for more high-quality studies to provide conclusive evidence and especially a need for studies regarding direct comparisons between multiple treatment options.