This randomised controlled trial (RCT) with a 3-year follow-up was aimed at assessing the clinical and radiographic outcomes of implants with either a hybrid or moderately rough macro-surface design placed in patients with a history of periodontitis.

Forty periodontitis subjects with a stable periodontal condition were included and randomly assigned to receive either a hybrid implant with a machined-collar surface (HS) or a conventional implant with a moderately rough-collar surface up to the shoulder (RS). Radiographic, clinical, microbiological and patient-related outcome measurements (PROMs) were assessed at baseline (implant loading) and 3, 6, 12, 24 and 36 months post-loading.

Thirty-six patients (17 and 19, in the test and control groups, respectively) completed the three-year follow-up. At this visit, mean marginal bone level (MBL) changes were -0.08 (SD 0.2) and 0.02 (SD 0.28) mm for the test and control groups, respectively, with only three patients exhibiting MBLs exceeding 1 mm and only one implant with a peri-implantitis diagnosis. Patients in both groups showed a high degree of satisfaction, and implants in both groups harboured a similar proportion and counts of measured periodontal pathogens. No significant differences were observed between the two groups regarding any of the radiographic, clinical or microbiological variables.

At the three-year follow-up, both implant groups demonstrated high peri-implant bone stability, as well as a low incidence of peri-implant diseases.

ClinicalTrials.gov (identifier NCT05010382). https://clinicaltrials.gov/ct2/show/NCT05010382?cond=peri-implantitis&cntry=ES&city=Madrid&draw=2&rank=5.

To describe participants' experiences of being treated for peri-implant mucositis.

A qualitative study with nine individual, semistructured interviews was performed. The interview guide was based on a focus group interview. The participants had recently been treated for peri-implant mucositis on one dental implant in a randomised controlled trial (RCT). The treatment included information, oral hygiene instructions, nonsurgical treatment with Er:YAG laser or ultrasonic scaler and professional cleaning in several sessions over 6 months. The interviews performed were analysed using qualitative manifest and latent content analysis.

The manifest results showed that learning how to brush the teeth, and repeated feedback, was appreciated, and increased the motivation to improve oral hygiene habits. Most participants experienced no discomfort from the treatment. The participants had an understanding that a longer treatment time was required to ensure the quality of the treatment. Respect and attention were important elements of the personal treatment. The latent results suggest that treatment with a laser or an ultrasonic scaler was not perceived as the most important part of the treatment. Participants felt that receiving information about the treatment process was more important; moreover, a person-centred approach gave a feeling of good and safe care.

The present study highlights factors of importance in treatment of peri-implant mucositis with laser and ultrasonic scaler. A person-centred approach with respect and attention is important for a good and safe experience and may be important factors in future treatments.

Peri-implantitis (PI) is a chronic inflammatory disease that ultimately leads to the dysfunction and loss of implants with established osseointegration. Ferroptosis has been implicated in the progression of PI, but its precise mechanisms remain unclear. This study explores the molecular mechanisms of ferroptosis in the pathology of PI through bioinformatics, offering new insights into its diagnosis and treatment. The microarray datasets for PI (GSE33774 and GSE106090) were retrieved from the GEO database. The differentially expressed genes (DEGs) and ferroptosis-related genes (FRGs) were intersected to obtain PI-Ferr-DEGs. Using three machine learning algorithms, the Least Absolute Shrinkage and Selection Operator (LASSO), Support Vector Machine-Recursive Feature Elimination (SVM-RFE), and Boruta, we successfully identified the most crucial biomarkers. Additionally, these key biomarkers were validated using a verification dataset (GSE223924). Gene set enrichment analysis (GSEA) was also utilized to analyze the associated gene enrichment pathways. Moreover, immune cell infiltration analysis compared the differential immune cell profiles between PI and control samples. Also, we targeted biomarkers for drug prediction and conducted molecular docking analysis on drugs with potential development value. A total of 13 PI-Ferr-DEGs were recognized. Machine learning and validation confirmed toll-like receptor-4 (TLR4) and FMS-like tyrosine kinase 3 (FLT3) as ferroptosis biomarkers in PI. In addition, GSEA was significantly enriched by the biomarkers in the cytokine-cytokine receptor interaction and chemokine signaling pathway. Immune infiltration analysis revealed that the levels of B cells, M1 macrophages, and natural killer cells differed significantly in PI. Ibudilast and fedratinib were predicted as potential drugs for PI that target TLR4 and FLT3, respectively. Finally, the occurrence of ferroptosis and the expression of the identified key markers in gingival fibroblasts under inflammatory conditions were validated by RT-qPCR and immunofluorescence analysis. This study identified TLR4 and FLT3 as ferroptosis and immune cell infiltration signatures in PI, unraveling potential novel targets to treat PI.

Placement of a dental implant in a patient on antiresorptive therapy has been hypothesized to increase the risk of medication-related osteonecrosis of the jaw (MRONJ) and/or impact implant survival. In patients with osteoporosis, the risk of MRONJ with antiresorptive therapy is only marginally higher than observed in the general population.

The International ONJ Taskforce conducted a systematic review of the literature and evaluated the outcomes of implant placement in individuals with osteoporosis receiving antiresorptive therapy.

The data were reviewed by the International Taskforce, and consensus was achieved on the following GRADEd recommendation. In patients with osteoporosis on antiresorptive therapy, the Taskforce suggests that antiresorptive therapy does not need to be stopped prior to proceeding with dental implant (weak recommendation, very low-quality evidence). Long-term bisphosphonate use maybe associated with a small increase in the risk of MRONJ (3 cases per 1000 patients; adjusted hazard ratio: 4.09, 95% CI: 2.75-6.09, P < .001, moderate certainty).

Current evidence does not suggest an association between antiresorptive therapy in patients with osteoporosis and dental implant failure. Implants may be safely placed in the presence of concomitant use of bisphosphonates or denosumab in patients with osteoporosis with no evidence of an increased risk of implant failure/compromise.

The aim of this study was to determine the bending moments of a further developed generation of a one-piece zirconia implant system, which, for example, has a reduced diameter in the neck area compared to the predecessor model.

A total of 48 one-piece ceramic implants with diameters of 3.6 mm and 4.1 mm were included. After preparation of the abutments of 50 % of the implants, 32 out of the 48 implants were subjected to artificial ageing in a chewing simulator (Force: 98 N; 1.2 or 5 million loading cycles; thermocyclicing: 5 °C / 55 °C). The implants were then subjected to static loading until fracture in order to determine the maximum load forces to calculate the bending moments.

Implants tested after 1.2 million loading cycles exhibited the highest bending moments (3.6 mm diameter without abutment preparation: 496.1 ± 50.6 Ncm; 3.6 mm diameter with abutment preparation: 507.9 ± 53.5 Ncm; 4.1 mm diameter without abutment preparation: 612.5 ± 49.0 Ncm; 4.1 mm diameter with abutment preparation: 656.9 ± 26.8 Ncm). In contrast, unloaded implants showed the lowest values (3.6 mm diameter without abutment preparation: 443.0 ± 38.6 Ncm; 3.6 mm diameter with abutment preparation: 436.1 ± 42.8 Ncm; 4.1 mm diameter without abutment preparation: 570.3 ± 64.8 Ncm; 4.1 mm diameter with abutment preparation: 560.9 ± 51.5 Ncm), while implants subjected to 5 million cycles of loading showed bending moment values between these two groups.

Within the limits of the present study, preparation of the abutment did not appear to have a negative effect on stability. Also, artificial ageing did not seem to have a negative effect on the fracture resistance; a possible negative effect on the bending moment would have to be investigated with >5 million loading cycles. The measured maximum fracture loads were generally higher than the masticatory forces described in the literature.

The investigated zirconia implants seem to be a viable alternative to titanium implants.

This study examines the impact of different 3D printing technologies on the accuracy of implant positions in printed dental models, a crucial factor in implant-supported prosthetics. A standardized titanium model with three bone-level implants was scanned using an industrial scanner to create a virtual reference model. Ten intraoral scans of the same model were performed, and the generated STL files were used to design physical models printed with three different 3D printers: two utilizing digital light processing (DLP) technology and one employing stereolithography (SLA) (n = 30). The printed models were then rescanned, and deviations from the reference STL file were analyzed. Results showed that the SLA printer exhibited the highest deviations (0.26 ± 0.17 mm), whereas the DLP printers demonstrated greater accuracy, with one DLP system (0.07 ± 0.02 mm) performing slightly better than the other (0.12 ± 0.13 mm). The SLA printer exhibited the most significant errors in the vestibulo-oral and occlusal-apical directions. The findings suggest that DLP printers offer superior precision for implant-supported restorations in digital workflows. Clinically, the choice of 3D printing technology significantly impacts model accuracy, emphasizing the importance of selecting the appropriate printer based on the required precision.

Nowadays dental implants are commonly used and to fulfil esthetic demands, zirconia has been suggested as an implant material as an alternative to titanium. Many researchers and systematic reviews are documented on it, but the results have been often inconsistent. This overview of systematic reviews aimed to report on the factors that influence the clinical effectiveness of zirconia (Zi) versus titanium (Ti) dental implants in anterior region.

This overview of systematic reviews (Registration Number CRD42023396206) is in accordance with the Transparent Reporting of Systematic Reviews and Meta-analyses. PubMed, Cochrane, Scopus, Embase and Google Scholar databases were sourced for systematic review and meta-analyses. Joanna Briggs Institute (JBI) criteria and Measurement Tool to Assess systematic Reviews" (AMSTAR-2), evaluated the quality. The PICO-focused question of this overview of systematic reviews was "What are the various factors influencing the clinical performance of Zi versus Ti implants in the anterior area?", Evaluations were assessed by two assessors. In case there was any uncertainty or dispute among the reviewers, the work was included for further screening. Using Cohen's kappa, the inter-reviewer reliability was evaluated.

Six reviews were chosen from 57 suitable reviews for this data analysis. Although the survival and effectiveness rates backed titanium implants, there was no conclusive proof of marginal bone loss. Zirconium implants performed better in terms of aesthetics.

Clinical performance of zirconia could be considered at par with titanium implants in the anterior area. Titanium has exhibited greater mechanical performance but no significant difference between two recorded. In future, studies with improved design are needed to identify biological and technical factors that affect implant's efficacy.

This is the first overview of systematic reviews focusing specifically on the anterior region, evaluates both aesthetic and biomechanical performance of Zi and Ti Implants, offers detailed insight into material-specific advantages and limitations. In the present clinical scenario it addresses a critical gap by comparing the performance of Zi and Ti implants and evaluates patient-centred priorities, particularly in the highly visible anterior region.

One of the key factors influencing osseointegration is the hydrophilicity of the surface of dental implants; high hydrophilicity is more advantageous than low hydrophilicity. This study aimed to compare the hydrophilic properties of titanium and zirconia implants from different manufacturers. An in vitro analysis was conducted on 15 implants-13 titanium and 2 zirconia-each featuring distinct compositions and surface treatments. Their hydrophilicity was assessed using the contact angle method, where a drop of saline solution was pipetted onto the apical part of the implant. For each implant, 30 contact angle measurements were taken at three different surface wetting time intervals. The contact angle is defined as the internal angle between the tangent to the surface of the liquid and the surface at the point of tangency; a smaller angle means a higher hydrophilicity. The results show that titanium implants from BTI UniCa, Nobel TiUltra, and Straumann Roxolid SLActive-which are classified as premium implants-exhibited the highest hydrophilicity. In contrast, zirconia implants demonstrated significantly lower hydrophilicity. Within this group, the Nobel Pearl implant exhibited smaller contact angles than the Bredent WhiteSKY implant. Our findings confirm that high-quality titanium implants show superior hydrophilicity, potentially improving clinical outcomes by accelerating healing and facilitating immediate loading protocols, but this could only be proven with an in vivo animal study. Conversely, the relatively lower hydrophilicity of zirconia implants highlights the need for continued advancements in zirconia composition and surface modification to optimize their osseointegration potential.

Soft tissue integration (STI) around dental implants determines their long-term success, and the key is to immediately construct a temporary soft tissue-like barrier to prevent bacterial invasion after implantation and then, promote STI. In response to this need, an injectable multi-crosslinked hydrogel (MCH) with abilities of self-healing, anti-swelling, degradability, and dry/wet adhesion to soft tissue/titanium is developed using gallic acid-graft-chitosan, oxidized sodium alginate, gelatin, and Cu2+ with water and borax solution as solvents, whose properties can be controlled by adjusting its composition and ratio. MCH can not only immediately build a sealing barrier to block the bacterial invasion in the oral simulation environment but also deliver outstanding antibacterial efficacy through the synergism of trapping bacteria and releasing bactericidal agents such as chitosan, gallic acid, aldehyde, and Cu2+. Moreover, MCH has an adjustable ROS-scavenging ability imparted by gallic acid, chitosan, and gelatin to reduce inflammation and can control the release of Cu2+. Based on these, it is believed that by injecting MCH around implants (percutaneous/transmucosal) after surgery, a universal non-aggressive strategy to promote STI can be developed for long-term implant success.

STATEMENT OF PROBLEM: Achieving and maintaining optimal tissue health and esthetics when immediately placing maxillary anterior implants with interim restorations has been challenging and the clinical outcomes heterogenous.

The purpose of this retrospective study was to evaluate the clinical outcomes of immediate placement of maxillary anterior implants with interim restorations and compare the tomographic and clinical results before and after implant placement in participants followed for 1 to 14 years.

Twenty participants receiving 25 postextraction single implants in the anterior maxilla were studied. Clinical parameters included pink esthetic score (PES) and white esthetic score (WES), peri-implant phenotype, implant probing, plaque index, and cone beam computed tomography (CBCT) to compare initial and at least 1 year after crown placement (postoperative). For qualitative variables, a descriptive analysis was carried out. The PES and WES results were analyzed by using nonparametric statistics, the median (ME) and the interquartile range (IQR) were used as summary measures, and the Wilcoxon sum of signs test was used to compare the total scores between the intervention area and the contralateral tooth. To compare pre- and postoperative data points, the paired t test was used (α=.05).

Mean ±standard deviation (SD) time of follow-up was 7.6 ±4.2 years. Twenty participants with a mean ±SD age of 62.4 ±11.0 years old received 25 implants. Mean ±SD initial torque value at implant placement was 38.6 ±9.63 Ncm. Bone height at the top of the alveolar ridge (BH) and bone width at the middle of the alveolar ridge (BW2) showed a statistically significant decrease between the initial and subsequent CBCT measurements (both P<.001). Likewise, the bone width at the alveolar crest (BW1) showed a statistically significant decrease between the initial and post-CBCT measurements (P=.006). Facial bone integrity (FBI) revealed a statistically significant increase between the initial and postoperative time periods (P<.001). The PES index showed a median of 9.0 IQR (8-10), statistically lower than the contralateral tooth (P=.032). No significant differences were found for the WES index or for FBI, regardless of the peri-implant phenotype.

Immediate implant placement in the maxillary anterior sextant was found to be a predictable procedure with good esthetic results when the protocol described was used. Labial bone loss is inevitable after tooth extraction but can be compensated for by filling the space with a xenograft material. Long-term gingival tissue integrity was maintained, regardless of phenotype, in periodontally healthy participants.

Background and Objectives: Static Computer-Assisted Implant Surgery (sCAIS) can be performed with different drill guiding systems. This study aimed to compare the accuracy of two guiding concepts of sCAIS in partially edentulous cases. Materials and Methods: Forty polyamide models of partially edentulous maxillae with seven implantation sites were fabricated. In total, 140 replica implants were placed with keyless (KL) and drill-key (DK) guiding systems using static, full-arch, tooth-supported surgical guides. Three-dimensional crestal and apical, angular and vertical deviations from the planned implant positions were compared using Mann-Whitney U and Kruskal-Wallis H tests. Intergroup homogeneity of variance homogeneity was examined using Levene's test to assess the precision. Results: Overall median 3D crestal and apical deviations of implants placed in the KL group were significantly higher compared to the DK group (0.86 mm [0.63-0.98] vs. 0.72 mm [0.52-0.89], p = 0.006 and 1.26 [0.98-1.52] vs. 1.13 [0.70-1.45], p = 0.012). In the subgroup analysis, implants placed with a KL system showed higher 3D crestal (p = 0.029), 3D apical (p < 0.001) and angular (p < 0.001) deviations in the extended anterior area, higher 3D crestal (p < 0.001) deviations in the proximal posterior single-tooth gap and higher vertical (p < 0.001) deviations in the distal site of free-end situation. Contrarily, the KL group showed lower 3D crestal (p = 0.007), 3D apical (p < 0.001), angular (p < 0.001) and vertical (p = 0.003) deviations in the distal posterior single-tooth gap, lower 3D apical (p = 0.007) and angular (p = 0.007) deviations in the distal site of free-end situation and lower vertical (p = 0.019) deviations in the proximal site of free-end situation. Conclusions: The deviations of both guiding concepts did not exceed the recommended safety margins. Statistically significant differences in deviations were found between two guiding concepts. Guiding concepts with superior accuracy varied across different sites of implantation.

To ensure accurate robot-assisted surgery, it is essential to identify the handpiece position at the end effector of the robotic arm. Clinically, the relationship between the optical tracking device and the handpiece has been typically confirmed by using a calibration plate at the end effector of the robotic arm. However, the accuracy of the handpiece calibration methods for robot-assisted implant placement remains unclear.

The purpose of this in vitro study was to evaluate the accuracy of bi-coordinate and multi-coordinate handpiece calibration methods, as well as the multi-coordinate handpiece plate under partial obstruction, in the context of robot-assisted implant placement.

In total, 120 implants were divided into 6 groups based on the calibration plate used in the study: bi-coordinate handpiece calibration plate for the maxilla (Bmx), bi-coordinate handpiece calibration plate for the mandible (Bmn), multi-coordinate handpiece calibration plate for the maxilla (Mmx), multi-coordinate handpiece calibration plate for the mandible (Mmn), partially obscured multi-coordinate handpiece calibration plate for the mandible with the primary coordinate unblocked and the auxiliary coordinate covered (MmnPrim), and partially obscured multi-coordinate handpiece calibration plate for the mandible with the auxiliary coordinate unblocked and the primary coordinate covered (MmnAux). Calibration of the robotic arm was conducted separately for each group. Then the robot autonomously performed osteotomies and implant placements at the first and second premolars according to the preoperative plan. Following surgery, the robotic software program calculated the deviation values between the planned and actual implant positions. Differences between the test groups were analyzed using 1-way analysis of variance (ANOVA) and the Bonferroni post hoc test (α=.05).

The ranges of angular deviation and 3-dimensional deviations at the implant platform and apex across the 6 groups were 0.30 degrees to 0.48 degrees, 0.31 to 0.36 mm, and 0.31 to 0.38 mm, respectively. No statistically significant differences were found among the groups (P>.05).

Both the bi-coordinate and multi-coordinate handpiece calibration methods demonstrated acceptable accuracy for robot-assisted implant placement. The multi-coordinate calibration plate provides a feasible method for robot calibration in scenarios where the mandible is partially obstructed.

Whether an early loading strategy can be applied to a single maxillary anterior implant with insufficient bone volume is debatable. Moreover, the clinical effect of using a small intestine submucosa (SIS) biological membrane in guided bone regeneration (GBR) surgery in such clinical scenarios is unclear.

The purpose of this randomized controlled trial was to determine the effectiveness and safety of an early loading strategy for patients who have undergone dental implant placement and GBR surgery for a missing maxillary anterior tooth and to clarify the effects of SIS membranes.

Thirty-six study participants were randomly assigned into 3 groups: the GBR with a resorbable non-crosslinked porcine collagen membrane (Bio-Gide) and delayed implant loading (Gide-DL) group, the GBR with a resorbable non-crosslinked porcine collagen membrane (Bio-Gide) and early implant loading (Gide-EL) group, and the GBR with an SIS membrane and early implant loading (SIS-EL) group. The degree of implant torque was ≥35 Ncm. Definitive restorations were completed 6 months after surgery in the Gide-DL group and 6 weeks after surgery in the Gide-EL and SIS-EL groups. Clinical examination, intraoral scanning, radiograph examination, and white and pink esthetic scoring was performed at the 1-year follow-up to evaluate the implant survival rate, peri-implant conditions, soft tissue contour changes, marginal bone resorption, and esthetics. Data with a normal distribution and homogeneous variance were analyzed via 1-way analysis of variance (ANOVA) and the least significant difference (LSD) multiple comparison test. Data without a normal distribution or homogeneous variance were analyzed via the Kruskal-Wallis H test and Bonferroni multiple comparison test (α=.05 for all tests).

No implant failures or significant differences in the probing depth, plaque index, or bleeding index among the 3 groups were detected at the 1-year follow-up. There was no significant difference in the soft tissue contour change among the 3 groups. Only the changes at 1 mm apical to the crown-gingival connecting margin in the SIS-EL group were significantly lower than those in the Gide-EL and Gide-DL groups (P<.05). The marginal bone levels and white and pink esthetic scores were not significantly different among the 3 groups (P>.05).

The early loading strategy is suitable for patients who have undergone dental implant placement and GBR for a missing maxillary anterior tooth with good primary stability, and favorable clinical effects can be achieved with the use of SIS membranes.

Background: This cross-sectional analytical study evaluates oral hygiene and periodontal status in patients with hypertension, given the established link between cardiovascular diseases and poor periodontal health. Methods: A total of 24 hypertensive patients (15 male; 9 female) and 30 healthy controls (19 male; 11 female) from Craiova, Romania, were assessed using Periodontal Probing Depth (PPD), the Plaque Index (PLQ), and the Bleeding on Probing Index (BPI). Results: The mean age was 62.2 years in the hypertensive group and 47.4 years in the control group. Oral hygiene was poorer in hypertensive patients (PLQ: 73% vs. 24.1% in controls), with higher PPD (5.2 mm vs. 3.7 mm) and BPI (82% vs. 23%). Among patients with dental implants, PLQ was 24% in hypertensive individuals vs. 15.6% in controls, PPD was 4.4 mm vs. 2.9 mm, and BPI was 44% vs. 15.5%. Conclusions: These findings indicate a higher risk of periodontal disease in hypertensive patients, though dental implants may decrease some adverse effects by improving oral hygiene and periodontal health in this population. In conclusion, our study highlights that patients with high blood pressure have a less favorable periodontal status compared to healthy controls.

This study assessed the impact of the buccal bone on hard and soft tissues in submerged and non-submerged immediate implants using a minipig model.

Sixty-five titanium implants (Camlog Progressive Line) were placed in four minipigs immediately after tooth extraction. All non-submerged (NSM) implants received a mechanically induced buccal bone defect (NSM-BD), whereas the submerged group (SM) was classified as defective (SM-BD) and intact (SM-BI). All bone defects underwent guided bone regeneration (GBR). After four months, the minipigs were sacrificed. Harvested specimens were analysed using histomorphometry and light and fluorescence microscopy. The evaluated parameters included the sulcus (S), implant epithelium (IE), connective tissue (CT), biological width (BW), highest soft tissue point (HSTP), and first hard tissue contact (FHTC).

Of the 65 implants four (6%) were lost, while all remaining implants demonstrated clinical stability (Periotest). Despite GBR failures caused by the pigs' hay consumption after one week, no significant differences (p > 0.5) were observed between SM-BD and NSM-BD in buccal parameters (NSM-BD/SM-BD: S = 0.6 mm, IE = 2.9/2.4 mm, CT = 3.5/3.4 mm, BW = 5.9/5.8 mm). Compared to SM-BI soft-tissue parameters increased in length with reduced buccal bone lamella (SM-BI/SM-BD: S = 0.4/0,6 mm; p ≤ 0.04, SM-BI/NSM-BD: IE = 1.8/2.9 mm; p ≤ 0.007, SM-BI/SM-BD: CT = 2.5/3.4 mm; p ≤ 0.01, BW = 4.0/5.8 mm; p ≤ 0.007). The buccal HSTP remained unaffected (p > 0.5; (NSM-BD = 1.8 mm, SM-BD = 1.0 mm, SM-BI = 2.0 mm; p > 0.5) for all groups.

A buccal bone defect resulted in prolonged S, IE, CT, and BW. However, the aesthetic parameter HSTP did not exhibit significant differences (p > 0.5) at the buccal implant site when comparing the SM and NSM healing protocols.

The primary aim of this in vitro study was to investigate the primary implant stability obtained in immediate and late implant placement scenarios. Secondary aims evaluated the effect of two distinct implant macro-designs and examined the correlation between resonance frequency analysis (RFA) and final insertion torque.

Partially edentulous maxillary models including six single sites simulating extraction sockets and healed alveolar ridges were used. Virtual implant planning facilitated static computer-assisted implant placement of bone level implants with either a shallow-threaded and cylindrical (BL), or deep-threaded and tapered implant macro-design (BLX). The insertion torque was continuously measured during implant placement, and RFA was performed after final implant positioning.

One-hundred and forty-four implants were equally distributed to two alveolar ridge morphologies and implant designs. Higher final insertion torque and RFA values were observed for implants placed in healed ridges compared to extraction sockets (40.8 ± 13.5 vs. 20.6 ± 8.4 Ncm, and RFA 70.7 ± 2.8 vs. 59.6 ± 6.5, both p < 0.001), and for BL implants compared to BLX implants (35.7 ± 13.0 vs. 25.7 ± 8.9 Ncm, and RFA 66.7 ± 4.4 vs. 63.6 ± 4.9, both p < 0.001). Insertion torque and mean RFA values positively correlated (r = 0.742; p < 0.001).

Primary implant stability is significantly affected by the alveolar ridge morphology and the implant macro-design, demonstrating higher values in healed sites and shallow-threaded, cylindrical implants. Therefore, a tailored selection of the implant design depending on the implant placement and loading protocol is recommended.

The accuracy of implant placement is a prerequisite for prosthetically driven implant surgery and is necessary to ensure the long-term stability of dental implants. Imprecise implant position may bring difficulties for restoration, damage anatomic structures, affect peri-implant tissues, and lead to ultimate implant failure.

The purpose of this retrospective clinical study was to compare the accuracy of implants placed with an autonomous dental implant robotic (ADIR) system with those placed with static computer assisted implant surgery (sCAIS).

Thirty-nine participants were enrolled in this retrospective study: 20 participants had received implant surgery with the ADIR system and 19 participants had implants placed with sCAIS. The preoperative plans and postoperative cone beam computed tomography (CBCT) scans after implant placement were matched during the study. The coronal, apical, and angular deviations were measured and analyzed. A linear regression model was established to analyze the source of deviation. MANOVA was used to compare differences in the major outcome variables (α=.05).

A total of 60 implants were placed in 39 participants (30 in each of the 2 groups). The mean ±standard deviation coronal, apical, and angular deviation of the ADIR system group and sCAIS group were 0.43 ±0.18 mm versus 1.31 ±0.62 mm (P<.001), 0.56 ±0.18 mm versus 1.47 ±0.65 mm (P<.001), and 1.48 ±0.59 degrees versus 2.42 ±1.55 degrees (P=.003), respectively. In addition, there was no significant difference in accuracy in the different implant regions (anterior, premolar, molar, maxilla, mandible) (P>.05). No complications were observed.

The accuracy of the implant position using the ADIR system was significantly higher than with sCAIS, suggesting that the ADIR system can achieve minimally invasive and excellent accuracy. In addition, implant regions had no significant influence on the accuracy of implant placement. (Keywords: Robotic system, Implant surgery, Static guide, Autonomous, Accuracy).

The study aimed to evaluate the accuracy and safety of a semi-active robotic system for implant placement in atrophic posterior maxilla.

Patients underwent robot-assisted implant placement in atrophic posterior maxilla were identified and included. Cone-beam computed tomography (CBCT) was performed before surgery. The virtual implant position and drilling sequences were planned in the robotic planning system. Patients with positioning marker took an intraoral scan. The preoperative CBCT and the intraoral scan were superimposed in the robotic software. After registration, the implant bed was prepared utilizing the robotic arm with 1 mm safety margin below the maxillary sinus floor. The transcrestal sinus floor elevation (TSFE) was performed by the dentist, followed by the implant placement with the robotic arm. A postoperative CBCT was taken and superimposed with the preoperative one to calculate the accuracy of implant placement. Complications and adverse events were recorded. Deviations between the implant platform and apex levels were analyzed using the paired t-test. P < 0.05 was considered statistically significant.

Twenty-seven implants of 20 patients were included. No intraoperative and postoperative complications were reported. The global, lateral and vertical platform deviations were 0.73 ± 0.27 mm, 0.35 ± 0.23 mm and 0.35 ± 0.57 mm, respectively. The global, lateral and vertical apex deviations were 0.77 ± 0.23 mm, 0.41 ± 0.20 mm and 0.34 ± 0.57 mm, respectively. There were significant differences between the global, lateral and vertical deviations between the implant platform and apex levels (P < 0.05, respectively). The angular deviation was 1.58 ± 0.76°.

High accuracy and safety for implant placement in atrophic posterior maxilla could be achieved using a semi-active robotic system, with the TSFE procedure performed by the dentist.

This study provides significant evidence to support the application of semi-active robotic systems for implant placement in atrophic posterior maxilla.

To: 1) analyze possible differences in the CIEDE2000 lightness, chroma and hue of the gingiva at the free gingival margin (FGM) and the middle zone of keratinized gingiva (MZ) between participants with an ISFP in the maxillary anterior region and participants with natural dentition and healthy gums; and 2) examine the perceptibility/acceptability of the differences in CIEDE2000 lightness, chroma and hue and in overall color, using the Euclidean and CIEDE2000 formulae.

The L*, a* and b* color coordinates were measured in 60 adult participants (30 with an ISFP and 30 with healthy teeth and gums) using a Spectroshade™ Micro spectrophotometer. From these coordinates, the changes in lightness (ΔL'), chroma (ΔC') and hue (ΔH') CIEDE2000 between the participants with and without an ISFP were quantified. The one sample t-tests were used to test whether there were significant changes in lightness, chroma and hue between the participants with and without an ISFP, and effect size was assessed with Cohen's d. The authors examined the differences in CIEDE2000 lightness, chroma and hue, and the overall color differences between the participants in pairs (with ISFP-without ISFP), comparing results with the published perceptibility and acceptability thresholds.

Statistically significant differences were found (p < 0.05) between participants with and without an ISFP in all color attributes at both zones, with all color attributes observed to be lower in the gingiva of participants with an ISFP. In both gingival zones, the ISFP had a large effect on lightness (Cohen's d > 0.8) and a medium effect on hue (Cohen's d between 0.5 to 0.8). The mean gingival color difference of participants with and without an ISFP was 8.72 units in the MZ and 9.60 units at the FGM, using CIEDE2000.

CIEDE2000 lightness, chroma and hue are significantly lower in participants with an ISFP, both at the FGM and the MZ, with particularly marked differences in lightness. The average color difference between healthy gingiva next to natural teeth and the gingiva adjacent to an ISFP is clinically unacceptable.

Gingival color needs to be considered an indicator of success, given the potential unesthetic gray show-through of transmucosal abutments with ISFPs. Unacceptable color changes caused by poorly planned ISFPs can lead patients to demand treatment be repeated with more esthetic materials or mucogingival surgery to "camouflage" the discoloration.

To evaluate the factors that influence the survival of dental implants and marginal bone loss (MBL) in patients taking osteoporosis or osteopenia medication.

This study included patients who underwent dental implant treatment after taking medication for osteoporosis or osteopenia. Electronic medical records were used to collect data of patient age, sex, age at osteoporosis or osteopenia diagnosis, types of medications, age at medication initiation, duration of medication before implant surgery, whether the medication was paused before surgery, paused duration of medication, implant survival status, and MBL before and after prosthetic treatment. Firth's logistic regression was used to analyze the relationships between each variable and implant survival as well as between MBL before and after prosthetic treatment.

Of the 267 patients, 111 with 209 implants were included in the study. The mean observation period was 57.9 months. The survival rate was 92.8% at the patient level and 96.2% at the implant level. No significant associations were found between implant survival and any of the variables examined. MBL before prosthetic treatment was significantly associated with use of receptor activator of nuclear factor-κB ligand (RANKL) inhibitors (P=0.032) and bone formation stimulators (P=0.022). Comparing the concurrent and single use of bisphosphonates and RANKL inhibitors, only the use of RANKL inhibitors alone was significantly associated with MBL before prosthetic treatment (P=0.039). MBL after prosthetic treatment was significantly associated with injection method among the routes of drug administration (P=0.011).

The implant survival rate in patients undergoing medical treatment for osteoporosis or osteopenia was comparable to the general implant survival rate. MBL before prosthetic treatment was associated with type of anti-osteoporotic medication, whereas MBL after prosthetic treatment was correlated with drug administration route. Further studies with larger sample sizes are required.

To assess the precision of implant placement when comparing tilted orientations to axial orientations, utilizing a fully guided surgical protocol in an edentulous mandibular model.

Fourteen rubber-coated mandibular models were scanned with fiducial markers using a commercial benchtop surface scanner, followed by cone beam computed tomography for implant planning through a dual-scan protocol. The models were randomly divided into control and experimental groups. In the control group, each model was planned for four axially oriented implants. Conversely, the experimental models were planned for two axially oriented implants near the lateral incisors and two posteriorly tilted implants at a 30-degree angle. A mucosal-supported, pin-retained surgical guide was designed and 3D-printed, facilitating the fully guided implant placement. All implants received scan bodies and were rescanned for evaluation of the trueness between the planned and the actual implant location using the implant planning software. Mixed model ANOVA was used to detect differences between groups with regards to angular deviation, offset at base, and offset at tip.

A total of 56 implants were placed across all models. Fourteen posterior implants in each group served as control and experimental conditions, while the remaining 28 anterior implants acted as secondary control. No significant differences were observed between the experimental and control groups in terms of angular deviation (p = 0.7001), offset at base (p = 0.6409), or offset at tip (p = 0.6931). Analysis comparing anterior implant deviations between groups and anterior to posterior implant deviations within the control arches also was not significant. However, secondary analysis revealed a significant difference between anterior and posterior implants within the experimental group for offset at base (p = 0.0087) and offset at tip (p = 0.0288).

Despite the limitations inherent to a benchtop study, the findings suggest that there are no statistically significant 3D deviations at the base or apex, nor in angular deviations, when comparing tilted and axial implant placements using a digital workflow and fully guided protocols in an edentulous model.

Advancements in implant design, surface characteristics, and surgical protocols have made implant restorations safe and highly predictable procedures. Bone metabolism plays a central role in the success of implant therapy. Diabetes mellitus is a significant disease impacting bone metabolism, particularly during the initial stages of osseointegration and in long-term survival. Moreover, aging is linked to various systemic conditions, such as diabetes, which increase the susceptibility of the periodontium and teeth to disease, often resulting in tooth loss. Studies on the impact of glycemic control on the success and longevity of implant-prosthetic rehabilitation in diabetic patients highlight a significant association between hyperglycemia and complications in implant therapy. This review identified 18 relevant publications through Medline, and studies were screened against the aim and objectives of the review. A total of five articles were excluded because of lack of focus on the effect of glycemic control on dental implants. Diabetic patients with poorly controlled blood glucose levels may face a heightened risk of developing implant complications. Effective glycemic control plays a critical role in the long-term success of dental implants in these individuals. Marginal bone loss (MBL) is a critical indicator of implant health and success. Clinical studies generally show greater MBL in diabetic patients compared to non-diabetic individuals. Furthermore, controlled type 2 diabetes mellitus (T2DM) has been associated with significantly better maintenance.

This clinical retrospective study aimed to compare the deviations in single-tooth implant placement using novel semi-autonomous robotic-assisted surgery system (sa-RASS) and dynamic navigation system (DNS) methods.

A retrospective analysis of medical records from January to December 2023 was conducted to compare the implantation accuracy of the sa-RASS and DNS in partially edentulous patients using cone-beam computed tomography. Platform, apex, and angular deviations were measured and analyzed. The Kolmogorov-Smirnov test was used to check the data distribution, along with t-tests or Mann-Whitney U-tests, where appropriate.

Fifty-seven patients (57 implants) were analyzed: 29 (29 implants) in the sa-RASS group and 28 (28 implants) in the DNS group. The comparison of platform, apex, and angular deviation between the sa-RASS group and DNS group were 0.91 ± 0.46 mm vs. 1.26 ± 0.51 mm (p < 0.001), 1.06 ± 0.60 mm vs. 1.51 ± 0.56 mm (p < 0.001), and 3.07° ± 1.66° vs. 3.71° ± 1.64° (p > 0.05), respectively. In addition, there was no significant difference in the accuracy of different implant regions (premolar, molar, maxilla, and mandible) or implant length (p > 0.05).

In the present study, sa-RASS implant placement showed better positional accuracy than DNS implant placement in platform and apex deviation, although these improvements in accuracy may have limited clinical relevance, suggesting that the sa-RASS might be advantageous in dental implant surgery.

ClinicalTrials.gov identifier: ChiCTR2400085089.

Background: Mandibular reconstruction poses challenges in achieving functional and aesthetic outcomes. Effective oral rehabilitation is crucial for restoring function and improving quality of life; however, the altered neomandibular anatomy complicates oral hygiene, increasing the risk of peri-implant complications and making successful rehabilitation more difficult. This study introduces a novel approach combining vestibuloplasty with patient-specific implant-retained splints to enhance oral health and improve rehabilitation outcomes. Methods: Three patients underwent mandibular reconstruction with a free vascularized fibula flap (FFF). After 6 months of osseointegration, vestibuloplasty and soft tissue refinement were performed, with a split-thickness skin graft placed on the FFF periosteum. An implant-retained splint was secured to the abutments for two weeks to support soft tissue healing. Implant survival, bone loss, and peri-implant health were evaluated over a 2-year follow-up. Results: A total of 12 implants were placed, primarily in the neomandible (83.3%), with a 100% survival rate. Implant survival was assessed. Implant survival was assessed based on established criteria for clinical success, including stability, presence of pain, bleeding on probing (BOP), pocketdepth, bone loss and lack of peri-implant radiolucency. Functional outcomes included normal mouth opening, laterotrusion, and protrusion. Pocket depths ranged from 3 to 4 mm, except for one implant in cases 1 and 2. The mean BOP was 51.7%. Conclusions: This case series introduces a surgical technique that combines CAD/CAM and vestibuloplasty to optimize dental rehabilitation in mandibular FFF reconstructions, demonstrating safe thinning of soft tissues for improved oral hygiene and survival.

The medial approach for minimally invasive harvesting of a deep circumflex iliac artery (DCIA) flap is described for reconstruction of the jaw. The associated preservation of the crest of the ilium prevents the raising of the abdominal internal oblique muscle (IO) in a standard fashion. However, reconstructive surgery of composite mandibular defects includes bone and soft tissue. To achieve this goal, we combined this technique with a new perforator-based raising of the IO for reconstruction of intraoral soft tissue.

In this study, we present eight cases of patients with composite mandibular defects who underwent the myo-osseous DCIA flap procedure with an IO perforator. Virtual surgical planning was employed to preplan the size and configuration of the graft. Cutting guides were made using CAD/CAM technology. The surgical procedure followed the described medial approach for minimally invasive harvesting, leaving the iliac crest, spine, and skin intact. In addition, we completely cut and isolated the IO with its sole attachment being the ascending branch of the DCIA. We used either a surgical guide with a slot to lead through both the transverse branch of the bone and the ascending branch of the IO or a surgical guide consisting of 2 parts.

In all instances, the flap successfully survived with a 100% success rate. There were no signs of infection, wound opening, or bleeding in either patient. Furthermore, the patients did not exhibit permanent complications related to the donor site. The internal oblique perforator flap exhibited remarkable integration in all patients and underwent rapid transformation. Notably, the flap developed keratinized mucosa (KM) that closely resembled the attached gingiva.

Our study demonstrated the effectiveness of a medial approach for harvesting a newly designed more flexible chimeric myo-osseous deep circumflex iliac artery flap. By incorporating virtual surgical planning and custom-made cutting guides for obtaining deep circumflex iliac artery flaps through the medial route along with an internal oblique perforator flap, we have established a highly promising method for the rehabilitation of patients with composite mandibular defects. This approach not only improves functional outcomes, but also enhances aesthetic results to maintain patients' quality of life.

Peri-implantitis, caused by bacterial biofilm on dental implants, leads to bone loss and tissue inflammation, ultimately causing oral health decline. Traditional methods to remove biofilm are ineffective in promoting reosseointegration on implant surfaces. This phenomenon can be attributed to two factors: incomplete removal of biofilm from hard-to-reach areas and alterations in the physicochemical properties of implant surfaces caused by decontamination procedures. To address this problem, we developed D-arginine-loaded chitooligosaccharide-capped pH-responsive mesoporous silica nanoparticles (Dar@MSN-COS) for improving the efficacy of decontamination of Water Jet (WJ). Dar@MSN-COS particles exhibit a targeted approach towards the extracellular polymeric substance (EPS) in order to disrupt the biofilm, and possess the capability to infiltrate confined areas between implant screws. Following this, the WJ treatment effectively removed residual biofilm and demonstrated improved cleaning efficacy. Furthermore, the decontamination of the Dar@MSN-COS combination with WJ promotes effective cell cytocompatibility on the titanium surface. The results of mechanistic experiments indicate that Dar@MSN-COS may act on biofilms by releasing a significant quantity of reactive oxygen species (ROS), suggesting it as a key contributing factor. In summary, our novel therapeutic protocol shows promise as an alternative solution for addressing the clinically complex aspects of peri-implantitis.

The advent of 3D-printing technology, which is capable of on-demand fabrication, has ushered in a new era for fixed implant prosthodontics. Over the past decade, immediately loaded 3D-printed titanium implants have demonstrated predictable clinical outcomes in human jaws, highlighting their superior osseointegration strength, which is attributed to their increased surface roughness. However, the biomechanical mechanisms underlying this enhanced osseointegration strength remain elusive, thereby impeding the standardization and broader clinical application of 3D-printed titanium implants.

Experimental 3D-printed titanium implants were fabricated via selective laser melting (SLM), and conventional sandblasted and acid-etched titanium implants (CNC-SLA) served as the control group. Implant surfaces were characterized with scanning electron microscopy, surface profilometry, energy-dispersive X-ray spectroscopy, and a contact angle meter. Implants (n = 10) were surgically inserted into the femoral condyle of New Zealand rabbits. At weeks 1, 2, and 8, micro-CT and undecalcified histological sections were used to assess histological osseointegration (n = 6), whereas removal torque analysis was performed to evaluate osseointegration strength (n = 4). At week 8, microscale finite element analysis of different bone-implant interfaces was conducted to predict the peri-implant bone strain under multidirectional implant loading.

The surface roughness of the SLM implants was significantly greater than that of the CNC-SLA implants. Histological osseointegration assessments revealed equal levels of SLM and CNC-SLA implants at weeks 1, 2, and 8. Notably, after week 2, bone interlocking phenomenon appeared on the SLM implants. The removal torque for the SLM implants at week 2 were significantly greater (P < 0.05) than that for the CNC-SLA implants at the same time point and was comparable to the CNC-SLA implants at week 8 (P = 0.775). The removal torque for the SLM implants at week 8 was further increased. Microscale finite element analysis revealed that the rough surface of the SLM implants dispersed harmful strains at the bone-implant interface into the surrounding bone, thereby mitigating the risk of damage to the bone-implant interface.

The rough surface of 3D-printed titanium implants fosters microscale bone interlocking and alleviates peri-implant bone strain concentration, which is a promising biomechanical basis for osseointegration strength.

The study aimed to investigate the influence of different gingival colors and abutment materials on the final color of peri-implant soft tissue. A total of 30-cylinder shaped specimens having 1.0- and 2.0-mm buccal thicknesses using 5 different gingiva-colored composites [light pink (LP), dark pink (DP), orange (Or), brown (Br), and purple (Pr)] were prepared. Implants were placed straight into the center of cylinders and connected to abutments [Titanium (Ti) and Zirconia (Zr)]. Color parameters were assessed using a spectroradiometer. Color differences (ΔE*ab and ΔE00) were calculated and compared with 50:50% perceptibility (PT) and acceptability (AT) visual thresholds. Color variation data were statistically analyzed using 2-way analyses of variance followed by Tukey HSD tests (a = .05). Significantly higher ΔE*ab and ΔE00 values were recorded in LP and Or groups with 1.0 mm buccal thickness and Ti abutments (P < .05). Regardless of the thickness applied, all the gingival color groups with Zr abutment presented ΔE*ab and ΔE00 values below AT. The mean ΔE*ab value decreased as the gingiva thickness increased in the LP, DP, and Or groups with Ti abutments. Abutment material significantly affected the mean ΔE00 values in the groups of LP, DP, and Or with a buccal gingiva thickness of 1.0 mm (P < .05). Gingival color and abutment material was found to be effective on the final color of peri-implant soft tissue. However, further clinical research is required to confirm these findings.

Dental implant materials, designs as well as general concepts for surgical techniques have evolved during the last decades. It has been validated that primary stability followed by bone apposition around implants is crucial for implant survival as most implant failures occur during the first year. However, new implant materials and different micro and macro designs have improved implant survival in more challenging clinical conditions. Therefore, clinical research with large patient groups is needed to investigate the effects of different implant designs and surgical protocols with the aim to improve early implant outcomes.

The purpose of the study is to investigate the clinical use of dental implant materials, designs, and surgical techniques related to early implant complications and failures.

All patients who had received implant surgery in 2007 and 2017 at three specialist centers in Sweden were identified using charge codes. Data were retrieved from a dental record system as well as from digital and analog registries on implant surgeries. Information on anamnestic data, bone status, implant materials and designs, surgery techniques, and early implant failures and complications during the first year was compiled and analyzed. Descriptive statistics were used for comparison of the time cohorts. The data were statistically analyzed with a multivariable logistic regression model with a significance level of p < 0.05 using early implant failures and complications as the dependent variables.

For 2007, 799 patients with 2473 implants were identified. For 2017, 1076 patients with 2287 implants were identified. However, 74 (3.7%) patients were excluded, mainly due to lack of data. Differences were observed when comparing the two cohorts. In 2017, fewer preoperative antibiotics were prescribed, more incidences of exposed implant threads were reported, more non-submerged implant surgeries were performed, shorter implant lengths were used, more implants were placed in augmented bone, and tapered implants with a variable design were used. Implants of commercially pure titanium (CP Ti) Grades 1-4 with moderately and minimally rough surfaces were used in 2007, whereas CP Ti Grade 4 and alloy titanium zirconium (TiZr) with moderately rough surfaces were used in 2017. Significantly higher number of implant failures were reported in 2017 at the implant level: 56 (2.4%) in 2017 compared to 26 (1.1%) in 2007. Eleven variables were shown to increase the risk of failure including exposed implant threads OR 3.56 (1.60, 7.91) p = 0.0018 and increased number of implants per patients 1.26 (1.14, 1.39) p < 0.001 analyzed at the patient level. Nine variables were shown to increase the risk of early implant complications, including exposed implant threads OR 4.52 (2.60, 7.87) p < 0.001, sinus membrane perforations OR 8.14 (2.46, 26.93) p < 0.001, and no prescription of preoperative antibiotics OR 4.52 (2.60, 7.87) p < 0.001 analyzed at the patient level.

This study reports on changes in implant materials, designs, and surgical techniques between 2007 and 2017. Significantly higher numbers of implant failures and complications were reported in 2017. Factors related to early implant complications and failures were identified.

Osseodensification is a novel approach that has significantly advanced the field of implant dentistry, particularly in the context of transcrestal maxillary sinus floor elevation. This technique involves the use of specially designed burs that compact and densify bone along the osteotomy walls, thereby enhancing implant primary stability and facilitating osseointegration in low-density bone. This article reviews the historical evolution of implant site preparation, and the biomechanical, histological, and clinical evidence of osseodensification with a special focus on its application in sinus floor augmentation. The integration of this technique into contemporary practice represents a paradigm shift, offering a minimally invasive and efficient solution for addressing the challenges of posterior maxilla, with improved patient-reported outcomes and low complication rate. Three different protocols for sinus lift and implant placement using osseodensification burs are proposed based on available literature, and risk factors for Schneiderian membrane perforation based on residual bone height are discussed, along with implant-related outcomes and patient-reported outcome measures. The potential for osseodensification to become a standard practice in sinus floor augmentation is emphasized, highlighting key aspects such as surgical protocol and patient selection.

To ensure long-term implant success, it is crucial to understand the force transmission from the implant to the surrounding bone. In dentistry, bioengineering methods are applied to investigate these processes. The aim of this study was to analyze the influence of different implant geometries on the surface strain behavior of porcine mandibles under load using a 3D optical camera system in combination with digital image correlation. Four different implant types were subjected to a force of 200 N in three different loading directions (axial, non-axial 15°, and non-axial 30°). Under axial loading, parallel-walled implants exhibited lower surface strain values on the peri-implant bone compared with tapered implants. However, when subjected to non-axial loading, these parallel-walled implants showed a substantial relative increase in strain by approximately a factor of 2.96 compared with axial conditions. At a 30° non-axial angle, long, tapered implants with a smaller diameter (BLX 3.75) produced lower peri-implant bone strains than implants with larger diameters and shorter lengths, while short, tapered implants (BLT) demonstrated a lower relative increase in strain (factor ~1.49) from axial to non-axial loading. Under non-axial loading, long, tapered implants with a small diameter resulted in lower strains in the peri-implant bone compared with implants with a larger diameter and shorter length. It was found that non-axial loads lead to higher strains than axial loads. Therefore, the success of implantation could be significantly influenced by selecting an appropriate implant geometry and the correct angulation of the implant.

The purpose of this study was to systematically compare and assess the effect of various wound closure interventions on the clinical outcomes following immediate implant placement (IIP) in the esthetic zone.

Studies comparing the clinical effect of different interventions in the process of wound closure in IIP were included.

A systematic search was conducted in PubMed, EMBASE, Cochrane Library, Web of science, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang Database.

A total of 34 studies involving 1213 implants and eight interventions were included in the network meta-analysis (NMA). The agreement between reviewers reached a kappa value of 0.84. In terms of reducing marginal peri-implant recession (MPR), as the primary outcome, NMA showed that connective tissue graft (CTG) [MD = -0.44, 95 % CI (-0.56, -0.33)], collagen matrix (CM) [MD = -0.32, 95 % CI (-0.46, -0.17)] and CGF [MD = -0.11, 95 %CI (-0.16, -0.06)] showed significant less MPR than the control group, and CTG [MD = -0.33, 95 %CI (-0.46, -0.20)] and CM [MD = -0.20, 95 %CI (-0.36, -0.05)] were also associated with less MPR compared to concentrate growth factor (CGF). The optimal intervention to prevent MPR was CTG. Among the secondary outcomes, CTG was determined as the optimal intervention to increase gingival thickness (GT), CGF ranked as the promising intervention to reduce marginal bone loss (MBL) and improve pink aesthetic score (PES).

The use of CTF could enhance soft tissue stability by minimizing MPR and increasing GT in the process of wound closure in IIP, and CGF could better prevent MBL and improving PES. However, the findings related to CGF were based on a limited number of studies.

CTG and CGF ought to be worthy of clinical promotion to intervene wound closure of IIP in esthetic area, with the ability of improving the peri-implant soft and hard tissues. However, clinicians should still consider the specific clinical situation when selecting the most appropriate intervention or alternative materials.

To evaluate long-term survival and success of dental implants and evaluate indicators affecting the long-term outcome.

Implant survival, success and crestal bone loss (BL) over time were evaluated. For covariates at patient level, Kaplan-Meier estimates of implant survival were compared between groups with the log-rank test. Observed mean bone loss (MBL) was plotted as a function of time. Cumulative frequencies of BL were plotted for different post-op times. Uni- and multivariate analysis was performed. Simple linear mixed and multiple linear mixed models for BL at 1, 5 and 10 years were fitted.

407 patients (221 women, 186 men; mean age 64.86 years (range 28-92, SD 10.11)), with 1482 implants, responded. Absolute implant survival was 94.74%; MBL was 0.81 mm (SD 1.58, range 0.00-17.00) after an average follow-up of 10.66 years (range 10-14, SD 0.87). Implant survival was influenced on implant level by smoking, implant width and early bone loss (EBL) > 0.5 mm; on patient level by a history of periodontitis. Indicators influencing MBL after the 1st year were abutment height, type of surgery and implant width, while after 5 and 10 years of function were abutment height, EBL > 0.5 mm and smoking.

Implant survival was significantly affected by a history of periodontitis on patient level and by smoking, implant width and EBL > 0.5 mm on implant level. Late bone loss was significantly affected by abutment height, EBL > 0.5 mm and smoking.

B670201524796.

Tooth loss is a prevalent problem faced by individuals of all ages across the globe. Various biomaterials, such as metals, bioceramics, polymers, composites of ceramics and polymers, etc., have been used for the manufacturing of dental implants. The success of a dental implant primarily depends on its osseointegration rate. The current surface modification techniques fail to imbibe the basics of tooth development, which can impart better mineralization and osseointegration. This can be improved by developing an understanding of the developmental pathways of dental tissue. Stimulating the correct signaling pathways through inductive material systems can bring about a paradigm shift in dental implant materials. The current review focuses on the developmental pathway and mineralization process that happen during tooth formation and how surface modifications can help in biomimetic mineralization, thereby enhancing osseointegration. We further describe the effect of dental implant surface modifications on mineralization, osteoinduction, and osseointegration; both in vitro and in vivo. The review will help us to understand the natural process of teeth development and mineralization and how the surface properties of dental implants can be further improved to mimic teeth development, in turn increasing osseointegration.

Digital surgical guides improve precision by detailing the direction, position, and angle of implants, which reduces surgery time and complications. A bibliometric analysis of guided surgery in implant dentistry is lacking.

The aim of this metrics-based analysis was to analyze the trends and key characteristics of articles related to guided surgery in implant dentistry.

The search was conducted in February 2024 on the Web of Science. The main characteristics of the studies were extracted and analyzed. Collaborative networks were generated using the Vosviewer software program. Dimension was consulted to measure Altmetric data. Correlation among data was determined by using the Spearman test.

A total of 799 articles published between 1993 and 2023 were included. Most were case reports or series (n=26) using static guided surgery (n=672), primarily for dental implant placement (n=754). The studies typically employed a combination of cone beam computed tomography (CBCT) and digital scanning (n=316) for surgical planning. The most frequently used software program was coDiagnostiX (n=89), and the most commonly used guide type was the printed guide (n=161). The country with the most articles was the USA (n=137), though Europe stood out as the leading continent (n=398). The Vosviewer demonstrated strong collaborations among authors. According to Dimensions, significant mentions were identified in Mendeley, news outlets, and X.

An emerging trend in guided implant dentistry research was identified over the past 30 years through the use of software programs and 3D-printers for the fabrication of surgical guides. Europe showed the greatest interest in this topic, predominantly conducting research on static guided surgery for implant placement. Additional clinical studies and systematic reviews are needed.

With the growing importance of implant brand detection in clinical practice, the accuracy of machine learning algorithms in implant brand detection has become a subject of research interest. Recent studies have shown promising results for the use of machine learning in implant brand detection. However, despite these promising findings, a comprehensive evaluation of the accuracy of machine learning in implant brand detection is needed.

The purpose of this systematic review and meta-analysis was to assess the accuracy, sensitivity, and specificity of deep learning algorithms in implant brand detection using 2-dimensional images such as from periapical or panoramic radiographs.

Electronic searches were conducted in PubMed, Embase, Scopus, Scopus Secondary, and Web of Science databases. Studies that met the inclusion criteria were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Meta-analyses were performed using the random-effects model to estimate the pooled performance measures and the 95% confidence intervals (CIs) using STATA v.17.

Thirteen studies were selected for the systematic review, and 3 were used in the meta-analysis. The meta-analysis of the studies found that the overall accuracy of CNN algorithms in detecting dental implants in radiographic images was 95.63%, with a sensitivity of 94.55% and a specificity of 97.91%. The highest reported accuracy was 99.08% for CNN Multitask ResNet152 algorithm, and sensitivity and specificity were 100.00% and 98.70% respectively for the deep CNN (Neuro-T version 2.0.1) algorithm with the Straumann SLActive BLT implant brand. All studies had a low risk of bias.

The highest accuracy and sensitivity were reported in studies using CNN Multitask ResNet152 and deep CNN (Neuro-T version 2.0.1) algorithms.

Plasma nitriding is one of the surface modifications that show more effectiveness than other methods. In this study, the plasma-based ion implantation (PBII) technique was performed on the surface of titanium alloy (Ti-6Al-4V, Ti64) using a mixture of nitrogen (N2) and argon (Ar), resulting in a plasma-nitrided surface (TiN-Ti64). The surface composition of the TiN-Ti64 was verified through X-ray photoelectron spectroscopy (XPS). TiN-Ti64 demonstrated superior hydrophilicity compared with Ti64. TiN-Ti64 exhibited higher surface hardness than the original surface. The biological responses of primary human alveolar bone cells (hAVs) were observed on the TiN-Ti64, revealing greater activation of cell adhesion and spreading compared with Ti64 and the control group (glass coverslip). Moreover, the TiN-Ti64 significantly promoted cell proliferation compared with Ti64 and tissue culture plates. The mineralization of hAVs on the TiN-Ti64 showed a significant increase, almost 20% greater than that of Ti64. Furthermore, a significant upregulation of mRNA expression for osteogenic differentiation marker genes, including BMP2, OCN, OPN, and RUNX2, was observed in TiN-Ti64 compared with other conditions. In addition, the TiN-Ti64 exhibited antibiofilm activity against Streptococcus aureus. In conclusion, the TiN-Ti64, modified with the PBII technique utilizing a mixture of N2 and Ar, emerges as a promising alternative for surface modification in dental implant applications.

This in vitro study aimed to assess the positional accuracy during the sequence of static computer-assisted implant surgery (sCAIS) according to the anatomical characteristics of the alveolar ridge.

Maxillary bone models with six single tooth gaps including clinical scenarios of healed alveolar ridge (HR), single-rooted (SRS), and three-rooted socket (TRS) morphologies were used in this study. Positional deviations during implant placement procedures were evaluated after the pilot osteotomy (PD), final osteotomy (FD), and implant placement with respect to the pre-planned implant position by using a software package. ANOVA and post hoc analyses were performed.

A total of 90 implants were included in this study. Higher mean angular, crestal, and apical deviations were found after the PD and FD (3.5 ± 2.4°, 0.7 ± 0.3 mm, and 1.4 ± 0.8 mm versus 3.6 ±2.2°, 0.6 ± 0.3 mm, and 1.2 ± 0.6 mm) compared to IP (2.8 ± 1.6°, 0.7 ± 0.3 mm, and 1.2 ± 0.5 mm, p ≤ 0.004). Implants placed in TRS demonstrated higher mean angular, crestal, and apical deviations (4.0 ± 1.7°, 0.8 ± 0.3 mm, and 1.6 ± 0.5 mm) compared to implants placed in SRS (2.5 ± 1.2°, 0.7 ± 0.3 mm, and 1.1 ± 0.4 mm) or HR (2.0 ± 0.9°, 0.5 ± 0.3 mm, and 0.8 ± 0.4 mm, p < 0.001).

Positional deviations during sCAIS procedures are initiated with the first implant osteotomy and persist throughout the drilling sequence. However, deviations slightly decreased after implant placement. The alveolar ridge morphology is strongly associated with positional deviations. Higher deviations were observed in three-rooted and single-rooted sockets simulating an immediate approach compared to healed sites simulating a delayed protocol.

To propose a new difficulty classification for vertical bone augmentation (VBA) based on different defect morphologies.

VBA procedures for dental implant placement present significant biological and technical challenges. Among the various techniques, guided bone regeneration (GBR) provides an optimal balance between the anticipated bone gain and the likelihood of postoperative complications. Understanding the specific configuration of defects and adjacent bone peaks is essential for tailoring treatment strategies and improving outcomes. The proposed Simple-Challenging-Difficult (SCD) difficulty classification was based on defect morphology (V-shaped, U-shaped, VV-shaped), including defect size (Height: < 5 mm, 5-8 mm, and > 8 mm), proximity of neighboring bony walls (Width: < 10 mm, 10-20 mm, and > 20 mm), as well as predictability of treatment outcomes.

The proposed difficulty classification for VBA serves as a guide for selecting the most appropriate GBR treatment modality and sequence for safe and predictable management of VBA in implant therapy. In addition, when determining the preferred treatment, it is again essential to consider site-specific and patient-related factors alongside the clinician's surgical experience and skill.

Identifying defect patterns and bone peak structures is crucial, and the proposed classification assists in decision-making in VBA treatment.

Assess whether horizontal ridge augmentation with guided bone regeneration (GBR) using deproteinized bovine bone mineral (DBBM), autologous bone, and a resorbable collagen membrane supports successful implant placement.

This open, prospective, single-cohort, multicenter clinical study included patients with ridge defects that required GBR prior to implant insertion. The primary endpoint was radiologically assessed bone gain after 8 months post-GBR, measured at the center of planned implant sites. Secondary endpoints included implant survival and success, marginal bone levels (MBLs), MBL changes, and soft tissue health.

Of 45 patients evaluated 8 months post-GBR, nine experienced dehiscence in the first 3 weeks of the healing period. GBR led to radiologically determined mean bone width gain of 4.0 ± 1.5 mm and 4.8 ± 1.7 mm, measured 1 and 3 mm from the top of the crest, respectively, allowing successful implant placement in 44 patients (97.8%). The cumulative implant survival and success rates were 98.9% and 95.5%, respectively. MBLs were stable: -1.18 ± 0.64 mm at definitive prosthesis placement (DPP) and - 1.07 ± 0.74 mm at 1 year. Soft tissue health and esthetics (plaque and bleeding indices, papilla, keratinized mucosa, and pink esthetic score) improved from DPP to 1 year. Patients were highly satisfied with implant function and esthetics, and their oral health-related quality of life improved.

GBR using DBBM and a collagen membrane offered a safe and effective treatment option for horizontal ridge augmentation sufficient to support implant-based tooth rehabilitation.

Registered at ClinicalTrials.gov NCT03028922 (registrations sites, as above listed affiliations, first posted January 23, 2017).

To clinically evaluate the outcomes following surgical coverage of single peri-implant mucosal recessions in the aesthetic maxillary area by means of the modified coronally advanced tunnel (MCAT) and subepithelial connective tissue graft (SCTG).

Eleven systemically healthy non-smoking patients (8 females) each presenting a single peri-implant mucosal recession in the anterior maxillary region were consecutively treated with MCAT in conjunction with SCTG. In all cases, the facial recession was associated with an impaired aesthetic appearance. Before reconstructive surgery and at 12 months postoperatively, clinical and aesthetic parameters were assessed. The primary outcome variable was the mean mucosal recession coverage (MRC).

Healing was uneventful in all cases. At 12 months, statistically significant (p < 0.05) recession coverage (MRC 94.71%) and improvement of aesthetics (pink aesthetic score) was obtained at all implants. Complete RC was obtained in 10 out of the 11 patients (90.9%). The treatment was associated with a statistically significant gain of keratinized and attached mucosa (p < 0.05).

The present results demonstrate that single peri-implant mucosal recessions in the maxillary aesthetic area can be successfully treated with MCAT and SCTG.