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30 August 2024, Volume 29 Issue 4
Previous Issue
Key Column “Systemic Diseases and Dental Implant Treatment”
Editorial Board of Chinese Journal of Oral Implantology
Editorial Board of Chinese Journal of Oral Implantology
2024, 29(4): 295-296. DOI:
10.12337/zgkqzzxzz.2024.08.001
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Clinical considerations of organ transplant patients receiving implant therapy
Tang Yiman, Qiu Lixin
2024, 29(4): 297-302. DOI:
10.12337/zgkqzzxzz.2024.08.002
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Organ transplantation is an effective treatment for end-stage organ disease. Based on the increase in life expectancy, the demand for restoration of missing teeth in organ transplant patients has gradually increased. Dental implants have become the preferred treatment of choice for restoring missing teeth. Although dental implants have high success rates in healthy adults, the risk of implant therapy is correspondingly increased in organ transplant patients with previous systemic diseases and immunosuppressive therapy. In this article, we describe the particularity and success of oral implant therapy in organ transplant patients, and further discuss how to conduct a comprehensive assessment when performing implant therapy in organ transplant patients. Besides, we also discuss how to develop an individualized treatment plan to prevent possible risks and complications, in order to provide clinical references for the implementation of safe and effective implant therapy for organ transplant patients.
Risks and countermeasures of dental implant treatment in osteoporosis patients
Liu Zhonghao, Dong Kai
2024, 29(4): 303-310. DOI:
10.12337/zgkqzzxzz.2024.08.003
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Osteoporosis (OP) is a systemic skeletal disease with the main characteristic of reduction of bone density and low bone mass. With the increasing age of the population, the incidence of OP increases year by year. Replacement of missing teeth with dental implants is one of the most common treatment options with a high success rate. However, in patients with OP, deterioration of bone tissue may lead to an increased risk of implant failure. Although OP is not a contraindication for implant therapy, clinicians should still pay great attention to associated risk factors. This article discusses the alveolar bone modeling and remodeling, the success rates of dental implants, the influence of anti-osteoporosis drugs, and the strategy of dental implant treatment in OP patients for clinical reference.
Animal experiment of prognosis of immediate implant placement and restoration in individuals with T2DM
Zhao Guoqiang, Song Yingliang
2024, 29(4): 311-319. DOI:
10.12337/zgkqzzxzz.2024.08.004
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Objective
To investigate the feasibility and prognosis of immediate implant placement and immediate restoration in patients with type 2 diabetes by establishing an animal model.
Methods
The type 2 diabetic animal model was established using New Zealand rabbits as the experimental group and healthy New Zealand rabbits as the control group. Both groups underwent immediate implantation and immediate repair. Micro-CT scanning, hard tissue section, and detection of relative inflammatory factors by real-time quantitative PCR were used to compare prognosis and histological remodeling between the two groups.
Results
The success rate for immediate implant placement and immediate restoration was 90% in both groups. In the early postoperative period (1~2 months), the peri-implant bone of the experimental rabbits in the T2DM group was significantly different from the control group in various microscopic parameters, in the meantime, the expressions of IL-6, IL-33 and TNF-α were significantly higher than those of the control group.
Conclusion
Animal experiments have shown that the immediate implant placement and immediate prosthesis are safe in type 2 diabetic animal models. However, attention should be paid to the slow formation of osseointegration and obvious inflammation of the soft tissue around the implant in the early stage.
Risk factor analysis and treatment strategies for oral implant restoration in patients with Sjögren syndrome
Chen Li, Fang Ming, Zhang Yanting, Zhang Xiaolin, Liu Qing, Zheng Zhaohui, Zhou Wei
2024, 29(4): 320-327. DOI:
10.12337/zgkqzzxzz.2024.08.005
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Sjögren syndrome (SS) is a common disease in oral clinical practice with typical symptoms such as dry mouth and dry eyes, often accompanied by complex systemic symptoms and a long history of medication. With the growing prevalence of dental implant restorations, there has been a corresponding rise in the demand for implantation treatments among individuals with Sjögren Syndrome. However, there is a lack of relevant treatment guidelines for implant restoration in these patients. This article presents a case of an implant-supported fixed complete dental prosthesis in a patient with Sjögren syndrome,summarizes our team's experience in the treatment of implant restoration in these patients, and discusses the risk assessment and treatment strategies for dental implant restorations in patients with Sjögren syndrome. A comprehensive risk assessment before treatment, a reasonable implant restoration plan, and consistent long-term plaque control are essential for the successful outcomes of implant restorations in patients with Sjögren syndrome.
Perioperative risk assessment and management of oral implant restoration in ASA Ⅲ cardiovascular disease patients
Zhang Yanting, Wang Wei, Chen Li, Zhao Wen, Zhou Wei
2024, 29(4): 328-335. DOI:
10.12337/zgkqzzxzz.2024.08.006
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With the widespread adoption of implant technology, ensuring the safe implementation of implant surgery for patients with complex systemic diseases has become a challenge that implant dentists must confront. Based on the patient's physical condition, the American Society of Anesthesiologists (ASA) classifies the perioperative risk. Patients at ASA Ⅰ~Ⅱ have an extremely low risk of surgery, while those at ASA Ⅳ and above have a very high risk and are not suitable for surgery. How to assess perioperative risks, perform implant surgery, and reduce serious perioperative complications for ASAⅢ patients is a question that more and more implant doctors are focusing on. This article aims to start with the most common clinical patients with cardiovascular diseases at ASAⅢ, exploring the risk assessment, prevention, complication management of oral implant surgery for such patients, providing a reference for the safe implant restoration for this category of patients.
Impact of osteoporosis on dental implantation and related clinical considerations
Qiu Yun, Wang Yulan, Zhang Yufeng
2024, 29(4): 336-341. DOI:
10.12337/zgkqzzxzz.2024.08.007
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With the development of dental technology, dental implants are gradually becoming the primary choice for restoring missing teeth. The quality and quantity of the alveolar bone are key to the success of implant surgery and the long-term retention of the implants. Osteoporosis is a systemic disease characterized by a decrease in bone mass and a reduction in bone density, affecting bones throughout the body, including the alveolar bone. Therefore, its characteristic oral manifestations can be indicative of an early diagnosis of osteoporosis. At the same time, the changes in bone density and bone structure in osteoporosis patients necessitate awareness of the treatment risks during implantation and modification of the treatment plan to improve the success rate of implant treatment. This article reviews the oral manifestations of osteoporosis, the risks of implant treatment, and the consideration for implant treatment through a literature review.
Research progress on the influence of depression on peri-implant health
Zhao Xintong, Meng Weiyan
2024, 29(4): 342-346. DOI:
10.12337/zgkqzzxzz.2024.08.008
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In recent years, implant-supported prostheses have become an important method for repairing missing teeth. However, the long-term survival rate of implants is affected by various systemic and local factors. Depression is a common mental disease with a high prevalence rate, which affects the healing process of soft and hard tissues after implant surgery. Moreover, depression often leads to oral dysbiosis, which can easily promote the occurrence and development of peri-implantitis and affect the long-term efficacy of implants. Antidepressants, such as SSRIs, also affect osseointegration. This article aims to review the effects of depression on the healing process of soft and hard tissues, bone metabolism, and oral microbiome after implantation, hoping to provide a clinical basis for the risk assessment and treatment strategy of implant treatment for patients with depression.
The impact of diabetes on the soft tissue seal surrounding dental implants
Wang Qian, Yuan Quan
2024, 29(4): 347-351. DOI:
10.12337/zgkqzzxzz.2024.08.009
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The soft tissue seal around the dental implants is recognized as a primary mucosal barrier against external stimuli and is critical for maintaining implant stability. Diabetes mellitus (DM) is a known risk factor for peri-implantitis. Persistent hyperglycemia can impair the barrier function of peri-implant soft tissues, leading to peri-implant diseases. Moreover, increased pathogenic bacterial infections, excessive inflammatory cytokine activity, and impaired wound healing in diabetic conditions may result in poor soft tissue sealing around implants. This review outlines the structure of peri-implant soft tissue sealing, explores the factors contributing to impaired soft tissue sealing in diabetes, and summarizes methods to improve the mucosal barrier in diabetic patients, providing guidance for implant treatment strategies in diabetic patients.
Original Article·Clinical Research
Biological complications of butt-joint dental implants: a retrospective case analysis
Chen Zhenqi, Yan Qi, Chen Yan, Shi Bin
2024, 29(4): 352-357. DOI:
10.12337/zgkqzzxzz.2024.08.010
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Objective
To retrospectively analyze cases of biological complications of the butt-joint dental implant system (Zimmer, America) and explore relevant risk factors.
Methods
Cases of biological complications occurring with butt-joint implant systems (Zimmer) at the Department of Dental Implantology, Hospital of Stomatology, Wuhan University from 2012 to 2022 were analyzed.
Results
A total of 65 implants were identified to have biological complications, with 1 624 implants being reviewed overall. Six implants developed peri-implantitis, while 59 implants developed peri-implant mucositis. The average patient age was (56.20±11.46) years, and the mean loading time was (4.06±2.36) years.
Conclusion
The maxillary and molar regions are common sites for biological complications associated with butt-joint dental implants. Special attention should be paid to the occlusal design of distal free-end implant restorations to avoid the adverse effects of occlusal overload. Although the "cold welding" effect is advantageous in reducing the impact of microleakage, it increases the risk of mechanical complications.
Case Report
Flapless alveolar ridge reconstruction for an anterior site with severe bone defect for implant therapy: a case report
Zhou Ying, Cong Longfeng, Zhang Xiang, Wang Sheng
2024, 29(4): 358-361. DOI:
10.12337/zgkqzzxzz.2024.08.011
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This case report presents a modified ridge preservation technique for the anterior site with severe bone defects after extraction. 9 months later, the implant was placed, during which temporary implant restorations were used to shape the gingiva, achieving good aesthetic results and stable function during follow-up. The diagnosis and treatment process and the results of this case suggest that this flapless alveolar ridge reconstruction technique is feasible, but further observation is needed for long-term effects.
Meta Analysis
Meta-analysis of the accuracy of dental implant robots in preclinical and clinical studies
Wang Yiming, Li Xinru, Teng Weiwei, Ma Junchi, Zhou Libo
2024, 29(4): 362-370. DOI:
10.12337/zgkqzzxzz.2024.08.012
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Objective
To systematically evaluate the accuracy of dental implant surgery assisted by a dental implant robot system in both preclinical and clinical studies.
Methods
Studies of dental implant robots were searched on online platforms like PubMed, Cochrane Library, Web of Science, Embase, CNKI, CQVIP, and Wanfang data from the establishment of the database to August 2023. The studies included preclinical (model and animal experiments) and clinical research. The main outcome measures were three-dimensional deviations between the targeted position and the implanted position, including the coronal deviation, apical deviation, and angular deviation of implants. Stata 14.0 and RevMan software were used for meta-analysis of the data. Subgroup analysis was used to compare errors in four aspects: different study designs and subjects, preparation of implant cavities versus insertion of implants, dentition condition, and specific anatomical structures.
Results
Finally, 23 studies (18 preclinical studies and 5 clinical studies) from 20 papers were included, comprising a total of 840 implant sites. The results of the meta-analysis showed that in the preclinical study of dental implant robot-assisted implantation, the coronal deviation, apical deviation, and angular deviation were 0.60 mm (95%
CI
: 0.51~0.70,
I
2
=0.0%), 0.73 mm (95%
CI
: 0.62~0.84,
I
2
=24.9%), and 1.25°(95%
CI
: 1.02~1.48,
I
2
= 47.9%), respectively. In clinical studies, the coronal deviation, apical deviation, and angular deviation were 0.62 mm (95%
CI
: 0.39~0.86,
I
2
=0.0%), 0.63 mm (95%
CI
: 0.39~0.87,
I
2
=0%) and 1.23°(95%
CI
: 0.71~1.76,
I
2
=15.9%), respectively.
Conclusion
There was no statistical difference in the coronal deviation, apical deviation, and angular deviation of dental implant surgery assisted by the dental implant robot system in preclinical and clinical studies, providing a reference for subsequent experiments and clinical applications.
Reviews
Recent progress in bone regenerative materials for implant dentistry
Li Xin, Liu Kaizheng, Wu Shiyu, Liu Yuanxiang, Huang Baoxin, Qiao Wei, Pan Haobo, Chen Zhuofan
2024, 29(4): 371-377. DOI:
10.12337/zgkqzzxzz.2024.08.013
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There has been an increasing number of cases involving bone regeneration in oral clinical treatments, and the requirements for related biomaterials are simultaneously getting higher. This review aims to summarize the research status of bone regeneration materials in the field of implant dentistry. First, specific characteristics of oral bone regeneration applications are introduced. Next, the biochemical and physical properties that affect the performance of materials are discussed, followed by some of the key issues in the field. Finally, an outlook on future research directions is provided to promote the development of next-generation oral bone regeneration materials.
Research progress on repair methods of maxillary sinus mucoperiosteum perforation in lateral window technique for sinus floor elevation
Fu Daxi, Tang Zengbin, Zhu Yilin, Shi Zimai, Pan Xiaobo
2024, 29(4): 378-384. DOI:
10.12337/zgkqzzxzz.2024.08.014
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Maxillary posterior tooth loss can lead to resorption of the alveolar ridge and continuous pneumatization of the maxillary sinus, resulting in insufficient bone quantity in the maxillary posterior region. Maxillary sinus floor elevation is a technique for augmenting the maxillary posterior region. Maxillary sinus mucoperiosteum perforation is one of the most common complications in the lateral window technique for sinus floor elevation. How to repair the perforation and the effects of different repair methods vary. This article reviews the different repair methods for maxillary sinus mucoperiosteum perforation in the lateral window technique for sinus floor elevation, aiming to provide some reference for clinical practitioners.
Strategies for implant surface decontamination in therapy of peri-implantitis
Yang Ting, Hu Wenjie
2024, 29(4): 385-390. DOI:
10.12337/zgkqzzxzz.2024.08.015
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Peri-implantitis is a biofilm-mediated pathological condition of peri-implant tissue, characterized by inflammation in peri-implant mucosa accompanied by progressive loss of supporting bone around dental implants. It is the main reason that affects the long-term result of dental implant restoration, which might eventually lead to implant failure. Implant surface decontamination is the key to the management of peri-implantitis. Non-surgical treatment and surgical treatment have both been used in clinical practice, but there is no gold standard protocol for implant decontamination. Therefore, it is of great significance to compare the characteristics of implants with and without peri-implantitis to understand the decontamination strategy for infected implant surfaces, which can provide a reference for clinicians in the decision-making when managing peri-implantitis.
Strategies for the use of photothermal therapy in peri-implant diseases
Gong Jing, Bo Meng, Fang Jiao, Wang Lin
2024, 29(4): 391-397. DOI:
10.12337/zgkqzzxzz.2024.08.016
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Photothermal therapy (PTT), as an emerging non-invasiveness therapeutic technology, has gradually gained wide attention in the treatment of peri-implant diseases with the convenient clinical operation and easy patient acception. Among them, the near-infrared light-responsive PTT provides a solution for the problems of insufficient intensity and depth in the traditional treatment modality. It also has the advantage of reducing the damage to surrounding tissues and promoting healing. In this paper, the strategies of using PTT in peri-implant diseases are reviewed to provide a reference for its clinical application in such diseases and its further development in the field of oral antimicrobial therapy.
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