Chinese Journal of Oral Implantology

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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

Chinese Journal of Oral Implantology 2024, 29 (4): 371-377. DOI: 10.12337/zgkqzzxzz.2024.08.013

Abstract （491）

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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.

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Impact of osteoporosis on dental implantation and related clinical considerations

Qiu Yun, Wang Yulan, Zhang Yufeng

Chinese Journal of Oral Implantology 2024, 29 (4): 336-341. DOI: 10.12337/zgkqzzxzz.2024.08.007

Abstract （487）

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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.

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Research progress on metal-organic frameworks in dental medicine

Li Jian, Liang Ye, Zhao Baodong

Chinese Journal of Oral Implantology 2024, 29 (6): 602-609. DOI: 10.12337/zgkqzzxzz.2024.12.025

Abstract （466）

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Metal-organic frameworks (MOFs) are nanoporous materials synthesized through the self-assembly of metal nodes and organic ligands. They are characterized by their highly ordered porosity, tunable pore size, large specific surface area, and diverse structures. With the advancements and applications of MOFs in the biomedical field, an increasing number of researchers have introduced MOFs into dental medicine for research. New MOFs have been tailored or developed based on the characteristics of the oral environment and diseases for use in oral disease treatment. The most commonly used MOFs in dentistry primarily include zeolitic imidazolate framework-8 (ZIF-8) and zeolitic imidazolate framework-67 (ZIF-67). The structure and function of MOFs are suitable for treating oral diseases, and they have shown promising results in researches related to periodontal disease, oral and maxillofacial tumors, dental pulp disease, and dental implants. However, their effectiveness still requires further validation through clinical trials.

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Risks and countermeasures of dental implant treatment in osteoporosis patients

Liu Zhonghao, Dong Kai

Chinese Journal of Oral Implantology 2024, 29 (4): 303-310. DOI: 10.12337/zgkqzzxzz.2024.08.003

Abstract （453）

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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.

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The impact of diabetes on the soft tissue seal surrounding dental implants

Wang Qian, Yuan Quan

Chinese Journal of Oral Implantology 2024, 29 (4): 347-351. DOI: 10.12337/zgkqzzxzz.2024.08.009

Abstract （445）

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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.

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Management of vertical bone deficiency in the posterior mandibular region

Qiu Lixin, Niu Lixuan

Chinese Journal of Oral Implantology 2024, 29 (5): 400-406. DOI: 10.12337/zgkqzzxzz.2024.10.002

Abstract （435）

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Vertical bone augmentation in the posterior mandibular region is technically demanding and prone to frequent complications. There is no consensus, either domestically or internationally, on the optimal technique. Furthermore, there is a lack of large-scale, high-quality clinical studies on the long-term outcomes of vertical bone augmentation followed by implant-supported restorations. This article provides a systematic review of complications and long-term outcomes of various vertical bone augmentation techniques, drawing on the authors' clinical expertise to provide information on decision-making.

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Application of a new Tent-Peg technique in the reconstruction of severe alveolar bone defects

Wang Mohan, Hu Yinghan, Wu Jing, Zou Duohong

Chinese Journal of Oral Implantology 2024, 29 (5): 459-466. DOI: 10.12337/zgkqzzxzz.2024.10.011

Abstract （421）

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Adequate bone volume is crucial for the successful placement and long-term stability of dental implants. Therefore, the reconstruction of severe alveolar bone defects hold significant clinical importance. With the development of guided bone regeneration (GBR) techniques, various GBR approaches have been applied in clinical practice to address alveolar bone defects. Based on the concept of "stability-centered" alveolar bone reconstruction, we developed a series of Tent-Peg medical products and established a new Tent-Peg technique. This technique enables the reconstruction of severe alveolar bone defects without the need for autologous bone, providing a novel solution for both the functional and aesthetic reconstruction of such defects. This innovative method has been successfully validated in clinical practice, and its appeal lies in its "three lows" (low technical sensitivity, low failure rate, and low cost) and "three easies" (easy to operate, promote, and popularize). To enhance clinicians' understanding of this innovative technique, this paper provides a comprehensive overview of the Tent-Peg medical product series and highlights the advantages of the new Tent-Peg technique, supported by clinical case demonstrations. This overview aims to promote the standardized application of this technique in clinical practice.

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Current status and prospects of lateral window technique for sinus floor elevation

Gao Shaojingya, Cai Xiaoxiao

Chinese Journal of Oral Implantology 2024, 29 (6): 549-554. DOI: 10.12337/zgkqzzxzz.2024.12.014

Abstract （408）

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This study provides a comprehensive review of the development, technological advancements, and both the current and future trends of the lateral window technique for sinus floor elevation in clinical applications. lateral window technique for sinus floor elevation is a surgical procedure performed in cases of insufficient alveolar bone height in the posterior maxillary region by elevating the Schneiderian membrane via a lateral window and filling it with bone substitute materials to support dental implants. Although this technique provides excellent surgical visibility and operational flexibility, it is associated with considerable trauma and potential complications. Advances in minimally invasive techniques and the application of digital technologies have significantly improved the precision and safety of lateral window technique for sinus floor elevation procedures. This study also discusses the challenges and solutions for simultaneous implantation in cases of low residual bone height. Finally, the article points out that despite the obvious advantages of the lateral window technique for sinus floor elevation, careful handling of technical details is required in practical operations to ensure high success rates and surgical safety. Future studies need more clinical data to further verify the impact of different technical parameters on surgical outcomes, in order to provide both scientific guidance and valuable reference for clinical practice.

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Clinical outcomes of 3D printing individualized titanium mesh for severe alveolar bone defects: a retrospective series

Xiong Zhenjie, Wei Yongxiang, Liu Qian, Chen Yaxin, Guo Xueqi, Ji Ruotong, Su Hanfu, Zou Yaokun, Wang Liping

Chinese Journal of Oral Implantology 2025, 30 (1): 27-34. DOI: 10.12337/zgkqzzxzz.2025.02.006

Abstract （390）

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Objective To analyze the clinical outcomes and accuracy of 3D printing individualized titanium mesh (3D-PITM) in the treatment of severe alveolar bone defects. Methods This study involved 30 patients who underwent 3D-PITM supported guided bone regeneration (3D-PITMs GBR) at the Affiliated Stomatological Hospital of Guangzhou Medical University starting in February 2020. All patients signed informed consent and underwent surgery followed by regular postoperative follow-up. Individualized titanium meshes were fabricated using 3D printing technology, with preoperative virtual design and planning. Patients were followed for 6 to 8 months postoperatively, and clinical outcomes, as well as two-dimensional (2D) and three-dimensional (3D) imaging data, were collected and analyzed. Results Among the 30 patients, 4 experienced titanium mesh exposure, yielding an incidence rate of 13.33% (95% CI: 4.30%~22.36%). However, none of the patients experienced postoperative infections. During the 6-to 8-month follow-up period, implant sites achieved satisfactory bone augmentation in both horizontal and vertical dimensions. Imaging measurements revealed significant increases in alveolar bone width and height at 6 to 8 months postoperatively compared to preoperative values ( P<0.05). Postoperative bone augmentation volume also demonstrated significant improvement ( P<0.05). Furthermore, there were no statistically significant differences in alveolar bone changes between preoperative virtual planning and postoperative measurements (immediate and at 6 to 8 months) , indicating that 3D-PITM provides predictable bone augmentation outcomes. Conclusion 3D printing individualized titanium mesh effectively supports bone regeneration, achieves a high degree of matching with the defect site, and ensures the stability and effectiveness of newly formed bone. The 3D-PITM technique demonstrates high precision in restoring severe alveolar bone defects. Although complications such as titanium mesh exposure may occur, appropriate management can prevent the adverse impact on subsequent restoration outcomes. 3D-PITM is clinically valuable for restoring complex alveolar bone defects, providing reliable postoperative predictions and optimizing surgical planning.

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Research progress on medication-related osteonecrosis of the jaw

Gao Tingting, Bao Yongjie, Lv Xiaoyan, Chen Xian, Liu Yang, Xu Yilei, Lu Huanyou

Chinese Journal of Oral Implantology 2024, 29 (5): 492-497. DOI: 10.12337/zgkqzzxzz.2024.10.016

Abstract （388）

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Medication-related osteonecrosis of the jaw (MRONJ) may be induced during the treatment of oral diseases in patients receiving anti-resorptive drugs such as bisphosphonates and denosumab, as well as angiogenesis inhibitors. However, the exact mechanism of MRONJ remains unclear, and although numerous studies have established clinical treatment databases, definitive treatment strategies have yet to be developed. Through a review of the literature, this study discusses the definition, etiology, staging, risk factors, treatment and prevention of MRONJ, providing a reference for clinical practice in oral healthcare.

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Alveolar ridge preservation in inflammatory extraction sites and implant surgery

Shao Zhiwen, Zhu Hanjiu, Song Yingliang

Chinese Journal of Oral Implantology 2024, 29 (5): 453-458. DOI: 10.12337/zgkqzzxzz.2024.10.010

Abstract （387）

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Alveolar ridge preservation after tooth extraction can reduce or even prevent alveolar bone resorption and soft tissue collapse during the healing process. This helps avoid complex soft and hard tissue augmentation procedures and provides good soft and hard tissue conditions for implant surgery. While conventional alveolar ridge preservation techniques have been widely applied and have shown predictable outcomes, there is still no standardized protocol for alveolar ridge preservation in cases where teeth are extracted due to periodontitis or periapical inflammation. To improve the success rate of alveolar ridge preservation in these inflammatory extraction sites, it is necessary to understand the various influencing factors of alveolar ridge preservation. This review discusses the indications for alveolar ridge preservation in inflammatory extraction sites, the impact of inflammation on alveolar ridge preservation, the key steps of this technique, and the timing of implant placement. It also shares experiences and techniques to optimize treatment outcomes.

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Causes, prevention and treatment of titanium mesh exposure after 3D printing individualized titanium mesh supported guided bone regeneration

Su Yucheng, Ren Bin

Chinese Journal of Oral Implantology 2025, 30 (1): 5-12. DOI: 10.12337/zgkqzzxzz.2025.02.003

Abstract （338）

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3D printing individualized titanium mesh serves as a space maintenance device, effectively creating and maintaining osteogenic space, reducing intraoperative time and the difficulty of surgery. It is a reliable bone augmentation solution for various types of alveolar ridge bone defects. However, during clinical application, postoperative titanium mesh exposure is the most common complication and requires clinicians' attention. This article elaborates on the causes, prevention, and treatment of postoperative titanium mesh exposure in guided bone regeneration supported by 3D-PITM, with the aim of providing clinical reference.

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The influence of bioabsorbable collagen membrane fixation protocols on horizontal ridge augmentation in the maxillary anterior region

Zhang Shuo, Liu Chang, Xiao Hanyu, Zhang Weifeng, Deng Huanze, Zhang Jian

Chinese Journal of Oral Implantology 2024, 29 (5): 420-428. DOI: 10.12337/zgkqzzxzz.2024.10.005

Abstract （321）

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Objective To evaluate the influence of bioabsorbable collagen membrane fixation protocols on horizontal ridge augmentation in the maxillary anterior region. Methods A total of 36 patients were enrolled in this retrospective study. One implant was placed in the maxillary anterior region, and simultaneous guided bone regeneration (GBR) surgery was performed. Participants were divided into 3 groups based on different bioabsorbable collagen membrane fixation protocols. Group 1: fixation with titanium pins; Group 2: fixation with absorbable sutures; Group 3: fixation with titanium pins and absorbable sutures. Cone beam computed tomography (CBCT) was performed immediately after surgery (T1) and at six months post-surgery (T2), respectively. The horizontal bone width of the augmented region was analyzed at the implant shoulder (H ₀) and 2, 4, 6 mm apical to the implant shoulder (H ₂, H ₄, H ₆). Changes in labial bone width during bone healing were calculated as absolute values (mm) and relative values (%). The incidence of postoperative complications was recorded. Results After six months of bone healing, all groups showed significant bone loss at H ₀-H ₆ compared to immediate post-surgery results ( P<0.05). At H ₂, horizontal bone loss in Group 1 was significantly less than in Group 2 ( P<0.05). Group 3 exhibited significantly less horizontal bone loss compared to Group 1 at H ₀ ( P<0.05), and Group 3 showed significantly less bone loss than Group 2 at H ₀-H ₄ ( P<0.05). There were no significant differences in the incidence of hematoma, wound bleeding, wound dehiscence, or infection among the groups ( P>0.05). Conclusion When implant placement with simultaneous horizontal ridge augmentation was performed in the maxillary anterior region, membrane fixation with titanium pins demonstrated superior results of the augmented region near the implant shoulder compared to fixation with absorbable sutures. However, the combined use of pins and absorbable sutures contributed to achieving better bone augmentation results compared to using either method alone.

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Strategies for the use of photothermal therapy in peri-implant diseases

Gong Jing, Bo Meng, Fang Jiao, Wang Lin

Chinese Journal of Oral Implantology 2024, 29 (4): 391-397. DOI: 10.12337/zgkqzzxzz.2024.08.016

Abstract （316）

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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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Clinical and histologic evaluation of autogenous dentin blocks for alveolar ridge augmentation

Gao Ming, Niu Lixuan, Zhu Yibo

Chinese Journal of Oral Implantology 2024, 29 (5): 435-439. DOI: 10.12337/zgkqzzxzz.2024.10.007

Abstract （313）

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Severe bone defects in the alveolar ridge of edentulous areas pose significant challenges for prosthetically-driven implant placement. Although there are currently several reliable techniques for alveolar ridge augmentation, they present certain limitations, such as high technical sensitivity, significant trauma, prolonged treatment periods, and high costs. The patient in this case presented with multiple missing teeth in both the upper and lower jaws, with a severe horizontal bone defect in the left lower posterior area. Autogenous dentin block augmentation was performed using her wisdom tooth. Two and a half years postoperatively, satisfactory alveolar bone width was achieved, allowing for the placement of a 5 mm diameter implant in dense alveolar bone with good primary stability. Intraoperative histological analysis of tissue specimens showed no abnormalities. One year after the final restoration, marginal bone stability was maintained. In this case, the application of autogenous dentin blocks for alveolar ridge augmentation effectively reconstructed the width of the alveolar ridge, with stable clinical outcomes observed nearly 4 years postoperatively.

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Clinical considerations of organ transplant patients receiving implant therapy

Tang Yiman, Qiu Lixin

Chinese Journal of Oral Implantology 2024, 29 (4): 297-302. DOI: 10.12337/zgkqzzxzz.2024.08.002

Abstract （311）

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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.

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Study on the osteogenic and antimicrobial properties of PEEK modified with a Ce-Ag-ZnO composite coating using PEI as a carrier

Dai Yating, Han Zekui, Ru Xiaona, Lyu Yuguang, Li Bing, Gao Shijun

Chinese Journal of Oral Implantology 2025, 30 (1): 54-61. DOI: 10.12337/zgkqzzxzz.2025.02.010

Abstract （311）

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Objective This study aimed to utilize polyetherimide (PEI) as a carrier to coat a Ce-Ag-ZnO composite layer, enhancing the osteogenic and antibacterial properties of polyetheretherketone (PEEK). Methods Ce-Ag-ZnO composite powder was dissolved in a PEI solution and applied to PEEK via spin coating to form a uniform and stable coating. Three groups were established: the blank group (PEEK), the control group (PEEK+PEI), and the experimental group (PEEK+PEI+composite powder). The surface morphology, hydrophilicity, phase composition, element release, and coating adhesion were analyzed. The osteogenic potential of the samples was assessed using CCK-8, live/dead cell staining, cytoskeletal staining, ALP activity quantification, alizarin red staining, and quantitative reverse transcription PCR. The antibacterial efficacy was evaluated through bacterial colony counting. Results The Ce-Ag-ZnO composite powder was successfully coated onto the PEEK surface with a uniform distribution, allowing for controlled release. The experimental group exhibited significantly enhanced hydrophilicity ( P<0.001). On the 7th day, the experimental group showed superior MC3T3-E1 cell proliferation ( P<0.001), with well-spread pseudopodia and clear adhesion. Alizarin red staining demonstrated pronounced mineralization. The modified PEEK significantly upregulated ALP activity ( P<0.001) and the expression of osteogenic genes, including Runx2, BMP-2, OPN, and OCN ( P<0.001). The experimental group also exhibited the lowest bacterial adherence ( P<0.001). Conclusion The composite coating on the PEEK surface enhanced its biocompatibility, osteogenic potential, and antibacterial properties, thereby optimizing the surface performance of PEEK implants.

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Simultaneous management of maxillary sinus cysts during sinus floor elevation

Bao Yuejie, Zhan Pingping, Lin Zhihao, He Gang

Chinese Journal of Oral Implantology 2024, 29 (6): 543-548. DOI: 10.12337/zgkqzzxzz.2024.12.013

Abstract （307）

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This article introduces a surgical approach for the simultaneous management of maxillary sinus cysts and sinus floor elevation using the double-window technique. The first lateral window is created to elevate the Schneiderian membrane and establish space for bone augmentation. Once the membrane is fully elevated and remains intact, a second small lateral window is created above the first to remove the cyst. The two windows are separated to prevent contamination of the graft material by the cystic contents. Additionally, a conservative surgical approach for the palliative treatment of sinus cysts is presented. Three representative cases are described to demonstrate specific techniques and surgical methods.

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Application of digital guides in full-arch immediate implantation of patients with periodontitis

Yang Aifen, Zhou Liwei

Chinese Journal of Oral Implantology 2024, 29 (6): 585-589. DOI: 10.12337/zgkqzzxzz.2024.12.022

Abstract （302）

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Implant-supported full-arch fixed restorations have become an important treatment for potentially edentulous jaws with severe periodontitis. The advent of immediate implantation has dramatically shortened the treatment period of patients, and digital guides allow for precise, efficient and minimally invasive immediate implant surgery. However, there are few clinical reports on full-arch immediate implantation using digital guides in patients with severe periodontitis. In this review, the application of different digital guides in full-arch immediate implant placement for patients with severe periodontitis is discussed and summarized.

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Clinical retrospective study of bone ring technique for 3-dimensional bone augmentation in implant restoration

Chen Gang

Chinese Journal of Oral Implantology 2024, 29 (5): 429-434. DOI: 10.12337/zgkqzzxzz.2024.10.006

Abstract （302）

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Objective To evaluate the efficacy and key points of the bone ring technique for three-dimensional bone augmentation with simultaneous implant placement in cases of single-tooth loss with bone defects. Methods A retrospective review of cases from August 2010 to February 2023 at the Department of Dentistry, Peking University Shenzhen Hospital, and U-dental Clinic in Shenzhen, where patients with single-tooth vertical bone defects were treated using the autogenous bone ring technique with simultaneous implant placement. Second-stage surgeries were performed 6 months postoperatively for final restorations. Complications, bone augmentation outcomes, implant failures, and postoperative bone resorption were assessed through clinical and radiographic evaluations. Results 167 teeth were treated with the bone ring technique. 2 implants failed before restoration, and 4 bone rings failed during the healing period. No further implant failures were observed after restoration. Of the 36 patients with complete CBCT data, the average vertical bone gain was (4.52±0.81) mm. Average vertical bone resorption was (0.25±0.11) mm at 6 months post-surgery and (0.52±0.23) mm at 1 year after final restoration. Conclusion The bone ring technique, when applied to cases with sufficient basal bone and vertical bone defects, is an effective method for achieving vertical bone augmentation with simultaneous implant placement. It demonstrates a high implant success rate and low complication rate.

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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

Chinese Journal of Oral Implantology 2024, 29 (4): 378-384. DOI: 10.12337/zgkqzzxzz.2024.08.014

Abstract （296）

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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.

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Strategies for implant surface decontamination in therapy of peri-implantitis

Yang Ting, Hu Wenjie

Chinese Journal of Oral Implantology 2024, 29 (4): 385-390. DOI: 10.12337/zgkqzzxzz.2024.08.015

Abstract （291）

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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.

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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

Chinese Journal of Oral Implantology 2024, 29 (4): 320-327. DOI: 10.12337/zgkqzzxzz.2024.08.005

Abstract （282）

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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.

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Biological complications of butt-joint dental implants: a retrospective case analysis

Chen Zhenqi, Yan Qi, Chen Yan, Shi Bin

Chinese Journal of Oral Implantology 2024, 29 (4): 352-357. DOI: 10.12337/zgkqzzxzz.2024.08.010

Abstract （279）

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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.

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Editorial Board of Chinese Journal of Oral Implantology

Chinese Journal of Oral Implantology 2024, 29 (4): 295-296. DOI: 10.12337/zgkqzzxzz.2024.08.001

Abstract （273）

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Meta-analysis of the accuracy of dental implant robots in preclinical and clinical studies

Wang Yiming, Li Xinru, Teng Weiwei, Ma Junchi, Zhou Libo

Chinese Journal of Oral Implantology 2024, 29 (4): 362-370. DOI: 10.12337/zgkqzzxzz.2024.08.012

Abstract （267）

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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, I²=0.0%), 0.73 mm (95% CI: 0.62~0.84, I²=24.9%), and 1.25°(95% CI: 1.02~1.48, I² = 47.9%), respectively. In clinical studies, the coronal deviation, apical deviation, and angular deviation were 0.62 mm (95% CI: 0.39~0.86, I²=0.0%), 0.63 mm (95% CI: 0.39~0.87, I²=0%) and 1.23°(95% CI: 0.71~1.76, I²=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.

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Research progress on the influence of depression on peri-implant health

Zhao Xintong, Meng Weiyan

Chinese Journal of Oral Implantology 2024, 29 (4): 342-346. DOI: 10.12337/zgkqzzxzz.2024.08.008

Abstract （255）

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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.

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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

Chinese Journal of Oral Implantology 2024, 29 (4): 358-361. DOI: 10.12337/zgkqzzxzz.2024.08.011

Abstract （253）

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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.

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Therapeutic strategy of staged bone augmentation in the esthetic zone combined with microsurgical apical surgery on adjacent teeth: clinical diagnosis and treatment process and case study

Du Aobo, Man Yi

Chinese Journal of Oral Implantology 2024, 29 (5): 440-444. DOI: 10.12337/zgkqzzxzz.2024.10.008

Abstract （252）

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In implant surgery in the esthetic zone of anterior teeth, different degrees of bone augmentation are often necessary to achieve an ideal anterior dental arch contour and soft tissue harmony. However, chronic periapical inflammation of adjacent teeth at the implant site may become a potential source of infection, leading to early failure of bone augmentation or further affecting the root of the implant, potentially resulting in retrograde peri-implantitis. This report presents a typical case involving an anterior dental bone defect with periapical lesions of adjacent teeth. Staged bone augmentation and implant restoration were performed by combining the dentin shell technique with microsurgical apical surgery. This approach avoided the trauma of harvesting autologous bone from a second surgical site during bone augmentation, offering a minimally invasive option for bone defects involving non-functional natural teeth, such as impacted teeth. Additionally, the potential source of infection from adjacent teeth was addressed during implant surgery, ensuring the long-term predictability of the treatment outcome.

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Animal experiment of prognosis of immediate implant placement and restoration in individuals with T2DM

Zhao Guoqiang, Song Yingliang

Chinese Journal of Oral Implantology 2024, 29 (4): 311-319. DOI: 10.12337/zgkqzzxzz.2024.08.004

Abstract （250）

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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.

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Application of bone blocks harvested from the lateral wall of the maxillary sinus in horizontal alveolar ridge augmentation using the tenting technique

Zhou Danhong, Hu Ling, Zhou Guodong, Qiu Yuesheng, Jiang Zhiwei, Yang Guoli

Chinese Journal of Oral Implantology 2024, 29 (5): 407-412. DOI: 10.12337/zgkqzzxzz.2024.10.003

Abstract （243）

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Objective To explore the clinical effect of bone blocks harvested from the lateral wall of the maxillary sinus on horizontal alveolar ridge augmentation using the tenting technique. Methods This study reviewed patients with dental defects who underwent horizontal tenting technique in the maxillary posterior region using bone blocks harvested from the lateral wall of the maxillary sinus at the Stomatology Hospital of Zhejiang University School of Medicine from November 2018 to March 2023. The width of the alveolar ridge in the grafted area was compared using cone beam computer tomography (CBCT) images taken preoperatively, immediately postoperatively, and 6 months postoperatively. Patients were also followed up clinically. Results There was a statistically significant increase in bone width at 0mm and 3mm from the top of the alveolar ridge in the immediate postoperative period compared to the preoperative period ( P<0.05). 6 months postoperatively, the increase in horizontal bone width at the top of the alveolar ridge was (3.60±2.29) mm compared to preoperative measurements ( P>0.05). The increase in horizontal bone width at 3 mm from the top of the alveolar ridge was (2.85±1.54) mm compared to preoperative measurements, and the difference was statistically significant ( P<0.05). And compared to the immediate postoperative period, the bone augmentation at different distances from the top of the alveolar ridge remained basically stable 6 months postoperatively, with no significant bone resorption observed ( P>0.05). Conclusion Bone blocks harvested from the lateral wall of the maxillary sinus show effective bone augmentation and favorable clinical outcomes when used in the horizontal alveolar ridge augmentation using the tenting technique. It provides a new surgical method for cases with insufficient alveolar ridge width in the maxillary posterior region, especially when combined with severe bone height deficiency requiring lateral window technique for sinus floor elevation.

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Clinical evaluation of collagen sponge for augmenting keratinized gingiva around dental implants

Zhong Zhitong, Huang Min, Wang Jing, Shen Qinyuan, Wu Runfa

Chinese Journal of Oral Implantology 2024, 29 (5): 474-479. DOI: 10.12337/zgkqzzxzz.2024.10.013

Abstract （242）

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Objective To evaluate the clinical efficacy of collagen sponge in augmenting keratinized gingiva around dental implants. Methods Fourteen patients with 16 surgical sites were randomly assigned to either the collagen sponge group or the free gingival graft group for keratinized gingiva augmentation. The width of keratinized tissue (WKT), soft tissue thickness (ST), color difference, and visual analogue scale (VAS) pain scores were measured at baseline, immediately after surgery, and at 6 weeks and 12 weeks postoperatively. Results At 12 weeks, the WKT was (5.81±0.75) mm and (3.50±0.53) mm ( P<0.001), and the change in soft tissue thickness was (0.83±0.44) mm and (0.04±0.07) mm ( P<0.05) in the free gingival graft and collagen sponge groups, respectively. The color difference values were 130.86±53.99 and 34.13±31.77 ( P<0.05), the VAS pain scores was 5.13±1.25 and 1.88±1.13 ( P<0.001), and the operative time was (38.17±4.56) min and (21.17±3.72) min ( P<0.01), respectively, showing statistically significant differences. Conclusion Collagen sponge can be used for peri-implant keratinized gingiva augmentation. Compared with free gingival grafts, collagen sponges provide better aesthetic results, reduce operation time, and avoid the additional trauma associated with donor site harvesting.

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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

Chinese Journal of Oral Implantology 2024, 29 (4): 328-335. DOI: 10.12337/zgkqzzxzz.2024.08.006

Abstract （240）

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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.

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Evaluation of micro crestal flap-alveolar ridge preservation in maxillary molar extraction for severe periodontitis: a retrospective study

Wei Yiping, Zhang Haoyun, Hu Wenjie, Xu Tao, Li Liman, Zhao Liping

Chinese Journal of Oral Implantology 2024, 29 (5): 413-419. DOI: 10.12337/zgkqzzxzz.2024.10.004

Abstract （237）

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Objective This retrospective clinical study aimed to investigate the effects of micro crestal flap-alveolar ridge preservation (MCF-ARP) following maxillary molar extraction in patients with severe periodontitis. Methods A total of 95 maxillary molars from 80 patients were included, with the teeth extracted and then either left to heal naturally or treated with MCF-ARP before implant placement. Changes in bone height, bone width, and maxillary sinus pneumatization were evaluated using imaging. Additionally, the proportion of patients requiring bone augmentation surgery during implant placement was recorded. Results After healing, the bone height at the center of the alveolar socket increased by 4.94 mm in the MCF-ARP group and 2.20 mm in the natural healing group. The bone width 1 mm below the crest of the ridge increased by about 4 mm in the MCF-ARP group, while it decreased by about 1 mm in the natural healing group. The maxillary sinus pneumatization was (0.50 ± 0.35) mm in the natural healing group compared to (0.23 ± 0.44) mm in the MCF-ARP group ( P=0.003). The proportion of patients requiring bone augmentation during implant placement was 67.6% in the natural healing group compared to 29.5% in the MCF-ARP group. Conclusion In patients with severe periodontitis, MCF-ARP can improve alveolar bone height and width, as well as reduce maxillary sinus pneumatization. This technique decreases the need for bone augmentation surgery during implant placement, thereby reducing the trauma and complexity of the implant procedure.

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A 5-year clinical observation on the application of non-resorbable membranes for bone augmentation in the aesthetic zone

Wan Peng

Chinese Journal of Oral Implantology 2024, 29 (5): 445-452. DOI: 10.12337/zgkqzzxzz.2024.10.009

Abstract （225）

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This case report describes the use of guided bone regeneration (GBR) combined with soft tissue augmentation for implant restoration in an extended edentulous space in the esthetic zone, employing heterogeneous bone and dense polytetrafluoroethylene (dPTFE) membranes with double-layered coverage using a pig-derived non-crosslinked collagen membrane (Bio-Gide). The patient presented with multiple teeth missing in the maxillary anterior region due to trauma sustained at a young age, accompanied by severe horizontal bone loss and slight vertical bone loss. Clinical treatment involved the simultaneous guided placement of implants with GBR using deproteinized bovine bone mineral (DBBM), dPTFE, and Bio-Gide membranes. After 6 months, soft tissue augmentation was performed in two stages: first using the tunneling technique with allogeneic de-epithelialized dermal matrix (AlloDerm), followed by a modified tunneling technique using a connective tissue graft (CTG). Gingival shaping was achieved with temporary restorations, followed by final aesthetic restoration to restore function and appearance. A 5-year clinical follow-up demonstrated that GBR with DBBM, dPTFE, and Bio-Gide achieved ideal bone volume gain, while AlloDerm/CTG with the tunneling technique produced satisfactory soft tissue augmentation, contributing to excellent aesthetic outcomes.

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A survey of the willingness and influencing factors for dental implants among middle-aged and elderly patients with missing teeth in five cities of Liaoning

Chai Haoran, Liu Yi, Wang Zunshuo, Lang Zheyu, Li Chenhui, Zhu Shenghui, Zhang Xuepu, Zhang Yue

Chinese Journal of Oral Implantology 2024, 29 (5): 467-473. DOI: 10.12337/zgkqzzxzz.2024.10.012

Abstract （219）

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Objective To investigate the willingness and influencing factors for dental implants among middle-aged and elderly patients with missing teeth in five cities of Liaoning Province. Methods Using population proportionate sampling (PPS) and a three-stage random sampling method, middle-aged and elderly patients with missing teeth in Shenyang, Fushun, Jinzhou, Panjin, and Chaoyang in Liaoning Province were selected as research subjects for a questionnaire survey. T-tests, analysis of variance, and structural equation modeling were used to explore the factors influencing implant willingness. Results There were statistically significant differences in the expected treatment outcomes of dental implants among patients with different educational levels ( P<0.05). Media channels used by patients to learn about implants also varied significantly across different income levels ( P<0.05). Significant differences were found in implant willingness, expected treatment outcomes, media channels, price barriers, and perceived risks between urban and rural patients ( P<0.05). Urban patients had higher scores for implant willingness (3.37), expected treatment outcomes (3.76), and media channels (3.52) compared to rural patients (2.91, 3.35, 3.12, respectively), while rural patients had higher scores for price barriers (2.94) and perceived risks (3.01) compared to urban patients (2.71 and 2.67, respectively). Structural equation modeling revealed that expected treatment outcomes ( β=0.185) and media channels ( β=0.277) had a significant positive impact on implant willingness, while price barriers ( β=-0.212), perceived risks ( β=-0.127), and geographical limitations ( β=-0.227) had a significant negative impact. Conclusion Price barriers, perceived risks, and geographical limitations are important factors contributing to the low willingness for dental implants among middle-aged and elderly patients with missing teeth in Liaoning Province. Therefore, it is necessary to promote dental implants through coordinated efforts from hospitals, the public, and manufacturers, in order to increase the application of dental implants.

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Comparison of bone augmentation effects between digital titanium mesh and resorbable collagen membrane: a retrospective study

Li Songhang, Cai Xiaoxiao

Chinese Journal of Oral Implantology 2025, 30 (1): 19-26. DOI: 10.12337/zgkqzzxzz.2025.02.005

Abstract （217）

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Objective To evaluate the clinical outcomes of bone augmentation using digital titanium mesh versus absorbable collagen membrane. Methods From January 2019 to December 2020, 24 patients with Terheyden type 2/4 or 3/4 bone defects were treated at the Department of Oral Implantology, West China Hospital of Stomatology. These patients were divided into two groups: the absorbable collagen membrane group (12 cases) and digital titanium mesh group (12 cases). Both groups underwent guided bone regeneration with absorbable collagen membrane and digital titanium mesh as barrier membranes, respectively. The two-dimensional and three-dimensional measurements of alveolar bone were taken at four time points: pre-surgery (T ₁), post- surgery (T ₂), before second-stage surgery (T ₃), and one year after loading (T ₄), to evaluate hard tissue stability. Results Both the absorbable collagen membrane group and the digital titanium mesh group achieved excellent bone augmentation outcomes after surgery. The average single-tooth augmentation was 354.43 mm ³ (330.04, 403.93) in the absorbable membrane group, and in the digital titanium mesh group, it was 368.98 mm³ (320.90, 441.61). Although the labial bone in the absorbable collagen membrane group was thicker than in the digital titanium mesh group at T ₂, after the healing and loading periods, the digital titanium mesh group exhibited thicker labial bone at all measurement points. Both in the short-term healing and long-term functional phases, the resorption of the labiolingual bone in the digital titanium mesh group was lower than in the absorbable collagen membrane group. Additionally, the digital titanium mesh group showed superior bone preservation results in terms of three-dimensional volume. Conclusion Digital titanium mesh offers superior bone augmentation effects compared to absorbable collagen membranes. It maintains a stable osteogenic space during the early healing phase and exerts a positive influence during the loading phase.

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Preface for the key column “bone augmentation”

Editorial Board of Chinese Journal of Oral Implantology

Chinese Journal of Oral Implantology 2024, 29 (5): 398-399. DOI: 10.12337/zgkqzzxzz.2024.10.001

Abstract （203）

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