Chinese Journal of Oral Implantology

Remain true to our original aspiration and keep our mission firmly in mind——In memory of the centenary of the Communist Party of China

Wang Xing

2021, 26(5): 275-276. DOI: 10.12337/zgkqzzxzz.2021.10.001

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Expert consensus on the management of sinus floor elevation mucoperiosteum perforation (first edition)

Chinese Society of Oral Implantology

2021, 26(5): 277-281. DOI: 10.12337/zgkqzzxzz.2021.10.002

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Maxillary sinus floor elevation is a common and standard method for the rehabilitation of atrophic bone in the posterior maxilla but has highly technical sensitivity and considerable complications. A common complication is the Schneiderian membrane perforation. Systemic reviews and expert-written forums are common in the literature. However, a consensus about the guideline for the management of the Schneiderian membrane perforation during maxillary sinus floor elevation has not been reached. To this end, experts from the Chinese Society of Oral Implantology discussed several times and have drafted this expert consensus in order to provide clinicians with practical and feasible measures for preventing, diagnosing, and treating the Schneiderian membrane perforation during the surgery of sinus floor elevation.

Effect of A-PRF on the biological performance of human bone marrow mesenchymal cells

Wang Jia, Zhao Ruimin, Gong Jiaming, Yu Zhanhai, Yin Lihua

2021, 26(5): 282-288. DOI: 10.12337/zgkqzzxzz.2021.10.003

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Objective The aim of this study was to investigate the cytobiological effects of advanced-platelet rich fibrin (A-PRF) on cells from human bone marrow mesenchyme (hBMMCs) in vitro. Methods hBMMCs were identified as adipogenic and osteogenic differentiation. A-PRF was observed under a scanning electron microscope and its growth factor was detected by human growth factor antibody array-membrane. CCK-8 and scratch tests were used to detect the effect of A-PRF on the proliferation and migration of hBMMCs at different concentrations. Alkaline phosphatase activity and alizarin red staining were used to detect the effect of different concentrations of A-PRF on the mineralization ability of hBMMCs. Results SEM showed that A-PRF is a three-dimensional network containing more than 40 cytokines, among which macrophage colony stimulating factor and human nerve growth factor had not been reported. 10% A-PRF increased cell proliferation and migration ability (P<0.05), but also promoted calcium deposition and ALP of hBMMCs (P<0.05). Conclusion A-PRF improved the osteogenic differentiation of hBMMCs and the proliferation and migration, and 10% A-PRF achieved the most obvious promotion effect. The favorable cytobiological effects of A-PRF on hBMMCs might serve as the basis for A-PRF applications in bone regeneration.

Impact of oxysterols coated bovine bone blocks for regeneration of critical-sized defects in dog mandible at the early stage of bone healing

Hu Xiao, Liu Wei, Wu Wangxi, Zhou Lei

2021, 26(5): 289-293. DOI: 10.12337/zgkqzzxzz.2021.10.004

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Objective To explore the impact of oxysterols coated bovine bone blocks (OBB) for regeneration of critical-sized defects in dog mandible at the early stage of bone healing. Methods Four beagle dogs were used in this study. After the mandibular third, fourth premolar, and first molar extraction, two standardized box-shaped defects (5 mm×10 mm×10 mm) were created on both sides of the mandible of each animal (n=4 animals, total 16 defects). Four weeks later, the defects were randomly augmented with OBB (n=8) or bovine bone blocks (n=8) in a split-mouth design. All animals were sacrificed 4 weeks after surgery. The specimens were decalcified for hematoxylin and eosin staining and immunohistochemical analysis of osteocalcin (OC). Results Histomorphometrical analysis (HE staining) revealed that the percentage of new bone was significantly higher in the OBB group (35.43±2.78)% in comparison with the BBB group (30.88±2.03）%, P<0.05. And the mean value of the number of vessels was (31.50±1.60) in the OBB group and (30.00±1.31) in the BBB group (P>0.05). The number of OC-stained cells was (63.50±7.50) in the OBB group and 55.50±5.15 in the BBB group. There is a significant difference in the numbers of OC-stained cells (P<0.05). Conclusion OBB can enhance the regeneration of critical-sized defects by stimulating the differentiation of osteoblastic cells at the early stage of bone healing.

Medical personnel cooperation during intraoral welding technique

Xia Wei, Wang Yarong, Zhao Yuyue, Wang Xuejiao, Rong Mingdeng, Chen Xiao

2021, 26(5): 294-298. DOI: 10.12337/zgkqzzxzz.2021.10.005

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Purpose The aim of this study was to summarize the experience and learning of high-quality nursing during intraoral welding. Methods From January 2020 to now, there were a total of 10 patients with fully edentulous patients. All the patients received the same day of surgery and installed a fixed, full-arch, or partial-arch prosthesis supported by an intraorally welded titanium framework created directly in the patient’s mouth using a titanium bar within one week. By analyzing the indications, preoperative preparation, intraoperative cooperation, and postoperative nursing cooperation of the welding technology, the nursing experience and experience of the four-hand operation in this process were summarized. Results All 10 patients received effective welding procedures after operations without operating or after-operating complications. Nursing cooperation was effective and essential during the perioperative period. Conclusion High predictability with welded titanium framework can be expected under certain circumstances. Sufficient explanation, preoperative preparation, and familiarity with nursing procedures and details before welding are necessary for efficient and safe implementation.

Clinical application of a static guided system controlled by extraoral device in oral implant surgery

Liu Feng, Dong Kai, Wang Meijuan, Zhou Wenjuan, Xu Sheng, Liu Zhonghao

2021, 26(5): 299-305. DOI: 10.12337/zgkqzzxzz.2021.10.006

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Objective To evaluate the clinical application and accuracy of a new static guided implant surgery system controlled by an extraoral device. Methods Forty-five patients with a single tooth missing were recruited, and the available bone of all included cases was sufficient. The patients were divided into three groups according to different surgical approaches: group 1, implantation with freehand; group 2, implantation guided by static surgery guide; and group 3, implantation guided via the new implant surgery system controlled by the extraoral device. By comparing the difference between the actual and virtual implant positions among the three groups, the clinical accuracy of the new implant surgery system was evaluated. Patient-reported outcome measurements (PROMS) and the operator related satisfaction were also evaluated. Results No statistical differences were found among groups with regard to the entrance deviation[(1.18±0.48）mm,(1.07±0.47) mm,(0.83±0.37) mm, P>0.05]. The accuracy of the new implant surgery system group at the apical part and for the angle aspect was higher than the other two groups [apical deviation: (1.60±6.76) mm, (1.42±4.40) mm, (1.03±0.54) mm, P<0.05; angle deviation: 5.71º±3.54º,4.63º±2.52º,2.75º±1.90º P<0.05]. For PROMS, there was no statistical difference among groups (P>0.05), and for the operator related satisfaction, the score of the operation visual field availability fluctuates greatly, ranging from 60 to 100. The score of other items was 70 to 90 and 90 to100. Conclusion For single tooth implantation with sufficient available bone, this new static guided system controlled by the extraoral device can achieve predictable clinical accuracy and acceptable patient and operator satisfaction.

Clinical application of “tenon-mortise” based whole-process digital combined guide plate in complete-mouth implant surgery.

Li Yan, Yang Qingran, Xu Guangzhou

2021, 26(5): 306-312. DOI: 10.12337/zgkqzzxzz.2021.10.007

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Objective This study was to conduct a preliminary investigation of the efficacy of “tenon-mortise” based combined digital whole-process surgical templates to assist in diagnosis, plan, and facilitate proper positioning for edentulous patients. Methods This clinical case analysis was to report the treatment of one case with advanced periodontitis, which in turn leads to loosening of teeth. Because of the advanced periodontitis, the remaining teeth were severely loose. A self-designed “tenon-mortise” based combined digital whole-process surgical templates were applied to guide the placement of the implant. The combined surgical templates include positioning plate, osteotomy plate, and implant plate. The connection between the two plates is based on the tenon-mortise joint, which facilitates implant surgery for edentulous patients. In addition, for the irregular alveolar ridge, the osteotomy plate, as one of the combined guided surgical templates, could be used to guide cutting and trimming the alveolar ridge. Using the self-designed “tenon-mortise” based combined digital guided surgical templates could successfully guide the entire surgical process. Results When comparing the planned and placed implant by CBCT, it was found that high accuracy was achieved by using the self-designed “tenon-mortise” based combined digital whole-process surgical templates. The mean angular deviation was 2.27°. The mean value of deviation at the shoulder and apex was 1.77 mm and 1.93 mm, respectively. The outcome of the immediate restoration was satisfying. Conclusion This self-designed template system provides a novel technique to guide whole-process digital implant surgery for edentulous patients. But the efficacy needs further investigation in clinical trials with larger sample sizes and longer follow-up periods.

Immediate implant placement and immediate restoration with a thin gingival biotype in the esthetic zone: 3 years of follow-up

Jiang Jiayang, Li Xiaoyu, He Mengxiao, Jin Zhuohua, Ou Yanzhen, Wang Dan, Meng Weiyan

2021, 26(5): 313-317. DOI: 10.12337/zgkqzzxzz.2021.10.008

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To investigate the clinical effect of immediate implant placement and immediate restoration after minimally invasive extraction of single tooth root fracture with thin gingival biotype in the maxillary esthetic zone, a restoration-oriented implant scheme was designed for a patient with thin gingival biotype in the maxillary esthetic zone before operation. This study did the immediate implant surgery with bone augmentation in a minimally invasive way using a bone level implant. The temporary restoration was restored immediately, and the final permanent restoration was formed 11 months later. After a 36-month follow-up, the synosteosis was well-formed and the marginal bone was stable after loading. The gingival margin was consistent with the same level as that of the contralateral natural tooth, the periprosthetic soft tissue obtained healthy pink esthetics and proper white esthetics, and the patient's satisfaction was high. Therefore, an immediate implant restoration can maintain the stability of soft and hard tissue in a short time, and meet both functional and esthetic demands of patients with single tooth loss and thin gingival biotype in the esthetic zone.

Dental implant treatment with a minimally invasive technique at periapical lesion site of posterior teeth: a case report

Wang Hanchi, Sun Xiaolin, Zhou Yanmin

2021, 26(5): 318-321. DOI: 10.12337/zgkqzzxzz.2021.10.009

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This case report describes a minimally invasive technique established by PESS, in which only platelet-rich fibrin (PRF) was used as a bone graft, combined with the endoscopic lifting of the maxillary sinus floor through the crest of the alveolar ridge, and immediate implantation at the periapical infected site with residual bone height less than 1 mm. Finally, the treatment time was successfully shortened, the implant stability was maintained, and the masticatory function of the posterior teeth was guaranteed.

Advances of wound closure in alveolar ridge preservation

Liu Zhenhui, Hu Wenjie

2021, 26(5): 322-327. DOI: 10.12337/zgkqzzxzz.2021.10.010

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Favorable soft and hard tissue morphology is the basis of successful implant therapy, following a tooth extraction, the alveolar ridge undergoes physiological remodeling which affects prosthetically driven implant restoration. Alveolar ridge preservation can effectively preserve the soft and hard tissue contour of tooth extraction sites and create conditions for implant restorations. Good wound closure is one of the important keys to ensure the success of the operation. This article discusses different methods of wound closure, in order to provide a reference for the clinical application of this technique to achieve ideal results.

Research progress on the application and mechanism of nanomaterials in stomatology

Zhang Han, Meng Lingxi, Wang Mican, Lu Jingwei, Mei Hongxiang, Liao Wen

2021, 26(5): 328-333. DOI: 10.12337/zgkqzzxzz.2021.10.011

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Nanomaterials have been widely used in the field of oral disease prevention and treatment, especially in controlling the development of caries and alleviating dentin allergy, due to their superior antibacterial properties and biocompatibility. Meanwhile, nanomaterials provide solutions for tissue regeneration, especially for oral tissue regeneration, due to their small particle size, high antibacterial activity and biocompatibility. At present, the research on nanomaterials in the field of dentistry focuses on the biological effects of various nanomaterials on different oral cells and clinical application studies. In this paper, we will review the biological effects of nanoparticles on oral cells, potential mechanisms and influencing factors, aiming to provide references for the development of new materials in the field of oral medicine and the prevention, diagnosis and treatment of oral diseases.

Research progress of bone window design for maxillary sinus floor elevation through lateral window approach

Zhang wen, Gu Xinhua

2021, 26(5): 334-338. DOI: 10.12337/zgkqzzxzz.2021.10.012

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The key of maxillary sinus floor elevation through lateral window approach is to expose and lift the sinus membrane, and the design of bone window is the primary factor to expose the sinus membrane. The traditional bone window is designed as a single and large window. If there is a sinus septum, 2 or 3 bone windows will be designed to avoid sinus septum. The lower boundary of the bone window is generally 3-5 mm at the bottom of the maxillary sinus. In recent years, many scholars have continuously studied the size, height, and distance from the alveolar ridge border, which has reduced intraoperative and postoperative discomfort and increased patient satisfaction. This article reviews the size, position, and shape of the bone window and digitally assisted lateral window osteotomy by consulting the recent literature.

Learning curve and its significance in oral and maxillofacial medicine

Wang Wenying, Li Shunshun, Shen Yue, Wang Feng

2021, 26(5): 339-342. DOI: 10.12337/zgkqzzxzz.2021.10.013

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In recent years, digital technologies popular in stomatology have brought dentists new challenges. Practicing and learning new technologies is very important in both clinical operation and education. The relationship between practice and proficiency is considered as the basis for acquiring certain abilities. To reveal such a relationship, the concept of "learning curve" was introduced. It visualizes the process of learning, providing a new method for performance evaluation. Through discussions of the concept and researches about the learning curve, this review explores the significance of the learning curve in stomatology and provides references for clinicians and educators in stomatology.

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