Table of Content

10 February 2022, Volume 27 Issue 1

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Expert consensus on complications of sinus floor elevation: compromised osteogenesis (first edition)

Chinese Society of Oral Implantology

2022, 27(1):  4-8.  DOI: 10.12337/zgkqzzxzz.2022.02.002

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Maxillary sinus floor elevation procedure is often used as a solution to increase the residual bone height in the maxillary posterior tooth area. There is no consensus on the prevention and management of complications after maxillary sinus elevation procedure despite numerous intra- and postoperative complications. This review mainly focuses on compromised osteogenesis after maxillary sinus floor elevation and reviews risk factors, clinical manifestations, methods for preventing and managing this complication, to provide evidence for clinical practice.

Surgical workflow of dynamic navigation system guided zygomatic implant surgery

Lan Gengliang, Tao Baoxin, Huang Wei, Wang Feng, Li Shunshun, Wu Yiqun

2022, 27(1):  9-15.  DOI: 10.12337/zgkqzzxzz.2022.02.003

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Due to the surrounding complex anatomical structures and the limited volume of zygoma bone, zygomatic implant placement is a highly technique-sensitive surgery. Clinically, applying a dynamic navigation system enables doctors to complete the implant placement under real-time monitoring, minimizing surgical risks and realizing preoperative planning. However, the dynamic navigation system still has an inevitable error caused by the type, distribution, and the number of registration markers, which will affect the registration accuracy, affecting the dynamic navigation accuracy at the surgery. The reduced precision of dynamic navigation surgery can cause serious surgical complications of zygomatic implant surgery. Furthermore, the operator’s familiarity with the dynamic navigation surgical process and proficiency in the zygomatic implant surgery may impact the final accuracy. This article summarizes the standard procedures and relevant factors that affect the accuracy of zygomatic implant surgery with a dynamic navigation system.

The study of surface properties of SLM 3D printing titanium mesh coating by polyurethane

Han Zekui, Zhang Liang, Xie Fei, Zheng Xiaoxiao, Chen Yingying, Wang Xinyu

2022, 27(1):  16-21.  DOI: 10.12337/zgkqzzxzz.2022.02.004

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Objective The surface of laser selective melting was treated by the polyurethane electrophoretic coating method. The better effects of titanium surface pretreatment technologies should include the following aspects, the surface is flat, few metal-dust, and the peaks of the blasted surface were found on the surface. Methods Experimental group, Group A: Normal processing; Group B1: SiO₂ sandblasting; Group B2: Al₂O₃ sandblasting; Group C1: SiO₂ sandblasting and acid etching; Group C2: Al₂O₃ sandblasting and acid etching; Group D1: Polyurethane coating (40V); Group D2: Polyurethane coating (60V); Group D3: Polyurethane coating (80V). The surface morphology of each specimen was observed. And its roughness, contact Angle, coating thickness were tested by relevant methods. Results The effect of the polyurethane coating group was significantly better than other surface treatment groups (P<0.001). There is nearly no metal powder on the surface of polyurethane coating with a thickness of 15-20 μm, the quantity of exposed peaks of the blasted surface is decreased. Conclusion The method of polyurethane electrophoretic coating could make the surface of SLM 3D printing titanium mesh more flat and hydrophobic, nearly a few metal-dust and foreign matter were found on the surface, and no Isocyanate monomer was present in the materials. It is expected to reduce the stimulation of gingival soft tissue and prevent the postoperative infection caused by SLM 3D printed titanium mesh. It’s safer to Implant into the alveolar bone.

A 5-year clinical observation on the effect of four different transmucosal height restoration abutments on marginal bone resorption

Yang Jingjing, Hu Changqi, Yu Zhengrong, Gong Jinmei, Huang Jiangqin, Wei Hongwu

2022, 27(1):  22-27.  DOI: 10.12337/zgkqzzxzz.2022.02.005

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Objective To evaluate the long-term clinical efficacy of restoration abutments with different transgingival heights after 5 years of implant restoration. Methods Patients who underwent implant restoration for dental defects in the Department of Stomatology, the Fourth Affiliated Hospital of Nanchang University from January 2015 to September 2015 were selected and divided into four groups according to the different transgingival heights of the restoration abutment selected when the final restoration was completed: Group A (≤1 mm), Group B (2 mm), Group C (3 mm), Group D (4 mm). According to the grouping situation, measurement was performed immediately after the implantation, when the final restoration was completed, and at least 5 years after the restoration using curved tomography to analyze the changes in the bone tissue at the implant neck. Results During the observation period, after at least 5 years of functional loading, the success rate of 63 implants was 96.83%. Among the four groups, the amount of bone tissue absorption around the implant in group A [T2-T1:（-0.627 ±1.030） mm]and in group B[T2-T1:（-0.017±0.424 ）mm]was statistically significant (P<0.05). The relationship between the prosthetic abutment with different transgingival heights and the exposure of the implant neck platform was statistically significant (P<0.05). Conclusion For self-locking taper-retained implants, when the final restoration is completed, the choice of restoration abutments with different gingival heights will have a certain impact on the absorption of bone tissue around the implant. Long gingival restorations are used under the same implant depth. The table can reduce the exposure of the implant neck platform after functional weight-bearing, thereby reducing the risk of infection of the implant from the surrounding environment.

Department of Oral Implantology, Hospital of Stomatology,Anhui Medical University, Hefei 230032, China

Zhang Wanting, He Jiacai

2022, 27(1):  28-33.  DOI: 10.12337/zgkqzzxzz.2022.02.006

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Objective To analyze impact factors of failed dental implant cases, and provide the theoretical guidance for clinical operation. Methods Cases in the Center of Oral Implantology from January 2012 to January 2021 with complete medical records were selected. The differences of gender, age, periodontal disease status, location of implants, implant, and surgical factors were compared between failed implants and successful implants. Statistical analysis software was SPSS 24.0. Statistical methods were the χ² test, Fisher’s Exact Test, and binary logistic regression. The level of statistical significance is expressed as P< 0.05. Results A total of 6124 implant cases were included in this study including 82 failed cases. The implant failure rate was 1.34%. There were 72 early failed cases and 10 late failed, with failure rates of 1.18% and 0.16%. Statistics results showed that the failure risk of men was higher than that of women (P< 0.001). Cases with implant diameter < 4.0 mm, implant length < 10 mm, and bone quality type Ⅳ showed a higher failure rate (P< 0.01). The failure risk in cases with internal sinus floor elevation (ISFE) was higher than those without the surgery (P< 0.001). The implant surface which were not sandblasted, large-grit, acid-etched (SLA) had a higher failure rate than those of SLA and SLActive (P=0.001). Age, upper or lower jaw, surgical site, the shape of implants, lateral approach of sinus floor elevation (LASF), and guided bone regeneration (GBR) had no statistical significance for dental implant failure. Conclusion The risk factors for the failure of dental implants were male, bone quality typeⅣ, implant diameter< 4 mm, implant length< 10 mm, non-SLA implant surface, ISFE surgical treatment, and periodontal disease.

Clinical research of the application of gold abutments in PFM crowns implant prosthetics

Wang Xia, Tang Suxia, Peng Lingyan, Chen Deping

2022, 27(1):  34-39.  DOI: 10.12337/zgkqzzxzz.2022.02.007

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Objective To review and evaluate clinical results of custom cast gold coping for dental implant restoration in special cases. In clinical application of implant restoration, when the occluso-gingival distance is 3.5-5.0 mm, it is difficult to adjust the stock abutment. In order to solve this clinical problem, this study discusses the implant restoration of porcelain fused to the metal （PFM）crown with a gold abutment, in order to provide a reference for solving this kind of clinical situation. Methods Clinically collected and reviewed 56 cases that the occluso-gingival distance (the distance from the implant shoulder to the opposing teeth） is 3.5-5.0 mm, and a total of 66 single crowns were restored with custom cast gold abutment from 2013 to 2021. The follow-up period during functional loading ranged from 24 to 72 months. Through periapical radiographs with parallel technique, and clinical examinations, the survival rate, incidence of complications, bone resorption around implants, and peri-implant soft tissue were evaluated. Results The survival rate of the implants using the custom cast gold coping is 100%; the incidence of technical complications is 3%; the incidence of biological complications is 21%; the average bone resorption around the dental implant is 1.18 mm, and the soft tissue is healthy. Conclusion In the situation of single implant crown restoration, when the occluso-gingival distance is 3.5-5.0 mm, the screw-retained integrated coping crown with custom cast gold coping can be applied as a reasonable option in this clinical situation.

Application of Leaderguid^TM template in implant surgery for patients with narrow mesiodistal space in the edentulous area: report of 9 cases

Tian Ye, Liu Yang, Shi Xiaolu, Chu Shunli

2022, 27(1):  40-44.  DOI: 10.12337/zgkqzzxzz.2022.02.008

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Objective To explore the application of a new improved Leaderguide^TM template in implant surgery for patients with narrow mesiodistal space, and to provide a reference for clinical treatment. Methods Nine patients with single tooth loss, narrow mesiodistal space, and insufficient bone quantity in the mesiodistal direction of the edentulous site were implanted with the LeaderguideTM template. The accuracy of the template was evaluated by measuring the distance between the implant and the mesiodistal adjacent teeth after surgery. Results The use of the Leaderguide^TM template for implant surgery achieved good results. The average distance between implants and the mesial adjacent teeth of all patients after the operation was （1.66±0.10） mm, and the average distance between implants and the distal adjacent teeth was （1.66±0.12） mm. The mesial and distal distances were all larger than the safety recommendation of 1.5 mm. And there was no implant failure and postoperative complications occurred during the follow-up period. Conclusion This case series shows that the Leaderguide^TM template can effectively assist in placing implants in patients with narrow mesio-distal space in the edentulous area.

Research progress of mucoperiosteum perforation in implant placement with transalveolar technique for sinus floor elevation

Deng Lei, Huang Haitao

2022, 27(1):  45-49.  DOI: 10.12337/zgkqzzxzz.2022.02.009

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Sinus floor elevation has become the main treatment for bone deficiency in maxillary posterior area.Although the technique of sinus floor elevation has become increasingly mature, there are still some reports of related complications.High perforation rate is often associated with the limitation of surgical field of vision during the transcrestal sinus floor elevation.Therefore, the research progress on this issue will be described in this paper.

Research advance on rat models of peri-implantitis

Dang Ruyi, Ji Ping

2022, 27(1):  50-53.  DOI: 10.12337/zgkqzzxzz.2022.02.010

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Peri-implantitis is the main cause of implant failure. However, the pathogenesis of peri-implantitis is still unclear. Effective treatments are also deficient. Animal models are important tools to explore pathogenesis and effective treatment methods. SD (Sprague-Dawley) rats are cheap and have a low cost of feeding. Biological reagents compatible with SD rats are also abundant. This article summarized three important aspects including design of the implant, time and site of implants, and methods of causing peri-implantitis to give property advice to researchers. In summary, It is close to the clinic to choose the design of the implant and healing abutment, implanting site of first molar region of maxillary, and implanting time of 3 weeks or 1 month after tooth extraction. Methods of causing peri-implantitis include inoculation of pathogenic bacteria, ligation of silk thread, and injection of lipopolysaccharide, which have their respective pros and cons. Researchers could choose different methods according to different purposes. At present, the hole preparation size and reaming drill speed for implant placement are not described clearly, which needs further research.

The role of macrophages in bone tissue repair and biomaterial integration

Qi Junnan, Fu Li

2022, 27(1):  54-57.  DOI: 10.12337/zgkqzzxzz.2022.02.011

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Macrophages are immune cells derived from monocytes, which play a key role in inflammation, tissue repair, and foreign body response. They participate in different stages of tissue remodeling and biomaterial integration by regulating their phenotypes. At the same time, biomaterials can also induce the response and phenotypic transformation of macrophages. In this paper, the role of macrophages in bone reconstruction and the regulation of macrophages in tissue regeneration by biomaterials will be reviewed.

Impact of bone harvesting methods on cell viability of autogenous bone particles in guided bone regeneration

Gan Jiawen, Dou Jiaqi, Xu Chenci, Wu Yiqun, Wang Feng

2022, 27(1):  58-63.  DOI: 10.12337/zgkqzzxzz.2022.02.012

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A variety of bone substitute materials can be used to repair and reconstruct clinical alveolar bone defects, but in the site with great bony volume insufficiency, it is very important to harvest and add a certain proportion of autogenous bone particles to achieve better clinical outcomes. The approaches to gain autografts include handheld instruments such as chisels and scrapers, rotating instruments such as trephines, piezoelectric instruments, and bone filters. It remains unclear which harvesting methods can provide autografts with the greatest osteoinductive and osteogenic potential in clinical bone augmentation. This review mainly summarized surgical results of different scholars using different methods of bone extraction from different sources of autologous bone, hoping to provide a reference for the selection of tools for bone extraction during clinical guidance of bone regeneration, to obtain the best bone induction effect and improve the quality of bone reconstruction.