Chinese Journal of Oral Implantology

Clinical implications of 3-dimensional osteogenesis model for maxillary sinus to promote osteogenesis in maxillary sinus

Zhou Yanmin, Qin Qiuyue

2023, 28(2): 69-76. DOI: 10.12337/zgkqzzxzz.2023.04.001

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The "3-dimensional osteogenesis model for maxillary sinus" (3D-OMMS) elucidated the osteogenic mechanism of maxillary sinus floor elevation. It provides a scientific theoretical basis for the treatment of maxillary sinus floor elevation in patients with missing maxillary posterior teeth. This manuscript reports the clinical application of "3D-OMMS" in the implants including single tooth or multiple teeth, immediate and delayed implants, transalveolar sinus floor elevation and lateral window approach sinus floor elevation, respectively. Preoperative and postoperative cone-beam computed tomography（CBCT）images were used to evaluate the osteogenic effect of the maxillary sinus region. In conclusion, the application of 3D-OMMS can form a three-dimensional space with diversified osteogenic directions in the maxillary sinus, shorten the vascularization osteogenesis path, accelerate the osteogenic process, improve the quality of new bone, and increase the success rate of implantation, which can be widely used in clinical practice.

Study on surface dealloying treatment and cytocompatibility of 3D printed nickel-titanium implants

Qin Xinyu, Zhang Liang, Chen Yingying, Han Zekui, Su Yucheng, Wang Xinyu

2023, 28(2): 77-81. DOI: 10.12337/zgkqzzxzz.2023.04.002

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Objective This paper investigates the optimal modification process of 3D printed nickel-titanium alloys by bioactive treatments such as sandblasting, acid etching, and dealloying. Methods The surface structure and properties of specimens were examined by scanning electron microscope (SEM), energy dispersive spectrometer (EDS) and contact angle measurement. In this study, bone marrow mesenchymal stem cells (hBMSCs) were used to study the biocompatibility and osteogenic activity of different surfaces. Results The hydrophilicity of the dealloying surface was improved. EDS results showed that the surface nickel elementdecreased from 52.1wt% to 18.6wt%, which not only accelerated the differentiation and proliferation of cells on the surface, but also enhanced the adhesion ability of cells. Conclusion The dealloyed surface constructed a more abundant nanoscale mesh structure, which significantly promoted the osteogenic differentiation and functional expression of cells, which was of great importance for improving the osseointegration ability and long-term stability of implants.

Influence of anatomical factors of maxillary sinus on the remodeling of bone graft materials for maxillary sinus floor lift

Yu Zhengrong, Guo Shuigen, Yang Jingjing, Mao Weihua, Wei Hongwu

2023, 28(2): 82-89. DOI: 10.12337/zgkqzzxzz.2023.04.003

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Objective To evaluate the effects of anatomical factors (sinus cavity width, sinus cavity angle, and sinus floor morphology) on the reconstruction of bone graft materials for transalveolar technique for sinus floor elevation. Methods A total of 36 implant sites in 23 patients were included to analyze the changes in bone height and bone density at 6 months and immediately after surgery, and to evaluate the effect of anatomical factors of maxillary sinus on bone graft material modification in the maxillary sinus. Results The sinus cavity width, sinus cavity angle, and sinus floor morphology (intruding angle) were significantly positively correlated with bone height changes, P<0.01. Sinus floor morphology (intruding angle) was negatively correlated with changes in bone density around the implant, P<0.05. There was no significant correlation between RBH and bone graft material reconstruction, and different contact numbers of the bone walls had no significant effect on bone graft material reconstruction. Conclusion There was a correlation between the anatomical factors of the maxillary sinus and the reconstruction of bone graft materials in the maxillary sinus, and the anatomical morphology of the maxillary sinus should be carefully evaluated before surgery.

Clinical analysis of extraction site preservation using Bio-Oss Collagen after extraction of maxillary molars

Yu Jiuyue, Jia Wenhao, Fang Li, Wang Jian, Li Jiangming, Liu Han, Guo Qili

2023, 28(2): 90-96. DOI: 10.12337/zgkqzzxzz.2023.04.004

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Objective To investigate a clinical treatment method for extraction site preservation using Bio-Oss Collagen after extraction of maxillary molars. Methods The clinical data of 6 cases were retrospectively analyzed, and all 6 patients were treated with Bio-Oss Collagen for extraction site preservation after extraction of maxillary molar teeth. These six cases met the following characteristics: the affected tooth was destructed in the alveolar bone in the area of its furcation due to periodontitis or combined periodontal-endodontic lesions, and needed to be extracted; the remaining bone height in the top central part of the alveolar ridge was less than 3.5 mm after the extraction of the affected tooth; the bone walls of the buccal, lingual, mesial and distal parts of the extraction socket were nearly intact. After extraction of the affected tooth, the granulation tissue in the alveolar socket was thoroughly removed. Bio-Oss Collagen was placed in the alveolar sockets and the soft tissues were cross-sutured to hold the graft in place. The sutures are removed 7-10 days after surgery. CBCT was taken preoperatively, immediately postoperatively and at six months postoperatively. The vertical height of the remaining alveolar ridge was measured using Mimics 20.0 at five sites: buccal and lingual in the coronal position, mesial and distal in the median sagittal position, and central. Results Primary healing was obtained in all six patients. At 6 months after extraction, the patients had well healed alveolar sockets, normal gingival color and texture, and no change in attached gingival width. CBCT taken at 6 months after extraction showed no change or a small increase in alveolar crest height at the buccal, lingual, mesial and distal sites, but an increase of 3.48 to 7.89 mm at the central site, among the 5 sites measured. Conclusion After extraction of maxillary molars, Bio-Oss Collagen can be used for extraction site preservation if the surrounding bone wall height is adequate. This method causes less trauma, has a shorter operation time, and its results are similar to those of conventional extraction site preservation.

Application of Bio-Oss Collagen with tent pole procedure in vertical bone augmentation of edentulous maxillary posterior area: a case report

Li Xiaoyu, He Jie, Wang Xueke, Duan Jingyi, Ge Chang, Meng Weiyan

2023, 28(2): 97-101. DOI: 10.12337/zgkqzzxzz.2023.04.005

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Vertical bone augmentation is one of the greatest challenges of bone regeneration in implant dentistry. When the bone defect is large, it is often necessary to open a second operative area for autologous bone block grafting or to use titanium mesh or non-absorbable membrane in combination with autologous bone blocks or particulates. The incidence of complications is high and the surgical trauma is significant. In this case, the patient had a severe vertical bone defect in the posterior maxillary region. Bio-Oss Collagen combined with titanium tent poles and absorbable collagen membrane were used for vertical bone augmentation. The average bone height increased by 6.57 mm at 6 months after bone grafting, which met the need of implant implantation. The bone tissue around the implant was relatively stable during the follow-up after restoration. Due to the predictable effect of bone augmentation, the simpler operation procedure and the less invasive results, this operation can provide a reference for the clinical selection of vertical bone augmentation.

The autologous platelet concentrates for maxillary sinus floor elevation: an overview of systematic reviews

Gong Jiaming, Zhao Ruimin, Zhang Qihang, Yu Zhanhai, Su Linhan

2023, 28(2): 102-108. DOI: 10.12337/zgkqzzxzz.2023.04.006

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Objective To evaluate the quality of methodology and evidence of the systematic reviews and meta-analyses (SR/MA) of autologous platelet concentrates (APC) for maxillary sinus floor elevation (MSFE). Methods PubMed, Embase, Cochrane Library, Scopus, CNKI, SinoMed, and WanFang databases were electronically searched to enroll SR/MA of APC for MSFE from inception to August 31, 2022. Two reviewers independently screened literature, extracted data, and employed the AMSTAR 2 and the GRADE for evaluating the quality of methodology of the included studies and the certainty of the evidence for outcomes respectively. Results A total of 13 SR/MA were included and the major conclusions were that APC presents limited influence on MSFE and might promote the healing of sinus tissue. The 9 items of AMSTAR 2 were reported well, and two items were not reported in any of the included SRs, and the quality was relatively convinced. The evidence grading of GRADE revealed that, in the total of 46 outcomes, 9 were graded as high-level, 25 as medium-level, 11 as low-level, and 1 as extremely low-level. Conclusion Most of the current evidence shows the advantages of APC in MSFE are not obvious, but the reliability of SR/Ma is inconsistent. High-quality clinical trials are still needed to verify the efficacy of APC for MSFE

Research progress on trace elements modification of PEEK implant

Luo Guisheng, Liu Yumeng, Wang Penglai, Yuan Changyong

2023, 28(2): 109-113. DOI: 10.12337/zgkqzzxzz.2023.04.007

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Polyetheretherketone (PEEK) is a high-performance specialty plastic with good mechanical properties and biocompatibility and is easy to process and form, making it an alternative material for dental implants. However, the lack of biological activity and the easy accumulation of plaque limit the clinical application of PEEK in the field of oral implantology. At present, many scholars solve the problem of biological inertia and plaque attachment of PEEK through trace elements modification. Different trace elements have their own advantages. Strontium, tantalum, manganese, and other elements can promote osteoblast differentiation. Fluorine, silver, zinc, and other elements can inhibit the growth of inflammatory bacteria, and the co-modification of various trace elements gives PEEK implant more diversified properties.

Research status on 3D printed individualized scaffold materials in alveolar bone augmentation

Cheng Yi, Huang Haitao

2023, 28(2): 114-118. DOI: 10.12337/zgkqzzxzz.2023.04.008

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Patients with severe bone mass deficiencies require bone augmentation surgery prior to implantation, and the success depends on the stability of the bone graft material and the ability to maintain the bone regeneration space. The scaffolds provide the spatial structure and osteogenic environment for bone regeneration, which are critical to the effect of bone augmentation. With the development of computer-aided design and computer-aided manufacturing, 3D printed individualized scaffolds prepared from different materials have emerged. In this paper, the characteristics and applications of titanium mesh, polyetheretherketone mesh and absorbable polymer composite scaffold materials are discussed, and the application effects and future development directions are evaluated.

Research progress of the socket shield technique

Luo Zhen, Liu Hong, Wu Wangxi

2023, 28(2): 119-123. DOI: 10.12337/zgkqzzxzz.2023.04.009

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The socket shield technique is a new technology emerging in oral implantology in the last decade or so. Its introduction is to fundamentally interrupt the process of physiologic resorption in the alveolar socket after the tooth extraction. But no consensus has been reached on the standard operation and long-term effect of this treatment. Meanwhile with the development of digital technology, how to accurately and efficiently apply the socket shield technique has gradually attracted attention. The clinical procedure, the complication, the evaluation index and the digital application of the socket shield technique will be reviewed in this paper, hoping to provide a theoretical basis for the promotion of this technique in oral implantology.

Combined use of computer-assisted dynamic navigation and socket shield technique in immediate implant placement

Liu Quan, Chen Jieyin, Liu Meixiu, Chen Zhuofan

2023, 28(2): 124-127. DOI: 10.12337/zgkqzzxzz.2023.04.010

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The optimal three-dimensional position of dental implants could be obtained by using computer-assisted dynamic navigation based on intraoperative tracking and real-time feedback. The recession of peri-implant soft- and hard tissues can be largely reduced by the socket-shield technique due to the preservation of root segments and periodontal ligaments. Therefore, the combined use of computer-assisted dynamic navigation and socket shield technique in immediate implant placement may be of value to achieve a satisfactory clinical outcome. The aim of this article was to elaborate on the main procedure in the combined use of computer-assisted dynamic navigation and socket shield technique in immediate implant placement.

Clinical procedure of transalveolar technique for sinus floor elevation

Chen Deping, Liu Qian, Pi Xuemin, Pan Hong, Ren Bin, Su Yucheng

2023, 28(2): 128-132. DOI: 10.12337/zgkqzzxzz.2023.04.011

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The transalveolar technique for sinus floor elevation is a common surgical approach when there is insufficient vertical bone height in the maxillary posterior region for implant treatment. This article describes the evolution of this technique and the technical points of the clinical approach. It is very difficult to assess the intactness of the maxillary sinus mucoperiosteum in transalveolar technique when simultaneous bone augmentation is required. The use of electronic endoscope is a very helpful method to better confirm the preparation depth of the implant site and the status of the maxillary sinus mucoperiosteum, thus effectively avoiding complications of bone augmentation due to the maxillary sinus mucoperiosteum perforation. This article focuses on the clinical procedures and considerations in the use of transalveolar technique for sinus floor elevation to provide a reference for clinicians to improve the predictability of this technique.

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