Chinese Journal of Oral Implantology

Preface for the key column on edentulous implant treatment

2023, 28(4): 216-216. DOI: 10.12337/zgkqzzxzz.2023.08.001

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Exploration of the application of digital technology in implant treatment of edentulous patients

Sun Wei, Shi Bin

2023, 28(4): 217-222. DOI: 10.12337/zgkqzzxzz.2023.08.002

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With the widespread application of digital technology in oral implantology, implant surgery and prosthetic procedures have been significantly optimized. However, the digital process of implant treatment for patients with edentulism has yet to be integrated. This paper combined the application of emerging digital technologies in the process of implant treatment for patients with edentulism and sorted out the full digital process in order to provide reference for implant specialists.

A case series on accuracy analysis of metal implant guides in edentulism

Luo Minrun, Bai Xueying, Zhu Yuxi, Wu Tao, Zhou Yi

2023, 28(4): 223-228. DOI: 10.12337/zgkqzzxzz.2023.08.003

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Objective This study analyzed the accuracy of implant placement in edentulism implant surgeries guided by metal guides through a case series. Methods Five cases of full or partial edentulism implant surgeries with a total of 35 implants were included. Preoperative cone beam computed tomography (CBCT) was performed to obtain three-dimensional data, which was then used to design the implant guide within software. Titanium metal guides were 3D-printed and used for guided implant placement. The accuracy of the metal guides was analyzed by comparing the planned implant positions with the postoperative positions. Results After excluding 5 partially guided implants, 1 zygomatic implant, and 4 maxillary sinus elevation implants, a total of 25 implants were included in the analysis. No guide fractures or thermal osteonecrosis were observed, and all implants achieved successful healing. In the mesiodistal direction, the average apex horizontal displacement was 0.91 (0.28-1.35) mm, neck horizontal displacement was 0.46 (0.23-0.83) mm, apex vertical displacement was 0.57 (0.29-0.80) mm, and angular deviation was 1.93° (1.02°-3.40°). In the buccolingual direction, the average apex horizontal displacement was 0.84 (0.43-1.51) mm, neck horizontal displacement was 0.77 (0.32-1.05) mm, apex vertical displacement was 0.52 (0.30-0.88) mm, and angular deviation was 2.77° (2.09°-4.21°). Conclusion In this limited case series of edentulism implant surgeries, metal guide plates have shown similar accuracy and clinical outcomes to those of resin guide plates.

Comparing the impact of full-guidance versus partial-guidance robotic technology on the accuracy of implant placement in edentulism

Zhang Sihui, Chen Weiyi, Cai Qin, Lin Yuxuan, Chen Jiang

2023, 28(4): 229-232. DOI: 10.12337/zgkqzzxzz.2023.08.004

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Objective The purpose of this study is to evaluate the accuracy of robotic technology in complete edentulous implant surgery, and to explore the influence of full-guidance versus partial-guidance on robotic implant accuracy. Methods From April 2022 to April 2023, there were 38 implants in 5 complete edentulous patients who underwent robotic implant surgery in the Fujian Medical University School and Hospital of Stomatology. The implant surgeries were completed with the assistance of the dental implant robot. The postoperative CBCT data were compared with the preoperative implant planning, and the deviations of implant neck, deviations of implant apex, and angular deviations of the implants were measured. All data were statistically analyzed by SPSS 26.0 software, and the measured values among the groups were compared by using independent sample t-test, with a significance level of α=0.05, and the difference was considered to be statistically significant at P< 0.05. Results The average deviation of implant neck of 38 implants was (1.20±0.76) mm, the average deviation of implant apex was (1.25±0.76) mm, and the average angular deviation was 2.94°±2.33°. Compared with the implant accuracy of the partial group and the full group, the deviation of implant neck of the partial group was (1.51±0.86) mm, the deviation of implant apex was (1.63±0.78) mm, and the angular deviation was 3.13°±2.71°, while the deviation of implant neck of the full group was (0.81±0.39) mm, the deviation of implant apex was (0.79±0.41) mm, and the angular deviation was 2.71°±1.82°. The full group displayed lower deviations at both the implant neck and apex compared to the partial group, and these differences were statistically significant. However, there was no significant difference in angular deviation between the groups. Conclusion Robotic technology demonstrates satisfactory accuracy for implant surgery in completely edentulous patients. Procedures entirely performed using robotic systems exhibit superior implant accuracy.

The evaluation of immediate full-process digital implant restoration in edentulous arches using a combination of three-dimensional scanning and CBCT registration technology

Ma Bowen, Lin Xiao, Geng Wei

2023, 28(4): 233-238. DOI: 10.12337/zgkqzzxzz.2023.08.005

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The ultimate goal of digital treatment in full-arch implant restoration is to "start with the end in mind". The challenge lies in utilizing full-process digital technology to acquire the three-dimensional position of dental implants and to replicate the predetermined occlusal relationship. This article presents a case report on the application of 3D scanning combined with CBCT registration technology for immediate full-arch implant restoration, achieving a truly digital workflow. It provides patients with accurate, comfortable, and efficient implant restoration treatment, leading to favorable clinical outcomes.

Advances in occlusal contact design of implant-supported dentures in complete edentulous patients

Li Zhiwen, Du bingran, Lin Yuan, Pan Yaopeng, Jin Liuli, Zhang Xueyang

2023, 28(4): 239-243. DOI: 10.12337/zgkqzzxzz.2023.08.006

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The design of occlusal contact of implant-supported dentures is one of the important factors to consider for implant restoration in patients with edentulism. Proper occlusal force can ensure the patients' chewing ability and avoid excessive loading on the implants, while improper occlusal force will affect the prognosis of implants. The design of the centric occlusal contact for patients with edentulism should ensure that the occlusal force is parallel to the long axis of the implants, reducing the existence of cantilevers and improper fulcrums, and maintain the even and stable contact of the posterior teeth. The first choice of implant protected occlusion is the canine guide occlusion..

An in vitro study on the comparison of implant accuracy of freehand, implant surgical guide, and dental implant robot

Su Tianyue, Zhao Jinrong, Teng weiwei, Liu Penghui, Li Xinru, Zhou Libo

2023, 28(4): 244-249. DOI: 10.12337/zgkqzzxzz.2023.08.007

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Objective To compare the implant accuracy of dental implant robot, freehand, and implant surgical guide under the same experimental conditions. Methods Solid rigid polyurethane was selected as the research medium. The 90 implant sites of the polyurethane model were divided into three groups: the first group is the freehand group (n=30), which is implanted by the doctor's freehand; the second group was the guide group (n=30), and the implant surgical guides were used to assist implant placement; and the third group was the robot group (n=30), which was assisted by dental implant robot while the implants were also placed by the same doctor. CBCT was taken for implant planning, and the implant placements were carried out by freehand, implant surgical guide and dental implant robot, and CBCT was taken again after surgery to analyze and compare the deviation between the actual implant position and the planned position. Results In the polyurethane experiment, compared with the freehand group, the total implant site deviation, the lateral implant site deviation, the total apex deviation, the lateral apex deviation, and the angular deviation in the guide and robot groups were reduced (P<0.05). There was no statistically significant difference between the guide group and the robot group in all directions of deviation (P>0.05). Conclusion Through the in vitro model experiment, it can be determined that dental implant robot is a more reliable and accurate implant technology than freehand method.

Clinical applications of autologous platelet-rich concentrate in keratinized mucosal augmentation

Zhu Yuemeng, Jia Kewen, Jiao Junjie, Chen Siyu, Ren Sicong, Chen Sheng, Zhou Yanmin

2023, 28(4): 250-259. DOI: 10.12337/zgkqzzxzz.2023.08.008

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Objective s To evaluate the clinical efficacy of the "open suture" combined with platelet-rich fibrin (PRF) in keratinized mucosal augmentation. Methods 84 patients with dentition defects accompanied by keratinized mucosal loss were enrolled in this study, receiving "open suture" combined with PRF after the implant surgery. CBCT was taken before and 3 months after surgery, and oral scanning was performed to record and measure the width of the keratinized mucosa. At the same time, patients were followed up to record the occurrence of postoperative complications and pain levels. Results Compared the preoperative period with 3 months postoperatively, the width of keratinized mucosa increased by（2.81±1.12）mm (P<0.05), while the gingival index (GI) and modified bleeding index (mBI) decreased by 0.85 ± 0.76 (P<0.05) and 0.58 ± 0.28 (P>0.05), respectively. There was no significant difference in the vestibular depth (VD) between these two-time points (P>0.05). Meanwhile, the risk of postoperative complications was low, and the patients' own pain was relatively mild. The VAS score for the first week after surgery is 1.58±0.43. Conclusion This flapless tension-releasing suture technique in combination with the PRF "open suture" could maintain blood supply at the bone-periosteum interface, and preserve the three-dimensional structure of the hard and soft tissues around the initial defect. Also, this suture method could achieve coordination and stability of soft and hard tissues and reduce the risk of complications such as wound dehiscence and mucosal perforation. In addition, without the need for periosteal elevation or free gingival grafts, minimally invasive intervention can promote the growth of soft and hard tissues, reduce the risk of postoperative infection in patients, and promote wound healing, thereby shortening the treatment cycle of patients and improving their postoperative comfort. This can become a predictable method of wound closure.

Clinical features and implant treatment in a patient with dentin dysplasia type I

Du Xinya, Lai Yulan, Yan Zhengbin, Chen Yunliang, Yang Xiaoyu

2023, 28(4): 260-264. DOI: 10.12337/zgkqzzxzz.2023.08.009

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Dentin dysplasia type I (DD-I) is a rare hereditary disturbance in dentin formation. It is characterized by the normal tooth crown but abnormal root development, which is manifested by the presence of short, blunted, and malformed roots; tooth loosening with alveolar abscess occurs at a young age in patients; imaging examination shows occluded pulp cavities. Typical dentin dysplasia type I is autosomal dominant. Patients often loss multiple teeth, and may become edentulous by their 30s. Clinical treatment is challenging. In this paper, a DD-I case is reported, summarizing its clinical manifestations, imaging and histological features, and related treatments in order to provide guidance for the clinical diagnosis and treatment of DD-I.

A case report on the digital construction of orthodontic-implant combined treatment objectives and warkflow

Wang Zixiao, Xia Shuchi, Deng Hanfeng, Wang Qing

2023, 28(4): 265-269. DOI: 10.12337/zgkqzzxzz.2023.08.010

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The autologous platelet concentrates for maxillary sinus floor elevation: a meta-analysis of randomized controlled trials

Zhao Ruimin, Gong Jiaming, Li Jianxue, Su Linhan

2023, 28(4): 270-278. DOI: 10.12337/zgkqzzxzz.2023.08.011

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Objective To systematically evaluate efficacy in the application of autologous platelet concentrates (APC) for maxillary sinus floor elevation (MSFE). Methods The databases of PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang from 1 January 2000 to 30 September 2022, were electronically searched to identify randomized controlled trials (RCTs) involving MSFE employing APC. The Cochrane Tool was employed to assess the risk of bias. Data were analyzed via RevMan 5.4 software. Results In total 16 RCTs were included. Meta-analyses showed that at 6 months after MSFE, APC presented significant advantages in the proportion of new bone formation, grafted materials absorption, vertical bone augmentation, and bone density except for the proportion of connective tissue, bone-to-bone graft contact rate, vertical bone resorption, and implant stability quotient; At 12 months after MFSE, employing APC mixed grafted materials resulted in a significantly better vertical sinus-bone height than employing bone grafted materials alone, but the latter presented a more stable vertical sinus-bone height. Conclusion Limited evidence implied that during a medium-short follow-up period, employing APC mixed bone grafted materials achieves better performance than sole bone grafted materials in terms of the proportion of new bone formation, sinus-bone height, bone density, and materials degradation, thus, no positive efficacy on the proportion of connective tissue, bone-to-bone graft contact rate and the stability of vertical sinus-bone resorption and implant. Further evidence from RCTs with higher homogeneity and longer follow-up period is needed to evaluate its superiority in MSFE.

A review of the application of osseointegrated implant removal techniques

Cai Guoxin

2023, 28(4): 279-284. DOI: 10.12337/zgkqzzxzz.2023.08.012

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In this paper, we searched CNKI, Google Scholar, PubMed, Embase and other databases from 2000 to 2022 for all the published literature related to the osseointegrated implant removal techniques, and counted the number of clinical cases of osseointegrated implant removal and the number of implants surgically removed, the location of implants, poor prognosis and other information. The clinical cases and surgical removals of osseointegrated implants were counted, and the numbers of implants, implant locations, and poor prognosis were summarized. The indications for osseointegrated implant removal were summarized, and the limitations and possible complications of various methods were discussed, and a series of decision-making options were proposed to help clinicians to determine the most appropriate minimally invasive technique for removing osseointegrated implants.

Selection of animal models simulating the human jawbone for in vivo experiments on oral implants

Wang Qi, Teng Weiwei, Su Tianyue, Shu Qianyi, Li Cuiying, Wang Xinyu, Zhou Libo

2023, 28(4): 285-289. DOI: 10.12337/zgkqzzxzz.2023.08.013

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With the improvement of our national living standard and the popularization of dental implant technology, dental implants have become the first choice for the restoration of partially or completely edentulous jaws. To improve the surgical skill level of clinicians and develop excellent implants are important measures to improve the success rate of implant restorations, and neither physician training nor new implant development can be accomplished without preclinical experiments on animal models. Therefore, this paper reviews the animals and animal models suitable for dental implant surgery. The results of literature analysis show that there are a variety of animals that can be used to simulate the human jawbone for implant surgery or for testing the new implants developed. Pigs are the closest animal model to the human jawbone in terms of feeding habits, ethical considerations, physical size, temperament, structural characteristics, tissue composition, and bone remodeling of the jawbone tissue. However, due to the different experimental purposes, different animal models can be selected to carry out experiments. Additionally, an array of animal models can be concurrently employed to meet diverse research needs and achieve clinical treatment objectives.

Research progress in reducing the residual excess cement in implant-supported cement-retained crown restorations

Tang Li, Chen Liyi

2023, 28(4): 290-294. DOI: 10.12337/zgkqzzxzz.2023.08.014

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Cement-retained method is the main retention method of fixed implant-supported denture and is widely used in clinics. Compared with screw-retained implant-supported restorations, cement-retained method offers superior aesthetics and lower production costs in the lab. Cement-retained method is easy to obtain passive fit. However, residual excess cement is a serious potential trouble in clinical practice, which is the main pathogenic factor of peri-implantitis and may even lead to implant failure. How to reduce residual excess cement is a problem that implantologists must pay attention to. In this review, five aspects of reducing residual excess cement are summarized from the management of dental crown and abutment, application of barrier materials, cements, and abutment dies, in order to provide clinical guidance for preventing and reducing cement-related complications.

Exploration of integration of ideological and political education in the training of implant dentistry postgraduate professional degree students

A Lan, Wang Lin, Sun Yue, Xu Wenzhou, Sun xiaolin, Ma Ling, Zhou Yanmin

2023, 28(4): 295-297. DOI: 10.12337/zgkqzzxzz.2023.08.015

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Ideological and political education for postgraduate students in implant dentistry involves weaving ideological and political themes into their professional training. Combining ideological and political courses with specialized courses in implant dentistry provides an effective strategy for comprehensive education throughout their postgraduate journey. This approach meets the pressing need to cultivate top-tier dental medical professionals. This paper analyzes the necessity of integrating ideological and political education into implant dentistry postgraduate training. It analyzes the characteristics unique to postgraduate professional degree training in this field, and presents specific integration measures. Feedback over the past three years from postgraduates highlights the successful integration of ideological and political education with their professional development. Such integration accentuates the value-driven guidance of ideological and political education, making moral teachings more vivid, specific, and impactful. This blended approach paves the way for a harmonious fusion of value formation with knowledge dissemination, ensuring a consistent influx of high-quality talents for the dental field. It upholds the fundamental mission of nurturing morally upright individuals and aligns with the Healthy China strategy.

Exploration of postgraduate training methods for implant dentistry based on multidisciplinary PBL teaching model

Sun Yuchen, Geng Wei, Lin Xiao, Liu Jingming, Sun Yujie

2023, 28(4): 298-301. DOI: 10.12337/zgkqzzxzz.2023.08.016

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Implant dentistry is an emerging discipline, and traditional teaching methods cannot effectively improve the comprehensive abilities of students in this field. In response, the multidisciplinary Problem-Based Learning (PBL) teaching model has emerged. The multidisciplinary PBL teaching model is student-centered, leveraging students' learning autonomy and enhancing their clinical skills. Through multidisciplinary teaching, the breadth of students' learning expands, and their capacity to synthesize knowledge is enhanced. This approach fosters the development of oral implantologists with robust comprehensive skills, aligning with the evolving needs of the dental sector.

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