Chinese Journal of Oral Implantology

Preface for the key column on implant-supported occlusal reconstruction

2024, 29(1): 1-2. DOI: 10.12337/zgkqzzxzz.2024.02.001

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Current status and progress of clinical application of oral occlusion

Chen Jiang, He Kaixun

2024, 29(1): 3-8. DOI: 10.12337/zgkqzzxzz.2024.02.002

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Oral occlusion involves tooth position, temporomandibular joint movement, and muscle function. Normal oral occlusion is crucial for chewing, pronunciation, facial expressions, and other functions. Malocclusion can cause a series of complications, including pain in the temporomandibular joint and chipping of restorations. Therefore, the importance of oral occlusion in the field of oral medicine has become increasingly prominent. Through in-depth research on oral occlusion, dentists can better diagnose and treat occlusion-related problems and improve treatment effects and patients' quality of life. This article intends to introduce the current status and future directions of oral occlusion research and guide the application and development of implant occlusion.

Determination of the occlusal plane in the computer-assisted design of implant-supported fixed complete-arch rehabilitation

Ye Ying, Liu Weicai

2024, 29(1): 9-15. DOI: 10.12337/zgkqzzxzz.2024.02.003

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Various digital techniques have been extensively applied in implant dentistry. When addressing edentulous cases with implant-supported fixed complete-arch rehabilitation, the determination of the occlusal plane is a critical step, which is a prerequisite for achieving stable occlusal function. This review discusses the employed digital techniques and data fusion, the techniques of virtual mounting, and various methods applied in occlusal plane determination. We hope this work could provide valuable insights into the clinical work in implant-supported occlusal rehabilitation.

Finite element analysis of the effect of different occlusal characteristics on the biomechanical behavior of posterior implant-supported single crown

Yang Feng, Wang Mengya, Yin Wenjie, Zhang Zheng, Chen Jiang

2024, 29(1): 16-23. DOI: 10.12337/zgkqzzxzz.2024.02.004

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Objective The purpose of this study is to investigate the effect of occlusal characteristics on the biomechanical behavior of the implant-bone interface of a posterior implant-supported single crown under immediate loading, using finite element analysis. This aims to provide reference for the selection of clinical occlusal characteristics. Methods The finite element model of an implant-supported crown with immediate loading and surrounding bone was constructed using the interference fit method. Six different occlusal characteristics were designed according to natural teeth. Ansys Workbench 2021 R2 software was used to analyze the axial static loading of 200 N. All the data were evaluated using the comparative analysis method to assess the impact of different occlusal characteristics on implant-bone interface displacement and Von Mises stress. Results A-B-C occlusal contact produced the smallest displacement of the implant and surrounding cortical and cancellous bone (10.52 μm, 5.67 μm, 9.34 μm), while prosthodontic platform occlusal (3 points) contact produced the largest displacement of the implant, cortical bone, and cancellous bone (15.24μm, 8.94μm, 12.15 μm). Compared with other occlusal contact types, A-B occlusal contact produced the largest Von Mises stress in the implant (71.91 MPa), significantly reduced the maximum Von Mises stress in cortical bone and had the largest maximum Von Mises stress in cancellous bone ( 18.04 MPa, 17.81 MPa). Conclusion Different occlusal characteristics significantly affect the displacement and Von Mises stress distribution at the implant-bone interface under immediate loading, and also change the stress concentration sites. A-B-C occlusal contact is beneficial in reducing the Von Mises stress on the implant and surrounding bone tissues, while A-B occlusal design has a slight advantage in the axial transmission of occlusal force.

In vitro study on the accuracy and reproducibility of parameters obtained by optical sensing mandibular movement tracing system

Shi Xiaorui, Zhang Jihao, Liu Feng

2024, 29(1): 24-29. DOI: 10.12337/zgkqzzxzz.2024.02.005

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Objective To measure and compare differences in sagittal condylar inclination (SCI) and sagittal frontal table inclination (SFTI) under different setting values and operating paths through in vitro experiments. Evaluate the accuracy and reproducibility of parameter results obtained by optical sensing mandibular movement tracing system. Methods Based on the actual intraoral scan data and dentition coordinate data files from recruited subjects, personalized measurement models and fixtures were designed and 3D-printed, then installed on the fully adjustable articulator. Bilateral SCI and SFTI were set with gradient changes from 10° to 60°, resulting in a total of 12 groups. The articulator module was used to complete the tracing of the mandibular movement and get the measurement parameters, followed by statistical analysis. Results Except for the 40° and 60° SCI groups and the 10° SFTI group, statistical differences were observed between the measured values and the set values, with standard deviation ranging from 0.300° to 2.994°. There was no statistical difference in SCI values obtained at different acquirement timings of hinge axis during operation. Conclusion The accuracy and reproducibility of parameters obtained by optical sensing mandibular movement tracing system can meet the needs of clinical applications, but there are still certain differences between the measured values and the setting values. Ensuring the stability of the test device, multiple tests on the same object, whether repeated hinge axis positioning is performed or not, has no significant impact on the results.

Implant restorations and occlusal reconstruction in partially edentulous patients aided by digital technology: a basic restorative procedure

Yan Yuwei, Lin Xiao, Ma Rui, Liang Chao, Geng Wei

2024, 29(1): 30-35. DOI: 10.12337/zgkqzzxzz.2024.02.006

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Occlusal reconstruction is a complex oral treatment procedure that requires a high degree of treatment accuracy, especially when it involves occlusal reconstruction treatment of implant-supported fixed restorations. The assistance of digital technology is conducive to improving the accuracy of treatment and providing long-term stability for patients of implant restorations and occlusal reconstruction. The purpose of this article is to discuss the basic restorative procedures of implant restorations and occlusal reconstruction in partially edentulous patients assisted by the digital technology of the neuromuscular analysis system and the electronic facebow for clinical reference.

Impact of implant restorative abutment emergence taper changes on gingival attachment

Xu Xinxin, Wang Xinyu, Han Zekui, Zhang Liang, Gao Shijun

2024, 29(1): 36-41. DOI: 10.12337/zgkqzzxzz.2024.02.007

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Objective To assess the impact of different tapers and materials of abutments on peri-implant soft tissue attachment in vivo, and to select the best abutment taper. Methods Ti6Al4V and zirconia abutments with different tapers were prepared using CAD/CAM technology. The abutments underwent surface treatment and were placed into the oral cavities of animals. The animals were executed four weeks after healing, and the gingival attachment to abutments with different materials and tapers was observed using HE staining and immunohistochemistry (IHC). Results Roughness Ti6Al4V Ra= 0.16 μm, zirconia Ra=0.34 μm. HE staining showed that there were more inflammatory cells in the 35° group than in the other groups, while there was no significant difference in the number and distribution of inflammatory cells in the 20°~ 30° groups, and the inflammation in zirconia group was more obvious than that in Ti6Al4V group. IHC staining demonstrated an immune response to laminin-5 at the interface between the abutment and the surrounding epithelium. The expression intensity reached its peak at 30° with the increase of the emergency taper. The expression in the zirconia group was weaker than that in the Ti6Al4V group. The MOD values (Mean Optical Density) of 20° to 40° were 0.27 ± 0.00, 0.29 ± 0.00, 0.35 ± 0.00, 0.24 ± 0.01 and 0.25 ± 0.01, respectively. The MOD values of Ti6Al4V and zirconia were 0.29 ± 0.00 and 0.20 ± 0.01, respectively. Conclusion The soft tissue attachment ability of the restorative abutment with 30° emergency taper was better, and the 3D-printed Ti6Al4V abutment was better than the digitally cut zirconia abutment.

Clinical evaluation of fiber-optic endoscope-assisted transalveolar sinus floor elevation with simultaneous implant placement

Su Hanfu, Chen Xili, Guo Xueqi, Ge Qing, Zhao Shiyong, Ge Linhu, Su Yucheng, Wang Liping

2024, 29(1): 42-48. DOI: 10.12337/zgkqzzxzz.2024.02.008

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Objective To investigate the clinical effect of fiber-optic endoscope-assisted transalveolar technique for sinus floor elevation with simultaneous implant placement. Methods 35 patients who visited the Affiliated Stomatology Hospital of Guangzhou Medical University from September 2017 to December 2018 were selected as research subjects. A total of 51 transalveolar sinus floor elevations with simultaneous implant placements were performed. The integrity of the sinus floor mucoperiosteum was examined intraoperatively using a fiber-optic endoscope with direct visualization compared with the Valsalva test. The relationship between maxillary sinus mucoperiosteal perforation and the following factors: alveolar bone quality (Lekholm and Zarb classification), sinus floor bone cortical bone thickness, sinus floor mucoperiosteal thickness, and sinus floor elevation height was also explored. The effect of perforation of the mucoperiosteum on the implant ISQ at 6 months postoperatively was also investigated. Results Among the 51 cases of transalveolar sinus floor elevation, only 2 cases of mucoperiosteal perforation were detected by the Valsalva test, while 10 cases of perforation were detected by the endoscope, and the results showed a significant difference (P=0.013). There was no significant correlation between sinus mucoperiosteal perforation and alveolar bone quality classification, sinus floor mucoperiosteal thickness (<3 mm), or sinus floor elevation height, while there was a significant correlation with sinus floor cortical bone thickness (P=0.001). Maxillary sinus mucoperiosteal perforations with a diameter of >2 mm required a longer healing time to obtain the ideal implant ISQ. Conclusion The fiber-optic endoscope can significantly improve the detection rate of sinus mucoperiosteal perforation in transalveolar sinus floor elevation, which is helpful for the operator to judge the condition of the sinus floor mucoperiosteum and to choose a more appropriate timing for restoration.

Comparison of the clinical effects of two different wound closure methods in extraction site preservation of maxillary molars

Liu Zongyi, Zhang Qingbin, Ye Zhanchao, Yu Changying, Liu Wanqing

2024, 29(1): 49-55. DOI: 10.12337/zgkqzzxzz.2024.02.009

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Objective To assess the clinical effects of concentrated growth factor (CGF) and free gingival grafting (FGG) in combination with Bio-Oss Collagen in extraction site preservation after maxillary molar extraction. Methods Thirty patients were randomly divided into two groups. The tooth sockets were filled with Bio-Oss Collagen, and then the wounds were closed using either CGF or FGG. Postoperative wound healing and the width of keratinized gingival tissue were observed, while CBCT was used to evaluate the changes in the alveolar bone and maxillary sinus floor. Results Group B exhibited a higher rate of wound healing compared to group A (P<0.05). The width of keratinized gingival decreased by (0.79±0.16) mm in group A and (0.35±0.18) mm in group B, respectively (P<0.05). There was no significant difference between the two groups regarding changes in alveolar bone or maxillary sinus floor (P>0.05). Conclusion Both CGF and FGG combined with Bio-Oss Collagen effectively reduced bone resorption during ridge preservation after maxillary molar extraction, with no significant differences observed in alveolar bone or maxillary sinus floor changes between the two groups. However, FGG demonstrated better wound healing rates and less reduction of buccal keratinized gingival compared to CGF.

The application of Internet plus health management mode in the perioperative period of dental implant patients

Xuan Yan, Hao Junyan, An Yang, Zhang Ting, Zhang Wenjing, Li Dan

2024, 29(1): 56-61. DOI: 10.12337/zgkqzzxzz.2024.02.010

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Objective To explore the effect of Internet plus health management mode in the perioperative period of dental implant patients. Methods Fifty eight patients who underwent oral implantation in Peking University Hospital of Stomatology from January 2023 to October 2023 were randomly divided into an experimental group of 29 cases and a control group of 29 cases using a randomized numerical table method.The control group implemented the routine health management mode, while the test group was given the Internet plus health management mode. After intervention, differences in the incidence of complications after implant surgery, preoperative preparation compliance, dental fear, and implant surgery satisfaction between the two groups were compared. Results The compliance of patients in the experimental group during preoperative periodontal treatment and blood pressure measurement during registration was higher than that of the control group. The total score of dental fear and its various dimensions was lower than that of the control group. Scores in postoperative follow-up reminders and medical service attitudes were higher than those of the control group, with statistically significant differences(P<0.05).There was no statistically significant difference (P>0.05) between the two groups of patients in terms of postoperative complications, preoperative eating, preoperative female no makeup, male shaving and smoking reduction compliance, preoperative and postoperative health guidance, health guidance methods, convenience of postoperative follow-up communication channels, and total satisfaction scores. Conclusion The Internet plus health management mode is conducive to improving the compliance of dental implant patients with preoperative periodontal treatment and blood pressure measurement during registration, reducing dental fear during implant surgery, and has obvious advantages in postoperative follow-up reminders.

Clinical effects of osseodensification technique for transalveolar sinus floor elevation

Wang Kexin, Ji Ping, Li Dize, Chen Yuan, Zhao Hongyong, Lu Qinyi, Bai Yaxin, Chen Tao

2024, 29(1): 62-69. DOI: 10.12337/zgkqzzxzz.2024.02.011

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Objective To investigate the clinical effects of the osseodensification technique applied to transalveolar maxillary sinus floor elevation with simultaneous implant placement. Methods A total of 39 patients underwent transalveolar sinus floor elevation using osseodensification and implant placement in the Department of Implantology, Stomatological Hospital of Chongqing Medical University from May 2022 to May 2023. 21 cases were female, and 18 cases were male, with ages ranging from 21 to 73 years old and an average of (51.67±11.68) years old. Definitive prosthesis was delivered 6 months after implant surgery. Cone-beam computed tomography (CBCT) was conducted preoperatively (T0), postoperatively (T1), and at 6-month follow-up (T2), measuring residual bone height (RBH), vertical bone height (VBH), and bone density (BD) at the implant site. Implant stability test (IST), sinus membrane perforation rate, and implant survival rate (SR) were recorded and analyzed 6 months after implant surgery. Results A total of 39 patients underwent maxillary sinus floor elevation surgery with 53 implants placed simultaneously. Alveolar bone heights ranged from 3.38 to 9.40 mm at T0, with a mean of (6.16±1.00) mm, (11.25±1.10) mm at T1, and (10.36±0.99) mm at T2. Significant differences in alveolar bone height were observed among different observation points (P <0.001). The BDT0, BDT1 and BDT2 were 196.65 Hu, 441.70 Hu, and 435.04Hu respectively. Significant differences in bone density between T0 and T1 (P<0.0001) were found. The sinus membrane perforation rate was 1.89%. 2 implants were lost in 6 months after surgery, yielding a cumulative implant survival rate of 96.23%. The remaining implants exhibited favorable IST values 77.61±4.78 at 6 months post-surgery, and no peri-implant inflammation was observed during the follow-up period. Conclusion The osseodensification technique may achieve optimal clinical effects for transalveolar sinus floor elevation. The technique exhibits acceptable short-term outcomes, while further studies on long-term clinical effects are required.

A case of complex implant treatment using robotics: immediate implant placement and immediate loading of a full dental arch

Meng Yilin, Qu Xiaohui, Teng Xinya, Li Ruhua, Bi Lifeng, Zou Derong

2024, 29(1): 70-76. DOI: 10.12337/zgkqzzxzz.2024.02.012

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Objective To verify the feasibility and accuracy of complex full dental arch implant treatment with the combination of an oral implant robot and a combined guide system. Methods A total of 6 implants were placed immediately after upper teeth extraction using an oral implant robot. The intraoral scan and CBCT data were reconstructed in the software, and the implant-retained denture was designed according to the principle of occlusal reconstruction. The implants, combined guide, and treatment scheme were planned with the restoration-driven implant concept. During the operation, the robot registration was performed, and the remaining teeth were extracted. The surgeon controlled the robot by a foot pedal, and the robot autonomously carried out the transalveolar sinus floor elevation at the 26 site and prepared the rest implant beds. The implants were placed, and the provisional fixed denture was fitted in position. A second CBCT was taken postoperatively to evaluate the accuracy with the previous planning data. Results A total of 6 implants were placed, with neck deviation of (0.65±0.22) mm, apical deviation of (0.57±0.19) mm, and angular deviation of 0.96°±0.24°. The patient had no postoperative complications and successfully adapted to the provisional implant-retained denture. Conclusion The use of the oral implant robot combined with the combined guide system to implement the full dental arch implant surgery can achieve high implant accuracy, avoid taking CBCT again during the operation, reduce the difficulty and time of the operation, and realize the restoration-driven immediate implant placement and immediate loading.

A case of infraocclusion after implant placement and restoration of upper left central incisor

Liu Lupeng, Zhao Ge, Yang Yundong, Xiao Huijuan

2024, 29(1): 77-81. DOI: 10.12337/zgkqzzxzz.2024.02.013

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The objective is to discuss the occurrence of infraocclusion after implant restoration in patients with missing upper anterior teeth,analyze and discuss the causes and clinical management methods of such complications. The patient's upper left central incisor was injured, and the crown and root were fractured subgingivally and could not be preserved. The affected tooth was extracted in a minimally invasive surgery and replaced by flapless immediate implant placement and immediate restoration. After 7 months, the zirconia ceramic crown restoration was delivered. CBCT and periapical radiographs with paralleling technique showed good osseointegration, sufficient thickness of the labial bone plate, and stabilization of marginal bone level. During the 5-year follow-up after implant placement, it was found that the implant settled and presented an infraocclusal situation.

Application of deep learning-assisted anatomical structure segmentation based on CBCT in implant dentistry

Gao Qiancheng, Li Xindong, Cao Mingguo, Liu Yunfeng

2024, 29(1): 82-86. DOI: 10.12337/zgkqzzxzz.2024.02.014

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Compared with manual segmentation and traditional algorithm segmentation, the application of deep learning for oral anatomical structure segmentation can obtain accurate and consistent segmentation results efficiently. This approach can quickly obtain the anatomical structure information of the surgical areas to design implant surgery and restoration. This review provides an overview of the progress in CBCT-based deep learning for anatomical structure segmentation in the field of implant dentistry.

Advances in the clinical application of computer-assisted implant surgery

Fu Shuang, Huang Bin, Feng Yi, Wang Haiyan, Sun Wei, Ji Wei, Shi Bin

2024, 29(1): 87-92. DOI: 10.12337/zgkqzzxzz.2024.02.015

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Computer-assisted technology has been applied in the field of implant surgery to improve the accuracy of implant placement and to achieve high success rate of implants and optimal aesthetic outcomes. There are two major types of computer-assisted implant surgery: static and dynamic computer-assisted implant surgery. Static computer-assisted implant surgery uses a surgical template to transfer the pre-designed implant position to patient while dynamic computer-assisted implant surgery guides implant placement using real-time tracking and navigation. With the rapid development of digital technology, computer-assisted implant surgery has been more and more widely used in clinical practice. In this paper, the clinical procedures of static and dynamic computer-assisted implant surgery are described. The accuracy of implant placement and factors influencing implant accuracy, clinical outcomes and patient-reported indicators of static and dynamic computer-assisted implant surgery are analyzed.

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