Chinese Journal of Oral Implantology

Expert consensus on sinus floor elevation with maxillary sinus cyst or cyst-like lesions

Chinese Society of Oral Implantology

2024, 29(3): 195-201. DOI: 10.12337/zgkqzzxzz.2024.06.001

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Sinus floor elevation is a predictable rehabilitation method commonly used to address bone deficiency in the maxillary posterior area. However, the presence of maxillary sinus cysts often presents a challenge for sinus floor elevation. At present, there is still a lack of guidelines or consensus on sinus floor elevation with maxillary sinus cyst. The purpose of this consensus is to provide clinicians with practical and feasible measures for sinus floor elevation with maxillary sinus cysts.

Preface for the key column "implant-related treatment and progress of congenital tooth agenesis"

2024, 29(3): 202-203. DOI: 10.12337/zgkqzzxzz.2024.06.002

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Implant treatment for patients with congenital tooth agenesis

Wu Yiqun, Wang Feng

2024, 29(3): 204-211. DOI: 10.12337/zgkqzzxzz.2024.06.003

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Congenital tooth agenesis primarily manifests as an insufficient number of teeth, hypoplasia of the maxillary and mandibular alveolar processes, and maxillofacial dysplasia, all of which can result in oral or systemic dysfunction. Congenital tooth agenesis is harmful, and its treatment is challenging. Dental implants are an ideal option to restore missing teeth in these patients due to their good stability and comfort. This article aims to analyze the challenges associated with dental implants in the treatment of congenital tooth agenesis and propose strategies for the reconstruction of oral function in patients with congenital tooth agenesis.

Research progress on digital methods for recording and transferring maxillomandibular relationship

Man Yi, Lan Dongping

2024, 29(3): 212-217. DOI: 10.12337/zgkqzzxzz.2024.06.004

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In recent years, the advancing development of digital dental technology has heralded a new era in full-arch implant restoration. A crucial element for successful complete denture is the accurate recording and transfer of the maxillomandibular relationship. Compared to traditional methods, digital technology has the potential to shorten the treatment cycle and improve the efficiency of diagnosis and treatment. This article elaborates on the application and advances of digital technology in recording and transferring the maxillomandibular relationship in edentulous patients. The opportunities and challenges presented by the digitization of dental technology to clinicians will be discussed, with the aim of providing them with a valuable reference.

Progress in research on genes associated with tooth agenesis

Zhang Han, Sun Yao

2024, 29(3): 218-223. DOI: 10.12337/zgkqzzxzz.2024.06.005

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Tooth agenesis, a prevalent oral disease, remains partially elusive in terms of its underlying pathogenic mechanism. Recent breakthroughs have elucidated a series of pathogenic genes associated with this condition, whose encoded proteins play key roles in regulating and guiding normal tooth germ development through essential signaling pathways. This review focuses on genes related to congenital tooth agenesis and their involvement in the signaling pathways of tooth developrnet. As research progreses, especialy through the use of model animal, insights into the pathogenic processes of this developmental anomaly may lead to effective strategies for treating congenital tooth agenesis by modulating the function of these genes or repairing defects in signal transmission.Moreover, this article also discusses the clinical characteristics of congenital tooth agenesis-causing genes observed in human patients and explores the potential link between these genes and the occurrence of tumors.

Research advances in treatment of tooth agenesis

Geng Chenxin, Liu Yang, Han Dong

2024, 29(3): 224-230. DOI: 10.12337/zgkqzzxzz.2024.06.006

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Tooth agenesis is the most common dental developmental anomaly in humans, which can cause significant chewing, pronunciation, aesthetic and craniofacial development problems. Due to the unique characteristics of tooth agenesis, its treatment is very time-consuming and costly, imposing huge economic burdens and mental stress on patients. The treatments include a sequential therapeutic strategy with a multidisciplinary team of pediatric dentistry, prosthodontics, oral and maxillofacial surgery, orthodontics, oral implantology, and other backgrounds, as well as emerging methods such as targeted molecular therapy and tissue engineering. This review provides an update on the knowledge on the characteristics of tooth agenesis, traditional treatments, and the rising fields of molecular therapy and tissue engineering. We also discuss the treatment effects of each method, aiming to provide a reference for the treatment of tooth agenesis.

Oral implantation strategies for patients with ectodermal dysplasia

Wang Mingxi, Gao Shan, Wang Long, Zhou Yongmiao, Tang Chunbo

2024, 29(3): 231-235. DOI: 10.12337/zgkqzzxzz.2024.06.007

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Ectodermal dysplasia(ED) is a genetic disorder characterized by abnormal tissue and structural development of ectodermal origin. Most of the patients have congenital tooth deficiency, alveolar bone dysplasia and other oral manifestations. In clinical practice, removable dentures are often used to replace missing teeth; but due to special anatomical conditions, removable dentures often have problems such as poor retention.In recent years, implant therapy has been used in the treatment of missing teeth in ED patients because of its better functionality and aesthetics. This paper summarizes the choice of the implantation time and implantation plans for ED patients, discusses the difficulties and solutions of implantation therapy, and outlines the application of digital technology in the treatment of ED patients, aiming to provide a reference for implantation therapy in ED patients.

Current research status of implant intervention in adolescents with severe tooth loss due to ectodermal dysplasia

Su Guanyu, Shen Yihan, Wu Yiqun, Wang Feng

2024, 29(3): 236-241. DOI: 10.12337/zgkqzzxzz.2024.06.008

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Tooth agenesis is a typical developmental abnormality in the oral and maxillofacial region among teenagers. Ectodermal dysplasia(ED) is the primary cause of severe tooth agenesis in adolescents. Teenagers with severe tooth agenesis benefit from implant intervention for the possibility of regaining masticatory function and speech function, as well as maintaining a pleasing facial appearance. In terms of retention and stability, implant-supported dentures for teenagers outperform conventional removable dentures. This review elaborates on the feasibility of implant placement in teenagers with ED, focusing on the considerations of implant placement and common methods for this special group of patients. Lastly, prospects for further study in this field are highlighted.

A systematic literature review on the implant survival rate for congenitally missing teeth

Zhao Yu, Zan Bingxin, Dai Qinggang

2024, 29(3): 242-251. DOI: 10.12337/zgkqzzxzz.2024.06.009

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Objective To review the relevant literature from the last decade reporting on the outcomes of congenitally edentulous patients after implant prosthetic restoration, and to synthesize the implant survival rates from different perspectives to provide information for clinical decision-making. Methods A search using the combination ("hypodontia" OR "oligodontia" OR "anodontia" OR "tooth agenesis" OR "congenitally missing teeth") AND "dental implant*" was used in databases such as PubMed, with a time frame from February 2014 to February 2024. The literature was screened according to the established inclusion and exclusion criteria, and the bibliographies of the selected research articles were manually searched. Results A total of 34 prospective/retrospective studies and some case reports on implant restorations in congenitally edentulous patients were finally included. It was found that the overall implant survival rate in these patients was high, with an average of 96.53%, depending on individual patient factors and treatment techniques. Congenital edentulism was categorized into simple congenital edentulism and syndromic congenital edentulism, with survival rates of 97.32% and 95.54%, respectively, based on the relationship with systemic diseases. There were slight differences in implant survival rates between different age groups, with 93.82% for patients aged 17 years and younger, and 96.83% for adult patients aged 18 years and older. The maxillary lateral incisors, with a high rate of congenital defects involving the anterior esthetic zone, had an ideal implant survival rate (98.48%). The implant survival rate for congenitally edentulous patients combined with bone augmentation techniques was 96.19%. The survival rates for zygomatic implants and small-diameter implants (or mini-implants) were 98.18% and 97.18%, respectively. Conclusion Implant surgery is a better solution to restoring oral function in congenitally edentulous patients. However, it still needs to be analyzed according to the patient's situation to improve the implant survival rates and the success of implant restoration.

Application and research progress of digital technology in bone augmentation for dental implants

Chen Jiang, Qiu Yubei

2024, 29(3): 252-257. DOI: 10.12337/zgkqzzxzz.2024.06.010

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Insufficient alveolar bone mass at the implant site is an important factor affecting the outcome of dental implants. Bone augmentation is an effective strategy to solve this problem. The application of digital technology provides a new approach for bone augmentation in oral implantology. This article presents the application and research progress of digital technology in bone augmentation for dental implants.

Research on mechanical properties of 3D printed titanium mesh with hyperbolic paraboloid morphology and traditional approximate alveolar ridge morphology

Wang Huaisheng, Wang Xinyu, Han Zekui, Jiang Tingting, Chen He, Liu Lu

2024, 29(3): 258-265. DOI: 10.12337/zgkqzzxzz.2024.06.011

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Objective To investigate the influence of hyperbolic paraboloid spatial structure on the mechanical properties of personalized titanium mesh. Methods Virtual bone augmentations were performed using 3-Matic 15 software on 3D models of the mandibles of patients with alveolar ridge resorption. The bone augmentations were performed with hyperbolic paraboloid structure and approximate alveolar ridge structure, respectively. Personalized titanium meshes with pore shapes of circular, triangular, quadrilateral, and hexagonal, and thicknesses of 0.2 mm, 0.3 mm, and 0.4 mm were fabricated. Finite element analysis models were constructed, applying the forces and constraints. The stress and displacement of titanium mesh in each group were analyzed. Results Under the same thickness, the stresses and displacements of the hyperbolic paraboloid titanium mesh with different pore structures were significantly lower than those of the approximate alveolar ridge titanium mesh; as the thickness decreased, the stress and displacement of titanium mesh in each group significantly increased. Conclusion This spatial structure of hyperbolic paraboloid can distribute the stress uniformly, reduce the stress concentration of the personalized titanium mesh, decrease displacement of the titanium mesh after loading, allowing the titanium mesh to combine good mechanical properties and thinner thickness, reducing irritation to soft tissues and the risk of titanium mesh exposure.

A case of digitally assisted immediate implant placement through impacted teeth in the aesthetic area

Zhao Ning, Li Xiaojie, Kou Ni, Ma Guowu

2024, 29(3): 266-271. DOI: 10.12337/zgkqzzxzz.2024.06.012

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This paper presents a case of digitally assisted immediate implantation through impacted teeth in the aesthetic area. The patient had a root fracture caused by an upper anterior teeth trauma. One impacted canine and two impacted supernumerary teeth were found in the bone on the root side of the affected teeth. During treatment, under the guidance of the digital surgical guide plate and assistance by Er : YAG laser, immediate implantation through the impacted teeth was achieved. At the same time, autologous bone grafting material and platelet-rich fibrin were mixed for bone grafting at the two implant sites. Provisional and permanent restorations were completed with digital technology at 5 months and 8 months after the first stage of surgery, respectively. Postoperative CBCT showed that the implants penetrated through the crown, apical cementum, dentin, and pulp of the impacted teeth. No pain or other complications were found during the follow-up visit. There were no clinical symptoms at the 18-month follow-up visit. CBCT images showed that the bone density around the implants had increased and the lamina dura had formed. In this case, immediate implantation through the impacted teeth in the aesthetic area was realized with the digital assistance, providing a new clinical idea for the selection of treatment options for impacted teeth and increased clinical data for other healing forms of implants besides osseointegration. However, the clinical effect of this kind of operation still needs long-term follow-up observation.

Implant restoration of extended edentulous spaces in the aesthetic zone using autogenous-heterogeneous bone grafting GBR with titanium mesh combined with keratinized tissue augmentation: a case report

Jiang Juanna, Li Junman, Chen Lin, Xie Liangkun

2024, 29(3): 272-276. DOI: 10.12337/zgkqzzxzz.2024.06.013

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This case report describes the implant restoration of extended edentulous spaces in the aesthetic zone using an autogenous-heterogeneous bone mixture as the bone grafting material for guided bone regeneration (GBR) with titanium mesh, combined with keratinized tissue augmentation. The patient presented with a traumatic fracture of the anterior maxilla, horizontal alveolar bone loss, and loss of multiple consecutive teeth. Autogenous bone was mixed with deproteinized bovine bone mineral heterograft and implanted in the area of bone loss. Titanium mesh and a bioresorbable barrier membrane were placed labially. After six months, implants were placed under the guidance of a simple prosthetic guide. Keratinized tissue augmentation was performed before second-stage surgery. The final esthetic restoration was completed after 6 months of wearing the provisional denture. The treatment outcomes demonstrated that the use of an autogenous-heterogeneous bone mixture as grafting material for guided bone regeneration with titanium mesh resulted in ideal bone augmentation, providing an optimal site for implant placement. The keratinized tissue augmentation procedure provided satisfactory clinical outcomes for the final aesthetic restoration. Therefore, we concluded that using an autogenous-heterogeneous bone mixture as grafting material for guided bone regeneration with titanium mesh is an effective method for increasing horizontal alveolar bone volume in the anterior region.

Effects of proton pump inhibitors on osseointegration of oral implants

Wang Mingyang, Huang Haitao

2024, 29(3): 277-283. DOI: 10.12337/zgkqzzxzz.2024.06.014

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Proton pump inhibitors (PPIs) are commonly used drugs to treat conditions related to abnormal gastric acid secretion. They have been found to affect bone metabolism, which can impact bone healing. There is ongoing research on the potential impact of PPIs on the success of implant surgery. Current studies suggest that PPIs may have a limited effect on implant failure rates. Therefore, caution should be exercised when considering treatment plans for patients taking PPIs, and discontinuing PPIs solely to improve implant success rates is not recommended.

Research progress on peri-implant soft tissue augmentation materials

Chen Jiaxin, Gu Xinhua

2024, 29(3): 284-288. DOI: 10.12337/zgkqzzxzz.2024.06.015

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With the increasing maturity of dental implant technology, the aesthetic effects of dental implants and long-term health of surrounding tissues in implant restorations are of growing concern. Due to the decrease in the amount of soft and hard tissue around the missing tooth area, dental defects often fail to meet the requirements for implant restoration. Therefore, the augmentation of soft and hard tissue around the implant is a key step in dental implantation. The purpose of this paper is to introduce common peri-implant soft tissue augmentation materials and provide references to solving the problem of peri-implant soft tissue insufficiency.

Influence factors of achieving predictable maxillary sinus bone augmentation

Zhao Yang

2024, 29(3): 289-294. DOI: 10.12337/zgkqzzxzz.2024.06.016

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Maxillary sinus floor elevation is a common surgical method to solve the problem of insufficient bone mass in the posterior maxillary region. Based on the special background of maxillary sinus bone augmentation, we explore the principles of achieving predictable maxillary sinus bone augmentation results from the mechanism of osteogenesis, which can be considered from four aspects: bone contact area, angiogenesis, stability of space, and safe healing.

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