Chinese Journal of Oral Implantology

Clinical application of implant technique in the pterygoid plate area-standard operational practice

Pu Yiping, Gao Zhenhua, Zhao Zhengyi, Zou Duohong, Yang Chi, Zhang Zhiyuan

2021, 26(3): 143-151. DOI: 10.12337/zgkqzzxzz.2021.06.001

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The technique of TPP (T:maxillary tuberosity,P:pterygoid plate,P:palatine) implants has been proposed, that the pillar composed of maxillary tuberosity,the pyramidal process of the palatineand the pterygoid process of the sphenoid in pterygomaxillary region can provide a certain volume of compact bone. Inclined implants of 30-50 degrees are placed in pterygoid region. As it is located in the end of distal part of maxilla, the distal cantilever of the prosthesis is completely eliminated. TPP implants with good initial stability are often applied in combination with the implants in anterior and bicuspid areas to provide favorable conditions for immediate loading. This technique can be applied for immediate implant and immediate restoration of maxillary complete arch or unilateral multiple posterior teeth loss with alveolar bone atrophy. Furthermore,the success rate is high (>90%). Due to avoiding the procedure of bone augmentation approach in maxillary sinus region and simplifying the procedure of implant surgery, it could reduce the trauma of patients, relieve postoperative reaction and pain, shorten the course of treatment and provide a new clinical solution for patients with insufficient bone in maxillary posterior area, especially for the patients who can not undergo bone graft procedure. However, clinicians still face many difficulties achieving effectively clinical application of this technique, including standard surgical protocol, the correct position of the placement site, preoperative evaluation, the design of length and placement angle, the safety procedure of the surgery and implant direction control and risk management, etc. Our team established standard surgical protocol of TPP technique for immediate implant and immediate loading with severe bone deficiency in maxillary posterior area. We sincerely hope that the article will provide a reference and basis for clinicians when applying the technique to avoid complex operation and complications related to bone augmentation, popularize the clinical application of the technique.

Clinical application of antimicrobial photodynamic therapy in the treatment of peri-implant diseases

Shi Bin, Yan Qi, Zhao Yaoyu

2021, 26(3): 152-158. DOI: 10.12337/zgkqzzxzz.2021.06.002

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The basic principle of antimicrobial photodynamic therapy (aPDT) is to produce singlet oxygen and other cytotoxic substance through the interaction of visible light of a specific wavelength with the photosensitizer, to kill the targeted bacteria/cell. Because of the limitations of mechanical debridement, aPDT has been applied clinically as a novel adjunctive therapy. Although existing single studies demonstrated improvement of peri-implant parameters in a short term, and has shown potential application prospects, especially in smoking and diabetes patients; high-level evidence (guideline consensus, systematic reviews, etc.) did not recommend aPDT as a routine therapy for peri-implant diseases. Future research should focus on standardizing the procedures of aPDT in order to establish high-quality clinical evidence to verify its long-term efficacy.

Modification and evaluation of a custom impression technique for soft tissue around dental implant

Han Xinxin, Li Yajin, Liu Xiaoqiang

2021, 26(3): 159-163. DOI: 10.12337/zgkqzzxzz.2021.06.003

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Objective The aim of this study was to modify the custom impression technique for soft tissue around a dental implant, to compare the clinical working time and material consumption for fabricating custom impression coping with conventional and modified methods, and to evaluate the clinical applicability of the modified method. Methods From October to December 2020, 20 implant-supported interim restorations of the maxillary anterior teeth were collected in the Department of Prosthodontics, Peking University School and Hospital of Stomatology. The conventional and modified methods were used to fabricate custom impression coping by self-controlled trial. Within the conventional method, a silicone matrix was used to capture the emergence profile of the interim restoration, thereafter a custom impression coping was made accordingly. In the modified method, a prefabricated reusable resin base embedding an implant analog was made. The base and a flowable silicone were used to register the soft-tissue transition zone created by the interim restoration. Finally, the tissue contour was transferred to the impression post. The working time and material consumption of the two methods were recorded and compared. Results In terms of clinical time, the average time of fabricating the index by the modified method was (323.6±20.3)s, which was significantly lower than that of the conventional method (482.8±43.5)s The average time of making impression coping with the conventional and modified methods were (213.4±10.9) s and (215.6±9.8) s, respectively. There was no significant difference between the two groups (P>0.05). In terms of the material consumption, the improved method does not require the use of self-cure resin, while the average weight of the self-cure resin of the conventional methods were (427.5±72.2) mg. There was significant difference between the two groups (P< 0.05). Regarding the consumption of the silicone matrix, the modified method was (524.5±29.1) mg, which was significantly lower than that of the conventional method (14473.1±732.6)mg. The difference between the two methods was significant. The average weight of pattern resin of the conventional and modified methods were (80.0±13.4) mg and (82.0±17.4) mg, respectively. The difference between the two groups was not significant (P>0.05). Conclusions The clinical working time and material consumption spent on fabricating the custom impression coping by the modified method were less than those of the conventional method. Therefore, the modified method of custom impression for soft tissue may save chairside time and materials. It is worthy of clinical application..

A comparative study of risk factors related to early and late implant failure

Chi yifan, Wang honghao, Zhang Lei, Han Xiaolan

2021, 26(3): 164-168. DOI: 10.12337/zgkqzzxzz.2021.06.004

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Objective To study and analyse the differences of risk factors between early and late failures of implants, in order to guide the preoperative preparation and postoperative maintenance of implant and improve the implants survival rate. Methods A total of 177 cases of implant failure among 7334 patients who underwent implant restoration in Hefei Stomatological Hospital from January 2011 to December 2018 were collected. According to the time of failure, cases were divided into early failure group and late failure group. The related risk factors that may affect the failure of planting were analyzed respectively, and the difference between the two groups of data were analyzed. Results There were significant differences between early implant failure and late implant failure in factors of gender, implant site, implant size and bone substitute. The female patients, with implants in anterior region or with bone substitute are more likely to fail early, while the male patients in posterior region are more likely to fail late. Conclusion The improved preoperative assessment and preventive treatment of risk factors can effectively reduce the early failure rate of implant. Regular follow-up, control of risk factors and timely maintenance would effectively prevent the late failure of implan.

Clinical analysis of the accuracy of digital guide

Liu Shan, Guo Pingchuan, Zhou Guojing

2021, 26(3): 169-173. DOI: 10.12337/zgkqzzxzz.2021.06.005

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Objective To evaluate the accuracy of the digital guide during implant surgery and discuss the clinical promotion value in the field oral implantology. Methods Twenty patients diagnosed with dentition defect were selected in Tianjin Xinaichi Dental Clinic from January 2017 to January 2019. Before surgery, CBCT was taken, CAD/CAM guide plate was prepared, and 65 implants were placed according to the instructions of the guide plate. CBCT examination will be performed immediately after the operation is completed. Through the method of characteristic point measurement, the difference of the implant shoulder, the implant apex and the overall deviation before and after the operation was measured. Use SPSS 21.0 software for analysis. Results The maximum deviation of the implant shoulder between the actual implant position and the designed position was 2.78mm, the minimum was 0.12mm, and the average deviation was (1.45±0.81)mm. The maximum deviation of the implant apex was 2.96mm, the minimum deviation was 0.51mm, and the average deviation was (1.62±0.90)mm. The maximum deviation of implant angle was 7.14°, the minimum deviation was 0.16°, and the average deviation was (3.27±2.47)°. There difference was statistically significant（P<0.05）. The comparative analysis showed that the linear deviation of the implant shoulder guided by the template in the mandibular implant group was significantly lower than that in the maxillary implant group (P<0.05). Conclusions The digital guide has good accuracy, and the accuracy of guided implant surgery in the mandible is higher than that of the upper jaw.

Observation of the effect of lidocaine spray on inhibiting pharyngeal reflex in oral implant patients

Zhuang Jiuru, Zhang Xueqin, Jiang Qiuhui, Xu Mengting, Liu Chunrui, Zhao Zhijuan

2021, 26(3): 174-177. DOI: 10.12337/zgkqzzxzz.2021.06.006

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Objective To observe the effect of lidocaine spray on inhibiting pharyngeal reflex in patients with oral implantation. Methods 90 patients with pharyngeal reflex sensitivity who received dental implantation treatment were included in this study. These patients were randomly divided into observation group and control group (n = 45/group). In the observation group, 1.5% lidocaine injection was sprayed on the base of tongue, soft palate and pharynx. In the control group, 2% lidocaine mucilage was applied on the base of tongue. The number of nausea and vomiting, hypertension and satisfaction evaluation was recorded. Results There were significantly differences in the incidences of nausea and vomiting, hypertension and satisfaction evaluation between the two groups (P<0.05). Conclusions Lidocaine spray can reduce nausea, vomiting and hypertension on patients with pharyngeal reflex sensitivity and improve the comfort level during dental implantation treatment.

Efficacy of ridge preservation in molar extraction sockets with severe wall defects in the aspect of improving soft and hard tissue conditions - a case report with 2.5-year follow-up

Shi Yutong, Wang cui, Hu Wenjie, Xu Tao, Liu Yunsong

2021, 26(3): 178-184. DOI: 10.12337/zgkqzzxzz.2021.06.007

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For molars that need to be extracted due to severe periodontitis or periodontal-endodontic combined lesions, the bone wall of the extraction socket is often seriously damaged. After natural healing, there will be problems such as insufficiency of soft and hard tissues at the implant site, which will make the implant placement more difficult. Minimally invasive tooth extraction and ridge preservation can achieve a certain degree of bone augmentation and maintain soft tissue contour, thus create good soft and hard tissue conditions for implant therapy. However, for mandibular molar sites with complete loss of buccal and lingual bone wall, the technical difficulty of ridge preservation increases. This article illustrates a case of ridge preservation in mandibular molars with severe bone defect to facilitate implant treatment and demonstrates the clinical management to achieve predictable clinical outcome.

Design, manufacturing, and clinical application of digital sequential assembled guide in full arch immediate implant placement and immediate restoration

Peng Lingyan, Liu Qian, Li Ruhua, Wang Xia, Pi Xueming, Su Yucheng

2021, 26(3): 185-191. DOI: 10.12337/zgkqzzxzz.2021.06.008

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This article discusses the method of precise implantation and provisionalization for patients who intend to accept the treatment of full arch immediate implant placement and immediate restoration. Digital technologies are used to design sequential assembled guide and prefabricated prosthesis. With the guidance of template, alveolar bone reduction following tooth extraction, implant site osteotomy and implant placement, as well as precise placement of temporary prosthesis are carried out. This clinical technology, which is effective and worthy of promotion, enables the implant surgery and prosthetic procedures quick, efficient and accurate. This article gives a systematic elaboration about the design, manufacturing, and clinical application of the digital sequential assembled guide in full arch immediate implant placement and immediate restoration.

Research progress of grafting marterials in maxillary sinus floor elevation

Deng Lei, Huang Haitao

2021, 26(3): 192-195. DOI: 10.12337/zgkqzzxzz.2021.06.009

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Simultaneous bone grafting with autogeneous bone or bone substitute is often necessary for traditional maxillary sinus lifting, to ensure the amount of bone formation. Although there are many research reports on its long-term osteogenic effect and clinical efficacy, this method still has some shortcomings. Therefore, Whether or not bone grafting is necessary in maxillary sinus lifting and what kind of grafting material can achieve better clinical effect has become a hot topic for scholars at home and abroad. This article summarizes the research progress of grafting materials in maxillary sinus lifting.

Research progress of immune cells in the process osseointegration

Li Xiaoyu, Cai Qing, Yin Zhaoyi, Jin Zhuohua, Wang Zixuan, Meng Weiyan

2021, 26(3): 196-201. DOI: 10.12337/zgkqzzxzz.2021.06.010

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High-quality osseointegration is the key to the success rate and long-term survival rate of implants. Immune cells could remove the tissue fragment and pathogen, regulate the inflammatory reaction, induce the recruitment of mesenchymal stem cells and osteogenic differentiation, etc., which could improve the osteogenic microenvironment and play an essential role in the process of implant osseointegration. In order to optimize the strategy of immune regulation for forming better implant osseointegration, this article will review the specific functions of different immune cells in the process of implant osseointegration.

Research progress on surface properties of titanium anodizing

Lv Lingfeng, Wu Dong

2021, 26(3): 202-205. DOI: 10.12337/zgkqzzxzz.2021.06.011

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The implant restoration is becoming more and more mature, due to the extensive research on implant morphology and surface properties by scholars domestic and international.Titanium, as materials of implant, has excellent biocompatibility. However, due to the biological inertia of the surface of pure titanium, its surface treatment has always been the focus of research.Anodization is a mature surface treatment technology nowadays, and the titanium oxide coating with porous morphology prepared by anodization has been proved to be an effective way to improve the biological activity of titanium surface.In this paper, the research progress and clinical application of anodized titanium surface are reviewed and analyzed.

Research progress and application prospect of digital implant technology in aesthetic area

Zhang Xinyue, Wang Baixiang, Wang Huiming

2021, 26(3): 206-210. DOI: 10.12337/zgkqzzxzz.2021.06.012

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Implant treatment in the aesthetic zone has always been difficult in the field of implant. A precise prosthetic-driven surgery is the key to the success of implant restoration in the aesthetic zone. With the era of big data approaching, the full digital process has become the tendency of future development. The full digital implant treatment integrates CAD/CAM（computer aided design / computer aided manufacturing,CAD/CAM）technology into the entire implant treatment process. Digital technology can not only make temporary prostheses at the same period after surgery, but also make temporary prostheses preoperatively, which greatly saves the chair side operation time. This article describes the process and technology of digital implant in aesthetic zone, hoping to provide a reference for clinicians to carry out digital implant treatment in the aesthetic zone.

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