Table of Content

10 April 2021, Volume 26 Issue 2

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Special Articles

A concept of biological - driven implant therapy ——The inevitable trend of this paradigm shift in prevention of periimplantitis

Li Dehua

2021, 26(2):  79-84.  DOI: 10.12337/zgkqzzxzz.2021.04.001

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Implant therapy has been developed as a routine modality for restoration of tooth missing with high predictability of treatment outcomes in a short or long run, based on rapid advancement of technology and innovation of treatment concepts. Contemporarily, restoration-driven implant placement is the fundamental principle, which has played an essential role in the progress of implant dentistry. Nonetheless, implants are artificial entities completely different from the natural teeth, especially with respect to the biological characteristics of implant-tissue interactions. The paradigm of implant treatment, thereby, should take these specific biological patterns of implant interface into consideration, not only satisfying the requirements of spatial positions of implants. This is the reason behind the necessity to propose the concept of biological-driven implant therapy. Starting from the predominant hypothesis of biofilm-induced periimplantitis, this article will comprehensively review the diversity of factors revealed that might induce or increase the risk of periimplantitis, including bacterial or non-bacterial factors, and elucidate thereafter the logical trend for the paradigm shift from restorative-driven to biological-driven implant therapy. The fundamental definition of biological-driven concept will be clarified and periimplantitis-related factors be discussed, eliciting a novel strategy for clinical prevention of periimplantitis.

Original Articles·Clinical Research

The study of measuring the accuracy of computer assisted real-time navigation technology in dental implant surgery

Chen Quanlin, Xu Sheng, Zhou Wenjuan, Chen Lin, Liu Zhonghao

2021, 26(2):  85-90.  DOI: 10.12337/zgkqzzxzz.2021.04.002

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Objective In this prospective study,the accuracy of computer assisted real-time navigation technology in dental implant surgery was calculated,which provided theoretical basis for the further improvement of the accuracy of minimally invasive implant surgery. Methods A according to the inclusion criteria,we enrolled a sample composed of patients who had computer assisted real-time navigation implants placed between June 2018 through December 2020 in Yantai Stomatological Hospital.The cone beam scan was taken and the intraoral scan was performed. The implants were placed by aid of the computer assisted real-time navigation software and the post-surgical CBCT was taken.The errors between the designed and the actually placed implants were measured to evaluate the accuracy and effectiveness.The pre-op virtual implant and the post-op actual implant were displayed in the same three-dimensional coordinate system.The errors of shoulder distance, root distance and angle of each implant were measured. The data was analysed by SPSS 22.0 software.The data in each group were expressed as mean±standard error(x±s).Independent sample t test was used to compare the measurements among the groups.The test level was a=0.05, P<0.05 was considered to have significant difference. Results Comparing the accuracy in maxillary and mandibular,the shoulder distance error was（0.59±0.16） mm and （0.63±0.19 ）mm,the root distance error was（0.75±0.14 ） mm and （0.70±0.18） mm,and the angle error was (3.46±1.80)°and (3.07±1.12)°respectively.Comparing the accuracy in anterior and posterior regions,the shoulder distance error was （0.60±0.21）mm and （0.60±0.16）mm,the root distance error was （0.72±0.16）mm and （0.72±0.15）mm, and the angle error was (3.28±1.85)°and (3.28±1.31)°respectively.Comparing the accuracy in flap and flapless, the shoulder distance error was （0.68±0.17）mm and （0.55±0.15）mm,the root distance error was （0.81±0.15）mm and （0.67±0.12）mm, and the angle error was (3.29±1.65)°and (3.35±1.58)°respectively. Conclusion The accuracy of computer-aided dynamic navigation system have no obvious deviation in shoulder distance, root distance and angle..

The clinical study of alveolar bone grafting in molar area

Dai Junfeng, Yu Qing

2021, 26(2):  91-95.  DOI: 10.12337/zgkqzzxzz.2021.04.003

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Objective To study the one year clinical effect of guided bone regeneration (GBR) of implant placement in the molar sites. Methods 55 patients were selected from August 2017 to July 2019, 58 implants were implanted, of which 29 were set as experimental with simultaneous implant placement and GBR, 29 patients were selected as control group. The survival rate, marginal bone loss (MBL), gingival index (GI) and probing depth (PD) were compared between the two groups. Results SPSS 20.0 was used to make statistics. Results The survival rate of implants in control group and experimental group was 100%; There was no significant difference in bone absorption at the margin; The gingival papilla index of experimental group was better than that of the control group (P<0.05), and there was no statistical difference in GI and PD between the experimental group and the control group. Conclusion The simultaneous implant placement in the molar sites with GBR can increase the height of the implant and the adjacent bone of the natural teeth and improve the filling degree of the gingival papilla.

Original Articles·Typical Case Analysis

Preliminary analysis of minimally invasive extraction and ridge preservation in maxillary molar with bone defect corresponding to the sinus floor due to severe periodontal lesions：a case analysis

Wei Ning, Xu Tao, Hu Wenjie, Liu Yunsong

2021, 26(2):  96-101.  DOI: 10.12337/zgkqzzxzz.2021.04.004

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Maxillary molars with severe periodontal lesions are often accompanied with bone defects even reaching the corresponding maxillary sinus floor. These bone defects will increase the difficulty and risk for implantation after the extraction of maxillary molars. The application of minimally invasive extraction with thorough debridement and site preservation of the maxillary molars can not only maintain the dimensions of alveolar ridge, but also reduce the requirement of sinus floor elevation.This paper illustrates the treatment procedures of implant replacement of a maxillary molar with severe periodontal lesions involving maxillary sinus floor using this technique.Changes of bone conditions were compared and analyzed in order to provide evidence and clinical experience for the management of similar cases.

Function oriented oral rehabilitation with implants by full digital flow technology-A case report

Zhang Sihui, Liu Xiangdong, He Kaixun, Wu Ling, Chen Jiang

2021, 26(2):  102-108.  DOI: 10.12337/zgkqzzxzz.2021.04.005

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This case aims to achieve functional oriented oral rehabilitation with implants based on integrated digital technology. The patient wore splint to restore masticatory function and parafunction were controllable. The position,direction and dimensions of the implants were designed taking into the consideration of contact point on occlusal surface, axial direction as well as bone volume. Treatment guide was printed under full digital workflow for implant placement and immediate loading. Six months later, occlusal data was obtained using facial scanner and jaw movement record system and then mounted on full adjustable articulator. Ttitanium framework and ceramic crown was fabricated after Wap-up designing process. In this case, function oriented implant placement and restoration was done effectively with fully digital work flow. Clinical outcome of occlusal rehabilitation was evaluated with T-scan and masticatory efficiency tester. Parafunction like bruxism was monitored closely. This method quantifies implant-supported reconstruction, which can better realize the patient's aesthetics and chewing functions, but it still needs further research on the accuracy of the digital production of the prosthesis.

Case Reports

Moderate application of short implants in atrophic posterior jaw areas

Deng Xiaotong, He Hong, Wang Ying, Zhang Xinyue, Sun Mingjie, Liu Xiaochen

2021, 26(2):  109-113.  DOI: 10.12337/zgkqzzxzz.2021.04.006

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Short implants are an increasingly common alternative in resorbed posterior zone. Despite the advantages they offer, risks have been described in the literature that can lead to marginal bone loss or even the loss of implants. Factors that affect the uncertainty of short implants application in posterior jaw areas are analyzed, and some suggestions for the clinical application of short implants are put forward in this review.

Digital data acquisition technology in oral implantology

Xiong Jiabi, Sun Wei, Shi Bin

2021, 26(2):  114-119.  DOI: 10.12337/zgkqzzxzz.2021.04.007

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With the rapid development of digital technology, diagnosis and treatment methods of the clinicians have been changed by these digital technologies in the field of dental implant. In particular, data acquisition technology, such as CBCT, digital intraoral scan, extraoral scan, facial scan, virtual facebow technique, are gradually popularized in medical institutions with its high precision, high efficiency, convenient transmission and low pollution. Recently, it has become one of the focuses to build "virtual patient" using various digital data to solve complex cases such as edentulous patients in implant dentistry. This paper summarized the characteristics and clinical application of digital data acquisition technology in the process of dental implant treatment.

Application of intraoral welding technique in edentulous implant restoration

Liu Xiangdong, Zhang Sihui, He Kaixun, Luo Jiakun, Chen Jiang

2021, 26(2):  120-123.  DOI: 10.12337/zgkqzzxzz.2021.04.008

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Immediate restoration after implant placement in edentulous patients can provide quick esthetic and function rehabilitation. So far there are still some problems in the fabrication of immediate prosthesis such as inefficiency of the prevention of implant micromovements. The fabrication usually takes much time. Intraoralwelding technique can be utilized to splint implants and shorten the time of immediate prosthesis welding the implant abutments and titanium bar in the oral cavity. This paper reviews the intraoral welding technique including its development history, principle, advantages, disadvantages and prospects..

Research and development of clinical application accuracy of dynamic navigation system in implant surgery

Wang Qingfu, Wang Feifan, Zhang Jian

2021, 26(2):  124-128.  DOI: 10.12337/zgkqzzxzz.2021.04.009

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Dynamic navigation system is more and more widely used in implant surgery. The accuracy is the key index to measure the system. In this study, the clinical application accuracy of the dynamic navigation system was compared with that of the free hand and static surgical guide system, and the influencing factors of error are summarized, and the future development trend is prospected. In regular implant surgery, the dynamic navigation system can achieve better clinical effect than the free hand operation, and is similar to that of the static guide system, and shows obvious technical advantages in complex operations such as zygomatic implant surgery.

Research progress on imaging evaluation methods of bone mineral density before immediate implant restoration

Feng Lan, Gu Xinhua

2021, 26(2):  129-134.  DOI: 10.12337/zgkqzzxzz.2021.04.010

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Alveolar bone density is considered to be one of the most important factors affecting the clinical outcome of immediate implant restoration. The bone density can be used to predict the initial stability of the implant, so as to decide the preoperative plan, implant selection, surgical protocal for immediate implant treatment, and at the same time refine the indications of implant treatment from the perspective of bone density. A large number of studies have shown that imaging methods such as dual-energy X-ray absorptiometry, panoramic X-ray film, periapical X-ray film, Micro-computed tomography, multi-slice computed tomography, cone beam computed tomography, etc., can assess the bone density of the recipient bone. However, the use of imaging methods to formulate the classification of bone mineral density used in clinical decision-making for immediate implant treatment of patients, especially in the treatment of patients with edentulous jaws, needs further research. This article reviews the research on obtaining bone mineral density data using imaging methods.

Application and research progress of concentrated growth factor in oral implantology and periodontology

Lei Chen, Wu Qirong, Tang Chunbo

2021, 26(2):  135-140.  DOI: 10.12337/zgkqzzxzz.2021.04.011

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Guided tissue regeneration (GTR) and guided bone regeneration (GBR) are the most common surgical procedures for soft and hard tissue regeneration in the field of dentistry. After decades of clinical applications of these techniques, challenges of esthetics and function rehabilitation have triggered the development of numerous bone or soft tissue subsitutes. However, the existing allograft or xenograft materials still carry potential risks of cross-infection and immune rejection,and for barrier membranes, acceptable mechanical strength and biodegradation may not be both achieved in most cases. These years, autologous platelet concentrates have emerged as innovative graft materials and come into common use due to the easiness of preparation, excellent biocompatibility and regenerative properties. Concentrated growth factor (CGF) is a new generation of platelet concentrates. The fibrin matrix scaffold inside is much stiffer than its previous generations, while the richer growth factors, cytokines and cells it contains better promote cell proliferation and differentiation, extracellular matrix synthesis and angiogenesis. This article reviewed the characteristics of CGF in terms of bone and soft tissue augmentation in oral cavity and its related research progress in dental clinics.