Placement Of Dental Implants Research Articles

EVALUATION OF THE EFFECTIVENESS OF IMMEDIATE DENTAL IMPLANTS PLACED IN EXTRAXTION SOCKETS WITH PERIAPICAL PATHOLOGY. A CONTROLLED CASE SERIES

Background:Immediate placement of implants in post-extraction sockets is a common and well-established treatment modality. However, extraction sockets with periapical pathology may negatively impact the outcome of this treatment procedure. Objective: The aim of this study was to evaluate the clinical outcomes of immediate placement of dental implants in infected extraction sockets with periapical pathology. Materials and Methods: The study included 37 patients who underwent tooth extraction with periapical pathology and immediate 151 Bio3 GmbH (Germany) implants placement. Postoperative results; implant survival, implant failure, marginal bone loss (MBL), and patient-reported function of the implants were assessed clinically and radiographically. Results: There were no complications during implant placement and in the postoperative period, no signs of infection around the implants were detected at the follow-up visit 4 weeks after implant placement, the soft tissues were in good condition, as evidenced by their healthy color and texture. The mean RFA for151 implants was 63.7 ISQ (implant stability), and after 3-5 months, respectively, 72.4 ISQ. The mean MBL after 12 months was 0.94, after 36 months the mean MBL was 1.28, at 60 months follow-up the mean MBL was 1.42. The functional and aesthetic results of prosthetic restoration were satisfied by the patients, as chewing function was restored, the esthetics of the facial profile and occlusion improved. The success rate of immediate implants after 5 years was 96.8%, and shows a similar survival rate to the published success rates for immediate implants placed in non-infected sites. Conclusion: Evidence suggests that immediate placement of implants in areas with periapical infections is a predictable and effective treatment protocol if the areas are thoroughly debrided prior to implant placement, high implants stability is achieved during implant placement, and systemic antibiotics are used.

RECONSTRUCTION OF THE ALVEOLAR RIDGE IN PERIODONTAL TISSUE PATHOLOGY UNDER COMPLEX ANATOMICAL CONDITIONS (CLINICAL CASE).

The optimal placement of dental implants in the jawbone tissue in cases of periodontal disease ensures conditions for the long-term success of osteointegration and the functioning of the prosthetic construction. However, the anatomical features of the mandible and maxilla often prevent dental implant surgeons from achieving the desired results after the placement of dental implants in cases of horizontal atrophy of the alveolar bone tissue [3,5-7]. Objective. To improve the treatment of patients with periodontal tissue pathology and horizontal alveolar ridge atrophy using an alveolar ridge split technique and to share our experience of applying this technique without bone augmentation. Materials and Methods. Preliminary examination was conducted using generally accepted subjective and objective examination methods. Targeted X-rays and computed tomography with 3D reconstruction were performed using the Morita Veraviewepas 3D Model X-550 (Japan). A 40-year-old female patient Z. presented to the Department of Therapeutic Stomatology, Periodontology, and FPGE Stomatology, complaining of the absence of tooth 24 and the damaged crown of tooth 25. Results and Discussion. In our study, we decided to apply our developed technique of gradual alveolar ridge split using a piezoelectric periotome in the affected area without using bone substitutes. We named this technique "stepwise splitting," using several sizes of spreader chisels (from larger to smaller sizes). The phosphorus-to-calcium ratio in the bone tissue preserves not only strength but also flexibility and elasticity, allowing the bone to act as a shock absorber while stretching the alveolar ridge transversely almost twice its size. This approach reduces stress loading during the osteointegration of dental implants under complex conditions. Conclusion. Modern research on the effectiveness and safety of dental implants under complex anatomical conditions associated with periodontal tissue pathology is impossible without the practical skills and experience of the dentist along with auxiliary diagnostic technologies. Therefore, new approaches have been introduced into clinical practice for the treatment of horizontal alveolar ridge atrophy of the mandible and maxilla using "stepwise" alveolar ridge splitting.

Increasing Bone Regeneration in Maxillary Sinus Augmentation Using Platelet-rich Fibrin: An Interventional Pre-Post Study.

This study aimed to evaluate the impact of a combination of immediate implant placement with maxillary sinus augmentation (MSA) solely using platelet-rich fibrin (PRF) on guided bone regeneration. An interventional before-after (pre-post) study design was used with 30 dental patients (≥18 years of age; 14 males and 16 females) with initial bone heights ranging between 4 and 6 mm. Following the general check-up and the creation of a study model, the planned implant location demonstrated an external right maxilla diameter of more than 5 mm, thereby validating the cone-beam computed tomography (CBCT) radiograph. The next step is the sinus lift operation, followed by the placement of dental implants. Production of PRF: 30 mL of venous blood was extracted and separated into three layers. The PRF was inserted into the space formed by the sinus floor and sinus membrane, and the flap was secured. The procedure involved creating an opening in the bone, separating the sinus membrane from the sinus floor, and making holes for implant insertion. The primary stability of the implant was assessed using an ISQ measurement device. Cone-beam computed tomography scans were taken and compared preoperatively, 6 months postoperatively, and follow-up assessments after 3 days, 7 days, and 6 months. And showed initial stability, pain, infection, blood bruises, peri-implant inflammation, osseointegration, bone loss around the implant, changes in bone thickness and sinus mucosa, and problems during the procedure. The Chi-squared test tested initial stability, whereas the paired sample t-test analyzed bone width and height changes. The study assessed the initial stability of a dental implant using bone density, with bones classified as D2 showing the strongest stability (76.7%). Three days after surgery, 26.7% of patients experienced mild pain, which decreased to 6.7% after 7 days. Six months later, the implant site showed no pain, no inflammation, and no bone loss. The ISQ was greater than 70, indicating strong integration with the surrounding bone. The thickness of the sinus membrane mucosa and alveolar bone changed significantly, with a significant difference (p < 0.05) in breadth and height. Sinus membrane perforation, hemorrhage, and flap tear were observed at a rate of 16.7%. Exclusively using PRF was highly effective in augmenting the bone level during maxillary sinus lift surgery (MSA), especially for immediate implant-supported rehabilitation purposes. This study highlights the significance of using PRF to promote healing and enhance the thickness of bone in MSA without a bone graft in immediate implant placement. How to cite this article: Nguyen XT, Le LN, Do TT, et al. Increasing Bone Regeneration in Maxillary Sinus Augmentation Using Platelet-rich Fibrin: An Interventional Pre-Post Study. J Contemp Dent Pract 2024;25(9):814-819.

Vertical ridge augmentation using deproteinized bovine bone material without covering with a membrane: a tunnel pouch technique- 4-year follow-up- A pilot clinical study.

The present pilot clinical trial was planned to evaluate the effect of particulate deproteinized bovine bone graft mixed with blood could be used as a vertical ridge augmentation material without covering with any form of collagen membrane in a tunnel pouch technique, resulting in sufficient bone formation to allow placement of dental implants, with maintenance of the newly formed bone after final restoration. Eight patients (three males and five females) were selected for this procedure and treated between February 2016 and December 2017. All these patients had a deficient vertical height of the posterior mandibular alveolar bone above the inferior alveolar canal. The particulate deproteinized an organic bovine bone graft (Bio Oss) mixed with blood was placed through the tunnel in the defected area and compacted firmly to form a dense pack. The average gain of alveolar bone in the first implant site after immediate post-op was 13.51±0.85, and in the second implant site was 13.84± 0.62. Histomorphometric analysis showed that about 70.31% of the area analyzed was occupied by the vital bone, the newly formed bone, whereas only 29.69% of the residual graft remained. In the present pilot study, the deproteinized bovine bone graft placed to enhance vertical and horizontal bone gain showed positive results in regaining the bone needed to place implants and maintaining the bone around restored implants for 4 years of follow-up.

SOFT TISSUE EXPANSION FOR TENSION FREE CLOSURE OF FLAP DURING GUIDEDBONE REGENERATION - A CASE REPORT

The compromised alveolar ridges preclude the placement of dental implants. The major problem with the regenerative procedures like block grafting, guided bone regeneration is flap opening during the initial healing period and exposure of the regenerative compartment. There is necessity for the tension free closure of the flap without relieving the periosteum or mucosa is required for the successful regeneration. The self-inflating osmotic tissue expander (Osmed) is used to expand the tissue prior to augmentation procedure. This report elaborates about the use of self-filling osmotic expander in severely compromised alveolar ridge defect cases (combined defect) prior to the augmentation procedure. The report concludes that the self-filling osmotic expander is a valuable tool in the efficient management of soft tissues prior to augmentation of severely compromised alveolar ridge cases.

Treatment Outcome of Using Guided Bone Regeneration for Bone Augmentation for the Placement of Dental Implants – A Systematic Review

ABSTRACT Aim: The objective of this review is to evaluate the treatment outcome differences between guided bone regeneration (GBR) and other techniques of bone augmentation for the placement of dental implants. Materials and Methods: This review was performed by two reviewers electronically on the PubMed and Cochrane database for articles published between 1990 and 2023. Only randomized clinical trials (RCTs) and prospective studies were included. Studies involved patients who have been treated with dental implants with simultaneous or previously performed GBR. Results and Discussion: A total of 470 studies were identified after implementing the search strategy across the different databases. The results that have been reported may also be influenced by these factors. Conclusion: After a careful evaluation of the limited evidence included in studies, it can be concluded that GBR is a stable and effective technique of bone augmentation when compared to block grafting and distraction osteogenesis.

Alveolar Ridge Augmentation using Customized Zirconia Membranes: A Systematic Review

Background Since the inception of intraosseous implants, the significance of alveolar bone volume has become crucial in formulating treatment plans for dental implants. Various barrier membranes have been extensively employed in alveolar ridge reconstruction, highlighting their efficacy. Recent advancements include the fabrication of customized barrier membranes using multiple materials, with titanium and zirconia being prominent choices. The objective of this study was to conduct a comprehensive review of all clinical studies, case reports, and case series that utilized customized zirconia membranes for alveolar ridge augmentation. Methods An electronic literature search was performed to find relevant clinical studies, case reports, and case series published in English up to August 2024. The following keywords used in the search were customized zirconia membrane, alveolar ridge augmentation, Guided bone regeneration, zirconia sheet, ceramic sheet, and Personalized membrane. The quality assessment was conducted using the Joanna Briggs Institute (JBI) critical appraisal checklist specific to each type of study. Results The electronic search initially yielded 539 articles. Following deduplication, 263 unique articles remained. Subsequent manual screening of titles and abstracts led to the exclusion of 250 articles, resulting in 13 remaining articles. After conducting a thorough full-text assessment of these 13 articles to verify adherence to the inclusion/exclusion criteria, 6 articles were further excluded, leaving a total of 7 articles included in this review. Conclusion While all studies included in this review were case series or case reports, customized zirconia membranes have demonstrated effectiveness in the literature for alveolar ridge augmentation, facilitating the placement of dental implants in all cases with relatively low complication rates, particularly membrane exposure. There is currently no literature evidence supporting the superiority of zirconia over other materials used in customized fabrication, nor is there evidence of superior design or preferred bone grafting under these membranes.

A Comparative Prospective Study on the Accuracy and Efficiency of Autonomous Robotic System Versus Dynamic Navigation System in Dental Implant Placement.

This study aimed to evaluate the efficiency of and discrepancies between planned and final implant positions using dynamic computer-assisted implant surgery (d-CAIS) and autonomous robotic computer-assisted implant surgery (r-CAIS) in clinical practice. The study included 83 patients, who received 135 implants between December 2022 and March 2024 (r-CAIS group: 43 patients with 71 implants; d-CAIS group: 40 patients with 64 implants). Cone-beam computed tomography scans taken before and after surgery assessed linear and angular deviations between the groups in both 2D and 3D spaces. The duration of surgery was also analysed. The angular deviation between d-CAIS and r-CAIS was 3.61° ± 1.65° versus 1.62° ± 0.93° (p < 0.001), the platform deviation was 1.12 ± 0.51 mm versus 0.50 ± 0.19 mm (p < 0.001) and the apex deviation was 1.36 ± 0.57 mm versus 0.58 ± 0.21 mm (p < 0.001). The d-CAIS group experienced significantly longer drilling and implant placement times compared to the r-CAIS group (10.6 ± 3.8 vs. 8.3 ± 3.4 min, p < 0.01), while preparation time showed no statistical difference between the groups (7.2 ± 3.3 vs. 6.2 ± 2.7 min, p > 0.05). The robotic system demonstrated higher accuracy and efficiency of implant placement than the dynamic navigation system in partially edentulous patients.

Comparing Medium to Long-Term Esthetic, Clinical, and Patient-Reported Outcomes Between Freehand and Computer-Assisted Dental Implant Placement: A Cross-Sectional Study.

The aim of the study was to compare medium to long-term clinical and patient-reported outcomes between implants placed with computer-assisted implant surgery (CAIS) and freehand protocols. Thirty dental implants in the anterior maxillary region with an average of 4 years after loading were assessed by means of Pink Esthetic Scores (PESs), marginal bone level (MBL), and clinical and patient-reported outcomes. CAIS significantly outperformed freehand placement with regard to PES scores (p = 0.011). Likewise, implants placed with CAIS showed significantly higher MBLs (p < 0.001). Bleeding on probing, probing depth, and prevalence of mucositis did not differ between the groups, while no peri-implantitis was diagnosed. The use of CAIS leads to superior outcomes in terms of esthetics and MBLs for implants placed in the esthetic zone as observed in medium to long-term follow-up. No difference was however observed with regard to peri-implant mucosa inflammation. This article highlights the outcome of computer-assisted implant surgery in achieving higher esthetic, MBL, and esthetic satisfaction compared to freehand implant placement. TCTR20240422015.

Surgical approach to management of oroantral communications. Case report

Abstract One of the most frequent post-extraction complications of posterior maxillary teeth is oroantral communication, which consists of direct communication between the maxillary sinus and the oral cavity. The recommendation is to make an immediate closure within the first 48 hours to avoid possible complications that may include an oroantral fistula or chronic sinus disease. Currently, different techniques have been described for closing communication, including various types of materials. Some of the techniques are exclusively oriented toward closure, while others seek to achieve bone regeneration by using bone substitutes for the subsequent placement of dental implants. The aim of this study is to describe a simple surgical technique for managing oroantral communication using a collagen sponge with hydroxyapatite and ribose and covering it with overlapping double layers of ribose cross-linked collagen membrane without fixation.

An Animal Ex Vivo Model Comparing Two Different Methods of Sinus Floor Elevation with Great Elevation Heights: Macroscopic, Microscopic and Radiological Analysis.

Maxillary sinus pneumatization increases with age and tooth loss, leading to a reduction in the maxillary alveolar ridge, which often results in insufficient bone height for the proper placement of dental implants. This study focused on performing maxillary sinus elevations in ex vivo bisected pig heads using novel access and elevation devices, comparing these with the osteotome sinus floor elevation (OSFE) technique. An experimental study was conducted using 20 ex vivo adult pig heads. The sinus elevations were divided into two groups: 10 heads were treated using the osteotome technique, and 10 heads were treated using a new device, which consists of a syringe with latex and saline solution, as well as a burr system for membrane access and control. In the osteotome technique, perforations of the Schneiderian membrane were observed, whereas the inflatable balloon device did not cause any lacerations. OSFE resulted in sinus membrane perforations at greater elevation heights, while the new balloon device successfully elevated the membrane without tearing it. Within the limitations of this study, maxillary sinus lifts using the new balloon technique proved to be minimally invasive procedures.

Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap

Computer-assisted mandibular reconstruction after mandibulectomy enables accurate reconstruction of the occlusal positions between the maxilla and mandible. Understanding the remaining teeth condition is essential for sensory mastication in patients with numerous tooth loss. However, no studies have examined the dental status of the remaining mandible after computer-assisted mandibular reconstruction using a fibular flap. This study evaluated the role of residual teeth and other factors in effective acquisition of oral intake after computer-assisted mandibular reconstruction using a fibular flap. Postoperative oral intake and associated factors were retrospectively examined in 57 consecutive patients. Oral intake was assessed using the Functional Oral Intake Scale. Multivariate analysis was performed to evaluate the remaining teeth arrangement (Eichner's classification), mandibular dentures, extent of resection (Brown's classification), age, performance of glossectomy, history of radiation therapy, and computer-assisted methods. Multivariate analysis revealed that Eichner's classification had a positive (p<0.001) and radiation therapy had a negative (p<0.05) impact on oral intake. The patients with dentures anchored to the remaining teeth in the occlusal support area (i.e., premolar and molar) had higher Functional Oral Intake score than those with dentures anchored to the remaining teeth in the non-occlusal support area (6.78±0.03 vs. 6.10±0.07, p<0.005). In computer-assisted mandibular reconstruction with accurate occlusion, the residual teeth in the occlusal support area are essential for good postoperative oral intake with dentures. During mandibulectomy, if oncologically acceptable, these teeth should be preserved, and selective placement of dental implants in the occlusal support area should be considered.

Exploring the Learning Curve of Dental Implant Placement Using a Task-Autonomous Robotic System Among Young Dentists From Different Specialties-A Pilot Module Study.

The learning curve effect of dynamic computer-assisted implant surgery (D-CAIS) was observed among inexperienced novice surgeons. The learning curves can provide valuable information for novice surgeons and valid comparisons between new and conventional techniques. Recently, robotic computer-assisted implant surgery (R-CAIS) has shown promise as a novel dental implant surgical technique for both partially and edentulous patients. However, its learning curve remains unknown. The aim of this study was to explore the learning curve of dental implant placement surgery with a task-autonomous robotic system among young dentists with different specialties. Four young dentists (mean age: 25.3 ± 1.5 years at the beginning of their first attempt) with equal representation of males and females and with different specialties participated in this study. None of the participants had prior experience in R-CAIS. Each operator placed eight implants over eight attempts using a semi-active task-autonomous robotic system. Among the eight implants, four were straight lateral incisor implants, and four were 30°-tilted premolar implants. The implants were placed in each dental quadrant of the maxillary and mandibular jaw modules. The operation time was recorded. Coronal, apical, and angular deviations between the planned and actual sites of implant placement were measured by merging preoperative and postoperative cone-beam computed tomography (CBCT) scans. The data were analyzed with repeated-measures ANOVA (α = 0.05). The mean time for implant placement was associated with the number of attempts (p < 0.01). The time taken for the second attempt was significantly shorter than that of the first attempt (33.26 vs. 30.47 min; p < 0.001) then it plateaued. Three-dimensional (3D) angular (p = 0.31), coronal deviation (p = 0.26), and apical deviation (p = 0.06) did not differ significantly among attempts. The mean values and standard deviations of 3D coronal deviation, 3D apical deviation, and 3D angular deviation were 0.71 ± 0.31 mm, 0.72 ± 0.30 mm, and 0.94 ± 0.58°, respectively. Neither the position of the jaw (p > 0.59) nor the tilt angle of the implant (straight or 30°-tilted, p > 0.85) was related to implant placement accuracy. Dentists quickly learned the basic workflow of R-CAIS and thus facilitated the clinicians in the mastery of implant placement on edentulous jaw modules, leading to a comparable operating speed and high precision. Moreover, the accuracy of placement of straight and tilted implants in both the maxilla and mandible with R-CAIS was satisfactory.

Horizontal bone augmentation with simultaneous implant placement using ridge splitting with sticky bone

Abstract Introduction A variety of bone grafting techniques had been used to augment horizontally deficient alveolar bone ridges to provide a sufficient bone volume to achieve a correct prosthetic three-dimensional placement of dental implants. Objectives To evaluate clinically and radiographically by cone beam computed tomography the amount of horizontal bone gain by ridge splitting with sticky bone technique for horizontal ridge deficiency with simultaneous implant placement; using piezo-assisted ridge splitting technique with sticky bone graft in patients who had bilateral posterior edentulous sites in the maxillary ridge. Patients and methods Seven patients with seven sites for ridge splitting modality. Each patient had posterior maxillary edentulous areas with horizontal ridge deficiency ranging from 3 to 5 mm. Piezo-assisted ridge splitting technique with simultaneous implant placement was used for augmentation. Patients were evaluated for clinical parameters, including ridge width using a bone caliper, radiographic assessment of marginal bone width and alveolar bone density using cone beam computed tomography, clinical attachment loss, plaque index, bleeding on probing, and pocket depth. Results were obtained at surgery time, 6 months postsurgery, and 18 months postsurgery. Results The was a statistically significant increase in bone width in the studied group. Also, bone density was slightly increased at implant and grafting sites at 6- and 18-months follow-ups. Furthermore, the group showed a statistically significant increase in bone width measured by bone caliper at baseline and at 6 months postsurgically. No significant changes were observed in plaque index, bleeding on probing, or clinical attachment level. Conclusion Ridge splitting with sticky bone surgical technique provides promising clinical and radiographic outcomes.

Role of Cone-Beam Computed Tomography in Assessment of Lateral Wall Thickness of Maxillary Sinus in Posterior Edentulous Maxilla

ABSTRACT Objective: To use Cone Beam Computed Tomography (CBCT) to evaluate the lateral wall thickness (LWT) of the maxillary sinus in the posterior edentulous maxilla, as well as the effect of ridge height (RH), edentulous region, type of edentulism (Complete and partial), age, and gender, for the placement of dental implants. Materials and Methods: To conduct this cross-sectional study, A CBCT scan of 60 patients of different age groups was taken for analysis. Each parameter was evaluated at the edentulous sites in the premolar and molar regions due to missing one or more posterior teeth at four levels from sinus floor 3, 7, 10, and 15 mm with residual RH less than 10 mm. Data were analyzed using Friedman’s ANOVA and one-way ANOVA. Bootstrapped linear regression was performed to assess the influence of various variables on LWT. Results: LWT increased from 3 mm to 15 mm in all teeth except the first premolar region, with significant differences (P &lt; 0.01). LWT was generally lower in premolars and higher in molars. Age, gender, and RH did not predict LWT (P &gt; 0.05), However, the type of edentulism significantly predicted LWT. (P = 0.005). Conclusion: CBCT scans are recommended before sinus surgeries due to anatomical variations.

The Accuracy of Dental Implant Placement With Different Methods of Computer-Assisted Implant Surgery: A Network Meta-Analysis of Clinical Studies.

Computer-assisted implant surgery (CAIS) has been introduced as a tool to aid in reaching a more accurate implant position. The aim of this network meta-analysis was to compare all the available CAIS techniques and obtain collective evidence on the method that offers the highest accuracy compared to freehand implant placement. Database search was done in PubMed, Scopus, and Cochrane library in addition to extensive search in the gray literature and related systematic reviews, aiming to find clinical studies that compared any CAIS technique with another, or with freehand implant placement. The outcomes evaluated were angle, platform, and apex deviation. The search process ended on March 18, 2024. Thirty-three studies were included. All CAIS techniques (static with partial or full guidance, dynamic with partial or full guidance, the combination of static and dynamic CAIS) showed significantly less deviation than freehand implant placement, except for the static CAIS with guidance for the pilot drill only. The combination of static and dynamic CAIS ranked best among all other methods. Based on the GRADE system, the certainty of evidence in the outcomes of the meta-analysis was judged as low or moderate. The current study demonstrates that computer-assisted implant surgery provides significantly higher accuracy in implant placement, with the combination of static and dynamic CAIS being the most precise. Nevertheless, future studies are needed, considering the different types, locations, and extents of edentulism in the analyzed investigations, as well as the necessity of obtaining stronger evidence. PROSPERIO number: CRD42023482030.

The Use Of Computer Assisted Planning To Increase The Predictability Of Intra Oral Welding Technique Of Dental Implants - A Clinical Study

Background: substantial progress has been made in terms of the immediate placement of dental implants after tooth extraction. In cases were the bone is healthy with no atrophy, Periapical lesions, infection and enough bone component is available immediate implant is considered. Recently implant abutment welding was introduced specially for those edentulous patients who need immediate loading and who wanted to go out of the surgery with full load of teeth and a perfect esthetics and function. Materials and Methods: In this prospective randomized controlled study, 8 patients of ASA physical status I and II belonging to age group of 50-60years undergoing dental implants, welding and immediate restorations were randomly allocated into 2 groups of 4 patients each, Group A with intraoral bending of wire and Group B in which wire was pre bent on a STL model before surgery (computer aided) Results: There was no significant difference between stability values measured at different intervals Intra-operative time and bone loss measured in group (B) was significantly higher than that measured in group (A) Conclusion: The use of computer assisted planning to increase the predictability of intra oral welding technique of dental implants saves much time intra operatively and preserves bone from being lost

Accuracy of Dental Implant Placement using Robotics. A Systematic Review of in vitro Studies.

Robotic-assisted techniques have the potential to revolutionize dental implantology by offering enhanced precision, accuracy, and clinical outcomes compared to computer-assisted implant placement techniques. This study aimed to evaluate the accuracy of dental implant placement using robot-assisted implant surgery in vitro settings. An unrestricted search of indexed databases along with a manual search was performed up to March 2024. In vitro, studies comparing the positioning accuracy of robotic systems in dental implant placement of planned pre-operative coordinates and postoperative outcomes in phantom and simulated models were included. QUIN Tool was used to assess the quality of the included studies. A total of 13 in vitro studies were included. All studies except one used entry, exit, or angle deviation as parameters to assess the accuracy of implants placed on phantom models or simulated virtual implant placement. Overall, pooled entry deviations were 0.72 ± 0.68 mm, exit deviations were 0.86 ± 0.92 mm, and angular deviations were 1.47 ± 1.610 favoring robot-assisted implant surgery. Based on the current evidence, robotic-placed implants have the potential to revolutionize dental implantology by offering enhanced precision, accuracy, and clinical outcomes compared to dynamic and static computer-assisted implant surgery techniques.

Combined use of PRPP, diode laser and piezosurgery device improves reparative osteogenesis previously to dental implants placement

ObjectiveCurrent study evaluated whether use of the platelet-rich powder (PRPP), piezosurgery device and diode laser after removal of jawbones cysts and benign bone formations and extraction of impacted tooth could enhance bone regeneration before dental implantation. MethodsA study was conducted among 200 patients with post-surgical cavities (not exceeding 1.5 cm upon cystectomy, benign bone tumor removal and impacted tooth extraction) who underwent plasma powder, autograft, allograft, xenograft or beta-tricalcium phosphate augmentation procedures. ResultsPRPP implantation in combination with irradiation of bone cavity by diode laser led to the formation of 15.40 % ± 2.1 of new bone. The activity of reparative osteogenesis on the bone surface was BB = 6.71 ± 1.3, which is 3 and 3.5 times higher than the mean value in comparison group after augmentation of xenograft and beta-tricalcium phosphate. The value of bone tissue resorption for main group patients was less pronounced (Ra.Oc = 25.20 % ± 2.1).The ratio between pro- and anti-inflammatory cytokines in the main group after 1, 7 and 30 days since surgical procedure was lower than the ratio of the corresponding cytokines in the comparison groups. ConclusionThe examination of computed tomograms, histological and morphometric analysis of bone tissue after trepanobiopsy, cytological analysis of swabs and enzyme immunoassay to determine local immunity indicated that the proposed method of treatment with the use of PRPP, the piezosurgery device and the diode laser has a positive effect: it helped to optimize reparative osteogenesis after filling post-surgical cavities and restore bone volume.

Incidental Findings Following Dental Implant Procedures in the Mandible: A New Post-Processing CBCT Software Analysis.

Background/Objectives: The aim of this study was to evaluate incidental findings in the mandible after the placement of dental implants using a new cone-beam computed tomography (CBCT) software. Methods: The initial sample consisted of 2872 CBCT scans of patients of both sexes. The parameters evaluated in this study were the location of the implants in the mandible, implant length, anatomical relationship of the implant with the mandibular canal, presence or absence of damage to the adjacent teeth, presence or absence of implant fractures, and presence or absence of bone support. Fisher's exact test was performed to compare the variables. The significance level was set at p = 0.05. Results: Out of 2872 CBCT scans, 214 images of patients with an average age of 44.5 years were included. The most frequent location of the implants was the posterior region (93.5%), with 54% of the implants having a length between 9 and 14 mm. It was found that 92% of the implants were positioned above the mandibular canal. Damage to adjacent teeth was observed, with no correlation with the implant positioning (p = 1.000). In 100% of cases of implants in the anterior region, there was bone support. Fracture was observed in 1.7% of implants with a length between 9 and 14 mm. Conclusions: The installation of implants in the mandible occurs more frequently in the posterior region, with a high presence of bone support and a low incidence of damage to adjacent teeth, anatomical structures, and fractures.