OBJECTIVE: To assess the osteogenesis height in maxillary sinus segment one year after zygomatic implantation by imaging methods, and evaluate the influence of patient factors, maxillary sinus anatomical factors and surgical factors on postoperative osteogenesis height. METHODS: This study is a retrospective study, including patients who underwent zygomatic implantation and whose zygomatic implants passed through the maxillary sinus at the Department of Implantology, Peking University School and Hospital of Stomatology from July 2017 to January 2022. Preoperative and postoperative cone beam CT (CBCT)was taken to measure and calculate the average osteogenesis height (AOH) in maxillary sinus segment of the zygomatic implants, then the residual bone height, the width and morphology of the maxillary sinus floor in the buccal and palatal directions were measured. Besides, the integrity of Schneiderian membrane during implant surgery, and the general information of the patients and zygomatic implants were recorded. By comparing anatomical situations and surgical characteristics, the differences of AOH under different conditions were analyzed. Then AOH was divided into two groups (obvious osteogenesis group and non-obvious osteogenesis group) using the median as the threshold, and the influencing factors of osteogenesis were evaluated using mixed effect generalized linear model univariable and multivariable analysis. RESULTS: A total of 47 zygomatic implants were implanted in 24 patients. During the average follow-up period of 12.1 months, there was no implant failure, and the implant survival rate was 100%. Postoperative CBCT showed that 43 zygomatic implants had osteogenic images in the maxillary sinus segment, most of which originated from the floor of the maxillary sinus, and the median AOH was 3.1 mm [interquartile range (IQR): 4.0 mm]. In terms of maxillary sinus width, there were 31 cases (66.0%) of wide type and 16 cases (34.0%) of narrow type. In the aspect of buccal and palatal morphology, 17 cases were taper (36.2%), 20 cases were round (42.6%), and 10 cases were flat (21.3%). The median of residual bone height was 2.8 mm (IQR: 2.2 mm) before operation. Univa-riate analysis of mixed effect generalized linear model showed that postoperative obvious osteogenic rate was related to the residual bone height (OR=2.09, P=0.006). Multivariate analysis showed that the resi-dual bone height (OR=2.55, P=0.022) and the shape of a taper maxillary sinus (OR=11.44, P=0.040) had a significant impact on the postoperative obvious osteogenic rate. CONCLUSION The maxillary sinus floor showed osteogenic images 1 year after the zygomatic implantation surgery. Larger residual bone height and the shape of a taper maxillary sinus may be favorable factors for osteogenesis.
Humans ; Maxillary Sinus/surgery* ; Cone-Beam Computed Tomography ; Retrospective Studies ; Zygoma/diagnostic imaging* ; Male ; Female ; Osteogenesis/physiology* ; Middle Aged ; Adult ; Dental Implants ; Aged ; Dental Implantation, Endosseous/methods*

OBJECTIVES: To study the clinical effect of the L-shape technique combined with concentrated growth factor on the horizontal bone defects of maxillary anterior teeth. METHODS: Twenty-five implants from 25 patients who underwent single maxillary anterior tooth implantation with simultaneous bone grafting were selected as the study subjects. Based on the bone grafting techniques, the patients were divided into a test group (L-shaped technique with guided bone regeneration combined with concentrated growth factor, 11 cases) and a control group (traditional guided bone regeneration combined with concentrated growth factor, 14 cases). The early discomfort and wound healing conditions in the two groups at two weeks after surgery were compared. The horizontal bone thickness, vertical bone thickness, and grayscale values in the augmentation area were measured immediately postsurgery and six months after surgery. Implant stability, hard tissue resorption within six months, and grayscale values were compared between the two groups. RESULTS: Differences in early discomfort, wound healing, implant stability, and grayscale values between the two groups were not statistically significant (P>0.05). Vertical bone thickness in the test group was significantly better than that in the control group at six months after surgery (P<0.05). The variation in horizontal bone thickness in the test group was significantly higher than that in the control group (P<0.05). CONCLUSIONS The application of the L-shape technique with concentrated growth factor for horizontal bone defects in the anterior maxillary area yielded satisfactory short-term results in terms of bone augmentation, early discomfort, wound healing, and implant stability at six months after surgery.
Humans ; Maxilla/diagnostic imaging* ; Intercellular Signaling Peptides and Proteins/therapeutic use* ; Wound Healing ; Bone Transplantation/methods* ; Dental Implantation, Endosseous/methods* ; Bone Regeneration ; Male ; Female ; Adult ; Dental Implants, Single-Tooth ; Middle Aged

In the realm of oral implantology, currently, there is no unanimous consensus or authoritative guideline regarding how to conduct implant restoration for cases involving oroantral communication or oroantral fistula. In these cases, the bony plate of the maxillary sinus floor is discontinuous, the oro-sinus mucosa is in communication, and a vertical alveolar bone defect exists. This paper presents a case of a patient with two oroantral communications who successfully underwent implant restoration via simple staged surgeries. Following a 2-year clinical follow-up, the implant remains in good condition, and the patient expresses satisfaction. The objective of this paper is to offer a simple, safe, and readily-promotable new approach for such cases.
Humans ; Dental Implantation, Endosseous/methods* ; Dental Implants ; Maxillary Sinus/surgery* ; Oroantral Fistula/surgery*

OBJECTIVES: This study aims to evaluate the short- to medium-term clinical efficacy of demineralized dentin matrix (DDM) particles applied during the immediate implantation of alveolar bone defects in the posterior region. METHODS: A total of 76 patients with 110 simple taper retentive implants were included in the conducted study and divided into Groups A and B in accordance with the bone grafting materials. Cone beam computed tomography and panoramic radiographs were taken immediately after implant surgery, immediate crown repair, and final follow-up time. The average follow-up time for Groups A and B was recorded. The primary observed clinical indicators were overall survival rate of the implant, bone resorption of the mesial and distal margins of the implant, buccal bone width resorption at the platform level and 1 mm below the platform, and bone height of the implant. Implant complication was a secondary observed clinical indicator. RESULTS: During the 1-to-5-year follow-up observation period, the mean follow-up of Group A was 38.2 months while that of Group B was 39.9 months. In Group A, two implants failed, one of which fractured, and implant overall survival rate was 96.4%. Four implants failed in Group B due to peri-implantitis, and implant overall survival rate was 92.6%. No statistically significant difference in implant overall survival rate was found between the two groups (P>0.05). In Group A, the average bone resorption in the mesial and distal margins of the implants was (1.011±2.047) mm and (0.841±2.183) mm, respectively. In Group B, the average bone resorption of the mesial and distal margins of the implants was (1.546±1.778) mm and (1.431±1.909) mm, respectively. No statistically significant difference was noted between the two groups (P>0.05). In Group A, buccal bone width resorption at the platform level and 1 mm below the platform of the implant was (0.782±2.084) mm and (0.681±2.307) mm, respectively. In Group B, buccal bone width resorption at the platform level and 1 mm below the platform of implant was (1.071±1.474) mm and (0.949±1.909) mm, respectively. No statistically significant difference was found between the two groups (P>0.05). In Group A, the buccal bone height of resorption of the implant was (1.044±2.214) mm. In Group B, the buccal bone height of resorption of the implant was (1.075±1.456) mm. No statistically significant difference in bone height was observed between the two groups (P>0.05). CONCLUSIONS During the 1-to-5-year follow-up observation period, DDM particles can effectively increase the height and width of alveolar bone, and they can achieve the same effect of maintaining alveolar bone contour and bone augmentation compared with deproteinized inorganic calf bone. DDM particles can be used as a potential new bone grafting material for the treatment of bone defects in clinical practice.
Humans ; Follow-Up Studies ; Dentin ; Cone-Beam Computed Tomography ; Dental Implants ; Male ; Female ; Adult ; Alveolar Bone Loss/surgery* ; Middle Aged ; Bone Transplantation ; Radiography, Panoramic ; Dental Implantation, Endosseous/methods* ; Immediate Dental Implant Loading

When selecting implant guidance methods or judging whether the patient can be implanted, many doctors ignore or only use visual inspection to estimate a patient's mouth opening. This phenomenon often leads to failure to complete the implantation due to insufficient mouth opening or the deflection of the implant due to limited angle, resulting in the high incidence of corresponding complications. The main reason is that doctors lack accurate analysis and control of the overall geometric conditions of the intraoral surgical area, and three-dimensional position blocking of surgical instruments occurs during the operation. In the past, mouth opening was defined as the distance between the incisor edges of the upper and lower central incisors when the patient opens his mouth widely, and the implant area could be in any missing tooth position. When it is in the posterior tooth area, the specific measurement scheme of the mouth opening could not be simply equivalent to the previous measurement method in the anterior tooth area. However, how to measure quickly and conveniently the mouth opening of any surgical area to determine whether it could be implanted and meet the needs of the selected guidance method remains unclear. This paper introduces new concepts, establishes new classification and corresponding accurate measurement scheme of implant area, and establishes a decision tree of implant methods guided by the actually measured value. Results provide a quantitative basis for rational formulation and implementation of implant treatment.
Humans ; Mouth ; Dental Implantation, Endosseous/methods* ; Incisor ; Clinical Decision-Making ; Dental Implants

Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.
Dental Implantation, Endosseous/methods* ; Dental Implants ; Esthetics, Dental ; Alveolar Ridge Augmentation/methods* ; Osseointegration ; Maxilla/surgery* ; Dental Implants, Single-Tooth

The use of dynamic navigation technology in edentulous jaw implant restoration can solve many problems associated with traditional edentulous jaw implant restoration. The benefits of dynamic navigation include fine positioning guidance, restoration-guided surgery, good aesthetic results, and the possibility of simultaneous conceptual design and real-time implant guidance, as well as the transition from "blind" to "direct" vision during the implantation. It can guide clinicians and adjust the plan in real time, improve the efficiency of communication between the clinician, technician, and patient throughout the process and so on. The workflow, current clinical application and challenges, accuracy analysis, and limitations of the dynamic navigation technology in the edentulous jaw are discussed in this paper, as well as an outlook on its future development, with the goal of contributing to the clinical development of dynamic navigation-guided implantology in the edentulous jaw.
Humans ; Dental Implantation, Endosseous/methods* ; Dental Implants ; Surgery, Computer-Assisted/methods* ; Esthetics, Dental ; Jaw, Edentulous/surgery* ; Technology

At present, mandibular defect repair and reconstruction is not only a simple sense of mandibular continuity restoration, but also a restoration of the physiologically positional relationship and movement balance of the upper and lower jaws. Eventually, the implantation of osseointegrated dental implants and implant-supported dental restoration should be accomplished to complete the reconstruction of the functional mandible. The technique can integrate multiple procedures such as fibular bone grafting, simultaneous dental implants and traction osteogenesis, and the perfect integration with digital technology can significantly improve the accuracy of digital dental implant traction technique. This paper will summarize and conclude the key points of the application of digital dental implant traction technique in mandibular defect reconstruction, in order to provide new ideas for the development of digital technique.
Humans ; Mandibular Reconstruction ; Dental Implants ; Dental Implantation, Endosseous/methods* ; Mandibular Neoplasms/surgery* ; Fibula/transplantation* ; Bone Transplantation/methods* ; Mandible/surgery*

Objective: To compare cusp and U-tube registration methods of dynamic navigation system in dental implant placement. Methods: Twenty resin mandible models and 40 implants were utilized, with implants being placed by a single researcher using one of the two registration methods selected at random. Accuracy was measured through the superimposition of the final and planned implant positions. Angular deviation, three-dimensional (3D) entry deviation, and 3D apex deviation were analyzed. Results: The 3D entry deviation, and 3D apex deviation and angular deviation of cusp group and U-tube group were (1.07±0.46) and (0.93±0.54) mm, (1.16±0.55) and (1.03±0.53) mm, 2.06°±0.98°and 1.62°±0.97°. No significant differences (t=0.91, P=0.368; t=0.79, P=0.436; t=1.42, P=0.164) were observed when comparing these two registration methods. Conclusions: Both the cusp and U-tube registration methods are highly accurate when implemented in vitro. The cusp registration technique can also overcome several of the limitations of the U-tube approach, and it is convenient for clinic.
Dental Implantation, Endosseous/methods* ; Dental Implants ; Surgery, Computer-Assisted/methods* ; Mandible/surgery* ; Imaging, Three-Dimensional ; Cone-Beam Computed Tomography ; Computer-Aided Design

Objective: To study the clinical outcomes and feasibility of immediate implantation after flap surgery and minimally invasive extraction in the maxillary molar area and to provide a reference for it. Methods: Forty-one patients (41 molars in total) with maxillary molars that could not be preserved, treated from June 2018 to June 2020 at the Department of Oral and Maxillofacial Surgery at the Affiliated Hospital of Qingdao University, were selected. There are 24 males and 17 females with the age of (49.7±1.8) years (range 18-66 years). Pre-operative cone-beam CT (CBCT) was taken for measurement and analysis. After flap surgery and minimally invasive tooth extraction, the inflammatory granulation tissues attached to the soft and hard tissues were completely scraped and clipped, followed by the preparation of the implants in the correct three-dimensional position. Torque value and implant stability quotient (ISQ) were recorded after implant placement and with non-submerged healing. CBCT examination was taken 6 months after surgery and ISQ value was checked before crown restoration. CBCT examination was also taken 1 year after the permanent restoration. The survival rate of 6 months after surgery, the success rate of 1 year after permanent restoration, and the size of jump gaps immediately after surgery, 6 months after surgery, 1 year after permanent restoration respectively, were performed. The ISQ values were compared immediately and 6 months after surgery. Results: A total of 41 implants were placed in 41 patients. Six months after surgery, the survival rate was 100% (41/41). Twelve months after permanent restoration, the success rate of the implant restoration was 100% (41/41). The torque value after implant implantation was (42.77±0.79) N·cm. The buccal and palatal jump gaps were (3.15±0.16) mm and (2.86±0.18) mm immediately after surgery, respectively. The mesial and distal jump gaps were (2.94±0.19) mm and (3.77±0.21) mm, respectively. CBCT showed that no jump gap around the implants at 6 months after surgery and 1 year after permanent restoration. The ISQ values at immediately and 6 months after surgery were (74.78±0.59) and (80.20±0.49) respectively, and the difference was statistically significant (t=-9.03, P<0.001). Conclusions: Immediate dental implantation in the correct three-dimensional position could achieve good osseointegration by means of flap surgery, minimally invasive extraction and thorough removal of inflammatory tissue on the surface of soft and hard tissues. The clinical outcomes were satisfactory.
Adolescent ; Adult ; Aged ; Dental Implantation, Endosseous/methods* ; Dental Implants ; Feasibility Studies ; Female ; Humans ; Immediate Dental Implant Loading ; Male ; Middle Aged ; Molar/surgery* ; Young Adult