Using digital technologies in concurrently performing missing tooth implantation and preparation of remaining teeth is a solution to reduce the number of visits and improve efficiency. This paper proposes a digital process for simultaneously implanting and preparing teeth. It integrates implant surgical guide and 3D-printed tooth preparation guide into a single guide and completes guided implant placement and precise tooth preparation. Based on "repair-oriented" virtual implant planning, the implant surgical guide can improve the efficiency and predictability of implant placement, and its linear accuracy is about 1 mm. The tooth preparation guide precisely guides tooth preparation and restoration space visualization, ensuring the quality of the tooth preparation. The two guides have different design accuracy requirements, and thus their combination improves the overall guiding accuracy requirements. The concurrent application of the two guides minimizes the clinical operation time, number of visits, and economic burden of patients.
Humans ; Surgery, Computer-Assisted ; Dental Implantation, Endosseous ; Printing, Three-Dimensional ; Technology ; Tooth Preparation ; Computer-Aided Design ; Dental Implants ; Imaging, Three-Dimensional ; Cone-Beam Computed Tomography

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

Jaw defects caused by various reasons often seriously affect appearance and function. The goal of the treatment of oral and maxillofacial tumors should include the cure of the tumor and the restoration of premorbid function. The development of microsurgery and digital surgery technology has promoted the development of jaw reconstruction with vascularized free bone flap. Good appearance and improved predictability could be obtained with the help of preope-rative visual design. How to rehabilitate occlusal function on the reconstructed jaw and improve the quality of life of patients has become an important research direction. This article discusses the challenge of jaw reconstruction, the selection of vascularized bone flap, the choice of implant timing, the treatment of peri-implant soft tissue, and the influence of radiotherapy on implants after jaw reconstruction.
Humans ; Dental Implants ; Plastic Surgery Procedures ; Free Tissue Flaps/surgery* ; Quality of Life ; Dental Implantation, Endosseous ; Fibula/surgery* ; Bone Transplantation ; Mandibular Reconstruction

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

OBJECTIVES: This study aimed to evaluate the long-term clinical efficacy of simple taper retentive implants in the posterior dental area after immediate implantation for 5-7 years. METHODS: Selected from January 2015 to December 2017 in the Fourth Affiliated Hospital of Nanchang University dental clinic line tooth area immediately after the implant prosthesis, a total of 38 patients, 53 implants, were deep into (bone under 2 mm or higher) and the upper structure was repaired. In addition, after the completion of tracking observation of 60-90 months, the implant surrounding bone health was recorded and analyzed. RESULTS: After 5-7 years of follow-up, 1 of the 53 implants failed to fall out, and the implant retention rate was 98.1%. The amount of bone resorption in the proximal and distal margins 5-7 years after implant restoration was (0.16±0.94) mm and (-0.01±1.29) mm, respectively, and the difference in bone height between the proximal and distal margins of the implant and the immediate post-restoration period was not statistically significant (P>0.05). No statistically significant differences were found in the effects of periodontitis, implant site inflammation, and smoking on peri-implant marginal bone resorption (P>0.05). CONCLUSIONS The single taper-retained implant broadens the indications for immediate implant placement in the posterior region, and its deep sub-osseous placement (≥2 mm below the bone) avoids to a certain extent the disturbance of the implant by external stimuli and the exposure of the cervical abutment of the implant, with the good long-term stability of the marginal bone around the implant.
Humans ; Dental Implantation, Endosseous ; Dental Implants ; Immediate Dental Implant Loading ; Follow-Up Studies ; Dental Implants, Single-Tooth ; Alveolar Bone Loss/surgery* ; Treatment Outcome ; Dental Prosthesis, Implant-Supported ; Dental Restoration Failure

Humans ; Esthetics, Dental ; Dental Implantation, Endosseous ; Dental Implants, Single-Tooth

OBJECTIVE: To investigate whether the placement of absorbable collagen membrane increase the stability of alveolar ridge contour after guided bone regeneration (GBR) using buccal punch flap. METHODS: From June 2019 to June 2023, patients who underwent GBR using buccal punch flap simultaneously with a single implant placement in posterior region (from first premolar to second molar) were divided into coverage group, in which particular bone graft was covered by collagen membrane and non-coverage group. Cone beam CT (CBCT) was taken before surgery (T0), immediately after surgery (T1), and 3-7 months after surgery (T2), and the thickness of the buccal bone plate at different levels (0, 2, 4, and 6 mm) below the smooth-rough interface of the implant (BBT-0, -2, -4, -6) was mea-sured after superimposition of CBCT models using Mimics software. RESULTS: A total of 29 patients, including 15 patients in coverage group and 14 patients in non-coverage group, were investigated in this study. At T0, T1, and T2, there was no significant difference in BBT between the two groups (P>0.05). At T1, BBT-0 was (2.50±0.90) mm in the coverage group and (2.97±1.28) mm in the non-coverage group, with corresponding BBT-2 of (3.65±1.08) mm and (3.58±1.26) mm, respectively. At T2, BBT-0 was (1.22±0.55) mm in the coverage group and (1.70±0.97) mm in the non-coverage group, with corresponding BBT-2 of (2.32±0.94) mm and (2.57±1.26) mm, respectively. From T1 to T2, there were no statistically significant differences in the absolute values [(0.47±0.54)-(1.33±0.75) mm] and percentages [(10.04%±24.81%)-(48.43%±18.32%)] of BBT change between the two groups. The thickness of new bone formation in the buccal bone plate from T0 to T2 ranged from (1.27±1.09) mm to (2.75±2.15) mm with no statistical difference between the two groups at all levels. CONCLUSION In the short term, the GBR using buccal punch flap with or without collagen membrane coverage can effectively repair the buccal implant bone defect. But collagen membrane coverage showed no additional benefit on alveolar ridge contour stability compared with non-membrane coverage.
Humans ; Cohort Studies ; Retrospective Studies ; Alveolar Ridge Augmentation ; Collagen ; Cone-Beam Computed Tomography ; Bone Regeneration ; Dental Implantation, Endosseous

This article reports a case of using immediate implant placement and immediate restoration combined with measurable implant surgical guides to restore compromised maxillary incisors caused by dental trauma. Target restoration was designed in the exoCAD software preoperatively, intraoral measurements were obtained in three directions, and the correct position of virtual implants was determined in BlueSky Plan 4. Afterward, measurable implant guides were designed and fabricated by 3D printing. Under the guidance of the measurable implant surgical guides and intraoperative measurement, the entry point was determined, the axial direction was verified when drilling to half the depth, and the 3D position was verified when drilling to total depth. Implants were inserted followed by verification once again. The temporary restoration, which was designed based on the target restoration and emergence profile of the original teeth and milled preoperatively, was connected to the implant immediately after surgery. Postoperative accuracy analysis showed that the mean linear deviations between the actual implant position and the pre-planned position were (0.57±0.17) mm at the entry point and (0.82±0.27) mm at the apex, and the mean angular deviation was (1.86±0.89) °, demonstrating that precise implant placement and immediate restoration were implemented.
Humans ; Dental Implantation, Endosseous ; Dental Implants ; Surgery, Computer-Assisted ; Imaging, Three-Dimensional ; Software

Orbital defect is a common type of maxillofacial defect, which can not be reconstructed by surgical means at present. However, there is no expert consensus on how to make prosthesis accurately and quickly to reconstruct the appearance of patients. In order to solve this problem, the Society of Prosthodontics, Chinese Stomatological Association invited several experts and professors from related professional fields in China to jointly study and develop this expert consensus. The purpose of this consensus is to comprehensively explain the knowledge of prosthesis in repairing orbital defects from the aspects of basic theory, prosthesis principles, prosthesis materials and prosthesis techniques, and to guide more prosthesis physicians to understand and master these knowledge and techniques. So as to improve the overall level of orbital defect repair and reconstruction in China, improve the quality of life of such patients, and better serve the majority of patients.
Humans ; Consensus ; Quality of Life ; Dental Implants ; Prosthesis Implantation ; China

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