implantology

内植学
  • 文章类型: Journal Article
    牙种植体骨折对长期治疗成功构成重大挑战。本系统综述旨在全面检查影响牙种植体骨折(IFs)的临床因素。此外,解决了选择正确类型的植入物和预防这种并发症的策略。在PubMed进行了系统的搜索,Scopus,和WebofScience数据库。符合条件的研究包括回顾性病例对照,前瞻性队列研究,和临床试验。最初的搜索产生了361篇文章,其中312项被排除在这些评论之外,病例报告,无关紧要,或用英语以外的其他语言写的。这留下了49篇文章,只有6人符合深入审查的资格标准。这些研究,所有回顾性病例对照,检查植入物特性,患者人口统计学,手术和假体变量,生物力学和功能因素,临床和程序变量,并发症和维护问题。使用ROBINS-I工具评估偏倚风险较低。主要研究结果表明,植入物直径和结构阻力之间存在相关性,更广泛的植入物显示骨折风险降低。此外,后部区域,尤其是磨牙和前磨牙,由于咀嚼力的增加,对IFs的敏感性更高。植入物的设计和材料可能会显著影响骨折风险,锥形植入物和螺钉保留假体显示出更高的脆弱性。生物力学过载,尤其是磨牙症患者,成为IFs的主要促成因素。假体类型显著影响骨折发生率,悬臂假体由于应力增加而带来更高的风险。种植体周围骨丢失与IFs密切相关,强调需要细致的术前评估和个性化管理策略。未来的研究应该优先考虑更大的和异质的群体与长期随访和标准化的方法,以提高结果的普遍性和可比性。在受控条件下进行随机对照试验和生物力学研究对于阐明导致IFs的复杂相互作用和制定有效的预防策略也至关重要。此外,整合患者报告的结局可以全面了解IFs对生活质量的影响.
    Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies included retrospective case-control, prospective cohort studies, and clinical trials. The initial search yielded 361 articles, of which 312 were excluded being these reviews, case reports, irrelevant, or written in languages other than English. This left 49 articles, with only 6 meeting the eligibility criteria for an in-depth review. These studies, all retrospective case-control, examine implant characteristics, patient demographics, surgical and prosthetic variables, biomechanical and functional factors, clinical and procedural variables, complications and maintenance issues. The risk of bias was assessed as low using the ROBINS-I tool. Key findings suggest a correlation between implant diameter and structural resistance, with wider implants demonstrating reduced fracture risk. Additionally, posterior regions, especially molars and premolars, exhibit higher susceptibility to IFs due to increased masticatory forces. Implant design and material may considerably influence fracture risk, with conical implants and screw-retained prostheses showing higher vulnerability. Biomechanical overload, particularly in patients with bruxism, emerges as a primary contributing factor to IFs. Prosthesis type significantly influences fracture incidence, with cantilever prostheses posing a higher risk due to increased stress. Peri-implant bone loss is strongly associated with IFs, emphasizing the need for meticulous preoperative assessments and individualized management strategies. Future research should prioritize larger and heterogeneous populations with long-term follow-up and standardized methodologies to enhance the generalizability and comparability of findings. Randomized controlled trials and biomechanical studies under controlled conditions are also essential to elucidate the complex interactions contributing to IFs and developing effective prevention strategies. Additionally, integrating patient-reported outcomes may offer a comprehensive understanding of the impact of IFs on quality of life.
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  • 文章类型: Journal Article
    使用牙科植入物对完全或部分无牙的患者进行康复是最常用的外科手术之一。Branemark的工作,观察到嵌入兔骨中的一块钛变得牢固附着且难以去除,介绍了骨整合的概念和革命性的现代牙科。从那以后,对改善植入材料以增强材料-组织整合的需求不断增长。人们坚信,纳米级材料将产生高效的下一代植入物,低成本,和高容量。这篇综述的目的是探讨纳米材料在植入学中的贡献。已经提出了多种纳米材料作为植入物表面定制的潜在候选者。它们可以具有固有的抗菌特性,为骨整合提供增强的条件,或充当生物分子和药物的储库。二氧化钛纳米管单独或与生物试剂或药物组合用于增强牙科植入物中的组织整合。关于免疫调节,为了避免植入物排斥,二氧化钛纳米管,石墨烯,石墨烯生物聚合物已经被成功利用,有时负载抗炎药和细胞外囊泡。可以通过金属纳米颗粒和壳聚糖或带有抗生素物质的混合涂层的固有抗菌特性来实现种植体周围炎的预防。为了改善耐腐蚀性,已经探索了各种材料。然而,尽管这些修改已经显示出了有希望的结果,未来的研究对于评估它们在人类中的临床行为并进行广泛的商业化是必要的。
    Rehabilitation of fully or partially edentulous patients with dental implants represents one of the most frequently used surgical procedures. The work of Branemark, who observed that a piece of titanium embedded in rabbit bone became firmly attached and difficult to remove, introduced the concept of osseointegration and revolutionized modern dentistry. Since then, an ever-growing need for improved implant materials towards enhanced material-tissue integration has emerged. There is a strong belief that nanoscale materials will produce a superior generation of implants with high efficiency, low cost, and high volume. The aim of this review is to explore the contribution of nanomaterials in implantology. A variety of nanomaterials have been proposed as potential candidates for implant surface customization. They can have inherent antibacterial properties, provide enhanced conditions for osseointegration, or act as reservoirs for biomolecules and drugs. Titania nanotubes alone or in combination with biological agents or drugs are used for enhanced tissue integration in dental implants. Regarding immunomodulation and in order to avoid implant rejection, titania nanotubes, graphene, and biopolymers have successfully been utilized, sometimes loaded with anti-inflammatory agents and extracellular vesicles. Peri-implantitis prevention can be achieved through the inherent antibacterial properties of metal nanoparticles and chitosan or hybrid coatings bearing antibiotic substances. For improved corrosion resistance various materials have been explored. However, even though these modifications have shown promising results, future research is necessary to assess their clinical behavior in humans and proceed to widespread commercialization.
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  • 文章类型: Journal Article
    以深度学习为代表的人工智能在种植牙修复领域备受关注。它广泛应用于手术图像分析,种植计划设计,假体形状设计,和预后判断。本文主要介绍了深度学习在口腔种植修复全过程中的研究进展。分析了当前研究的局限性,并展望了未来的发展方向。
    Artificial intelligence represented by deep learning has attracted attention in the field of dental implant restoration. It is widely used in surgical image analysis, implant plan design, prosthesis shape design, and prognosis judgment. This article mainly describes the research progress of deep learning in the whole process of dental implant prosthodontics. It analyzes the limitations of current research, and looks forward to the future development direction.
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  • 文章类型: Journal Article
    目的:本范围审查旨在确定3D打印技术在牙科种植中使用的现有证据。由于该主题的广泛范围及其在植入学中的应用,确定了三个主要重点领域:(1)定制牙科植入物,(2)外科植入导向器的制造工作流程,和(3)相关的植入物支持的假体因素,其中包括金属初级框架,二级陶瓷或聚合物上部结构,和3D植入物模拟模型。
    方法:在线数据库(Medline,科克伦,Embase,和CINAHL)用于鉴定截至2023年2月以英文发表的研究。在确定的1737项研究中,两名经验丰富的审查员独立进行了筛选和选择。文章评估了增材制造(AM)技术,材料,打印,和有关牙科种植的后处理参数。
    结果:检查了符合纳入标准的132项全文研究。定制牙科植入物的13项研究,22项关于手术植入导向器工作流程的研究,并纳入了30项相关植入物支持假体因素的研究。
    结论:(1)关于AM钛和氧化锆植入物的临床证据很少。早期生存率数据,骨整合,和机械性能正在报告中。(2)3D打印是一种经过验证的制造技术,可用于生产外科植入物指南。遵守制造商的说明至关重要,使用MultiJet打印机可获得最佳精度。(3)3D打印假体结构和上层建筑的质量显著提高,特别是在金属合金上。然而,金属和陶瓷的铣削技术可以实现更好的边缘配合和机械性能。
    OBJECTIVE: This scoping review aimed to identify the available evidence in the use of 3D printing technology in dental implantology. Due to the broad scope of the subject and its application in implantology, three main areas of focus were identified: (1) customized dental implants, (2) manufacturing workflow for surgical implant guides, and (3) related implant-supported prostheses factors, which include the metallic primary frameworks, secondary ceramic or polymer superstructures, and 3D implant analog models.
    METHODS: Online databases (Medline, Cochrane, Embase, and CINAHL) were used to identify the studies published up to February 2023 in English. Two experienced reviewers performed independently the screening and selection among the 1737 studies identified. The articles evaluated the additive manufacturing (AM) technology, materials, printing, and post-processing parameters regarding dental implantology.
    RESULTS: The 132 full-text studies that met the inclusion criteria were examined. Thirteen studies of customized dental implants, 22 studies about the workflow for surgical implant guides, and 30 studies of related implant-supported prostheses factors were included.
    CONCLUSIONS: (1) The clinical evidence about AM titanium and zirconia implants is scarce. Early data on survival rates, osseointegration, and mechanical properties are being reported. (2) 3D printing is a proven manufacturing technology to produce surgical implant guides. Adherence to the manufacturer\'s instructions is crucial and the best accuracy was achieved using MultiJet printer. (3) The quality of 3D printed prosthetic structures and superstructures is improving remarkably, especially on metallic alloys. However, better marginal fit and mechanical properties can be achieved with milling technology for metals and ceramics.
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  • 文章类型: Journal Article
    UNASSIGNED: Additive manufacturing (AM), also known as 3D printing, has the potential to transform the industry. While there have been advancements in using AM for dental restorations, there is still a need for further research to develop functional biomedical and dental materials. It\'s crucial to understand the current status of AM technology and research trends to advance dental research in this field. The aim of this study is to reveal the current status of international scientific publications in the field of dental research related to AM technologies.
    UNASSIGNED: In this study, a systematic scoping review was conducted using appropriate keywords within the scope of international scientific publishing databases (PubMed and Web of Science). The review included related clinical and laboratory research, including both human and animal studies, case reports, review articles, and questionnaire studies. A total of 187 research studies were evaluated for quantitative synthesis in this review.
    UNASSIGNED: The findings highlighted a rising trend in research numbers over the years (From 2012 to 2022). The most publications were produced in 2020 and 2021, with annual percentage increases of 25.7% and 26.2%, respectively. The majority of AM-related publications in dentistry research originate from Korea. The pioneer dental sub-fields with the ost publications in its category are prosthodontics and implantology, respectively.
    UNASSIGNED: The final review result clearly stated an expectation for the future that the research in dentistry would concentrate on AM technologies in order to increase the new product and process development in dental materials, tools, implants and new generation modelling strategy related to AM. The results of this work can be used as indicators of trends related to AM research in dentistry and/or as prospects for future publication expectations in this field.
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  • 文章类型: Journal Article
    目标:在选择性手术和航空方面,通过关注所谓的人为因素,可以预期并发症的减少。清单是克服其中一些问题的众所周知的方法。我们旨在评估有关清单在种植牙科中使用的当前证据。
    方法:在以下数据库中进行了电子文献检索:CINHAL,Medline,WebofScience,和科克伦图书馆,直到2022年3月。根据结果和其他文献,设计了外科植入治疗的初步检查表。
    结果:确定了三篇涉及牙种植体和检查表的出版物。其中一项涉及植入物牙科检查清单的使用,并被描述为质量评估研究。其余两项研究基于文献研究和专家意见为清单提供了建议。
    结论:根据我们的结果,在牙科种植中使用检查表的证据极低。考虑到巨大的潜力,可以说有必要赶上。在创建新的植入物清单时,我们致力于满足高质量清单的标准。未来的对照研究将有助于将其置于广泛的基础上。
    结论:清单是预防并发症的众所周知的方法。特别是在航空领域,但是许多外科专业和麻醉都采用了这个成功的概念。随着种植学已成为牙科发展最快的领域之一,清单必须成为其中不可或缺的一部分。
    OBJECTIVE: In both elective surgeries and aviation, a reduction of complications can be expected by paying attention to the so-called human factors. Checklists are a well-known way to overcome some of these problems. We aimed to evaluate the current evidence regarding the use of checklists in implant dentistry.
    METHODS: An electronic literature search was conducted in the following databases: CINHAL, Medline, Web of Science, and Cochrane Library until March 2022. Based on the results and additional literature, a preliminary checklist for surgical implant therapy was designed.
    RESULTS: Three publications dealing with dental implants and checklists were identified. One dealt with the use of a checklist in implant dentistry and was described as a quality assessment study. The remaining two studies offered suggestions for checklists based on literature research and expert opinion.
    CONCLUSIONS: Based on our results, the evidence for the use of checklists in dental implantology is extremely low. Considering the great potential, it can be stated that there is a need to catch up. While creating a new implant checklist, we took care of meeting the criteria for high-quality checklists. Future controlled studies will help to place it on a broad foundation.
    CONCLUSIONS: Checklists are a well-known way to prevent complications. They are especially established in aviation, but many surgical specialties and anesthesia adopt this successful concept. As implantology has become one of the fastest-growing areas of dentistry, it is imperative that checklists become an integral part of it.
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  • 文章类型: Journal Article
    背景和目的:烟草是当今唯一最可预防的死亡原因,与无数疾病相关,包括癌症和神经学,心血管,和呼吸道疾病。吸烟还会给口腔健康带来负面影响,可能损害牙科植入物的治疗。本综述旨在评估吸烟对牙种植体失败率和边缘骨丢失(MBL)的影响。材料和方法:在三个数据库中进行电子搜索,加上手动搜索期刊。进行了荟萃分析,除了元回归,以验证比值比(OR)和MBL与随访时间的相关性.结果:该综述包括292篇出版物。总之,在吸烟者和非吸烟者中放置了35,511和114,597植入物,分别。成对荟萃分析显示,与不吸烟者相比,吸烟者植入物的失败风险更高(OR2.402,p<0.001)。上颌骨种植体失败组间差异有统计学意义(OR2.910,p<0.001),以及下颌骨(OR2.866,p<0.001)。两组之间的MBL平均差异(MD)为0.580mm(p<0.001)。随访每增加一个月,两组之间的MBLMD估计OR降低0.001(p=0.566),MBLMD增加0.004mm(p=0.279)。虽然没有统计学意义。因此,随访对组间效应大小(OR)和MBLMD无明显影响.结论:植入吸烟者的植入物比植入非吸烟者的植入物的失败风险高140.2%。
    Background and Objectives: Tobacco is today the single most preventable cause of death, being associated with countless diseases, including cancer and neurological, cardiovascular, and respiratory diseases. Smoking also brings negative consequences to oral health, potentially impairing treatment with dental implants. The present review aimed to evaluate the influence of smoking on dental implant failure rates and marginal bone loss (MBL). Materials and Methods: Electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, in addition to meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. Results: The review included 292 publications. Altogether, there were 35,511 and 114,597 implants placed in smokers and in non-smokers, respectively. Pairwise meta-analysis showed that implants in smokers had a higher failure risk in comparison with non-smokers (OR 2.402, p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 2.910, p < 0.001), as well as in the mandible (OR 2.866, p < 0.001). The MBL mean difference (MD) between the groups was 0.580 mm (p < 0.001). There was an estimated decrease of 0.001 in OR (p = 0.566) and increase of 0.004 mm (p = 0.279) in the MBL MD between groups for every additional month of follow-up, although without statistical significance. Therefore, there was no clear influence of the follow-up on the effect size (OR) and on MBL MD between groups. Conclusions: Implants placed in smokers present a 140.2% higher risk of failure than implants placed in non-smokers.
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  • 文章类型: Journal Article
    This narrative review aims to evaluate the current evidence for the application of magnetic resonance imaging (MRI), a radiation-free diagnostic exam, in some fields of dentistry.
    BACKGROUND: Radiographic imaging plays a significant role in current first and second level dental diagnostics and treatment planning. However, the main disadvantage is the high exposure to ionizing radiation for patients.
    METHODS: A search for articles on dental MRI was performed using the PubMed electronic database, and 37 studies were included. Only some articles about endodontics, conservative dentistry, implantology, and oral and craniofacial surgery that best represented the aim of this study were selected.
    RESULTS: All the included articles showed that MRI can obtain well-defined images, which can be applied in operative dentistry.
    CONCLUSIONS: This review highlights the potential of MRI for diagnosis in dental clinical practice, without the risk of biological damage from continuous ionizing radiation exposure.
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  • 文章类型: Journal Article
    系统综述的目的是分析动物模型和人类在牙周学和种植学中结合使用骨替代物和载体。搜索了电子数据库,并进行了额外的手工搜索。研究策略是根据PRISMA指南实现的。包括的标准是:骨替代物和载体的组合,体内研究,精确数量的标本,组织学和影像学分析,用英语写的。对个别研究的偏倚风险进行评估。本系统综述选择并调查了32篇文章。与简单的生物材料相比,结果并未显示出使用复合生物材料的优越性,但表明了将其用作生物活性剂载体的有效性。未来的研究需要确定骨替代物和载体的合适关联,并探索对其使用的兴趣,例如生长因子的支持。
    The aim of the systematic review was to analyze the use of combination of bone substitutes and vectors in periodontology and implantology among animals models and humans. Electronic databases were searched, and additional hand search was performed. The research strategy was achieved according to the PRISMA guidelines. The including criteria were: combination of bone substitutes and vectors, in vivo studies, a precise number of specimens, histological and radiographic analysis, written in English. The risk of bias was evaluated for individual studies. Thirty-two articles were selected and investigated in this systematic review. The results do not show a superiority of the use of composite biomaterial in comparison with simple biomaterial but suggest the efficacity of their utilization as a carrier of bioactive agents. Future studies need to identify the suitable association of bone substitutes and vectors and explore interest in their use such as the support of growth factors.
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  • 文章类型: Journal Article
    In recent years, cold atmospheric plasma (CAP) technologies have received increasing attention in the field of biomedical applications. The aim of this article is to review the currently available literature to provide an overview of the scientific principles of CAP application, its features, functions, and its applications in systemic and oral diseases, with a specific focus on its potential in implantology. In this narrative review, PubMed, Medline, and Scopus databases were searched using key words like \"cold atmospheric plasma\", \"argon plasma\", \"helium plasma\", \"air plasma\", \"dental implants\", \"implantology\", \"peri-implantitis\", \"decontamination\". In vitro studies demonstrated CAP\'s potential to enhance surface colonization and osteoblast activity and to accelerate mineralization, as well as to determine a clean surface with cell growth comparable to the sterile control on both titanium and zirconia surfaces. The effect of CAP on biofilm removal was revealed in comparative studies to the currently available decontamination modalities (laser, air abrasion, and chlorhexidine). The combination of mechanical treatments and CAP resulted in synergistic antimicrobial effects and surface improvement, indicating that it may play a central role in surface \"rejuvenation\" and offer a novel approach for the treatment of peri-implantitis. It is noteworthy that the CAP conditioning of implant surfaces leads to an improvement in osseointegration in in vivo animal studies. To the best of our knowledge, this is the first review of the literature providing a summary of the current state of the art of this emerging field in implantology and it could represent a point of reference for basic researchers and clinicians interested in approaching and testing new technologies.
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