To evaluate the effects of the alveolar ridge split (ARS) technique on gained horizontal width of the alveolar ridge and implant survival rate.
Electronic searching was performed in six electronic databases (Pubmed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, and SIGLE) from January 1, 2010, to November 1, 2023. Two authors performed study selection, data extraction, and study qualities (ROBINS-I and RoB 2.0) independently. Meta-analysis was performed by Comprehensive meta-analysis 3.0.
24 included studies were observational, and 1 study was a randomized controlled trial (RCT). 14 studies investigated the gained width of the horizontal alveolar ridge, and 17 examined the implants\' survival rate. For assessment of risk of bias, nine studies were high risk of bias and 16 studies were moderate risk of bias. Meta-analysis demonstrated that the pooled gained alveolar ridge width was 3.348 mm (95%CI: 4.163 mm, 2.533 mm), and the implant survival rate was 98.1% (95%CI: 98.9%, 96.9%). Seven studies showed seven different complications including exposure, infection, bad split, dehiscence, fracture, paresthesia and soft tissue retraction.
Recent ARS technique seems to be an effective method of bone augmentation with enough gained width and a high implant survival rate. Further long-term and RCTs research remains needed to enhance the study quality.
The ARS technique could generate sufficient bone volume, and implants had a high-level survival rate. Therefore, ARS has been proposed to be a reliable horizontal bone augmentation technique that creates good conditions for the implantation of narrow alveolar crests.

As maxillofacial surgical techniques have advanced, vascularized bone free flap transplantation has become the standard treatment for repairing maxillofacial defects. In this meta-analysis, we summarize the survival rates of implants after VBFF surgery for maxillary and mandibular reconstructions and investigate the factors affecting patient outcomes.
The PubMed, Embase, and Wanfang databases were searched up to May 31, 2022. The results of the treatment effect are presented as the risk ratio or odds ratio, using 95% confidence intervals. Statistical significance was calculated at α = 0.05 (two-tailed z tests).
35 studies were included in our analysis. The results revealed a 3-year and 5-year implant survival rate of 95.2% and 85.4% in VBFFs, respectively. The location of jaw defects (maxilla or mandible) or timing of implantation was not found to have a statistically significant influence on the survival rate. However, statistically significant differences were observed in the failure of implants placed in irradiated bone tissue.
Statistically significant differences were not found in the implant survival rate between simultaneous and delayed implantation, or between maxillary and mandibular defects. However, dental implants placed in irradiated flaps tended to have a lower survival rate than those surgically placed in non-irradiated flaps.

OBJECTIVE: To evaluate early to medium-term effectiveness of total hip arthroplasty (THA) in patients with a history of hip preservation surgery with secondary severe osteoarthritis for developmental dysplasia of the hip (DDH).
METHODS: The clinical data of 25 DDH patients (31 hips) who had severe osteoarthritis after hip preservation surgery and received THA between September 2009 and March 2021 were retrospectively analyzed. There were 1 male and 24 females; the age ranged from 18 to 65 years, with an average age of 43 years; 8 hips were classified into Crowe type Ⅰ, 9 hips were type Ⅱ, 3 hips were type Ⅲ, and 11 hips were type Ⅳ. The time between osteotomy and THA ranged from 31 to 51 years, with an average of 31.96 years. Preoperative hip flexion range of motion was (69.31±29.72)°, abduction range of motion was (24.00±14.79)°; and Harris hip score was 45.3±15.5. Postoperative Harris hip score, hip range of motion, complications, radiographic findings, and implant survival rate were analyzed.
RESULTS: Patients in both groups were followed up 2-132 months, with an average of 51 months. During the follow-up, periprosthetic fracture occurred in 1 case; there was no complication such as dislocation, periprosthetic infection, nerve palsy, or deep vein thrombosis. At last follow-up, the hip flexion range of motion was (109.52±11.17)°, abduction range of motion was (41.25±5.59)°, showing significant differences when compared with preoperative values ( t=8.260, P=0.000; t=6.524, P=0.000). The Harris hip score was 91.5±4.1, and the difference was significant when compared with preoperative score ( t=11.696, P=0.000); among them, 13 cases were excellent and 12 cases were good. Radiographic evaluation showed that the center of acetabular rotation moved up 0-18 mm (mean, 6.35 mm). The cup abductor angle was 28°-49° (mean, 37.74°) and the coverage rate was 69.44%-98.33% (mean, 81.04%). All femoral stems were fixed in neutral position without varus or valgus. No osteolysis, radiolucent line, or implant migration was observed. By the end of follow-up, none of the patients underwent revision and the survival rate of prothesis was 100%.
CONCLUSIONS: THA is still the gold standard for the treatment of DDH patients with secondary osteoarthritis after hip preservation surgery. The postoperative joint function can be rapidly restored, the patients\' quality of life can significantly improve, and the early to medium-term survival rate of the prosthesis is satisfactory.
UNASSIGNED: 评价保髋手术后继发重度骨关节炎的发育性髋关节发育不良（developmental dysplasia of the hip，DDH）患者行人工全髋关节置换术（total hip arthroplasty，THA）术后的早中期临床疗效。.
UNASSIGNED: 回顾分析2009年9月—2021年3月收治的保髋术后继发重度骨关节炎并接受THA的25例（31髋）DDH患者临床资料。男1例，女24例；年龄18～65岁，平均43岁。Crowe分型为Ⅰ型8髋，Ⅱ型9髋，Ⅲ型3髋，Ⅳ型11髋。截骨手术距此次THA时间为13～51年，平均31.96年。术前髋关节屈曲活动度（69.31±29.72）°，外展活动度（24.00±14.79）°；Harris评分（45.3±15.5）分。分析患者术后Harris评分、髋关节活动度、并发症、影像学结果和假体生存率。.
UNASSIGNED: 两组患者均获随访，随访时间2～132个月，平均51个月。1例股骨柄远端出现假体周围骨折；无髋关节脱位、假体周围感染、神经麻痹或下肢深静脉血栓形成等并发症发生。末次随访时髋关节屈曲活动度为（109.52±11.17）°，外展活动度为（41.25±5.59）°，与术前比较差异有统计学意义（ t=8.260， P=0.000； t=6.524， P=0.000）。Harris评分为（91.5±4.1）分，与术前比较差异亦有统计学意义（ t=11.696， P=0.000）；其中优13例，良12例。影像学评估显示，髋臼旋转中心上移0～18 mm，平均6.35 mm；髋臼外展角28°～49°，平均37.74°；臼杯覆盖率为69.44%～98.33%，平均81.04%。所有股骨柄均中立位固定，未见内翻或外翻；未见假体周围骨溶解、透亮线发生；所有假体固定在位，未见松动及移位。截止随访终点，所有患者均未接受翻修手术，假体生存率为100%。.
UNASSIGNED: 对于保髋术后继发重度骨关节炎的DDH患者，THA仍是治疗该类患者的金标准，术后患者可迅速恢复关节功能，生活质量明显改善，假体的早中期生存率令人满意。.

Schneiderian membrane (SM) thickness >2mm is regarded to be a pathological mucosal change. The aim of the current study is to answer the question\" Does presence of pathological changes in the SM increase the risk of sinus perforation during surgical sinus floor elevation (SFE)?\" An electronic database (PubMed, Embase, Cochrane Library, and Chinese database) were systemically searched for the studies published until February 2020. Randomized and non-randomized studies that reported the incidence of SM perforation in patients with SM pathology (antral pseudocyst or mucosal thickening) during SFE. The outcome measures were the incidence of SM perforation and implant survival rate. The pooled odds ratio (OR) with 95% confidence intervals and the Fixed-effects model were calculated. P-value ≤ 0.05 was considered to be statistically significant. Eighteen studies with a total of 1542 patients and 1797 SFE were included. Statistically insignificant difference in the incidence of SM perforation was observed between the normal-appearing sinus and thickened sinus mucosa (Fixed; OR, 0.896; 95%CI, 0.504 - 1.59; P =0.707, I 2 =32%). The rate of SM perforation in the normal sinus, mucosal thickening, and antral pseudocysts was 14%, 6%, and 6% respectively. The Implant survival rate was 98% in the normal sinus, and 100% in antral pseudocyst and mucosal thickening. SM thickening or antral pseudocyst did not increase the risk of membrane perforation and implant failure rates. Future RCTs are needed to evaluate the risk of the presence of pathological changes in the SM on the failure of the bone augmentation and dental implant.

BACKGROUND: The conventional implant approach involves flap elevation, which may result in increased soft tissue and bone loss and postoperative morbidity. The flapless surgical technique, aided by three-dimensional medical imaging equipment, is regarded as a possible alternative to the conventional approach to alleviate the above issues. Several studies have been performed regarding the role of flapless implant surgery. However, the results are inconsistent and there is no robust synthesis of long-term evidence to better inform surgeons regarding which type of surgical technique is more beneficial to the long-term prognosis of patients in need of implant insertion.
OBJECTIVE: To compare the long-term clinical performance after flapless implant surgery to that after the conventional approach with flap elevation.
METHODS: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and grey literature databases were searched from inception to 23 September 2019. Randomised controlled trials (RCTs) and cohort studies comparing the long-term clinical performance after flapless implant surgery to that after the conventional approach over a follow-up of three years or more were included. Meta-analyses were conducted to estimate the odds ratios (ORs) or mean differences (MDs) and their 95% confidence intervals (CIs) between the long-term implant survival rate, marginal bone loss, and complication rate of the flapless and conventional groups. Subgroup analyses were carried out to account for the possible effects of the guided or free-hand method during flapless surgery.
RESULTS: Ten articles, including four RCTs and six cohort studies, satisfied the eligibility criteria and nine of them were included in the meta-analysis. There was no significant difference between the long-term implant survival rate [OR = 1.30, 95%CI (0.37, 4.54), P = 0.68], marginal bone loss [MD = 0.01, 95%CI (-0.42, 0.44), P = 0.97], and complication rate [OR = 1.44, 95%CI (0.77, 2.68), P = 0.25] after flapless implant surgery and the conventional approach. Moreover, subgroup analyses revealed that there was no statistically significant difference between the implant survival rate [guided: OR = 1.52, 95%CI (0.19, 12.35), P = 0.70]; free-hand: n = 1, could not be estimated), marginal bone loss [guided: MD = 0.22, 95%CI (-0.14, 0.59), P = 0.23; free-hand: MD = -0.27, 95%CI (-1.10, 0.57), P = 0.53], or complication rate [guided: OR = 1.16, 95%CI (0.52, 2.63), P = 0.71; free-hand: OR = 1.75, 95%CI (0.66, 4.63), P = 0.26] in the flapless and conventional groups either with use of the surgical guide or by the free-hand method.
CONCLUSIONS: The flapless surgery and conventional approach had comparable clinical performance over three years or more. The guided or free-hand technique does not significantly affect the long-term outcomes of flapless surgery.

OBJECTIVE: To investigate the influence of maturation timing upon histological, histomorphometric and clinical outcomes when deproteinized bovine bone mineral (DBBM) was used as a sole biomaterial for staged maxillary sinus floor augmentation (MSFA).
METHODS: Patients with a posterior edentulous maxillary situation and a vertical bone height ≤ 4 mm were included in this study. A staged MSFA was carried out. After MSFA with DBBM as a sole grafting material, biopsy cores were harvested with simultaneous implant placement followed by a healing period of 5, 8, and 11 months, respectively. Micro-CT, histologic and histomorphometric analyses were performed.
RESULTS: Forty-one patients were enrolled and 38 bone core biopsies were harvested. Significantly greater BV/TV was observed between 5- and 8-month healing from micro-CT analysis. Histomorphometric analyses showed the ratio of mineralized newly formed bone increased slightly from 5 to 11 months; however, no statistically significant difference was reached (p = .409). Residual bone substitute decreased from 37.3 ± 5.04% to 20.6 ± 7.45%, achieving a statistical significant difference from of 5 up to 11 months (p < .01). Moreover, no implant failure, biological or technical complication occurred after 12-month follow-up of functional loading.
CONCLUSIONS: DBBM utilized as sole grafting material in staged MSFA demonstrated to be clinically effective regardless of the healing period. Histomorphometrical and micro-CT assessments revealed that at later stages of healing (8 and 11 months) there is a higher proportion of newly-bone formation compared to earlier stages (5 months). Moreover, the longer the maturation period, the substantially lesser remaining biomaterial could be expected. Even though, these facts did not seem to negatively impact on the implant prognosis 1-year after loading.