Emilio Couso‐Queiruga, Christoph A. Ramseier, Vivianne Chappuis, Simone F. M. Janner M, Daniel Buser, Urs Brägger, Giovanni E. Salvi
{"title":"Impact of Marginal Misfit in Implant‐Supported Fixed Dental Prostheses on Peri‐Implant Bone Levels: A Retrospective Quantitative Analysis","authors":"Emilio Couso‐Queiruga, Christoph A. Ramseier, Vivianne Chappuis, Simone F. M. Janner M, Daniel Buser, Urs Brägger, Giovanni E. Salvi","doi":"10.1111/clr.70053","DOIUrl":"https://doi.org/10.1111/clr.70053","url":null,"abstract":"ObjectivesTo evaluate the impact of the marginal fit of implant‐supported prostheses (ISP) on peri‐implant bone levels. Additionally, the study aimed to determine a clinically relevant threshold for the radiographic vertical misfit gap at the ISP, when present, and to identify potential risk factors associated with changes in bone levels.MethodsThis study involved subjects who received ISPs for tooth replacement therapy. Standardized intraoral periapical radiographs were taken 10 years after loading to assess the radiographic distance between the implant shoulder and the most coronal point of crestal bone (DIB). ISP marginal gaps were categorized as no gap or gap, with vertical dimensions categorized as 0 mm, > 0‐ < 0.1 mm, and ≥ 0.1 mm. A multivariable linear mixed‐effect model was applied to control for potential confounders.ResultsA total of 301 patients and 505 implants with a 10.6 ± 0.7 years follow‐up were analyzed. ISPs without gaps exhibited statistically significantly lower DIB values (3.22 ± 0.8 mm) than those with gaps (3.43 ± 0.6 mm; <jats:italic>p</jats:italic> = 0.001). Gaps ≥ 0.1 mm were associated with statistically significantly higher DIB values (3.45 ± 0.7 mm; <jats:italic>p</jats:italic> = 0.001) compared with gaps between > 0 and < 0.1 mm (3.36 ± 0.5 mm; <jats:italic>p</jats:italic> = 0.001), or no gaps (3.22 ± 0.7 mm; <jats:italic>p</jats:italic> = 0.001). Each increment of 0.1 mm in the vertical crestal gap corresponded to a significant increase in DIB values (0.08 mm; <jats:italic>p</jats:italic> = 0.03). Finally, smoking and a history of periodontitis were independent risk factors for increased DIB.ConclusionsMarginal misfit of ISP affects peri‐implant bone stability, with gaps ≥ 0.1 mm linked to higher DIB. Smoking and periodontitis are independent risk factors for increased DIB.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"39 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ralf-Joachim Kohal,Agneta Lith,Futoshi Komine,Junichi Honda,Benedikt C Spies,Felix Burkhardt,Kirstin Vach
{"title":"Ten-Year Results of a Prospective Study on One-Piece Zirconia Oral Implants for Single-Tooth Reconstruction.","authors":"Ralf-Joachim Kohal,Agneta Lith,Futoshi Komine,Junichi Honda,Benedikt C Spies,Felix Burkhardt,Kirstin Vach","doi":"10.1111/clr.70049","DOIUrl":"https://doi.org/10.1111/clr.70049","url":null,"abstract":"OBJECTIVESThe intention of this 10-year prospective cohort investigation was to clinically and radiographically investigate the outcomes of a one-piece zirconia implant system for single-tooth replacement.MATERIALS AND METHODSA total of 65 patients received 66 single-tooth implants restored with all-ceramic crowns. Follow-up assessments were conducted at the time of prosthetic delivery, after 1, 3, 5, and 10 years. Peri-implant soft tissue parameters were evaluated. To assess peri-implant bone loss, standardized radiographs were taken at implant placement, prosthetic delivery, at the 1-, 3-, 5-, and 10-year follow-ups. Statistical analysis was conducted using linear mixed regression models and Wilcoxon Signed Rank tests to compare differences over time and between groups (p < 0.05).RESULTSOver the course of 10 years, 16 implants were lost, yielding a cumulative survival rate of 73.3%. Fifteen patients were lost to follow-up over the 10-year period. The average marginal bone loss of the remaining implants was 1.09 mm. Probing depth, attachment level, and bleeding showed an increase over time, while plaque index slightly decreased.CONCLUSIONSGiven the high implant loss rate after 10 years and the high occurrence of advanced bone loss observed in this study, the implant was not recommended for routine clinical use.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"75 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marc Balmer,Benedikt C Spies,Margherita G Liguori,Kirstin Vach,Ronald E Jung,Ralf-Joachim Kohal
{"title":"Long-Term Performance of Bi-Layered Single Crowns Supported by Zirconia Implants: 7.5-Year Results of a Two-Center Prospective Cohort Study.","authors":"Marc Balmer,Benedikt C Spies,Margherita G Liguori,Kirstin Vach,Ronald E Jung,Ralf-Joachim Kohal","doi":"10.1111/clr.70051","DOIUrl":"https://doi.org/10.1111/clr.70051","url":null,"abstract":"OBJECTIVETo evaluate the survival and success rates of veneered zirconia-based single crowns (SCs) supported by zirconia implants in posterior regions, along with patient-reported outcomes, over 7.5 years.MATERIALS AND METHODSForty-five patients received zirconia implant-supported posterior SCs (n = 45) composed of zirconia frameworks layered with a leucite-reinforced feldspathic ceramic. At 7.5 years, clinical parameters and technical complications were assessed. Technical success was determined according to modified United States Public Health Service (USPHS) criteria. Patient-reported outcome measures (PROs) were evaluated using visual analog scales (VAS). Wilcoxon matched-pairs signed-rank test, mixed-effects ordered logistic regression, and linear mixed models analyzed time-dependent effects.RESULTSThirty SCs (n = 30) could be evaluated at the 7.5-year follow-up (mean: 92.1 ± 3.4 months). Kaplan-Meier survival for SCs was 97.5% [95% CI: 83.6%-99.6%]. Success dropped to 79.4% [63.0%-89.2%] due to reconstructions with major chipping (n = 3), occlusal roughness (n = 7), marginal crevice (n = 1), and over-contouring (n = 2). PROs showed significant improvements from pre-treatment to delivery (VAS scores: 93%-97%) and remained stable throughout the follow-up period.CONCLUSIONVeneered zirconia-based SCs supported by zirconia implants in posterior sites demonstrated high survival rates and consistently met patients' functional and esthetic expectations. Despite these favorable outcomes, the considerable incidence of technical complications warrants further investigation through long-term clinical studies.CLINICAL SIGNIFICANCEWhile veneered zirconia crowns offer favorable esthetics, their susceptibility to chipping in posterior regions suggests that monolithic alternatives may be preferable. Further research is needed to optimize material selection and minimize technical complications.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"31 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Zirconia Minimizes Myeloid Innate Immunity as Dental Implants: An In Silico and In Vivo Study.","authors":"Li-Tzu Wang,Hsuan-Hao Chang,Yi-Ting Liao,Wei-An Chen,Yu-Wen Huang,Yi-Wen Chen","doi":"10.1111/clr.70037","DOIUrl":"https://doi.org/10.1111/clr.70037","url":null,"abstract":"AIMWhile titanium has traditionally been the industry standard, zirconia presents superior physical and chemical properties that merit further investigation into its clinical efficacy. This study aims to examine the immunological responses associated with zirconia and titanium dental implants, emphasizing the potential advantages of zirconia as a viable alternative.MATERIALS AND METHODSThis study compares the immune responses to titanium and zirconia implants using a murine model, in which two implants were placed in the maxillary edentulous region for 7 days. Following this period, peri-implant tissue was harvested from 9 and 45 mice to assess myeloid immunity at both the transcriptomic and cellular levels, respectively.RESULTSOur findings indicate that zirconia implants exhibit superior biocompatibility compared to titanium implants, evidenced by transcriptomic data showing a minimal myeloid cell-mediated inflammatory response. Specifically, zirconia implants significantly reduce the infiltration and attachment of myeloid cells, particularly polymorphonuclear neutrophils. Additionally, zirconia implants prevent the polarization of macrophages to the inflammatory M1 phenotype, which is markedly heightened in titanium peri-implant tissues, promoting instead a shift toward the regenerative M2 phenotype.CONCLUSIONSThese results suggest that zirconia implants can minimize inflammation and promote better healing. This experimental in vivo study provides evidence that zirconia implants offer a more biocompatible solution in the field of dental restoration compared to titanium.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"20 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Cairo, Cosimo Rupe, Raffaele Cavalcanti, Luca Landi, Antonio Rupe, Nicola Marco Sforza, Walter Castelluzzo, Maria Di Martino, Luigi Barbato
{"title":"Cross‐Linked Volume‐Stable Collagen Matrix Versus Connective Tissue Graft for Soft Tissue Augmentation at Implant Site. A Non‐Inferiority, Multicenter Randomized Clinical Trial","authors":"Francesco Cairo, Cosimo Rupe, Raffaele Cavalcanti, Luca Landi, Antonio Rupe, Nicola Marco Sforza, Walter Castelluzzo, Maria Di Martino, Luigi Barbato","doi":"10.1111/clr.70050","DOIUrl":"https://doi.org/10.1111/clr.70050","url":null,"abstract":"AimsTo compare the efficacy of cross‐linked volume‐stable collagen matrix (VCMX) versus connective tissue graft (CTG) to increase buccal peri‐implant mucosal thickness (MT) around dental implants.MethodsThe present is a parallel, randomized multi‐center clinical trial, according to the CONSORT statement. Clinical centers were four Italian periodontal settings. All patients received a soft tissue augmentation procedure, by means of CTG or VCMX. The primary outcome variable was peri‐implant mucosal thickness (MT) difference at 12 months follow‐up. The statistical unit was the patient. An analysis of covariance was performed for this outcome variable. Secondary outcomes were patient‐reported outcome measures (PROMs), complications, variability among operators, and changes in keratinized mucosa width (KMW).ResultsA total of 98 patients completed the study, 49 in each group. MT increase was 1.0 ± 0.75 in the CTG group and 0.66 ± 0.58 mm in the VCMX group. CTG showed superior results to VCMX for MT gain (0.37 mm, 95% CI: 0.13–0.61, <jats:italic>p</jats:italic> = 0.002). In cases of Baseline MT ≥ 2 mm, CTG and VCMX yielded comparable results. VCMX was associated with shorter chair time (diff: 10.0 min; 95% CI: 5.02 to 14.98; <jats:italic>p</jats:italic> < 0.0001). Patients in the VCMX group experienced fewer days of discomfort (0.46 days, 95% CI: 0.06–0.99, <jats:italic>p</jats:italic> = 0.05), while no differences were found for final aesthetic and general satisfaction (CTG: 99.28 ± 2.28, VCMX: 98.48 ± 3.92, <jats:italic>p</jats:italic> = 0.22).ConclusionsBoth techniques improved MT, and CTG yielded better outcomes. VCMX was associated with shorter chair time and less postoperative discomfort, but both procedures achieved excellent final patient satisfaction.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"54 6 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F C A Lima,S De Moraes,S C Sartoretto,P S Nunes,C M S F Dos Santos,B Ghiraldini,F J B Bezerra,J M Granjeiro,M D Calasans-Maia,R S Louro
{"title":"Does Calcium Phosphate Peri-Implant Grafting Improve Osseointegration of Dental Implants? An Experimental In Vivo Study.","authors":"F C A Lima,S De Moraes,S C Sartoretto,P S Nunes,C M S F Dos Santos,B Ghiraldini,F J B Bezerra,J M Granjeiro,M D Calasans-Maia,R S Louro","doi":"10.1111/clr.70046","DOIUrl":"https://doi.org/10.1111/clr.70046","url":null,"abstract":"OBJECTIVEThis in vivo study aimed to evaluate the osseointegration of dental implants with a nanostructured hydroxyapatite (HAnano) coating or a double acid-etched (DAA) surface, grafted with or without calcium phosphate in the peri-implant gap, in low-density bone in a sheep model.MATERIALS AND METHODSThirty implants (15 HAnano and 15 DAA) were installed in the iliac crest of five sheep (2-4 years old). Six implants were placed per animal: two with a xenograft biomaterial, two with an alloplastic biomaterial, and two without grafting (control). Microtomographic analyses evaluated the percentage of bone and biomaterial for all groups. Histomorphometric analysis assessed bone-implant contact (BIC), bone occupied area fraction (BAFo), and biomaterial presence after an 8-week healing period. Data were analyzed using repeated-measures ANOVA or mixed-effects models with a significance level of 0.05.RESULTSNo complications were observed during the healing period. The average BIC across all groups was 55%, ranging from 4.6% to 67.7%. BAFo averaged 30%, with biomaterial occupying 22% and connective tissue 44% of the interface area. There were no statistically significant differences between grafted and non-grafted groups for BIC (p = 0.413), BAFo (p = 0.097), connective tissue presence (p = 0.192), and for the percentage of bone and biomaterial (p = 0.959), bone percentage (p = 0.283), or biomaterial percentage (p > 0.0959).CONCLUSIONPeri-implant grafting with xenograft or alloplastic biomaterials did not significantly enhance osseointegration compared to ungrafted implants in small peri-implant defects. These results suggest that spontaneous healing may suffice in such cases.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"35 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philipp Kauffmann,Susanne Wolfer,Christina Behrens,Pauline Schlosser,Christian Dullin,Uwe Schirmer,Klaus Liefeith,Henning Schliephake
{"title":"Dual Growth Factor Release From Collagen Based Multilayer Films on Ti-Surfaces Enhances Periimplant Bone Formation and Angiogenic Activity-An Experimental In-Vivo Study.","authors":"Philipp Kauffmann,Susanne Wolfer,Christina Behrens,Pauline Schlosser,Christian Dullin,Uwe Schirmer,Klaus Liefeith,Henning Schliephake","doi":"10.1111/clr.70045","DOIUrl":"https://doi.org/10.1111/clr.70045","url":null,"abstract":"OBJECTIVESThe aim of the present study was to assess the effect of dual growth factor release from collagen-based polyelectrolyte multilayer films (PEMs) on titanium implants on periimplant bone formation and angiogenetic activity in minipig mandibles.MATERIAL AND METHODSDisc shaped Ti implants (5 × 7 × 1 mm) were coated with polyelectrolyte multilayer films and loaded with rhBMP-2, rhVEGF165, and a combination of both. Uncoated and unloaded Ti implants served as controls. The implants were inserted press-fit into 5 mm trephine cavities in minipig mandibles and evaluated after 4 and 13 weeks for bone formation, bone implant contact, and periimplant expression of CD31.RESULTSAfter 4 weeks, there was no significant difference in periimplant bone formation nor bone-implant contact between the different surface conditions. CD31 expression was significantly increased around PEM coated implants loaded with VEGF and BMP each. After 13 weeks, bone implant contact and bone formation were significantly increased only around PEM coated implants with simultaneous release of BMP-2 and VEGF165. Expression of CD31 was significantly enhanced around all PEM coated implants loaded with growth factors regardless of the type or combination.CONCLUSIONIt is concluded that simultaneous release of rhBMP-2 and rhVEGF165 may be required to achieve significant improvement of periimplant bone formation and bone implant contact. Angiogenesis as reflected by CD31 expression is enhanced by both rhVEGF165 and rhBMP-2 to a similar extent without an additive effect of simultaneous release.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"73 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vertical Ridge Augmentation in the Anterior Maxilla Using a Dual‐Texture e‐PTFE Membrane and Autogenous Bone: A 2‐ to 5‐Year Retrospective Case‐Series Study","authors":"David González, Herman Sahlin, Christer Dahlin","doi":"10.1111/clr.70044","DOIUrl":"https://doi.org/10.1111/clr.70044","url":null,"abstract":"ObjectivesTo evaluate a novel protocol for vertical ridge augmentation with titanium‐(Ti)‐reinforced dual‐texture expanded polytetrafluoroethylene (e‐PTFE) membranes, 100% autogenous bone, and 12 months of bone healing in the anterior maxilla.Material and MethodsThis retrospective study included 14 consecutive patients treated between 2016 and 2021. Large defects, including both vertical and horizontal components, were treated with autogenous bone grafting and non‐resorbable Ti‐reinforced dual‐texture e‐PTFE membranes. Implants were placed in the augmented bone after 12 months. All clinical and radiographical parameters were retrieved from patient records.ResultsThe case series included 14 patients treated with 15 e‐PTFE membranes. The mean initial vertical defect size was 7.5 ± 5.1 mm (range: 3–23 mm). All membranes remained unexposed during the entire healing period (12.6 ± 1.2 months). No complications that needed intervention occurred. Complete bone fill was achieved, that is, regenerated bone filled the entire volume created by the membrane, in all treated defects. Twenty‐three implants were placed. The survival rate was 100% and the mean marginal bone level was 0.08 ± 0.11 mm after up to 5 years.ConclusionsExcellent vertical augmentation outcomes can be achieved in the anterior maxilla using a non‐resorbable Ti‐reinforced e‐PTFE membrane and an autogenous bone graft, followed by 12 months of healing before implant placement. The implants demonstrated stable marginal bone levels after loading. This case series has limitations, mainly the retrospective nature and small sample size, but it indicates that the proper choice of methods, materials, and healing times during GBR results in a predictable clinical outcome.","PeriodicalId":10455,"journal":{"name":"Clinical Oral Implants Research","volume":"46 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}