Jordi Gargallo-Albiol

Objective: To determine the influence of an intermediate prosthetic abutment on peri‐implant marginal bone loss (MBL) around two implant‐supported fixed restorations in the posterior area. Material and Methods: This study included patients with partial edentulism requiring two implants in the posterior maxilla or mandible. All implants were bone‐level tapered implants, placed through a fully guided approach and finalized with a CAD/CAM temporary and final full zirconia restoration. The total sample comprised 30 patients (60 implants), divided into a Control group (direct to implant connection, non‐intermediate abutment; 12 patients, 24 implants) and a Test group (intermediate abutment; 18 patients, 36 implants). The Test group was further divided into two abutment height subgroups: 1 mm (7 patients) and 2.5 mm (11 patients). MBL was measured using periapical x‐ray imaging on the day of surgery, at definitive crown delivery, and at 4, 6, 12, and 24 months post‐surgery. Results: The Test group (intermediate abutment) had lower MBL (0.83 ± 0.25 mm) than the Control group (1.17 ± 0.35 mm; p = 0.001). The secondary analysis of the abutment height subgroups did not differ significantly in MBL, although values showed a trend towards a more favorable for the highest intermediate abutment. Conclusions: This randomized clinical trial demonstrated that direct implant connection prosthesis induced greater MBL around implants in splinted crowns for an implant‐supported fixed restoration when compared with the use of an intermediate abutment. Trial Registration: ClinicalTrials.gov ID: NCT06017115

Introduction: The primary objective was to assess 1‐year clinical and radiographic outcomes of a newly designed implant with a machined long neck in the anterior region, including marginal bone loss, horizontal bone width, vertical bone height, and implant survival and success rates. The secondary objective was to evaluate the effect of guided bone regeneration on bone dimensional changes and implant survival and success rates. Materials and Methods: A total of 117 implants in 58 patients who received the novel implant in the anterior region were included. Marginal bone loss, horizontal bone width, and vertical bone height changes were assessed using panoramic radiographs and cone beam computed tomography (CBCT) scans obtained after prosthetic restoration and at the one‐year follow‐up. Implant survival and success rates, along with the influence of guided bone regeneration (GBR) on bone dimensional changes, were statistically analyzed. Results: Within the one‐year follow‐up period, implant survival and success rates were 97.43% and 91.45% at the implant level, and 94.83% and 82.76% at the patient level, respectively. Among the 114 surviving implants, the mean marginal bone loss was 0.46 ± 1.05 mm. In the subset of 32 implants with available CBCT data, horizontal bone width and vertical bone height changes were minimal in both buccal and palatal/lingual aspects. Subgroup analyses indicated that guided bone regeneration provided measurable advantages in preserving bone dimensions at specific sites, particularly in the mid‐buccal region and the palatal/lingual vertical height. However, at most other reference points, dimensional changes were comparable irrespective of whether GBR was performed. Conclusion: A novel implant featuring a machined long neck exhibited clinically acceptable outcomes with respect to implant survival, implant success, and bone dimensional stability over a one‐year follow‐up period.

Background and Aims: Decortication of interdental alveolar cortical bone is performed to shorten orthodontic treatment duration. The objective of this meta-analysis was to evaluate the effect of corticotomy using piezosurgery on the reduction in orthodontic treatment time, comparing it to conventional single-phase orthodontic treatment. Methods: A thorough electronic search was performed to obtain randomized clinical trials that compared the treatment duration between piezocision-assisted orthodontic treatment with conventional orthodontic treatment. Overall treatment time measured in months, was analyzed, and patient age and tooth location were evaluated as potential factors affecting treatment duration. Results: Based on the eleven randomized clinical trials included in the meta-analysis, results showed a significant weighted mean difference between piezocision-assisted corticotomy orthodontics and conventional single-phase orthodontics only (−1.80 months, [95% CI (−2.51, −1.08), p = 0.771]). Patient age and tooth location showed no statistically significant difference between the investigated groups. Conclusions: Piezocision-assisted corticotomy is effective in accelerating orthodontic tooth movement and reducing an average of 1.80 months treatment time. This reduction, although modest, represents a 30.72% decrease in overall treatment duration.

(1) Background: Dynamic guided surgery is a computer-guided freehand technology that allows highly accurate procedures to be carried out in real time through motion-tracking instruments. The aim of this research was to compare the accuracy between dynamic guided surgery (DGS) and alternative implant guidance methods, namely, static guided surgery (SGS) and freehand (FH). (2) Methods: Searches were conducted in the Cochrane and Medline databases to identify randomized controlled clinical trials (RCTs) and prospective and retrospective case series and to answer the following focused question: “What implant guidance tool is more accurate and secure with regard to implant placement surgery?” The implant deviation coefficient was calculated for four different parameters: coronal and apical horizontal, angular, and vertical deviations. Statistical significance was set at a p-value of 0.05 following application of the eligibility criteria. (3) Results: Twenty-five publications were included in this systematic review. The results show a non-significant weighted mean difference (WMD) between the DGS and the SGS in all of the assessed parameters: coronal (n = 4 WMD = 0.02 mm; p = 0.903), angular (n = 4 WMD = −0.62°; p = 0.085), and apical (n = 3 WMD = 0.08 mm; p = 0.401). In terms of vertical deviation, not enough data were available for a meta-analysis. However, no significant differences were found among the techniques (p = 0.820). The WMD between DGS and FH demonstrated significant differences favoring DGS in three parameters as follows: coronal (n = 3 WMD = −0.66 mm; p =< 0.001), angular (n = 3 WMD = −3.52°; p < 0.001), and apical (n = 2 WMD = −0.73 mm; p =< 0.001). No WMD was observed regarding the vertical deviation analysis, but significant differences were seen among the different techniques (p = 0.038). (4) Conclusions: DGS is a valid alternative treatment achieving similar accuracy to SGS. DGS is also more accurate, secure, and precise than the FH method when transferring the presurgical virtual implant plan to the patient.

Dental implants have changed modern dentistry, providing a long-term, effective solution for tooth loss

Background: Tooth autotransplantation is defined as the surgical repositioning of an autogenous tooth in another surgical site within the same individual. Aim: The aim of this research was to analyze the outcome of tooth transplantation using immature donor teeth compared with closed apex teeth and to compare differences between donor tooth positions on the arch. Methods: Electronic and manual literature searches were performed in different databases, including the National Library of Medicine (MEDLINE), EMBASE (OVID), Cochrane Central (CENTRAL), and the digital library of the Universitat Internacional de Catalunya (UIC University) from 1978 to March 2021. Studies were selected when they fulfilled the following criteria: only human prospective clinical studies, minimum sample size of 10 patients, minimum follow-up of 1 year, studies reporting or with at least deducible data on survival rates, immediate tooth autotransplantation with completed or incomplete root formation, and publications in the English language. A meta-analysis of random effects was developed to estimate the global effect measure of the survival rate, success rate, and root resorption involving the total sample, as well as open- and closed-apex groups. Results: Twenty-four articles were eligible for analysis. The Cohen’s kappa corresponding to this review was 0.87, and the risk assessment was considered low–moderate for the included studies. Overall survival and success rates were 95.9% and 89.4%, respectively, with a mean follow-up of 4 years and an overall mean age of 25.2 ± 12.3 years. Closed apex teeth showed a survival rate of 3.9% lower than that of open apex teeth. Higher complication rates were found for both inflammatory external root resorption and replacement root resorption in the closed-apex group, without reaching statistical significance. Conclusions: Tooth autotransplantation is a viable treatment alternative, regardless of the apical condition, with high survival and success rates after a mean follow-up of 4 years. Open-apex donor teeth could be considered the gold-standard option, showing lower complication rates when compared to closed-apex donor teeth. Future randomized controlled clinical studies are needed to examine the long-term prognosis of this technique.

The purpose of this clinical series was to evaluate the clinical and radiographic outcomes of 20 zirconia dental implants, with a minimum follow-up of two years. Patients with at least one zirconia dental implant were included, with a mean follow-up of 34.05 months. The patient complaints such as pain and foreign body sensation, as well as clinical parameters including peri-implant infections with suppuration, implant mobility, gingival index (GI), modified plaque index (mPI), modified sulcus bleeding index (mBI), probing depth (PD) and radiological distance between the implant shoulder to the closest mesial and distal bone-to-implant contact (BIC), were assessed. All zirconia implants were successfully integrated without any pain or foreign body sensation. No mobility was detected in any of the 20 implants. Clinical examination revealed a mean PD of 2.56 mm and a radiological mean distance between the implant shoulder and the initial site of visible bone-to-implant contact (BIC) of 1.44 mm. In addition, GI, mPI and mBI indicated minimal to no inflammation. Results obtained from this series suggest that one-piece zirconia dental implants achieve good clinical and radiographic outcomes over a mean follow-up of 34 months and may be deemed a good option in patients with favorable bone conditions.