SCIENTIFIC HIGHLIGHTS
Short overviews on recently published scientific evidence.
Issue 2/2025
Edited by Dr. Marcin Maj
IN THIS ISSUE
EDITOR’S CHOICE
Obesity prolongs the pro-inflammatory response and attenuates bone healing on titanium implants (Derek Avery et al. 2025)
and
Similar patient-reported satisfaction and professional appraisal of implantsupported fixed dental prosthesis fabricated by different workflows (A Nanda et al., 2025)
Monolithic Zirconia Single Crowns Supported by Narrow- or StandardDiameter Titanium-Zirconium Implants in Posterior Sites: 1-Year Results of a Randomized Controlled Trial (N H M Alsabeeha al., 2025)
EDITOR’S CHOICE
Acta Biomater. 2025 Jan 15:192:473-486
Obesity prolongs the pro-inflammatory response and attenuates bone healing on titanium implants
Derek Avery, Lais Morandini, Luke Sheakley, Asmaa Alajmi, Leah Bergey, Henry J Donahue, Rebecca K Martin, Rene Olivares-Navarrete
STUDY OBJECTIVES AND METHODS AND RESULTS
This study aimed to determine how obesity induced by a high-fat diet (HFD) affects the inflammatory response to modified titanium (Ti) implants and subsequent bone formation.
RESULTS
• Obese mice had significantly more neutrophils, pro-inflammatory macrophages, and T cells and fewer antiinflammatory macrophages and mesenchymal stem cells (MSCs) in the peri-implant tissue than lean mice.
• Obesity also increased circulating adipokines and pro-inflammatory cytokines when compared to lean animals. Bone formation around Ti implants was reduced in obese mice compared to controls.
• Adoptive transfer of bone marrow cells isolated from obese mice into wild-type mice demonstrated the localized impact of obesity on immune cell function and phenotype, promoting a pro-inflammatory peri-implant microenvironment and attenuating bone formation post-implantation.
CONCLUSIONS
These results show that obesity significantly affects the inflammatory response to modified Ti implants, prolonging the proinflammatory response to the implanted biomaterial and compromising bone formation.
Adapted from D Avery al., Acta Biomater. 2025 Jan 15:192:473-486, for more info about this publication, click HERE
Clin Cosmet Investig Dent. 2025 Mar 27:17:201-207
Two-Stage Crestal Sinus Elevation Using Osseodensification Technique for Single Molar Restoration: A Case Report
Raed AlRowis
STUDY OBJECTIVES METHODS AND RESULTS
This report presents a two-stage approach for crestal sinus elevation using the osseodensification technique in a case of severe vertical bone deficiency (<3 mm). Traditional approaches to maxillary sinus elevation with less than 3 mm of residual bone height typically require a lateral window technique. A 55-year-old male patient presented with a missing maxillary right first molar with residual bone height of 2 mm. The treatment involved: Stage 1: Crestal sinus elevation using osseodensification with Versah burs and allograft placement. Stage 2: After 6 months of healing, placement of a Straumann Bone Level Tapered implant (4.1 × 10mm) with 35 Ncm insertion torque and final prosthetic restoration was started 4 months after implant placement. Then, follow-up at 12 months demonstrated stable peri-implant tissues, maintained bone levels, and excellent patient satisfaction. Radiographic evaluation showed uniform bone formation around the implant and maintained sinus floor elevation.
CONCLUSIONS
The case demonstrates that osseodensification can provide a predictable alternative to lateral window approaches even in cases with severe vertical bone deficiency (<3 mm), offering reduced invasiveness with enhanced bone density and favorable clinical outcomes.
Adapted from R AlRowiset al., Clin Cosmet Investig Dent. 2025 Mar 27:17:201-207, for more info about this publication click HERE
J Prosthet Dent. 2025 Mar 18:S0022-3913(25)00180-5
Evaluation of the effects of the small intestine submucosa biological membrane on guided bone regeneration and early loading of dental implants in the maxillary anterior region: A randomized controlled trial
Chao Liang, Yao Wang, Jun Li, Wei Geng
STUDY OBJECTIVES AND METHODS
The aim of this study was to determine the effectiveness and safety of an early loading strategy for patients who have undergone dental implant placement and GBR surgery for a missing maxillary anterior tooth and to clarify the effects of SIS membranes. Thirty-six study participants were randomly assigned into 3 groups: the GBR with a resorbable non-crosslinked porcine collagen membrane (Bio-Gide) and delayed implant loading (Gide-DL) group, the GBR with a resorbable non-crosslinked porcine collagen membrane (Bio-Gide) and early implant loading (Gide-EL) group, and the GBR with an SIS membrane and early implant loading (SIS-EL) group. The degree of implant torque was ≥35 Ncm. Definitive restorations were completed 6 months after surgery in the Gide-DL group and 6 weeks after surgery in the Gide-EL and SIS-EL groups. Clinical examination, intraoral scanning, radiograph examination, and white and pink esthetic scoring was performed at the 1-year follow-up to evaluate the implant survival rate, peri-implant conditions, soft tissue contour changes, marginal bone resorption, and esthetics. Data with a normal distribution and homogeneous variance were analyzed via 1-way analysis of variance (ANOVA) and the least significant difference (LSD) multiple comparison test. Data without a normal distribution or homogeneous variance were analyzed via the Kruskal-Wallis H test and Bonferroni multiple comparison test (α=.05 for all tests).
RESULTS
• No implant failures or significant differences in the probing depth, plaque index, or bleeding index among the 3 groups were detected at the 1-year follow-up.
• There was no significant difference in the soft tissue contour change among the 3 groups.
• Only the changes at 1 mm apical to the crown-gingival connecting margin in the SIS-EL group were significantly lower than those in the Gide-EL and Gide-DL groups (P<.05).
• The marginal bone levels and white and pink esthetic scores were not significantly different among the 3 groups (P>.05).
CONCLUSIONS
The early loading strategy is suitable for patients who have undergone dental implant placement and GBR for a missing maxillary anterior tooth with good primary stability, and favorable clinical effects can be achieved with the use of SIS membranes.
Adapted from C Liang al., J Prosthet Dent. 2025 Mar 18:S0022-3913(25)00180-5, for more info about this publication, click HERE
Int J Implant Dent. 2025 Mar 12;11:20.
Early marginal peri-implant bone loss around tissue-level implants: a retrospective
radiographic evaluation
A Solderer, C Giuliani, D B Wiedemeier, R E Jung, P R Schmidlin
STUDY OBJECTIVES AND METHODS
The aim of this study was to retrospectively assess the potential impact of biological and host factors on radiographic bone loss following tissue-level implant placement and prosthetic rehabilitation. The University database was reviewed to identify patients treated with tissue-level implants between 2006 and 2020 at the University of Zurich, Switzerland. The study included patients who received screw-retained implant rehabilitations in the posterior area without simultaneous hard- or soft-tissue augmentations and had a follow-up period of at least 12 months. Radiographic measures of marginal bone loss and supracrestal tissue height were conducted using periapical x-rays at different time points. Additional factors analysed included age, gender, smoking status, history of periodontitis, jaw of treatment, type of reconstruction, and prosthetic emergence angle. Associations between marginal bone loss and potential explanatory variables were visualised and analysed. Elastic net regressions were applied to examine potential relationships with marginal bone loss.
RESULTS
• A total of 1,479 patients were treated with tissue-level implants. After applying inclusion and exclusion criteria, 106 patients with 106 implants were included in the statistical evaluation after one year (T1, n = 106 implants), and 59 patients with 59 implants were evaluated after three years (T2, n = 59 implants).
• The mean marginal bone loss was 0.93 mm (SD 0.83) at T1 and 1.04 mm (SD 0.97) at T2.
• A strong correlation (Spearman) was found between mesial and distal bone loss. Smoking status and the jaw undergoing treatment were associated with bone loss.
• While these associations were observed in the univariate analysis, a more comprehensive multivariate analysis revealed that these variables had a limited effect on explaining radiographic bone loss.
CONCLUSIONS
During the initial rehabilitation period in tissue-level implants in this cohort smoking status and jaw of treatment seemed to influence early peri-implant bone loss. Further, a strong correlation between mesial and distal MBL was observed. Additional research is required to determine factors contributing to early bone loss following implant-prosthetic rehabilitation.
Adapted from A Solderer et al., Int J Implant Dent. 2025 Mar 12;11:20, for more info about this publication, click HERE
Oral Health Prev Dent. 2025 Mar 6:23:141-148
The Effect of Patient-related Factors Age, Sex, Implant Location, and Periodontitis on Crestal Bone Loss
in the Posterior Ridge: A Retrospective Study
Yi Feng, Mengna Lin, Xiaofeng Wang, Fuming He
STUDY OBJECTIVES AND METHODS
The aim of this study was to investigate the effects of patient-related factors such as age, sex, implant location, and history of periodontitis, on crestal bone loss in the posterior region throughout the surgical healing and functional periods. This study evaluated 311 implants from 163 patients, with an average follow-up of 27.10 months. Implants were assessed based on age, sex, implant location, and history of periodontitis. Crestal bone loss was quantified by measuring bone level changes using oral panoramic radiographs. Time T1 was defined as the period from implant placement to the healing phase, and T2 as the period from the second-stage surgery to the follow-up visit. Group comparisons were made using the Mann-Whitney U-test, with significance set at p 0.05.
RESULTS
• At T1, crestal bone loss averaged 0.27 ± 0.40 mm; at T2, it averaged 0.40 ± 0.50 mm.
• A statistically significant difference at T1 was observed between patients aged 20-39 and 40-59, and between these two age groups in female patients (p 0.05). During T2, within the 40-59 age group, bone resorption differed statistically significantly between males and females (p 0.05).
• Statistically significant differences were also noted between males aged 40-59 and those 60 years or older, and between females aged 20-39 and 40-59 (p 0.05). There were no differences between the other groups.
CONCLUSIONS
Crestal bone loss correlates with patient age and sex. Increased attention should be given to female patients within certain age ranges. Patients with history of periodontitis can maintain bone tissue stability around the implant.
Adapted from Y Feng et al., Oral Health Prev Dent. 2025 Mar 6:23:141-148, for more info about this publication, click HERE
J Dent. 2025 Mar:154:105593
Application of a semi-active robotic system for implant placement in atrophic posterior maxilla: A retrospective case series
Ningbo Zhao, Rongrong Zhu, Lifan Liao, Meng Zhang, Longlong He, Qin Zhou
STUDY OBJECTIVES AND METHODS
The purpose of this study was to evaluate the accuracy and safety of a semi-active robotic system for implant placement in atrophic posterior maxilla. Patients underwent robot-assisted implant placement in atrophic posterior maxilla were identified and included. Cone-beam computed tomography (CBCT) was performed before surgery. The virtual implant position and drilling sequences were planned in the robotic planning system. Patients with positioning marker took an intraoral scan. The preoperative CBCT and the intraoral scan were superimposed in the robotic software. After registration, the implant bed was prepared utilizing the robotic arm with 1 mm safety margin below the maxillary sinus floor. The transcrestal sinus floor elevation (TSFE) was performed by the dentist, followed by the implant placement with the robotic arm. A postoperative CBCT was taken and superimposed with the preoperative one to calculate the accuracy of implant placement. Complications and adverse events were recorded. Deviations between the implant platform and apex levels were analyzed using the paired t-test. P < 0.05 was considered statistically significant.
RESULTS
• Twenty-seven implants of 20 patients were included.
• No intraoperative and postoperative complications were reported.
• The global, lateral and vertical platform deviations were 0.73 ± 0.27 mm, 0.35 ± 0.23 mm and 0.35 ± 0.57 mm, respectively.
• The global, lateral and vertical apex deviations were 0.77 ± 0.23 mm, 0.41 ± 0.20 mm and 0.34 ± 0.57 mm, respectively.
• There were significant differences between the global, lateral and vertical deviations between the implant platform and apex levels (P < 0.05, respectively).
• The angular deviation was 1.58 ± 0.76°.
CONCLUSIONS
High accuracy and safety for implant placement in atrophic posterior maxilla could be achieved using a semi-active robotic system, with the TSFE procedure performed by the dentist.
Adapted from N Zhao et al., J Dent. 2025 Mar:154:105593, for more info about this publication, click HERE
Int J Oral Maxillofac Implants 2025 Feb 7;40(1):90-98
Monolithic Zirconia Single Crowns Supported by Narrow- or Standard-Diameter Titanium-Zirconium Implants in Posterior Sites: 1-Year Results of a Randomized Controlled Trial
Nabeel H M Alsabeeha, Fatemeh Amir-Rad, Sunyoung Ma, Maanas Shah, Haifa Hannawi, Andrew Tawse-Smith, Warwick J Duncan, Zaid H Baqain, Momen A Atieh
STUDY OBJECTIVES AND METHODS
The purpose of this study was to compare the prosthetic outcomes of screw-retained monolithic zirconia (Zr) single crowns supported by either narrow-diameter (3.3 mm) or standard-diameter (4.1 mm) tissue-level titanium-zirconia (TiZr) implants in posterior sites. A total of 18 participants, each with a missing molar or premolar tooth requiring an implantsupported single crown, were randomly assigned to either the test or control group. All participants received screwretained monolithic Zr single crowns supported by single tissue-level TiZr implants. Test group participants received narrow-diameter implants (3.3 mm), whereas control group participants received standard-diameter implants (4.1 mm). A modified version of the United States Public Health Service (USPHS) criteria was used to assess the prosthetic outcome across 12 parameters after 1 year of function. Data were analyzed descriptively, and statistical analysis was performed using a statistical software (SPSS, Version 28.0; IBM) with the level of significance set at P < .05.
RESULTS
• Of the 18 single crowns delivered, 16 were available for review at the 1-year follow-up, including 7 in the test group and 9 in the control group.
• Patient characteristics and crown site distribution were similar, with no significant differences observed between the two groups (chi-square test; P < .05).
• There were no crown failures, meaning a crown survival rate of 100% was achieved after 1 year. The prosthetic outcome based on USPHS criteria was comparable between the two groups with no significant differences observed (chi-square test; P < .05).
• There were 19 prosthetic events in total (10 in the test group and 9 in the control group), with no significant differences between the groups (chi-square test; P < .05).
• Loss of proximal contact was the dominant event, with a total of eight events (three in the test group and five in the control group).
• Patient satisfaction after 1 year was high in both treatment groups, with no significant differences detected.
CONCLUSIONS
Screw-retained monolithic Zr single crowns supported by either narrow- or standard-diameter tissue-level TiZr implants in posterior sites have comparable prosthetic outcomes after 1 year. Long-term results from well-designed trials are still needed to validate the findings of the present study.
Adapted from N H M Alsabeeha et al., Int J Oral Maxillofac Implants. 2025 Feb 7;40(1):90-98, for more info about this publication, click HERE
Clin Implant Dent Relat Res. 2025 Feb;27(1):e70003
Influence of Implant Geometry on the Surface Strain Behavior of Peri-Implant Bone:
A 3D
Analysis
Moritz Löhlein, Constantin Motel, Manfred Wichmann, Ragai Edward Matta
STUDY OBJECTIVES AND METHODS
The purpose of this study was to analyze the influence of different implant geometries on the surface strain behavior of porcine mandibles under load using a 3D optical camera system in combination with digital image correlation. Four different implant types were subjected to a force of 200 N in three different loading directions (axial, non-axial 15°, and non-axial 30°).
Under axial loading, parallel-walled implants exhibited lower surface strain values on the peri-implant bone compared with tapered implants. However, when subjected to non-axial loading, these parallel-walled implants showed a substantial relative increase in strain by approximately a factor of 2.96 compared with axial conditions. At a 30° non-axial angle, long, tapered implants with a smaller diameter (BLX 3.75) produced lower peri-implant bone strains than implants with larger diameters and shorter lengths, while short, tapered implants (BLT) demonstrated a lower relative increase in strain (factor ~1.49) from axial to non-axial loading. Under non-axial loading, long, tapered implants with a small diameter resulted in lower strains in the periimplant bone compared with implants with a larger diameter and shorter length. It was found that non-axial loads lead to higher strains than axial loads. Therefore, the success of implantation could be significantly influenced by selecting an appropriate implant geometry and the correct angulation of the implant.
RESULTS
• Under axial loading, parallel-walled implants exhibited lower surface strain values on the peri-implant bone compared with tapered implants. However, when subjected to non-axial loading, these parallel-walled implants showed a substantial relative increase in strain by approximately a factor of 2.96 compared with axial conditions.
• At a 30° non-axial angle, long, tapered implants with a smaller diameter (BLX 3.75) produced lower peri-implant bone strains than implants with larger diameters and shorter lengths, while short, tapered implants (BLT) demonstrated a lower relative increase in strain (factor ~1.49) from axial to non-axial loading.
• Under non-axial loading, long, tapered implants with a small diameter resulted in lower strains in the peri-implant bone compared with implants with a larger diameter and shorter length.
CONCLUSIONS
It was found that non-axial loads lead to higher strains than axial loads. Therefore, the success of implantation could be significantly influenced by selecting an appropriate implant geometry and the correct angulation of the implant.
Adapted from M Löhlein et al., Clin Implant Dent Relat Res. 2025 Feb;27(1):e70003, for more info about this publication, click HERE
Int J Periodontics Restorative Dent. 2025 Mar 6;45(2):185-198
Electrolytic Surface Decontamination in the Reconstructive Therapy of Periimplantitis: Single-Center Outcomes
Alberto Monje, Ramón Pons, Pedro Peña
STUDY OBJECTIVES AND METHODS AND RESULTS
This study aimed to analyze the electrolytic method (EM) as an adjunct to mechanical decontamination and compare it to hydrogen peroxide (HP), also used as an adjunct to mechanical decontamination, in the reconstructive therapy of periimplantitis. At the 12-month follow-up (T2), 19 patients (n = 23 implants) completed the study.
RESULTS
• None of the tested modalities demonstrated superiority in the assessed clinical parameters.
• Only mucosal recession showed higher stability in the EM group. Similarly, radiographic marginal bone level gain and defect angle changes at T2 did not differ between the evaluated strategies.
• Notably, disease resolution was ~16% higher for the EM group; however, differences were not statistically significant. Additionally, it was demonstrated that pocket depth and the intrabony component depth at baseline were predictors of disease resolution.
CONCLUSIONS
EM combined with mechanical instrumentation results in a safe and effective surface decontamination modality in the reconstructive therapy of peri-implantitis. This strategy resulted in a disease resolution rate of ~91%.
Adapted from A Monje et al., Int J Periodontics Restorative Dent. 2025 Mar 6;45(2):185-198, for more info about this publication, click HERE
REFERENCES
D Avery al., Acta Biomater. 2025 Jan 15:192:473-486 | R AlRowiset al., Clin Cosmet Investig Dent. 2025 Mar 27:17:201-207 | C Liang al., J Prosthet Dent. 2025 Mar 18:S0022-3913(25)00180-5 | A Solderer et al., Int J Implant Dent. 2025 Mar 12;11:20 | Y Feng al., Oral Health Prev Dent. 2025 Mar 6:23:141-148 | A Nanda et al., Evid Based Dent. 2025 Mar;26(1):21-22 | N Zhao et al., J Dent. 2025 Mar:154:105593 | N H M Alsabeeha et al., Int J Oral Maxillofac Implants. 2025 Feb 7;40(1):90-98 | L Liegeois et al., Clin Oral Implants Res. 2025 Mar;36(3):397-409 | M Löhlein et al., Clin Implant Dent Relat Res. 2025 Feb;27(1):e70003 | A Monje et al., Int J Periodontics Restorative Dent. 2025 Mar 6;45(2):185-198 | source: www.pubmed.gov | Dr. Marcin Maj holds the position of Head of Global Scientific Affairs at Institute Straumann in Basel, Switzerland
