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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (15 June 2025) | Viewed by 9213

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Dr. Octavi Camps

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Guest Editor

1. Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
2. Bellvitge Biomedical Research Institute (IDIBELL) Research Institute, Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Spain
Interests: oral surgery; dental implant; oral implants; periodontitis; dentistry

Dr. Jorge Toledano-Serrabona

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Guest Editor

1. Department of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Campus de Bellvitg, C/Feixa Llarga s/n, Pavelló Govern, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
2. Bellvitge Biomedical Research Institute, Oral Surgery and Implantology, (IDIBELL), 08907 Barcelona, Spain
Interests: oral surgery; dental implant; oral implants; periodontitis; dentistry

Special Issue Information

Dear Colleagues,

This Special Issue, titled “Research Progress in Osseointegrated Oral Implants”, offers a comprehensive and insightful exploration into the latest advancements, research findings, and emerging trends within the field of osseointegrated oral implants. Through a collection of research articles contributed by experts in the field, this Special Issue covers a wide spectrum of topics ranging from implant design and surface modifications to surgical techniques, biomaterials, and clinical outcomes. Authors delve into innovative strategies aimed at enhancing osseointegration, improving implant stability, and mitigating peri-implant complications, providing valuable insights into the complex interplay between implant materials, biological responses, and clinical outcomes. Moreover, this Special Issue addresses current challenges and future directions in oral implantology.

Dr. Octavi Camps
Dr. Jorge Toledano-Serrabona
Guest Editors

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Keywords

dental implants
peri-implantitis
osseointegration
guided surgery
navigation surgery
robotic surgery
implant surface
implant stability

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Published Papers (7 papers)

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13 pages, 401 KB

Open AccessArticle

The Correlation Between Cracked Teeth and National Insurance Coverage of Dental Implants in South Korea: A Retrospective Cohort Analysis

by Se Hoon Kahm, YoungHa Shim and SungEun Yang

J. Clin. Med. 2025, 14(15), 5507; https://doi.org/10.3390/jcm14155507 - 5 Aug 2025

Viewed by 583

Abstract

Background/Objectives: The expansion of National Health Insurance (NHI) coverage for dental implants in South Korea has substantially increased implant placements among older adults. While implants offer functional and esthetic benefits, their lack of periodontal ligaments alters occlusal force distribution, potentially increasing biomechanical stress on adjacent or opposing teeth. This study aimed to investigate the association between the increased number of dental implants and the incidence of cracked teeth following the introduction of implant insurance. Methods: A retrospective analysis was conducted using the Clinical Data Warehouse of Seoul St. Mary’s Dental Hospital. Patients who underwent molar crown restorations between 2014 and 2022 were included. The incidence and clinical features of cracked teeth were compared before (2014–2015) and after (2016–2022) the introduction of implant insurance. Statistical analyses assessed differences in symptom presentation, pulp status, and treatment outcomes. Results: Among 5044 molars restored with crowns, 1692 were diagnosed with cracks. The incidence of cracked teeth significantly increased after NHI coverage for implants (25.5% vs. 32.6%, p < 0.001). Cases after insurance implementation showed fewer signs and symptoms at initial presentation (67.4% vs. 50.0%, p < 0.001), reduced irreversible pulpitis (37.2% vs. 25.8%, p < 0.001), and increased preservation of pulp vitality (46.9% vs. 57.8%, p < 0.001). These shifts may reflect changes in occlusal adjustment practices and earlier clinical intervention. Conclusions: The findings suggest a temporal link between increased implant placement and the rising incidence of cracked teeth. Implant-induced occlusal changes may contribute to this trend. Careful occlusal evaluation and follow-up are essential after implant placement, and further prospective studies are warranted to confirm causality and refine prevention strategies. Full article

(This article belongs to the Special Issue Research Progress in Osseointegrated Oral Implants)

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30 pages, 4515 KB

Open AccessArticle

Implant-Supported Oral Rehabilitation in Head and Neck Cancer Patients: A 20-Year Single-Center Study (2005–2024)

by Manuel Tousidonis, Santiago Ochandiano, Carlos Navarro-Cuellar, Carlos Navarro-Vila, Javier López de Atalaya, Cristina Maza, Ana María Lopez Lopez, Ignacio Navarro-Cuellar, Alba García Sevilla, Gema Arenas de Frutos, Raul Antunez-Conde, Paloma Planells del Pozo and Jose Ignacio Salmeron

J. Clin. Med. 2025, 14(15), 5435; https://doi.org/10.3390/jcm14155435 - 1 Aug 2025

Viewed by 515

Abstract

Background/Objectives: Oral cancer resection often leads to maxillofacial defects and dentition loss, compromising patients’ quality of life. Implant-supported prosthetic rehabilitation offers a reliable solution to restore function, though factors such as bone reconstruction, radiotherapy, and timing of implant placement (immediate vs. delayed) may influence outcomes. This study aimed to evaluate long-term implant survival and rehabilitation timelines in oncologic patients, comparing two cohorts (2005–2014 and 2015–2024) to assess the impact of evolving clinical practices. Methods: A retrospective cohort study was conducted at Hospital General Universitario Gregorio Marañón (Madrid, Spain), including 304 patients who underwent ablative oral cancer surgery and subsequent implant-based rehabilitation between 2005 and 2024. Data on demographics, oncologic treatment, reconstruction, implant timing, and prosthetic rehabilitation were collected. Outcomes were compared using Kaplan–Meier analysis and appropriate statistical tests between the 2005–2014 (n = 122) and 2015–2024 (n = 182) cohorts. Results: A total of 2341 Ticare Implants^® were placed, supporting 281 prostheses. Implant placement during primary surgery increased from 41% to 71% (p < 0.001). The median time from surgery to prosthesis significantly decreased from 24 to 15 months (p < 0.001). Five-year implant survival was 95% in the early cohort versus 97% in the later cohort. Implant survival was comparable between irradiated and non-irradiated patients (~94–96%). Fixed prostheses became more frequent (92% vs. 79%, p = 0.002). Conclusions: Implant-supported rehabilitation in oncologic patients is highly feasible and durable, with improved timelines and functional outcomes associated with early implant placement and modern digital planning strategies. Full article

(This article belongs to the Special Issue Research Progress in Osseointegrated Oral Implants)

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16 pages, 1099 KB

Open AccessFeature PaperArticle

Influence of Healing Abutment Height on Secondary Implant Stability Using Resonance Frequency Analysis: A Prospective Clinical Study

by Alicia Martín-Martín, Esteban Pérez-Pevida, Saray Férnandez-Hernández, Jaime Lubillo-Valdeón and Aritza Brizuela-Velasco

J. Clin. Med. 2025, 14(14), 5140; https://doi.org/10.3390/jcm14145140 - 19 Jul 2025

Viewed by 378

Abstract

Background/Objectives: The aim of the present study is to evaluate the influence of the healing abutment height on secondary implant stability measured by resonance frequency analysis. In this prospective observational clinical study of 30 implants, the secondary stability of the implant was measured via resonance frequency analysis of the abutment during the osseointegration process. Methods: Two groups were compared: a <4 group (n = 15), with a space between the healing abutment and the antagonist of <4 mm, and a ≥4 group (n = 15), with a space of ≥4 mm. Results: Statistically significant differences (p < 0.05) in the implant stability values obtained at surgery (T0) and at the eighth week of osseointegration (T8) were observed between the two groups, with higher values for the <4 group. Pearson’s correlation analysis revealed a trend towards a significant relationship with the mean force (−0.6546) and a linear inverse relationship, so that by decreasing the distance between the abutment and the contact with the antagonist, the secondary implant stability values increased. A comparison of the mesial and distal peri-implant marginal bone levels at T0 and T8 did not reveal statistically significant differences (p > 0.05). A greater healing abutment height, placing it closer to the antagonist, increases and accelerates secondary stability, as measured by resonance frequency analysis. Conclusions: The results of the study support the recommendation of using high healing abutments, placing the abutment close to the opposing occlusal plane, according to biomechanical criteria. Full article

(This article belongs to the Special Issue Research Progress in Osseointegrated Oral Implants)

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13 pages, 7382 KB

Open AccessArticle

Single Teeth and Partial Implant Rehabilitations Using Ultra-Hydrophilic Multi-Zone Anodized Surface Implants: A Retrospective Study with 1-Year Follow-Up

by Miguel de Araújo Nobre, Carolina Antunes, Ana Ferro, Armando Lopes, Miguel Gouveia, Mariana Nunes and Diogo Santos

J. Clin. Med. 2025, 14(1), 66; https://doi.org/10.3390/jcm14010066 - 26 Dec 2024

Cited by 1 | Viewed by 1063

Abstract

Background/Objectives: In the last decades, dental implant surfaces have been evolving to increase success and implant survival rates. More studies evaluating outcomes with implants with ultra-hydrophilic multi-zone anodized surfaces are necessary. The aim of this study is to evaluate the short-term outcome of implants of conical connection with anodized ultra-hydrophilic surfaces for support of single teeth and partial rehabilitations. Methods: In this retrospective study, patients received parallel-walled implants with a gradually anodized surface. The primary outcome measure was implant survival. Secondary outcome measures were marginal bone loss and mechanical and biological complications. This study included 253 conical connection implants with anodized ultra-hydrophilic surfaces, placed in 145 patients (71 males and 74 females; average age: 55.8 years). Sixty patients presented comorbidities, and 19 patients presented smoking habits. Results: Ten patients (15 implants) were lost to follow-up. Two implants failed in two patients, resulting in a cumulative survival rate of 99.2%, with 98.5% and 100% for males and females, respectively, and 99.1% and 100% for single teeth and partial rehabilitations, respectively. The average marginal bone loss was 0.52 mm at 1 year, with 0.60 mm and 0.42 mm for males and females, respectively, and 0.52 mm and 0.50 mm for single teeth and partial rehabilitations, respectively. The rate of mechanical complications was 4.8% and 3.2% at patient and implant levels, respectively. Biological complications occurred in one patient (0.7%) at one implant (0.4%). Conclusions: These results indicate that the use of implants with ultra-hydrophilic multi-zone anodized surfaces for single teeth and partial rehabilitations is viable in the short term. Full article

(This article belongs to the Special Issue Research Progress in Osseointegrated Oral Implants)

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12 pages, 2323 KB

Open AccessArticle

7-Year Follow-Up of Maxillary Overdentures Supported by Mini-Dental Implants

by Luc Van Doorne, Laure Demeulenaere, Marie Dejans and Hugo De Bruyn

J. Clin. Med. 2024, 13(22), 6891; https://doi.org/10.3390/jcm13226891 - 15 Nov 2024

Cited by 1 | Viewed by 1556

Abstract

Background: Mini dental implants (MDIs) are alternatives to support an overdenture when a standard diameter implant cannot be placed due to lack of bone volume. They reduce the need for invasive bone grafting and lower the barrier for treatment. Aim: This prospective study reports on implant and patient-centered outcomes of flaplessly placed, early loaded MDIs supporting horseshoe-shaped maxillary overdentures after 7 years of function. Materials and Methods: Patients with a CBCT-confirmed thin alveolar crest received 5–6 one-piece MDIs using mentally guided flapless surgery. The conventional denture was relined and MDIs were provisionally loaded within one week. After 6 months the non-splinted MDIs were actively loaded with a horseshoe overdenture. Implant and prosthetic survival, peri-implant health (PPD and BoP) and patient-related outcomes using OHIP-14 and Subjective Masticatory Evaluation were assessed after 7 years. Results: 185 MDIs were placed in 14 females and 17 males. During provisional loading, 32 MDIs were lost, and 17 replacements were required in 16 patients. In total, 170 out of 202 totally placed MDIs were supporting 29 overdentures after 6 months. Cumulative implant failure increased from 15.8% at the moment of active loading to 34.7% at 7 years. After 7 years, 76% of the initially placed overdentures remained functional, mean PPD was 3.48 (SD 0.86), BoP was 0.20 (SD 0.40) and peri-implantitis incidence was 0.9%. The total OHIP-14 was reduced from 21.3/56 (SD: 13.1) preoperatively to 15.6/56 (SD 12.8) at provisional loading (p > 0.1) and 7.3/56 (SD 6.7) at final loading (p = 0.006), and it remained unchanged up to 7 years at 6.57/56 (SD: 8.92) (p > 0.5). Conclusions: Maxillary MDIs provide an acceptable treatment option in patients with deficient bone volume that cannot or refuse to be treated with bone grafting. Despite one third of the MDIs being lost, remaining MDIs had good peri-implant health, prosthetic success was 71% and Oral Health Related Quality of Life was beyond expectations. Full article

(This article belongs to the Special Issue Research Progress in Osseointegrated Oral Implants)

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23 pages, 8155 KB

Open AccessArticle

A Vision-Guided Robotic System for Safe Dental Implant Surgery

by Daria Pisla, Vasile Bulbucan, Mihaela Hedesiu, Calin Vaida, Ionut Zima, Rares Mocan, Paul Tucan, Cristian Dinu, Doina Pisla and TEAM Project Group

J. Clin. Med. 2024, 13(21), 6326; https://doi.org/10.3390/jcm13216326 - 23 Oct 2024

Cited by 1 | Viewed by 3088

Abstract

Background: Recent advancements in dental implantology have significantly improved outcomes, with success rates of 90–95% over a 10-year period. Key improvements include enhanced preplanning processes, such as precise implant positioning, model selection, and optimal insertion depth. However, challenges remain, particularly in achieving correct spatial positioning and alignment of implants for optimal occlusion. These challenges are pronounced in patients with reduced bone substance or complex anthropometric features, where even minor misalignments can result in complications or defects. Methods: This paper introduces a vision-guided robotic system designed to improve spatial positioning accuracy during dental implant surgery. The system incorporates advanced force-feedback control to regulate the pressure applied to bone, minimizing the risk of bone damage. A preoperative CBCT scan, combined with real-time images from a robot-mounted camera, guides implant positioning. A personalized marker holder guide, developed from the initial CBCT scan, is used for patient–robot calibration. The robot-mounted camera provides continuous visual feedback of the oral cavity during surgery, enabling precise registration of the patient with the robotic system. Results: Initial experiments were conducted on a 3D-printed mandible using a personalized marker holder. Following successful patient–robot registration, the robotic system autonomously performed implant drilling. To evaluate the accuracy of the robotic-assisted procedure, further tests were conducted on 40 identical molds, followed by measurements of implant positioning. The results demonstrated improved positioning accuracy compared to the manual procedure. Conclusions: The vision-guided robotic system significantly enhances the spatial accuracy of dental implants compared to traditional manual methods. By integrating advanced force-feedback control and real-time visual guidance, the system addresses key challenges in implant positioning, particularly for patients with complex anatomical structures. These findings suggest that robotic-assisted implant surgery could offer a safer and more precise alternative to manual procedures, reducing the risk of implant misalignment and associated complications. Full article

(This article belongs to the Special Issue Research Progress in Osseointegrated Oral Implants)

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17 pages, 1173 KB

Open AccessSystematic Review

Safety and Accuracy of Guided Interradicular Miniscrew Insertion: A Systematic Review and Meta-Analysis

by Margalida Santmartí-Oliver, Adrià Jorba-García, Tania Moya-Martínez, Cristina de-la-Rosa-Gay and Octavi Camps-Font

J. Clin. Med. 2024, 13(24), 7697; https://doi.org/10.3390/jcm13247697 - 17 Dec 2024

Cited by 1 | Viewed by 1182

Abstract

Background: Achieving ideal anchorage is crucial in orthodontics for controlled tooth movement. Miniscrews (MSs) have improved skeletal anchorage, but freehand placement poses risks like root damage and limited precision. Guided techniques, including radiographic guides and computer-assisted methods (static [sCAS] and dynamic [dCAS]), were developed to enhance accuracy and safety. Objective: This systematic review and meta-analysis aimed to evaluate the safety and accuracy of MS placement using different guidance approaches. Materials: A systematic search up to March 2024 identified studies on guided MS insertion, assessing safety (root contact/damage) and accuracy (angular, coronal, and apical deviations) of guided vs. freehand placement. Two reviewers assessed the risk of bias and study quality using RoB 2 for RCTs, NOS for cohort studies, and an adapted tool for pre-clinical studies. Random-effects meta-analysis was performed for studies with common parameters, and safety outcomes were pooled using logit-transformed proportions. Heterogeneity was evaluated with I² and χ² tests. Results: Eleven studies (652 MSs) were included, though no dCAS studies were analyzed. The only RCT had “some concerns” regarding risk of bias, cohort studies ranged from medium to low quality, and most pre-clinical studies had high bias risk. sCAS significantly reduced root damage compared to freehand methods (OR = 0.11; 95% CI: 0.04–0.36; p < 0.001; I² = 1%) and reduced angular and linear deviations. Due to heterogeneity, no quantitative synthesis of accuracy outcomes was performed. Conclusions: sCAS improves the safety and accuracy of MS insertion compared to freehand and radiographic guide methods. These results highlight the clinical benefits of sCAS in orthodontics. Future studies should refine protocols and explore dCAS for further accuracy improvements. Full article

(This article belongs to the Special Issue Research Progress in Osseointegrated Oral Implants)

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