Search Results (68)

Background and Objectives: This scoping review aims to synthesize evidence on clinical and non-clinical factors associated with malpractice claims in implant dentistry and to identify strategies for prevention. Materials and Methods: A literature search was conducted in PubMed, Scopus, and Web of Science in accordance with PRISMA-ScR guidelines, including peer-reviewed studies published within the last 10 years. Results: Eight studies met the inclusion criteria. Clinical causes of litigation included improper implant placement, inferior alveolar nerve injury, lack of osseointegration, peri-implant infection, and the use of inappropriate or outdated implant systems. Non-clinical factors included inadequate informed consent, poor documentation, deviation from the treatment plan, and ineffective communication. Conclusions: Malpractice in implant dentistry is largely preventable. Risk reduction depends on accurate diagnosis, careful treatment planning, adherence to surgical principles, and clear patient communication with appropriate informed consent. Full article

Background: Successful spinal stabilization depends not only on early mechanical fixation but also on durable biological integration at the bone–implant interface. This study aimed to compare a two-stage allograft-augmented fixation strategy, intended to promote biological fixation, with conventional posterior segmental stabilization (PSS) in the treatment of screw loosening following multilevel spinal surgery for degenerative spine pathology. Methods: This retrospective comparative study included 40 patients who underwent multilevel spinal stabilization between January 2022 and February 2025, with follow-up completed by November 2025. Patients were divided into a conventional PSS group (n = 28) and a two-stage allograft-augmented fixation group (OI-focused strategy, n = 12). Demographic characteristics, comorbidity burden, length of hospital stay, complications, Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), and sagittal radiographic parameters—including lumbar lordosis (LL), sagittal vertical axis (SVA), sacral slope (SS), and pelvic incidence (PI)—were evaluated preoperatively and at 1, 6, and 9 months postoperatively. Results: The groups were similar in terms of age, sex, body mass index, smoking status, and number of operated levels. Despite the significantly higher Charlson Comorbidity Index and Elixhauser Comorbidity Index scores in the OI-focused group, hospital stay was significantly shorter. VAS and ODI scores were comparable preoperatively and at 1 month; however, significantly better pain and functional outcomes were observed in the OI-focused group at 6 and 9 months. Radiologically, SVA was significantly lower in the OI-focused group at 6 and 9 months. Late differences were also observed in LL and SS, while PI remained similar between groups. Fusion-related findings were interpreted cautiously because fusion was assessed using plain radiographs and osseointegration was not directly measured. Conclusions: The two-stage allograft-augmented fixation strategy was associated with better mid-term pain control, improved functional recovery, and better preservation of selected sagittal alignment parameters compared with conventional PSS. However, these findings should be interpreted cautiously due to the retrospective design, limited sample size, imbalanced groups, absence of direct osseointegration measurement, and lack of CT-based fusion analysis. Full article

Background: There are still insufficient studies based on large patient cohorts that evaluate both functional and surgical outcomes after internal hemipelvectomy and 3D-printed endoprosthesis implantation. This study aimed to determine how the method of pelvic bone defect reconstruction determines early functional, surgical, and radiographic outcomes. Methods: The aims of the study were achieved based on retrospective observations of 49 patients who underwent surgical treatment at several centres in Poland. All patients underwent internal hemipelvectomy and implantation of 3D-printed prostheses. Surgical parameters were assessed, including operative time, blood loss, and surgical complications (infections, implant loosening, dislocations), as well as bone osseointegration. Functional outcomes were assessed using the HHS and MSTS-93 scales, and pain intensity was measured using the VAS. Outcomes were stratified according to implant design and fixation method based on the West China Classification. Results: The most commonly performed procedures were internal hemipelvectomies of Enneking Type I + II and II + III, with reconstructions most frequently classified as WChC-Aa (15%) and WChC-Bb (44%). Functional assessments revealed significant improvement across all patients. Both the HHS and MSTS-93 values demonstrated marked progress from preoperative averages of 44 (HHS) and 12 (MSTS-93) to 64, 70.2, and 76 (HHS) and 19, 20, and 20.2 (MSTS-93) after 6 weeks, 3 months, and 6 months, respectively. Correspondingly, pain intensity decreased from a mean preoperative VAS score of 8.5 to 4.4, 3.4, and 3.2 after surgery. Osseointegration occurred in 53%, 75%, and 83% of patients after 6 weeks, 3 months, and 6 months, respectively. Wound-healing complications were observed in 6 patients, while deep infection developed in 4 cases. In 3 patients, the implant was removed. Implant loosening was noted in imaging studies in 7 patients (14%) and 8 patients (16%) at 3 and 6 months postoperatively, respectively. Local tumour recurrence was observed in 6 cases. Conclusions: The extent of pelvic tumour resection and the reconstruction method appear to influence surgical parameters, the risk of complications, and operative time. Functional outcomes measured using VAS, HHS, and MSTS-93 scales showed improvement following surgical treatment and tended to improve over time; however, these findings should be interpreted with caution given the relatively short follow-up period and the lack of assessment of minimal clinically important difference (MCID). The use of 3D-printed implants may facilitate precise pelvic reconstruction and enable early mobilization and rehabilitation. Full article

This article provides an overview of modern surface engineering technologies used in the manufacturing of dental components, with a particular focus on dental implants, abutments, and crowns. The main objective of the study is to critically evaluate selected surface treatment and coating deposition methods applied to materials such as titanium, zirconia, hydroxyapatite, and NiTi alloys, and to discuss their relevance in terms of functionality, biocompatibility, and sustainability. The analyzed technologies include anodic oxidation, alkaline oxidation, electrochemical coating deposition, and other surface modification approaches aimed at improving osseointegration, corrosion resistance, and antibacterial performance. This literature review was conducted as a narrative review supported by the PRISMA framework, using the Scopus and Web of Science databases for the period 2016–2025. The findings highlight the increasing importance of surface treatments as a key factor influencing the durability and clinical success of dental implant systems. At the same time, the results indicate that the environmental aspects and energy efficiency of manufacturing and surface treatment processes are still addressed only marginally or qualitatively in the available literature. The identified research gaps include the lack of quantitative data on the energy demand of individual technologies, the absence of standardized indicators for environmental impact assessment, and the limited number of comparative studies evaluating different surface modification techniques in the context of dental manufacturing. Overall, the results emphasize the need for a more systematic sustainability assessment of surface engineering as an integral part of modern dental manufacturing practice. Full article

Bacterial infections and the lack of bioactivity of titanium implants and their alloys remain critical challenges for the long-term performance and clinical success of these devices. These issues arise from the undesirable combination of early microbial adhesion and the limited ability of metallic surfaces to form a bioactive interface capable of supporting osseointegration. To address these limitations simultaneously, this study employed electrical discharge machining (EDM), which enables surface topography modification and in situ incorporation of bioactive ions from the dielectric fluid. Ti-6Al-4V ELI surfaces were modified using two dielectric fluids, a fluorine/phosphorus-based solution (DF1-F) and a calcium/phosphorus-based solution (DF2-Ca), under positive and negative polarities. The recast layer was characterized by SEM and EDS, while bioactivity was evaluated through immersion in simulated body fluid (SBF) for up to 21 days. Antibacterial performance was assessed against Staphylococcus aureus at 6 h and 24 h of incubation. The results demonstrated that dielectric composition and polarity strongly influenced ionic incorporation and the structural stability of the modified layers. The DF2-Ca(+) condition exhibited the most favorable bioactive response, with Ca/P ratios closer to hydroxyapatite and surface morphologies typical of mineralized coatings. In antibacterial assays, Ca/P-containing surfaces significantly decreased S. aureus attachment (>80–90%). Overall, EDM with Ca/P-containing dielectrics enables the fabrication of Ti-6Al-4V surfaces with enhanced mineralization capacity and anti-adhesive effects against Gram-positive bacteria, reinforcing their potential for multifunctional biomedical applications. Full article

This retrospective study aimed to evaluate the survival rate of hybrid dental implants in different patient profiles and clinical conditions. A total of 1215 patients’ files were analyzed from patients with at least one hybrid dental implant inserted at ILAPEO College (Curitiba, Brazil) from 2018 to 2024. The data collection was performed from 2021 to 2024. Parameters related to patients, implants, and surgical characteristics were collected. Descriptive summary statistics were estimated for all parameters. The associations between the dependent variables “implant survival” and patient, procedure, and implant characteristics were assessed by the Cox proportional hazards model. A total of 4783 hybrid dental implants (Helix, GM, Neodent) were placed in 1215 patients with a mean age of 57.17 ± 12.09 years. The most frequent patients’ medical conditions were diabetes, hypertension, thyroid dysfunction, use of steroids (corticoids), psychological limitations, and bruxism and clenching. Patients were followed for a mean period of 29.54 ± 18.95 months. Immediate loading was applied in 2302 (48.13%) implants and conventional loading in 1735 (36.27%). One hundred and fifty-one implants were lost due to a lack of osseointegration, resulting in an implant survival rate of 95.4% (CI: 94.4%; 96.6%). Adverse events were reported in 389 (8.13%) implants. Uncontrolled hypertension, hypertension without information on control, absence of final abutment, replacement implant, and adverse event occurrence were associated with implant loss. Treatment using a hybrid macrogeometry dental implant is an option for total or partial edentulous patients with compromised health and different clinical conditions. Full article

Porosity and roughened surfaces of implant materials have been shown to lead to improved cellular attachment and enhanced osseointegration. These topography changes in the surface also aid in the mechanical interlocking of the material to the bone. Polyetheretherketone (PEEK) has emerged as a popular alternative to titanium-based implants due to its lack of stress-shielding effect, radiolucency, and high chemical resistance. However, PEEK is bioinert, thus requiring surface modifications to elicit appropriate cellular responses that lead to successful osteointegration of the material in vivo. Sulfonation is a process used to modify the surface of PEEK, which can be controlled by varying parameters such as soak time and soak temperature, thereby fabricating a porous surface on the material. This work aimed to ensure the repeatability of a previously optimized sulfonated and hydrothermally treated PEEK surface and subsequently observe the mechanical properties, bacterial attachment, and cellular response of pre-osteoblast MC3T3-E1 cells on the surface. This study found that while all PEEK surfaces had similar cell and Staphylococcus aureus attachment, the sulfonated and hydrothermally treated PEEK (peak mean load of 605 N, p ≤ 0.0001) and the sulfonated only PEEK (peak mean load of 495 N, p = 0.0240) had a higher level of performance in expulsion testing than smooth PEEK due to its mechanical interlocking ability. Imaging and contact angle analysis confirm that a surface with repeatable porosity can be achieved. Full article

Implant primary stability is a prerequisite for obtaining osseointegration and clinical success. Insertion torque (IT) is measured during implant placement and is expressed in Ncm. It represents the quantification of the frictional force experienced by the implant as it progresses apically through a rotational motion along its axis. Usually, to achieve osseointegration, a value within the range of 20–40 Ncm is desirable. Below a threshold of 20 Ncm, implants have a decrease in survival rate, while implant stability is guaranteed above 20 Ncm. The main goal of this study was to evaluate whether high values of IT affect osseointegration, implant health, and healing, by highlighting the positive and negative effects of IT > 50 Ncm on peri-implant bone, soft tissues, and long-term stability. This scoping review considered randomized clinical trials, observational studies, and cohort studies. Studies failing to meet the predefined inclusion criteria were excluded from the analysis. The review process adhered to the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) guidelines. Ultimately, a total of 11 studies were included in the final synthesis. Based on the studies included, the literature suggests that high values of IT guarantee adequate primary stability and better osseointegration. However, high IT is significantly associated with greater marginal bone loss, depending on bone density. Accordingly, IT values > 50 Ncm may provoke greater compressive forces with a negative impact on the jawbone. An elevated strain on the bone can induce necrosis and ischemia, due to an alteration of circulation, which in turn is responsible for marginal bone loss and reduced osseointegration. Lack of osseointegration ultimately leads to an early implant failure. As concerns soft tissue recession, a higher decrease is measured in implants placed with high-insertion torque. Nonetheless, additional clinical trials are warranted to assess long-term outcomes, quantify the incidence of these complications, and explore the impact of emerging clinical variables. Full article

Objectives: This study aims to investigate the underlying causes of dental implant failure, focusing on implant-related complications and associated risk factors. Understanding these factors will help improve treatment planning and enhance implant success rates. Methods: A retrospective case-control study was conducted using clinical, medical, surgical, and radiographic records of patients who underwent dental implant removal due to complications. Key factors analyzed included patient-related variables (age, gender, medical conditions, periodontal disease), implant-related factors (implant site, implant system, restoration status), and procedural aspects (previous surgical interventions and reasons for implant removal). Results: The findings revealed that implant type (p = 0.004) and type of restoration (p = 0.001) significantly influenced implant survival. Gender (p = 0.001), medical conditions, smoking status (p = 0.004), and restoration status (p = 0.005) were significantly associated with specific failure mechanisms. Lack of osseointegration (36.4%) and absence of primary stability (22.4%) were the predominant causes of implant failure. Prior surgical interventions (p = 0.001) and decisions for re-implantation (p = 0.005) significantly affected implant removal frequency. Conclusions: Implant survival is influenced by multiple factors, with implant type, restoration type, and gender playing key roles in failure outcomes. Patient-specific risk assessment, particularly regarding medical conditions and smoking, meticulous surgical technique, and appropriate prosthetic planning, is vital for improving implant longevity and minimizing failure rates. Full article

Implant-associated infections (IAIs) are major complications in dental and orthopedic implants, potentially compromising osseointegration and eventually causing implant loosening or removal. Thus, early prevention of bacterial adhesion and biofilm formation is critical for successful long-term osseointegration. Polyetheretherketone (PEEK) exhibits excellent physicochemical properties and an elastic modulus similar to bone tissue, making it a promising material for dental and orthopedic implants. However, its inherent lack of antibacterial properties limits its ability to prevent IAIs. Herein, an antibacterial coating with controlled drug release and excellent biocompatibility is designed by immobilizing minocycline (Mino)-doped carboxymethyl chitosan (CMCS) onto the PEEK surface via a polydopamine (PDA)-mediated Michael addition and Schiff base reaction. The coating is characterized by SEM, XPS, water contact angle measurements, and in vitro Mino release assays. Antibacterial activity is evaluated using the zone of inhibition (ZOI), turbidity, and colony counting assays, while biocompatibility is assessed through a SEM analysis of cell morphology and CCK-8 assay. The results show that the Mino-modified coating is successfully fabricated on the PEEK surface, achieving sustained Mino release for up to 14 days. Among the three Mino concentrations, the PEEK-0.5Mino group demonstrates the best balance of antibacterial activity and biocompatibility, highlighting its potential for preventing IAIs in orthopedic and dental applications. Full article

Objective: A peri-implant gap or a “jumping gap” between an implant surface and the buccal bone can often complicate the successful integration of dental implants, impairing osseointegration and long-term implant stability. Although various techniques and materials are available for managing this gap, there is no consensus on the most effective approach. The current literature lacks standardized, evidence-based guidelines for selecting the optimal technique or material for managing peri-implant gaps, especially following immediate implant placement. This systematic review aims to evaluate the efficacy of various techniques and materials to manage the peri-implant gap to improve the implant stability, bone preservation, and esthetic outcomes using the PROSPERO registration number CRD42024508852. Methods: A comprehensive search of the MEDLINE, Embase, and Cochrane databases was conducted, and various studies were selected, including 11 randomized clinical trials that investigated different grafting materials and techniques for managing the gap between the implant and the buccal plate. The selected studies were assessed for the risk of bias, and the data were extracted based on primary outcomes such as implant stability, bone density, and esthetic parameters. Results: The findings indicate that xenografts and alloplastic grafts were superior in preserving bone volume compared to platelet-rich fibrin. Techniques like the socket shield and immediate provisional prothesis methods showed promise in maintaining soft tissue and bone integrity. However, heterogeneity across the studies limits definitive conclusions. Conclusions: Further high-quality research is needed to establish standardized guidelines for peri-implant gap management. The selection of techniques and materials should be tailored to individual patient needs. Full article

In the design of mandibular implants, the application of previous research findings, which highlight the significance of asymmetric occlusal load transfer schemes, is often lacking. The generated identical oblique occlusal force for maximum muscle efficiency may not be the sole criterion for assessing the load-bearing capacity of a mandibular prosthesis. The hypothesis of this study was that the load-bearing capacity of extensive mandibular prostheses is significantly underestimated when assuming mandibular support at the temporomandibular joint on the occlusal side compared to the assumption of perfect osseointegration between the implant and bone. Finite Element Method (FEM) simulation studies were conducted to analyze occlusal load transfer, considering two joint support conditions: support in both temporo-mandibular joints and support in only one joint, opposite the bite side. Additionally, two variants of the implant-bone connection were examined: an optimistic scenario assuming complete osseointegration and a pessimistic scenario assuming no osseointegration, with fixation achieved solely through bone fixation plates. The findings indicated a significant underestimation of the loads transferred by the implant and bone tissue when symmetrical joint support and osseointegration were assumed. Although there is currently no conclusive evidence supporting the complete exclusion of the joint, the computational results demonstrated that, in the absence of precise data regarding the percentage contribution of the joint on the occlusal side, it is preferable to employ more stringent criteria for assessing the load-bearing capacity of mandibular prostheses. This assessment should include the exclusion of joint support on the occlusal side to ensure a more conservative and reliable evaluation of the prosthesis’s mechanical performance. Full article

Nowadays, custom-made subperiosteal implants are emerging as a solution in all those cases where there is lack of healthy bone tissue to support endosseous implants. The development of innovative techniques has allowed the production of grids that precisely match the patient’s anatomy. Elucidating the impact of laser-melted Ti6Al4V grids on both hard and soft tissues with which they come into contact is, therefore, mandatory. In this study, we analyzed the effects of five different surface treatments on a human osteoblast-like cell line (MG-63). In particular, the cell proliferation and osteogenic response were evaluated. Taken together, our data demonstrate that in our in vitro setting, the new surface treatment developed by Al Ti color could enhance osteogenesis and improve the stabilization of the implant to the residual bone by stimulating the best osteogenic response in MG-63 cells. Although further studies are required to validate our data in an in vivo model, our results provide the basis for future advances in implantology for the long-term maintenance of osseointegration. Full article

Autografts, allografts, and synthetic bone substitutes are essential in reconstructive orthopedic surgery. Although autografts and allografts provide excellent skeletal integration, their use is limited by host morbidity and graft acquisition challenges. Synthetic materials like β-tricalcium phosphate (β-TCP) offer promising osseoconductive properties as a potential substitute. This study evaluated the osseointegration of β-TCP ceramic cylinder implants in bone defects in rabbits. Eighteen New Zealand rabbits underwent radial diaphysis ostectomy to create a critical segmental defect and were divided into three groups: Group A received β-TCP blocks, Group B received allogenous cortical bone grafts, and Group C underwent ostectomy without defect filling. Postoperative assessments included clinical evaluations, radiographs, micro-computed tomography, and histology at various time points to assess osseointegration and implant resorption. At the 120th postoperative day, Group B showed successful bone integration without infection. In contrast, Group A showed no osseointegration or resorption of the β-TCP implants, and Group C exhibited bone non-union. While β-TCP demonstrated biocompatibility, it lacked osseoconductivity, likely due to low porosity. β-TCP implants did not promote bone consolidation, suggesting that further research on porosity and shape is needed to improve their suitability for veterinary orthopedic reconstructive surgery. Full article

Advancements in implant design, surface characteristics, and surgical protocols have made implant restorations safe and highly predictable procedures. Bone metabolism plays a central role in the success of implant therapy. Diabetes mellitus is a significant disease impacting bone metabolism, particularly during the initial stages of osseointegration and in long-term survival. Moreover, aging is linked to various systemic conditions, such as diabetes, which increase the susceptibility of the periodontium and teeth to disease, often resulting in tooth loss. Studies on the impact of glycemic control on the success and longevity of implant–prosthetic rehabilitation in diabetic patients highlight a significant association between hyperglycemia and complications in implant therapy. This review identified 18 relevant publications through Medline, and studies were screened against the aim and objectives of the review. A total of five articles were excluded because of lack of focus on the effect of glycemic control on dental implants. Diabetic patients with poorly controlled blood glucose levels may face a heightened risk of developing implant complications. Effective glycemic control plays a critical role in the long-term success of dental implants in these individuals. Marginal bone loss (MBL) is a critical indicator of implant health and success. Clinical studies generally show greater MBL in diabetic patients compared to non-diabetic individuals. Furthermore, controlled type 2 diabetes mellitus (T2DM) has been associated with significantly better maintenance. Full article