The occurrence of dental implant malpositioning and related factors: A cross-sectional cone-beam computed tomography survey

Prevalence of Dental Implant Positioning Errors: A Radiographic Analysis

Objectives Implant placement errors remain a persistent challenge, leading to complications such as peri-implant bone loss, neurosensory issues, and, in severe cases, implant failure. This study evaluates the prevalence and characteristics of dental implant positioning errors in patients treated at the Dental University Hospital. Methods: A sample of 500 cone-beam computed tomography (CBCT) scans was used to assess implants for positioning errors, including thread exposure, proximity to anatomical structures, and violations of inter-implant and implant-tooth distances. Results: A total of 56.6% of the implants exhibited positioning errors, with the maxillary posterior region being the most commonly affected area (51.6%). The most frequent errors observed were thread exposure (37.7%) and implant proximity to the maxillary sinus (27.7%). Statistical analysis revealed significant correlations between implant positioning errors and anatomical location, underscoring the need for meticulous preoperative planning and advanced imaging. While factors such as patient age, implant length, and diameter were analyzed, no statistically significant differences were found in error prevalence based on sex or demographic variables. Conclusions: This study highlights the importance of combining clinical expertise with advanced imaging modalities like CBCT to minimize implant positioning errors and improve patient outcomes. Future research should focus on refining surgical techniques and evaluating the impact of the implants' design and patient-specific factors on the accuracy of placements.

[Strategies for prevention and treatment of vascular and nerve injuries in mandibular anterior implant surgery]

Important anatomical structures such as mandibular incisive canal, tongue foramen, and mouth floor vessels may be damaged during implant surgery in the mandibular anterior region, which may lead to mouth floor hematoma, asphyxia, pain, paresthesia and other symptoms. In severe cases, this can be life-threatening. The insufficient alveolar bone space and the anatomical variation of blood vessels and nerves in the mandibular anterior region increase the risk of blood vessel and nerve injury during implant surgery. In case of vascular injury, airway control and hemostasis should be performed, and in case of nerve injury, implant removal and early medical treatment should be performed. To avoid vascular and nerve injury during implant surgery in the mandibular anterior region, it is necessary to be familiar with the anatomical structure, take cone-beam computed tomography, design properly before surgery, and use digital technology during surgery to achieve accurate implant placement. This article summarizes the anatomical structure of the mandibular anterior region, discusses the prevention strategies of vascular and nerve injuries in this region, and discusses the treatment methods after the occurrence of vascular and nerve injuries, to provide clinical reference.

Incidental Findings Following Dental Implant Procedures in the Mandible: A New Post-Processing CBCT Software Analysis

Background/Objectives: The aim of this study was to evaluate incidental findings in the mandible after the placement of dental implants using a new cone-beam computed tomography (CBCT) software. Methods: The initial sample consisted of 2872 CBCT scans of patients of both sexes. The parameters evaluated in this study were the location of the implants in the mandible, implant length, anatomical relationship of the implant with the mandibular canal, presence or absence of damage to the adjacent teeth, presence or absence of implant fractures, and presence or absence of bone support. Fisher's exact test was performed to compare the variables. The significance level was set at p = 0.05. Results: Out of 2872 CBCT scans, 214 images of patients with an average age of 44.5 years were included. The most frequent location of the implants was the posterior region (93.5%), with 54% of the implants having a length between 9 and 14 mm. It was found that 92% of the implants were positioned above the mandibular canal. Damage to adjacent teeth was observed, with no correlation with the implant positioning (p = 1.000). In 100% of cases of implants in the anterior region, there was bone support. Fracture was observed in 1.7% of implants with a length between 9 and 14 mm. Conclusions: The installation of implants in the mandible occurs more frequently in the posterior region, with a high presence of bone support and a low incidence of damage to adjacent teeth, anatomical structures, and fractures.

Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies

Background and Objectives: The present systematic review and meta-analysis undertake a comparison of studies that examine the accuracy of robot-assisted dental implant placement in relation to static computer-assisted implant surgery (SCAIS), dynamic computer-assisted implant surgery (DCAIS), and freehand procedures. This study aims to provide a comprehensive understanding of the precision of robot-assisted dental implant placement and its comparative efficacy in relation to other placement techniques. Methods: The guidelines recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to organize and compose this review. Four electronic databases (PubMed, Web of Science, Scopus, and Cochrane) were systematically searched for pertinent articles. Articles were selected following the inclusion and exclusion criteria. Qualitative and quantitative analyses of the selected articles were performed. Results: The initial electronic search resulted in 1087 hits. Based on the inclusion and exclusion criteria, five articles were selected for qualitative analysis, out of which three were considered for quantitative analysis. Three parameters were considered for accuracy evaluation (angular, coronal, and apical deviation). The mean angular deviation was -1.22 degrees (95% CI, -1.06--1.39), the mean coronal deviation was -0.15 mm (95% CI, -0.24--0.07), and the mean apical deviation was -0.19 mm (95% CI, -0.27--0.10). Conclusions: The robotic implant system was found to have significantly lower angular deviations and insignificantly lower coronal and apical deviations compared to DCAIS. Within the limitations of this review, it can be concluded that robot-assisted implant placement in resin models permits higher accuracy compared to DCAIS and SCAIS systems. However, due to the limited number of comparative studies with high heterogeneity, the findings of this review should be interpreted with caution. Further research is necessary to confirm the clinical application of robotics in implant surgery.

Clinical and CBCT Assessment of Crestal Bone Changes in Immediate and Delayed Placement of Implant

Objectives

The present research was done to assess the crestal bone changes in immediate and delayed dental implant placement.

Materials and Method

Twenty four implant sites in participants within the age group of 25-60 years in both genders were done with immediate (Group I) and delayed implant (Group II) placement method. Clinical parameters such as pain, mobility, and radiographic assessment for crestal bone alterations were recorded at baseline, 3 months, and 6 months.

Results and Conclusion

On intergroup assessment, the mean variation of the pain, mobility, and crestal bone loss was insignificant.

Multi-planar 2.5D U-Net for image quality enhancement of dental cone-beam CT

Cone-beam computed tomography (CBCT) can provide 3D images of a targeted area with the advantage of lower dosage than multidetector computed tomography (MDCT; also simply referred to as CT). However, in CBCT, due to the cone-shaped geometry of the X-ray source and the absence of post-patient collimation, the presence of more scattering rays deteriorates the image quality compared with MDCT. CBCT is commonly used in dental clinics, and image artifacts negatively affect the radiology workflow and diagnosis. Studies have attempted to eliminate image artifacts and improve image quality; however, a vast majority of that work sacrificed structural details of the image. The current study presents a novel approach to reduce image artifacts while preserving details and sharpness in the original CBCT image for precise diagnostic purposes. We used MDCT images as reference high-quality images. Pairs of CBCT and MDCT scans were collected retrospectively at a university hospital, followed by co-registration between the CBCT and MDCT images. A contextual loss-optimized multi-planar 2.5D U-Net was proposed. Images corrected using this model were evaluated quantitatively and qualitatively by dental clinicians. The quantitative metrics showed superior quality in output images compared to the original CBCT. In the qualitative evaluation, the generated images presented significantly higher scores for artifacts, noise, resolution, and overall image quality. This proposed novel approach for noise and artifact reduction with sharpness preservation in CBCT suggests the potential of this method for diagnostic imaging.