Background: Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but its clinical effectiveness remains undetermined. This systematic review aimed to comprehensively investigate BR grafts in diverse scenarios of ridge defect with simultaneous or staged implant placement. Methods: Electronic retrieval of MEDLINE, Embase, Cochrane Library(CENTRAL), Web of Science, Scopus, and citation search until August 3, 2023, was used to identify relevant clinical articles that utilized BR grafts for ridge defect reconstruction. The quality of evidence in the studies reviewed was assessed with the Joanna Briggs Institute Critical Appraisal tool. The protocol was registered in Prospective Register of Systematic Reviews (CRD42023453943). Results: Fourteen studies with 251 BRs were identified, of which 8 studies were for alveolar ridge augmentation, 4 studies were for extraction socket augmentation, and 2 studies were for sinus floor elevation. Reported sources of BRs included autografts, allografts, and xenografts. The follow-up period ranged from 4 months to 4.7 years. Regarding the primary outcomes, the utilization of BR grafts demonstrated favorable bone gain along with acceptable graft absorption and marginal bone loss. Regarding the secondary outcomes, satisfactory bone mineral density and implant stability were confirmed, accompanied by a recorded incidence of postoperative complications (20 cases) and an implant failure rate of 5.58%. Conclusions: BR grafting with simultaneous or staged implant insertion is an effective approach for reconstructing alveolar ridge deficiencies. The BR grafts demonstrate favorable bone remodeling and osteointegration with the alveolar bone and implant; however, its success may be compromised by complications. Future studies should further investigate the clinical efficacy of BR grafting comparing to other bone augmentation techniques in diverse scenarios.

Purpose: The application of a computer-aided navigation system (CANS) in zygomatic complex (ZMC) fractures has been extensively reported, but individual results are heterogeneous. The purpose of this sys-tematic review was to evaluate the role of CANS in the surgical treatment of unilateral ZMC fractures. Methods: Electronic retrieval of MEDLINE, Embase, and Cochrane Library (CENTRAL) and manual search-ing until November 1, 2022 were used to identify cohort studies and randomized controlled trials employing CANS in the surgical treatment of ZMC fractures. The identified reports contained at least 1 of the following outcome variables: accuracy of reduction, total treatment time, amount of bleeding, postoperative complica-tions, satisfaction, and cost. Weighted or mean differences (MD), risk ratios, and corresponding 95% confi-dence intervals (CI) were calculated, where P<.05 and I2>50% random-effect model was adopted, and a vice versa fixed-effect model was adopted. Descriptive analysis was applied to qualitative statistics. The proto-col was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Ana-lyses (PRISMA) guidelines and prospectively registered with PROSPERO (CRD42022373135). Results: A total of 562 studies were identified, of which 2 cohort studies and 3 randomized controlled trials with 189 participants were included. Meta-analysis indicated that employing CANS significantly decreased the reduction error (MD = 0.86, 95% CI 1.58 to 0.14; P = .02, random-effect model) compared with conven-tional surgery without using CANS. The differences in total treatment time (preoperative planning time: MD = 1.44, 95% CI 3.55 to 6.43; P = .57 and operative time: MD = 3.02, 95% CI 9.21 to 15.26; P = .63, fixed-effect model) and amount of bleeding (MD = 14.86, 95% CI 8.86 to 38.58; P = .22, fixed-effect model) were not statistically significant between the two groups. Descriptive analysis suggested that postoperative complications, postoperative satisfaction, and cost were also similar with or without CANS. Conclusion: Within the limitations of the present review, the reduction accuracy of unilateral ZMC frac-tures using CANS is superior to that of conventional surgery. CANS presents limited influence on operation time, amount of bleeding, postoperative complications, postoperative satisfaction, and cost. & COPY; 2023 Published by Elsevier Inc. on behalf of the American Association of Oral and Maxillofacial Surgeons

目的 通过Meta 分析方法系统评估牙槽嵴缺损时使用帐篷技术进行骨增量的有效性.方法 电子检索2002 年4 月1 日至2022 年10 月10 日PubMed、Embase、Scopus、Cochrane Library、CNKI、万方、SinoMed数据库有关牙槽嵴增量使用帐篷技术和常规骨增量技术的对照研究.结果 共纳入9 篇研究,其中7 篇研究有关水平骨增量,2 篇研究有关垂直骨增量.Meta 分析结果显示,帐篷技术与引导骨再生在水平骨增量[MD=0.89,95%CI(-0.07,1.85),P=0.07]和术后并发症[RR=3.90,95%CI(0.85,17.96),P=0.08]上表现相似.帐篷技术与引导骨再生和Onlay植骨相比有更少的骨吸收[MD=-3.98,95%CI(-6.32,-1.65),P=0.0008],较Onlay植骨可获得更多的垂直骨增量[MD=1.09,95%CI(0.38,1.81),P=0.003],但在种植体植入率上表现相似.结论 有限证据表明,在牙槽嵴增量中帐篷技术可获得与引导骨再生或Onlay植骨类似或略佳的骨增量效果且骨吸收率更低,可作为扩增牙槽嵴轮廓的替代方案.

Purpose: The use of intraoperative imaging (IOI) to improve the reduction adequacy of zygomatic arch (ZMA) fractures has been reported, but few systematic reviews have examined this topic. The aim of this review was to investigate and compare the value of IOI with conventional methods without IOI (N-IOI) for the closed reduction of ZMA fractures. Methods: Electronic retrieval of MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, and citation search until December 2, 2022, was used to identify controlled clinical trials that employed IOI for improving adequacy in closed reduction of ZMA fractures. The predictor variable was the use of IOI-yes/no (IOI vs N-IOI). The covariates included imaging technique (ultrasound, C-arm, and cone beam computed tomography) and ZMA fracture type (M-shape fracture, mechanistic force in 1 direction; variable fracture, mechanistic force in 2 directions). The primary outcome variables were the reduction adequacy of ZMA fractures (the remaining cortical step and dislocation angle) compared with the ideal mirrored position. Weighted or mean differences, risk ratios, and corresponding 95% confidence intervals were calculated, where P >.05 and I-2 < 50% fixed effect model was adopted, and a vice versa random effect model was adopted. Results: A total of 1250 studies were identified, of which 6 studies with 259 participants were included. The meta-analysis results indicated that compared with N-IOI, IOI yielded fewer cortical steps (-1.76 [-2.42, 1.10], P <.00001, fixed model) and dislocation angles (-5.60 [-8.08, 3.12], P<.00001, fixed model) in patients with variable ZMA fractures, while no significant difference was detected in the M-shape ZMA fracture (-0.72, [-2.93, 1.48], P =.52; -1.48, [-3.51, 0.55], P =.15). Although there was no significant difference in postoperative correction (0.35, [0.06, 2.01] P =.24, fixed model), all secondary revision cases occurred in the N-IOI group. Descriptive analysis showed that IOI yielded better symmetry and appearance satisfaction. Conclusion: IOI improved the adequacy of the procedure and led to a better postoperative appearance, especially for patients with variable ZMA fractures. Furthermore, the use of IOI avoided the risk of secondary surgery. In future studies, researchers should standardize the scale and outcomes to facilitate the intuitive evaluation of reduction adequacy. (C) 2023 American Association of Oral and Maxillofacial Surgeons

Recently, dental implants have had the most important role in oral rehabilitation. Peri-implantitis is considered a common complication of dental implants. Adjacent natural teeth with untreated endodontic pathology may be a potential risk for implant placement. Retrograde/periapical peri-implantitis (RPI), the inverting of the progress direction of peri-implantitis. Radiographically, it is characterized by signs of periapical bone loss and normal coronal osteointegration of the implant; and its prevalence is closely associated with endodontic lesions of adjacent teeth. Another novel separate disease entity is known as the endodontic peri-implant defects (endo-implant defects), manifesting as the peri-implant marginal bone loss due to endodontic pathology of adjacent teeth, to which endodontists and implantologists are supposed to attach great importance. This current study presented two cases of different types of peri-implant infection in which conducting proper intervention to the endodontic lesions of adjacent teeth resulted in full radiographic and clinical resolution of peri-implant defects.

BACKGROUND:Autogenous particulate dentin (APD) has been used as a bone graft material for bone augmentation, but the specifics of its effect on alveolar ridge preservation (ARP) are uncertain. The aim of this study was to investigate the clinical and histomorphometric performance of APD compared with blood clot healing or other grafted materials in ARP. METHODS:MEDLINE, Embase, Web of Science, Scopus and the Cochrane Library and citation databases were searched until August 2, 2023 to identify randomized controlled trials that employed APD for ARP. Two independent meta-analyses were performed based on the different control groups (Group I: blood clot healing; Group II: other grafted materials). Weighted or mean differences (MDs) and corresponding 95% confidence intervals (CIs) were calculated. The protocol was prospectively registered with PROSPERO (CRD42023409339). RESULTS:A total of 238 records were identified, of which ten studies with 182 participants were included. The meta-analysis indicated that APD resulted in fewer changes in horizontal ridge width (Group I: MD = 1.61, 95% CI 0.76-2.46; Group II: MD = 1.28, 95% CI 1.08-1.48) and labial bone height (Group I: MD = 1.75, 95% CI 0.56-2.94; Group II: P < .05) than the control treatments. Regarding histomorphometry, APD yielded a satisfactory proportion of vital bone area (MD = 10.51, 95% CI 4.70-16.32) and residual material area (MD = -8.76, 95% CI -12.81 to -4.71) in Group II, while there was no significant difference in Group I. Moreover, none of the secondary outcomes were significantly differed between groups. CONCLUSION:Within this study limitations, APD effectively maintained the horizontal and vertical dimensions of the extraction sockets and exhibited favorable osteogenic properties and degradation capacity. Further well-designed randomized controlled trials with larger samples and longer follow-up periods are needed to evaluate whether APD is superior to other substitutes for ARP.

Background: Autogenous tooth block (ATB) has been used as an alternative material for bone regeneration, but its efficacy compared with autogenous bone block (ABB) remains uncertain. The aim of this systematic review was to investigate and compare the clinical and histological performance of ATB and ABB grafts in lateral alveolar ridge augmentation (LARA).Methods: Electronic retrieval of MEDLINE, Embase, Cochrane Library (CENTRAL), Scopus, Web of Science, China national knowledge infrastructure, Wanfang data, SinoMed, and manual searching until July 2023 were used to identify controlled clinical trials employing ATB grafts in LARA. The identified reports included at least one of the following outcome variables: ridge width gain, graft resorption, postoperative complications, histology, and histomorphometry. Weighted or mean differences (MD), relative risk, and corresponding 95% confidence intervals (CI) were calculated. Descriptive analysis was applied to the qualitative statistics. The protocol followed the preferred reporting items for systematic reviews and meta-analyses statement and was prospectively registered in PROSPERO (CRD42023399611).Results: Four controlled clinical trials with 77 participants each using ATB and ABB grafts were included. Meta-analysis indicated that ATB grafts resulted in greater bone width (MD = 1.31, 95% CI [0.92, 1.71], P < .00001) and less graft resorption (MD = -0.71, 95% CI [-1.22, -0.21], P = .005) than ABB grafts on LARA. There was no statistical difference in postoperative complications between ATB and ABB grafts (relative risk = 0.81, 95% CI [0.32, 2.04], P = .66). Furthermore, the ATB grafts exhibited positive replacement resorption with alveolar bone for favorable signs of new bone activity on histology and histomorphometry.Conclusion: Within the limitations of this study, ATB grafts could serve as an alternative material for ABB to support LARA. Further research with a longer follow-up period is required to verify these findings.

OBJECTIVES:This study aimed to systematically evaluate the safety and clinical efficacy of 4 mm-extra-short implant (ESI) placement in severely atrophic posterior areas.METHODS:Databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang from January 1, 2010, until August 31, 2022, were searched to identify randomized controlled trials or controlled clinical trials related to ESI and standard implants (SI). An additional hand search of the references of included articles was also conducted. Meta-analyses were carried out with RevMan 5.4 software.RESULTS:A total of 11 studies were included, involving six randomized controlled trials and five controlled clinical trials. The meta-analyses indicated that when implants were placed in the posterior area, the implant survival rate between ESI and SI did not significantly differ [RR=1.23, 95%CI (0.66, 2.27), P=0.52]. ESI resulted in significantly stable marginal bone level [MD=-0.16, 95%CI (-0.25,-0.07), P=0.000 7] and less biological complications [RR=0.34, 95%CI (0.19, 0.62), P=0.000 4] but more mechanical complications [RR=2.89, 95%CI (1.05, 7.92), P=0.04].CONCLUSIONS:Based on the limited evidence, ESI could achieve clinical outcomes similar to those of SI when the height of the posterior alveolar bone is less than 5 mm, with lower technical sensitivity and fewer postoperative clinical complications than SI. Due to insufficient evidence and limited sample size, further clinical trials are needed to verify the long-term efficacy of ESI.

Objective To evaluate the quality of methodology and evidence of the systematic reviews and meta-analyses（SR/MA） of autologous platelet concentrates（APC） for maxillary sinus floor elevation（MSFE）. Methods PubMed, Embase,Cochrane Library, Scopus, CNKI, SinoMed, and WanFang databases were electronically searched to enroll SR/MA of APC for MSFE from inception to August 31, 2022. Two reviewers independently screened literature, extracted data, and employed the AMSTAR 2 and the GRADE for evaluating the quality of methodology of the included studies and the certainty of the evidence for outcomes respectively. Results A total of 13 SR/MA were included and the major conclusions were that APC presents limited influence on MSFE and might promote the healing of sinus tissue. The 9 items of AMSTAR 2 were reported well, and two items were not reported in any of the included SRs, and the quality was relatively convinced. The evidence grading of GRADE revealed that, in the total of 46 outcomes, 9 were graded as high-level, 25 as medium-level, 11 as low-level, and 1 as extremely low-level. Conclusion Most of the current evidence shows the advantages of APC in MSFE are not obvious, but the reliability of SR/Ma is inconsistent. High-quality clinical trials are still needed to verify the efficacy of APC for MSFE

目的 探讨与传统即刻种植(CII)相比,即刻种植联合根盾技术(SST)的临床应用效果.方法 电子检索2010年 5 月-2021 年 11 月 PubMed、Embase、Cochrane Library、Web of Science、CNKI、万方数据库有关 SST 和CII的随机对照研究(RCT),且对关键文献进行引文索引.使用Cochrane风险评估工具评估偏倚风险,使用Rev-Man 5.4 对数据进行分析,探讨2种技术对种植体周软硬组织、种植体稳定性(ISQ)、并发症和失败率的影响.结果 共14篇RCT纳入本研究,其中英文8篇,中文6篇.随访时间从6个月至36个月不等,平均随访时间为14.21个月.Meta分析结果显示,2组除ISQ的差异无统计学意义外(P＞0.05),SST组具有更少的唇侧骨板改变(P＜0.05),更稳定的种植体边缘骨水平(P＜0.05)和更好的美学效果(P＜0.05);但是在并发症和种植失败率方面,2组差异均无统计学意义(P＞0.05).结论 即刻种植中,在中短期随访时间内,应用SST在降低种植体周骨吸收和维持软组织形态上具有一定的优势,但仍需要更多长期的RCT来评估现有的优势表现.

OBJECTIVES:This investigation aimed to systematically evaluate the efficacy and safety of applying autogenous dentin (ATD) in alveolar ridge augmentation. METHODS:The PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang databases were electronically searched from January 1, 2010 to March 19, 2022 to identify clinical trials and cohort studies that employed ATD in alveolar ridge augmentation. The Cochrane Tool and the Newcastle-Ottawa Scale were employed to assess the risk of bias in randomized controlled trials and cohort studies, respectively. Data were analyzed via RevMan 5.4 software. RESULTS:A total of 10 studies were included, 5 of which compared ATD with autologous bone and 5 with deproteinized bovine bone matrix (DBBM). Meta-analysis indicated that ATD had preferable performance [MD=2.01, 95% confidence interval (CI) (1.09, 2.93), P<0.000 1] in horizontal ridge augmentation compared with autologous bone but similar effect in vertical ridge augmentation [MD=-0.06, 95%CI (-0.21, 0.08), P=0.39] at 6 months after alveolar ridge augmentation. In terms of material absorption, ATD was significantly less than autologous bone or DBBM [MD=-0.59, 95%CI (-1.03, -0.15), P=0.008; MD=-0.63, 95%CI (-1.18, -0.07), P=0.03], but no significant difference in implant stability quotient and postoperative complications was observed [MD=-0.76, 95%CI (-3.04, 1.52), P=0.51; RR=1.01, 95%CI (0.33, 3.12), P=0.98]. CONCLUSIONS:ATD, as a bone grafted material for alveolar ridge augmentation, not only achieves similar or better bone incremental performance than autologous bone or DBBM but also has less absorption. However, further evidence from clinical trials with larger samples, higher quality, and longer follow-up period are needed to evaluate its superiority.

Objective To systematically evaluate the effect of interimplant distance（IID） on peri-implant bone resorption by systematic evaluation and meta-analysis.Methods Databases in PubMed, Embase, Cochrane Library, Web of Science, CNKI and Wanfang Date until March 2022 were searched to identify animal studies or population studies that comparing peri-implant bone resorption at different IID, and citation indexes were carried out for the critical literatures. Results A total of 9 studies were included,including 7 animal studies and 2 clinical trials. Using 3 mm as the standard IID, metaanalysis indicated that there was no statistically significant difference in marginal bone resorption between IID=2 mm and IID=3 mm of animal studies [MD=0.05, 95%CI（-0.10,0.19）, P=0.54]; Clinical trials showed slightly greater marginal bone resorption at IID=2 mm than at IID=3 mm, which is not statistically significant [MD=0.11, 95%CI（-0.09,0.31）, P=0.27]. There was no statistically significant difference in vertical bone resorption at IID=2 mm or 3 mm [MD=-0.10,95%CI（-0.27,0.07）, P=0.24]. Conclusions Based on the limited evidence, performance was similar for IID=2 mm compared to IID=3 mm. There is still a need to refine the assessment groups, improve the assessment methods and further confirm the relationship between IID and peri-implant bone resorption.

BACKGROUND:Implant periapical lesion (IPL), as a peri-implant disease originating from implant apex, maintains coronal osseointegration in the early stage. With the understanding to IPL increasingly deepened, IPL classification based on different elements was proposed although there still lacks an overall classification system. This study, aiming to systematically integrate the available data published in the literature on IPL associated with histopathology, proposed a comprehensive classification framework and treatment decision tree for IPL.METHODS AND FINDINGS:English articles on the topic of "implant periapical lesion", "retrograde peri-implantitis" and "apical peri-implantitis" were searched on PubMed, Embase and Web of Science from 1992 to 2021, and citation retrieval was performed for critical articles. Definite histopathology and radiology of IPL are indispensable criteria for including the article in the literature. The protocol was registered in PROSPERO (CRD42022378001). A total of 509 papers identified, 28 studies were included in this review. In only one retrospective study, 37 of 39 IPL were reported to be at the inflammatory or abscess stage. 27 cases (37 implants) were reported, including acute non-suppurative (1/37, developed to chronic granuloma), chronic granuloma (5/37), acute suppurated (2/37), chronic suppurated-fistulized (6/37), implant periapical cyst (21/37), poor bone healing (2/37), foreign body reaction (1/37). Antibiotics alone did not appear to be effective, and the consequence of surgical debridement required cautious interpretation because of the heterogeneity of lesion course and operation. Implant apicoectomy and marsupialization were predictable approaches in some cases.CONCLUSIONS:The diversiform nature of IPL in the case reports confirms the need for such histopathological classification, which may enhance the comparison and management of different category.

Kochaji在2017年介绍两例在种植体植入后因手术创伤、感染因素造成种植体周发生囊肿的病例,并将其命名为种植体周囊肿(peri-implant cyst).由于种植体周囊肿罕见且造成种植体周支持骨丧失,临床上常与种植体周炎(peri-implantitis)、逆行性种植体周炎(retrograde peri-implantitis)相混淆.因此,本文通过系统回顾种植体周囊肿的文献,就其临床表现、鉴别诊断及治疗方式等做一综述.

目的 观察改良型富血小板纤维蛋白(advanced-?platelet-rich?fibrin,?A-PRF)对人骨髓间充质细胞(human?bone?marrow?mesenchymal?cells,?hBMMCs)生物学性能的影响.方法 对hBMMCs进行多向分化能力鉴定,扫描电镜及人生长因子阵列膜检测A-PRF微观结构及分子构成,CCK-8检测A-PRF对hBMMCs增殖的影响,划痕实验检测A-PRF对hBMMCs迁移的影响,通过碱性磷酸酶活性检测及茜素红染色检测不同浓度A-PRF对hBMMCs矿化能力的影响.结果 扫描电镜结果显示A-PRF为三维网状结构;人生长因子阵列膜检测发现A-PRF含有40多种细胞因子,并含有巨噬细胞集落刺激因子受体(macrophage?colony?stimulating?factor?receptor,?M-CSF-R)及人神经生长因子β(β-nerve?growth?factor,?β-NGF);体外实验可见10％A-PRF可以提高细胞增殖(P<0.05)和迁移能力,同时可促进hBMMCs形成钙沉积和碱性磷酸酶活性表达(P<0.05).结论 A-PRF对hBMMCs的成骨分化、增殖和迁移有促进作用,其中10％的A-PRF促进作用更为明显.因此,A-PRF对hBMMCs具有良好的细胞生物学效应,可为临床选择A-PRF促进骨组织再生提供初步实验依据.