ABSTRACT Purpose This study aimed to compare marginal bone loss (MBL) associated with Hybrid Funnel Technique (HFT) and conventional drill osteotomy for implant site preparation when bioactive implants are used, testing the null hypothesis that no significant differences occur at 1‐ and 3 years. Materials and Methods This prospective non‐randomized controlled clinical trial included patients undergoing implant rehabilitation with bioactive‐surface implants. Implants were placed using either conventional subtractive drilling (control group) or HFT (test group), which combines selective cortical preparation with medullary osteocompaction. The primary outcome was radiographic MBL at 3‐year follow‐up. Secondary outcomes included bleeding on probing (BoP) and plaque index (PI). Statistical analyses were performed at implant level, and linear mixed‐effects models were used to account for clustering within patients and adjust for potential confounders. Results A total of 87 implants in 43 patients were analyzed (42 control, 45 HFT). At 1‐year follow‐up, the test group reported significantly lower MBL (0.33 ± 0.43 mm vs. mean = 0.78 ± 0.82 mm; Mann–Whitney p‐value = 0.006). At 3 years, MBL was significantly higher in the conventional site preparation group compared with the HFT group (1.34 ± 0.79 mm vs. 0.46 ± 0.69 mm; p < 0.001). In multivariate mixed‐effects analysis, the implant site preparation technique was the only variable independently associated with MBL at 3 years (β = −1.10 mm, 95% CI = −1.675 to −0.527, p < 0.001), while insertion torque and other baseline variables showed no significant association. In addition, the HFT group demonstrated significantly lower BoP and PI scores, indicating more favorable peri‐implant soft tissue conditions. Conclusions Despite the use of identical bioactive‐surface implants, implant site preparation technique significantly influenced peri‐implant bone remodeling. HFT demonstrated superior preservation of marginal bone over 3 years, suggesting that reduction of cortical compression during osteotomy provides a biological advantage. Implant site preparation remains a key determinant of long‐term peri‐implant bone stability.
L. Canullo, Yaniv Mayer, Federica Mattalia et al.· Clinical Implant Dentistry a...· 0 citations
Wettability of dental implants surface might be an additional key variable in the regeneration process and osseointegration. The aim of the study was to evaluate the effect of a new nanoscale roughness, combined with super-hydrophilic surface on bone volume change after trans-crestal sinus floor lift procedure for implant positioning. The study was reported according to SPIRIT guidelines. A 12-month, single-center, parallel group clinical trial was conducted to compare changes in bone regeneration and crestal bone level as shown on x-ray, following trans-crestal sinus floor lift using a collagenated hydroxyapatite graft and insertion of single dental implants with two different surfaces: moderately rough surface implants (Control Group – CG) and nanoscale super-hydrophilic surface implants (Test Group – TG). Radiographic bone volume and maximum height of regenerated bone as well as peri-implant crestal bone level were evaluated immediately following implant insertion and after 12 months. A multivariate regression model was built to address the impact of surface characteristics and clinical variables on the outcome. The study was completed by 25 participants (12 in the TG and 13 in the CG). CG achieved a volume change of 94.54mm3 (SD 70.24), while the TG increased by 207.41mm3 (SD 168.10) Focusing on bone height gain, CG presented 6.25 mm (SD 1.88), compared to 5.02 mm (SD 1.71) in the TG. For both outcomes, no statistically significant differences were found between the two groups (p = 0.087 for bone volume change; p = 0.123 for bone height gain). Multivariate linear regression models only partially explained observed variance (respectively 8.6 and 35.4%), resulting in non-statistically significant predictions. Despite the trend of a higher bone volume observed in the hydrophilic surface group, taking into consideration all the variables, this study did not reveal any significant differences in terms of bone regeneration between groups. Within the limitations of this study, implants with a nanoscale super-hydrophilic surface did not result in significantly greater bone regeneration than conventional moderately rough implants following transcrestal sinus floor elevation, although a trend toward increased bone volume was observed. Further clinical studies are required to clarify the potential regenerative advantages of hydrophilic implant surfaces.
L. Canullo, D. Baldi, P. Pesce et al.· Oral and Maxillofacial Surge...· 0 citations
