Aug 2026· Journal of Advances in Dental Practice and Research· 0 citations· 13 references
TL;DR
Immediate placement of extra-wide diameter implants in posterior molar sites demonstrated high survival rates and maintenance of crestal bone levels above the implant platform, suggesting this approach is a predictable treatment option.
Abstract
To evaluate crestal bone level changes and survival of immediately placed extra-wide diameter implants in posterior molar sites.
This prospective clinical study included 30 patients requiring molar extraction and implant placement, with 28 patients completing follow-up. A total of 29 implants were placed immediately following atraumatic extraction and positioned subcrestally. Crestal bone levels were measured radiographically at placement and at a minimum of 1-year post-restoration using calibrated ImageJ analysis.
The mean crestal bone level was 1.28 mm at placement and 0.46 mm at follow-up, with a mean change of 0.82 mm (95% confidence intervals: 0.34–1.29 mm). This difference was statistically significant (
p
= 0.001). Despite this change, crestal bone levels remained coronal to the implant platform at follow-up. One implant failure occurred, resulting in a survival rate of 96.5%.
Immediate placement of extra-wide diameter implants in posterior molar sites demonstrated high survival rates and maintenance of crestal bone levels above the implant platform, suggesting this approach is a predictable treatment option.
Immediate implants placed 6 mm below the mid-buccal gingival level showed significantly less short-term marginal bone loss than immediate implants placed 4 mm below the gingiva after a period of 1 year.
Jonas Alkimavicius, Manish Rathi, Ula Linkeviciute et al.· Journal of Prosthodontics· 0 citations
Background and Clinical Significance: Immediate implant placement in mandibular molars represents a clinical challenge due to lower trabecular bone density and anatomical limitations of the interradicular septum. Osseodensification has been proposed as an alternative to improve primary stability in sites with low bone quality. Case Presentation: This report describes the case of a 54-year-old female patient with a mesial root fracture in the lower right first molar, treated by atraumatic extraction followed by immediate implant placement using a densifying drilling protocol. After careful root removal, the interradicular septum was expanded using Versah burs at 1200 rpm, allowing placement of a 4.0 × 7 mm Implacil Duecone implant with a final insertion torque of 25 Ncm. The residual gap was filled with a xenogeneic bone substitute and covered with a dense polytetrafluorethylene membrane for alveolar preservation. Healing progressed uneventfully and, after four months, adequate bone formation was observed, enabling prosthetic rehabilitation with a single ceramic crown. After 4 postoperative years we could find peri-implant tissue stability. Conclusions: The clinical outcome supports current evidence indicating that osseodensification may enhance initial stability and predictability of immediate implants placed in posterior mandibular regions.
Márcio de Carvalho Formiga, Jucielly Santos Lesnik de Souza, Gustavo Dos Santos Coura et al.· Reports· 0 citations
OBJECTIVE
Evidence on zirconia dental implants remains limited. This retrospective study evaluated clinical and radiographic outcomes of contemporary ceramic implant systems placed in private practice with variable follow-up of up to 11 years.
MATERIALS AND METHODS
This retrospective cohort evaluation included 174 patients receiving 275 zirconia implants (one-piece systems and a two-piece tissue-level screw-retained system) placed between 2013 and 2025 with a minimum one-year follow-up. Implant survival and success rates were assessed. Standardized periapical radiographs were analyzed using ImageJ to measure marginal bone levels at placement and annually thereafter. Peri-implant soft tissue health was evaluated using the modified Plaque Index and modified Gingival Index.
RESULTS
Kaplan-Meier cumulative implant survival was 97.6%, and overall success was 95.3%. Mean first-year marginal bone loss ranged from 0.25 to 0.74 mm, with a pooled mean of 0.49 mm. Mean annual bone loss after year 1 was low at 0.12 mm/year. Soft tissue indices remained low, and no suppuration was observed. Two implant fractures occurred (0.73%); remaining failures were associated with lack of osseointegration or aseptic loosening.
CONCLUSIONS
Within the limitations of this retrospective study, contemporary ceramic implant systems demonstrated high survival and success with stable peri-implant bone levels and favorable soft tissue conditions.
CLINICAL SIGNIFICANCE
This study provides real-world clinical and radiographic data on contemporary ceramic implant systems, including one-piece ceramic implants and ATZ two-piece ceramic implants with carbon fiber screws. These findings may help clinicians contextualize the observed performance of ceramic implants in daily practice. Ceramic implants may represent a viable metal-free treatment option for appropriately selected patients, particularly in esthetically demanding situations, when careful case selection, system-specific training, and adherence to surgical and restorative protocols are applied.
M. Monzavi, Medis Masnavi, Ayman Zraiqat et al.· Journal of Esthetic and Rest...· 0 citations
OBJECTIVES
This randomized clinical study aimed to assess implant placement accuracy and radiographic outcomes of computer-guided versus freehand ridge split and expansion with simultaneously inserted implants in patients with horizontally deficient maxillary anterior ridges over a 2-year follow-up period.
METHODS
Twenty-two volunteers were randomly allocated (1:1) to either a computer-guided or a freehand group. The primary outcome was implant placement accuracy. Secondary outcomes included postoperative complications, marginal bone loss, horizontal ridge width changes, and peri-implant defect resolution. All parameters were evaluated radiographically at baseline, immediately after surgery, and at 3, 6, 12, and 24 months.
RESULTS
The computer-guided group demonstrated lower angular deviation versus the freehand group (1.45 ± 0.43° vs. 10.02 ± 3.24°; p < 0.001) and entry point deviation (0.54 ± 0.19 mm vs. 2.16 ± 0.31 mm; p < 0.001). Depth deviation showed a non-significant difference. Three, six, and twelve months after surgery, the freehand group exhibited higher marginal bone loss (1.02 ± 0.13, 1.57 ± 0.13, 1.58 ± 0.13, and 1.73 ± 0.17 mm, respectively) than the computer-guided group (0.27 ± 0.13, 0.35 ± 0.13, 0.36 ± 0.13, and 0.39 ± 0.15 mm, p < 0.001). The computer-guided approach also was associated with minimal ridge collapse and enhanced peri-implant defect fill.
CONCLUSIONS
The present preliminary findings suggest that computer-guided ridge split and expansion were associated with improved implant placement accuracy and peri-implant hard tissue preservation compared with the conventional freehand approach over 2 years. Both techniques achieved successful implant outcomes without major complications. However, these observations should be interpreted cautiously as preliminary evidence requiring external validation, given the limited sample size, single-operator design, and mid-term follow-up duration. Multicenter studies with larger cohorts and longer follow-up are required before confirming definitive clinical superiority.
CLINICAL SIGNIFICANCE
The present preliminary findings suggest that integrating the digital workflow into ridge split and expansion may enhance surgical precision and peri-implant hard tissue stability in narrow maxillary ridges. Nevertheless, the potential advantages of the guided approach require confirmation through larger, well-designed clinical trials before recommending widespread, routine clinical implementation.
CLINICAL TRIAL REGISTRATION
The study was prospectively registered in the ClinicalTrials.gov registry (Identifier: NCT06135506) on 11/11/2023 under the title "Artificial Intelligence/Computer Guided Ridge Splitting for Treating Horizontal Ridge Defects."
CLINICALTRIALS
gov PRS: Record Summary NCT06135506.
Asmaa Allam, N. Hatata, Walid S. Salem et al.· E -journal of dentistry· 0 citations
Introduction: This study aimed to compare implant stability and crestal bone loss between titanium platelet-rich fibrin (T-PRF)-treated implants and conventional implants. Methods: A prospective, randomized, split-mouth clinical trial was conducted in 10 healthy patients, with 20 implants per mouth (test and control). Each patient received one T-PRF-treated implant and one conventional implant. Implant stability was assessed using implant stability quotient (ISQ) at placement and at 3 months. Crestal bone loss was evaluated radiographically at 3 and 6 months. Soft tissue parameters were assessed at follow-up visits. Results: The T-PRF group showed higher ISQ values and reduced bone loss, with trends favoring the intervention at the three-month follow-up compared with the control group. Bone loss at three and six months was lower around anterior implants in the T-PRF group than in the control group. At this time, T-PRF may help improve soft tissue measurements; however, the measured values did not differ significantly from those of the control groups. Due to limitations such as a small sample size, a relatively short follow-up period, and varying baseline crestal bone levels, these findings should be interpreted with caution. Conclusion: Due to the restrictions of this split-mouth study, T-PRF-treated sites showed a trend towards increased early implant stability and decreased crestal bone loss compared to control sites. However, because of the small sample size and short follow-up period, conclusive evidence cannot be drawn about the clinical superiority of T-PRF. Further appropriately powered randomized controlled trials with prolonged follow-up periods are necessary to determine the long-term clinical efficacy of T-PRF in implant therapy. Clinical Trial Registration number: CTRI/2022/11/047159.
Anuraga Tejaswi Thotimpuri, M. Pasupuleti, G. Penmetsa et al.· Journal of Advanced Periodon...· 0 citations