Robotic systems have emerged in dental implant surgery due to their accuracy. Autonomous robotic surgery may offer unprecedented advantages over conventional alternatives. This clinical protocol was used to show the feasibility of autonomous robotic surgery for immediately loaded implant-supported full-arch prostheses in the maxilla. This case report demonstrated the surgical protocol and outcomes in detail, highlighting the pros and cons of the autonomous robotic system. Within the limitations of this study, autonomous robotic surgery could be a feasible alternative to computer-assisted guided implant surgery.
Peri-implantitis, a complex condition that can lead to dental implant failure, is characterized by inflammatory destruction resulting from immune dysregulation. Oral microbial dysbiosis and foreign body stimulation are the main factors contributing to such dysregulation, impairing immune cell function and triggering an inflammatory response. Immune dysregulation plays a critical role in the pathophysiology of peri-implantitis, impacting the balance of T cell subsets, the production of inflammatory factors, and immune-related molecular signaling pathways. Understanding the relationship between immune dysregulation and peri-implantitis is crucial for developing targeted strategies for clinical diagnosis and individualized treatment planning. This review explores the similarities and differences in the immune microenvironment of oral bacterial infections and foreign body rejection, analyzes the relevant molecular signaling pathways, and identifies new key targets for developing innovative immunotherapeutic drugs and effective and personalized treatment modalities for peri-implantitis. Additionally, it addresses the challenges and potential directions for translating immunotherapy into clinical practice for peri-implantitis, offering insights that bridge the gaps in current literature and pave the way for future research.
19 October 2023 in Clinical Oral Implants Research
Objectives: This study evaluated the accuracy of dental implant placement using the robotic computer‐assisted implant surgery (r‐CAIS) technology in fully edentulous patients.Materials and Methods: Fully edentulous and terminal dentition patients were enrolled for r‐CAIS technology. Based on the cone‐beam computed tomography (CBCT) examination, a customized positioning marker and a preoperative surgical plan were created before surgery. During the implant surgery, the implant osteotomy and placement were automatically performed using an autonomous robotic surgery system under the surgeon's supervision. A postoperative CBCT scan was used to determine the discrepancies between the planned and placed implants.Results: Ten patients with 59 implants underwent autonomous robotic surgery. No adverse surgical events occurred. The deviations of global coronal, global apical, and angular were 0.67 ± 0.37 mm (95% CI: 0.58–0.77 mm), 0.69 ± 0.37 mm (95% CI: 0.59–0.78 mm), and 1.27° ± 0.59° (95% CI: 1.42°–1.11°), respectively.Conclusions: The autonomous r‐CAIS technology proved an accurate surgical approach for implant placement in fully edentulous patients due to the control of the angular deviation. Autonomous robotic surgery seems promising as an accurate technology for treating fully edentulous patients. However, further trials are required to provide more hard clinical evidence.
Background: Increased attention has been focused on the associations of periodontal disease with the onset and progression of cognitive impairment. Although the associations are likely to be multifactorial, few studies have explored the role of mitochondrial dysfunction in the periodontitis‐dementia link.Methods: Cross‐sectional data of 1,883 participants aged ≥60 years in the National Health and Nutrition Examination Survey 2011‒2014 were analyzed. The following data were collected: 1) general information on sociodemographic, behavioral, and health‐related factors; 2) periodontal status (mean attachment loss [AL] and mean probing depth [PD]); 3) mitochondrion‐derived biomarker of mitochondrial dysfunction (blood sample concentration of methylmalonic acid [MMA]); 4) cognitive function (Consortium to Establish a Registry for Alzheimer's disease immediate recall [CERAD‐IR] and delay recall [CERAD‐DR], animal fluency test, and digit symbol substitution test [DSST]). Mediation analysis weighted for complex survey design was used to assess the effect of MMA on the association of periodontal status with cognitive function after adjusting for potential confounders.Results: Participants with Stage III and IV periodontitis had lower scores on cognitive performance and higher MMA levels than those with Stages I/II periodontitis. Circulating MMA was significantly associated with CERAD‐DR (weighted β [SE] = −0.076 [0.011]) and DSST (weighted β [SE] = −0.039 [0.009]), which mediated 9.9% and 6.0% of the total association of mean PD with cognitive function. Moreover, MMA mediated 11.7% and 5.8% of the association of mean AL with CERAD‐DR and DSST, respectively.Conclusion: The findings suggest that MMA, a biomarker of mitochondrial dysfunction, plays a mediating role in the link between periodontitis and cognitive impairment in older adults aged ≥60 years.
Zinc-based biodegradable metals (BMs) have been developed for biomedical implant materials. However, the cytotoxicity of Zn and its alloys has caused controversy. This work aims to investigate whether Zn and its alloys possess cytotoxic effects and the corresponding influence factors. According to the guidelines of the PRISMA statement, an electronic combined hand search was conducted to retrieve articles published in PubMed, Web of Science, and Scopus (2013.1–2023.2) following the PICOS strategy. Eighty-six eligible articles were included. The quality of the included toxicity studies was assessed utilizing the ToxRTool. Among the included articles, extract tests were performed in 83 studies, and direct contact tests were conducted in 18 studies. According to the results of this review, the cytotoxicity of Zn-based BMs is mainly determined by three factors, namely, Zn-based materials, tested cells, and test system. Notably, Zn and its alloys did not exhibit cytotoxic effects under certain test conditions, but significant heterogeneity existed in the implementation of the cytotoxicity evaluation. Furthermore, there is currently a relatively lower quality of current cytotoxicity evaluation in Zn-based BMs owing to the adoption of nonuniform standards. Establishing a standardized in vitro toxicity assessment system for Zn-based BMs is required for future investigations.