| Objective:The global research status and development trend of osteoporosis as well as dental implant therapy are evaluated through a bibliometric analysis of related research on osteoporosis and dental implant therapy;in the meanwhile a retrospective study was conducted to evaluate the long-term clinical outcome of computer-assisted edentulous implant fixation in high-risk osteoporosis population in order to provide evidencebased bases for the clinical treatment of osteoporosis.Materials and methods:1.Bibliometric Analysis and Visualization study on the relationship between Osteoporosis and Dental Implant TherapyAll the literature about osteoporosis and dental implant therapy from December1994 to February 2020 was searched through SCI-EXPANDED database.RStudio software was utilized to make a quantitative analysis of the relevant literature,so as to grasp the current research situation in this field.VOSviewer software was used to investigate the visualization of related literature,such as coupling and co-citation,furthermore the future research hotspots as well as development trends in this field were also analyzed.2.Long-term clinical follow-up study on computer-assisted edentulous implant fixation restoration in middle-aged and elderly patientsThe patients were selected from November 2012 to January 2016 in Yantai Stomatological Hospital among those with a good health status and no contraindications for implant surgery.Computer-assisted edentulous implant fixation treatments were finally collected for 15 middle-aged patients(23 single jaws)with a total of 145 implants.Mucosa-supporting guide was used for all patients to complete the implant placement,and a temporary restoration was performed immediately after surgery.The final restoration was performed one year after surgery,and a one-piece prosthesis or a segmented prosthesis was delivered according to the objective situation and subjective will of the patients.The imaging data and medical records of the patients before and after operation were collected,the implant retention rate,biological complications and the incidence of hardware complications were evaluated.And both the pre-operative design and the post-operative cone beam CT were introduced into Simplant software to compare the position difference of the implant between the pre-operative design and post-operative outcome,so as to evaluate the accuracy of computer-assisted dental implant technique.The apical slices after a temporary restoration and follow-up of 5 years were introduced into Adobe Illustrator CC2019 and image J software to evaluate changes of the level of peri-implant marginal bone and bone mineral density,meanwhile a Chinese-version OHIP-14 questionnaire was used to evaluate the patients’ satisfaction with implant restoration and their oral health quality in daily life.Results:1.Through the bibliometric analysis of 267 articles finally included in this study,a conclusion was drawn.:The number of documents published all over the world was the largest in 2017,and the amount of literature cited has been on the rise.There is the largest number of documents published and cited in China,which is the country that has made the greatest contributions in this field.The largest number of documents and H index are published by "CLINICAL ORAL IMPLANT SRESEARCH".All studies can be divided into four parts: clinical experiments,in vivo experiments,bisphosphate and in vitro experiments.In the future,researches in this field may be focused in vitro experiments on how to promote the osseointegration mechanism of implants.2.At the end of this study,15 patients aged from 50 to 67(58.6 ±5.3)years old were included(11 male patients and 4 female patients).A total of 145 implants were placed,including 79 implants on maxilla and 66 on mandible.A total of 23 single jaws were repaired,13 with one-stage prostheses and 10 with two-piece prostheses,with a total of 35 prostheses,15 screw retention prostheses and 20 adhesive retention prostheses.The average follow-up time was 74.3 months(60-94 months).(1)Of the 145 implants,2 cases of loosening and failing occurred before loading,and 2 others were reimplanted after cleaning the placement sockets.The 5-year cumulative retention rate of the implant was 98.6%(2/145).Of the 145 implants,the incidence of implant-related biological complications and hardware complications of implant restoration was 2.8%(4/145)and 45.7%(16/35)respectively.(2)No implant complications such as nerve injuries,abnormal bleeding or sinus lesions was recorded in the 15 patients.The result of accuracy evaluation of mucosasupported implant guide showed the deviation of implant shoulder was 0.78 ±0.59 and1.38 ±0.63 mm in apical,0.65 ±0.35 mm in depth and 4.12 °±2.77 °mm in angle.There was a positive and moderate correlation between shoulder deviation and apical deviation(r=0.417,P<0.05),but there was no correlation among other deviations(P>0.05).There was no significant difference in the shape of square arch or oval arch on the implant accuracy(P<0.05).(3)After 5 years of implant loading,the marginal bone resorption of maxillary implants [(0.74 ±0.36)mm] was higher than that of the mandibular marginal bone resorption [(0.65 ±0.34)mm],but the difference was not statistically significant(P>0.05).Other influencing factors such as sex,jaw,restoration mode,dental arch shape,retention,bone type and implant system did not affect the bone level around the implant(P>0.05).(4)After 5 years of implant loading,the bone mineral density around the implant decreased over time,and that decreasing around implants with a one-piece prosthesis was significantly higher than that with a segmental prosthesis(P < 0.05).The reduction of bone mineral density around implants with screw retention was significantly higher than that around adhesive retention(P<0.05).As for the impact of bone type on the bone mineral density surrounding the implant,there was no significant difference between the crest parietal region and the sub-crest region,but in the middle region,apical lateral region and apical area,the decrease of bone mineral density of Type-I bones was the highest and that of Type-IV bones was the lowest.(5)In this study,the Chinese-version OHIP-14 was used to assess patient satisfaction.The final average score was 0.33,the quality of oral health of the patients was higher,and the clinical outcome of implant restoration was satisfactory.Conclusion:1.The research field of osteoporosis and dental implant therapy is still being developed,and China has made the greatest contribution on this field,in which CLINICALORALIMPLANTSRESEARCH magazine is the core journal.In the future,the research hotspot in this field may focus on in vitro experiments,so as to promote specific mechanisms for the osseointegration of implants.2.The edentulous implant surgery guided by computer(mucosa-supported implant guide plate)has a high accuracy and can fully meet the clinical demand.3.Middle-aged and elderly patients,as a high-risk group susceptible to osteoporosis,can obtain long-term and stable clinical outcome by receiving computerasided dental implant fixation restoration treatment,which is related to the bone type of the implant site,prosthesis design and retention mode but has nothing to do with sex,upper and lower jaw,dental arch shape,implant system or immediate implant placement. |
PDF Full Text Request