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Open research questions in Dental Implant Techniques and Outcomes

645 unresolved questions extracted from the limitations and future-work sections of 10,633 Dental Implant Techniques and Outcomes papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Therefore, current findings support the biological plausibility of CAP as an adjunctive strategy, while its clinical effectiveness and optimal application protocols remain to be established through well-designed in vivo studies and clinical trials.

    Cold atmospheric plasma for implant surface decontamination and osseointegration: a scoping review with implications for peri-implantitis management · 2026 · DOI

  • While reconstructive surgery has been proven effective in regenerating peri‐implant tissues, the long‐term stability of the regenerated tissues and the impact of supportive peri‐implant care (SPIC) on bone levels remains underexplored.

    Bone stability after regenerative peri‐implantitis treatment: A 10‐year follow‐up case study · 2026 · DOI

  • Within the limitations of the current study, it can be concluded that the modified traditional protocol applied predelivery and at delivery demonstrated better results compared to the conventional protocol in terms of the distribution of relative masticatory pressure, presence of premature contacts, pressure variation between occlusal contact points (balanced / unbalanced), and treatment management values.

    In Vivo Evaluation Of Two Different Protocols For The Fabrication Of Implant-Supported Overdenture Prostheses · 2026 · DOI

  • The reviewed studies exhibit several limitations. Many are laboratory or finite-element investigati- ons that simulate connectors and occlusal loads; their outcomes may not fully predict in-mouth per- formance. Clinical studies tend to be retrospective or case reports with small samples. There is incon- sistency in studying parameters (e.g. different con- nector dimensions, materials, loading conditions), making direct comparisons difficult. Furthermore, the “survival” of FDPs can be defined variably (frac- ture vs. debonding vs. secondary caries), and long- term (>5–10 year) data specifically linking failures to connector design are scarce. These gaps under- score the need for standardized methodologies and prospective clinical trials to validate design recom- mendations.

    Connectors and attachments in the survival of fixed dental prostheses: a comprehensive review · 2026 · DOI

  • sample size, and protocol transparency reduce the overall quality of evidence. in assessor blinding, According to the Revised Cochrane Risk of Bias Tool (RoB2), the study was graded overall to have “some concerns” risk of bias rather than high risk. Although the randomization and allocation methods were appropriate and an intention-to-treat approach was used, concerns remained regarding baseline imbalances between groups, moderate attrition, and the potential for detection bias because treating clinicians performed a substantial proportion of the follow-up assessments on their own restorations (41%). Additionally, the relatively small sample size and absence of technical complications limited the statistical power to detect rare failures. SB is a parafunctional activity characterized by rhythmic or activity during sleep2. non-rhythmic masticatory muscle Although not classified as a disorder, SB has been associated with several clinical consequences, including tooth wear, temporomandibular disorders, headaches, and muscular pain. The etiology of SB is multifactorial and may involve central nervous system activity, psychological stress, anatomical factors, environmental Importantly, SB has also been linked with obstructive sleep apnea (OSA), with some theories suggesting that SB may function as a compensatory mechanism to help maintain airway patency during sleep. Effective management of SB often requires a influences, and genetic predisposition. 1Department of Orthodontics, University at Buffalo School of Dental Medicine, Buffalo, NY, USA. email: [email protected] Received: 29 May 2026 Accepted: 4 June 2026 2 multidisciplinary approach involving sleep physicians, dentists, and other healthcare professionals3. Sleep bruxism has traditionally been regarded as a major risk factor for ceramic restoration failure, frequently leading clinicians to avoid all-ceramic crowns in these patients. This randomized controlled trial challenges this long-standing clinical assumption by demonstrating comparable survival and complication rates restored with between bruxism and non-bruxism patients monolithic ceramic crowns. The findings suggest that SB alone may not increase complication or failure rates over a 3-year period. A notable strength of this study lies in its structured bruxism assessment, which incorporated electromyographic monitoring in addition to clinical indicators and patient reporting—allowing SB to be identified through subject, clinical, and device-based assessment methods2. Many previous studies relied solely on indirect signs such as tooth wear, potentially overestimating the relationship between bruxism and restoration failure. By improving diagnostic rigor, the authors provide stronger evidence regarding the true clinical impact of SB.

    Do sleep bruxism patients experience higher complication or failure rates with monolithic lithium disilicate or zirconia molar crowns? · 2026 · DOI

  • Despite the growing clinical evidence, several limitations make it difficult to isolate the specific effect of the implant– abutment micro-gap on peri-implant inflammation and bone loss.

    Implant–Abutment Interface and Peri-implant Inflammation in One-Piece and Two-Piece Dental Implants: A Narrative Review · 2026 · DOI

  • Within the limitations of this study, the use of CAD/ CAM-fabricated 3D-printed surgical guides resulted in significantly greater accuracy of implant placement com- pared with conventional freehand techniques, as reflected in reduced angular, coronal, apical, and depth deviations.

    Comparison of 3D Printed and Conventional Surgical Guides for Dental Implant Placement Accuracy: A Clinical Study · 2026 · DOI

  • This study has several limitations that should be consid- ered when interpreting the results. The sample size was relatively small, which may restrict the generalizability of the findings, and the inclusion of heterogeneous implant sites—spanning maxillary and mandibular regions as well as anterior and posterior areas—may have influenced devi- ation values. The absence of fixation pins in both groups could have allowed minor guide movement during osteot- omy preparation. Additionally, the use of a 1-month post- operative CBCT scan may have introduced measurement variability due to early bone remodelling; however, this timing was dictated by institutional ethical and logistical constraints rather than a methodological advantage. Scan timing does not influence radiation dose, and immediate postoperative CBCT would have been more appropriate for accuracy assessment. Another limitation is the lack of blinding, as the same surgeon performed the implant place- ments and conducted the radiographic evaluations, poten- tially introducing operator bias. The conventional guides did not incorporate CBCT-derived positional transfer and were instead fabricated manually on diagnostic casts, which 1 3Journal of Maxillofacial and Oral Surgery may inherently reduce accuracy. Occasional guide instabil- ity may also have occurred due to anatomical constraints. Finally, the relatively short follow-up period limits the ability to draw conclusions about long-term implant sur- vival beyond early osseointegration. In addition, statistical analysis was performed at the implant level rather than the patient level. As some patients contributed more than one implant, observations may not be completely independent, which could influence statistical interpretation. Further- more, implant survival was assessed only at 1 month and at the time of loading; therefore, this outcome reflects early osseointegration rather than long-term implant success. The relatively short follow-up period also prevented evaluation of the long-term clinical performance of CAD/CAM surgi- cal guides after definitive prosthetic rehabilitation. Although early implant survival was 100% in both groups, the short observation period limits the clinical inter- pretation of survival outcomes and does not reflect long- term implant success.

    Comparison of 3D Printed and Conventional Surgical Guides for Dental Implant Placement Accuracy: A Clinical Study · 2026 · DOI

  • Additionally, operator learning curves and long-term clinical outcomes were not evaluated and warrant further investigation. However, the study is limited by a modest sample size (n = 30) and non-randomised group allocation, which may affect generalisability and introduce selection bias.

    Comparative Evaluation of Accuracy Between Dynamic and Hybrid Navigation Systems in Dental Implant Placement · 2026 · DOI

  • Within the limitations of this study, zirconia and titanium implants demonstrated distinct but not definitively superior microbial profiles; zirconia showed a tendency toward reduced bacterial colonization, while titanium exhibited lower microbial diversity, without clear evidence that one material is clinically superior to the other.

    Microbial evaluation of zirconia and titanium implants in the anterior mandibula: a randomized controlled clinical trial · 2026 · DOI

  • First, a key limitation is the inability to perform subgroup analyses based on glycemic control (such as HbA1c ≤7 vs. Sixth, the potential effect of diabetes‑related comorbidities (such as cardiovas‑ cular disease and nephropathy) on NDI outcomes could not be assessed because most included studies either excluded patients with significant comorbidities or did not report this information. However, these PROs could not be evaluated due to insufficient data in the included studies.

    Efficacy of narrow‑diameter implants in restoring dentition defects in patients with diabetes: A systematic review and meta‑analysis · 2026 · DOI

  • Buser D, Sennerby L, De Bruyn H (2017) Modern implant den- tistry based on osseointegration: 50 years of progress, current trends and open questions.

    Influence of Peri-implant Bone Defects and Implant Diameter on Primary Stability: An In Vitro Study · 2026 · DOI

  • Conflict of interest For the study, follow-up duration was limited to 6 months, which may not fully capture long-term occlusal adaptation. The sample size, although statistically calculated, was relatively modest. Additionally, occlusal analysis was performed under The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

    Prospective evaluation of occlusion time and force distribution in implant-supported fixed prostheses using the T-scan · 2026 · DOI

  • Artifacts caused by metallic restorations, variations in voxel resolution, and challenges in identifying specific anatomical boundaries in complex anatomical situations limit CBCT imaging reliability.

    <b>Accuracy and Clinical Pitfalls of Cone-Beam CT for Planning Zygomatic Implant Placement: A Systematic Review</b> · 2026 · DOI

  • CONCLUSIONS: Considering the limitations of this study, individualized one-piece Zr abutments exhibited a significant increase in lingual microgaps and comparable changes in microleakage to Ti abutments after 24 months of functional loading.

    Evaluation of microgaps and microleakage at the implant-abutment interface of individualized abutments in the maxillary anterior region under functional loading: A pragmatic clinical trial · 2025 · DOI

  • Despite numerous advancements in patient-specific implants (PSIs), the biomechanical impact of PSI thickness and the number of screws used for fixation remain unexplored.

    Finite element analysis of shape and thickness variations in patient-specific implants for t-shaped genioplasty · 2025 · DOI

  • Although titanium, cobalt-chromium, zirconia, and polyether ether ketone (PEEK) are widely used, their biomechanical performance under dynamic loading conditions remains insufficiently investigated.

    Biomechanical behavior of titanium, cobalt-chromium, zirconia, and PEEK frameworks in implant-supported prostheses: a dynamic finite element analysis · 2025 · DOI

  • Most reviews addressed anatomical, surgical, and prosthetic factors for improving single-unit IIP and IR in the esthetic zone, with limited evidence for molars or multiunit prostheses.

    Immediate Implant Placement and Restorations in Single-Unit and Multiple-Unit FDPs: A Scoping Review of the Current Evidence, Indications, and Clinical Protocols · 2025 · DOI

  • CLINICAL SIGNIFICANCE: IOS could be a viable alternative particularly for shorter distances in the edentulous jaw, although the clinical implications of these deviations need to be investigated in future studies.

    Accuracy of digital and conventional implant impressions in edentulous jaws: A clinical comparative study · 2025 · DOI

  • OBJECTIVES: Since peri-implantitis is an increasing and prevalent concern in clinical practice and there is no consensus regarding the best therapeutic protocol, this study evaluated the knowledge and behaviours of dentists working in Implantology regarding implant-related infections modulating factors and therapeutic protocols used in the management of peri-implantitis.

    Peri‐implantitis: Knowledge and attitudes of implantology clinicians regarding the disease management · 2024 · DOI

  • Likewise, theories have been suggested regarding the intrusion of natural teeth when they are connected to an implant as part of a fixed partial denture as well as intrusion when a tooth is located between adjacent implants, but the process of intrusion, and resultant extrusion, is not fully understood.

    Proposal regarding potential causes related to certain complications with dental implants and adjacent natural teeth: Physics applied to prosthodontics · 2024 · DOI

  • Conclusion: Within the limitations of the present study, the obtained results indicate that short implants provided a similar clinical and radiographic performance compared to long implants placed in combination with a sinus augmentation procedure (lateral window) up to 12 months after prosthetic loading.

    Comparative evaluation of hard and soft tissue parameters by using short implants and standard long implants with sinus lift for prosthetic rehabilitation of posterior maxilla · 2024 · DOI

  • Considering the limitations of the present study, the absence of PIMT was found to be associated with peri-implantitis, which was itself associated with early implant failure.

    Effect of Implant Maintenance on Incidence of Peri-implantitis and Early Implant Failure: Retrospective Cohort Study · 2024 · DOI

  • CONCLUSION: Within the limitations of this study, implant angulations upto 15 degrees do not affect differential change in retention of Novaloc patrices.

    Effect of implant angulation and patrice on the retention of overdenture attachment systems: An in vitro study · 2023 · DOI

  • CONCLUSIONS: The characteristics of the currently used ISBs vary widely and the available scientific evidence is not yet conclusive about the optimal design of ISB.

    Characteristics of intraoral scan bodies and their influence on impression accuracy: A systematic review · 2023 · DOI

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645 open questions have been extracted from the limitations and future-work passages of 10,633 Dental Implant Techniques and Outcomes papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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