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Introduction Purpose Materials and methods Results Conclusion Bidirectional vertical ridge augmentation in the posterior maxilla is very challenging.To evaluate the regenerative potential of micrografts, derived from periosteum or bone tissue, added to an anorganic xenograft in vertical reconstruction of the posterior maxilla, by a prospective, controlled study.After clinical selection and the analysis of CBCT scans, 24 posterior maxillary sites, in 19 patients, were treated by using Barbell Technique®. Sites requiring both inlay and onlay reconstruction were enrolled in the study. In the Control Group (CG, n = 8), a xenograft was used in the inlay site and for the onlay site, a 1:1 mix of xenograft and an autograft was used. In Test Group 1 (TG1, n = 8), both inlay and onlay sites were grafted with the xenograft associated with the micrografts derived from periosteum. In Test Group 2 (TG2, n = 8), both inlay and onlay sites were grafted with the xenograft associated with the micrografts derived from bone. Six months after the procedures, CBCT scans were obtained, and bone biopsy samples were harvested during implant placement surgery. The bone specimens were analyzed histomorphometrically, by measuring the percentages of vital mineralized tissue (VMT), non vital mineralized tissue (NVMT) and non mineralized tissue (NMT). Immunohistochemically, the levels of VEGF were categorized by a score approach.Histomorphometric analysis revealed, for the inlay grafts, no significant difference among the groups for VMT, NVMT and NMT. However, for onlay grafts, CG achieved a higher amount of VMT in comparison with TG2, and the opposite occurred for NMT values. In this regard, no statistical difference was observed between CG and TG1. Concerning immunohistochemistry, the VEGF values for CG and TG1 were slightly higher than those obtained by TG2 for both inlay and onlay grafts, but without statistical significance. CBCT analysis showed a similar level of gain for all groups, for both inlay and onlay bone augmentation sites. Clinically, one implant (in CG) within a total of 50 implants installed, had early failure and was replaced after 3 months. All patients received implant supported prosthesis.This study indicated that the clinical use of micrograft derived from periosteum may have some potential to increase bone formation in onlay reconstructions, unlike the micrograft derived from bone tissue. [ABSTRACT FROM AUTHOR]

Objectives Materials and methods Results Conclusions To reveal the force profiles recorded by haptic autonomous robotic force feedback during the transcrestal sinus floor elevation (TSFE) process, providing a reference for the surgery strategy during TSFE.A total of 42 maxillary sinus models with different angles of the sinus floor (30°, 40°, 50°, 60°, 70°, 80°, and 90°, compared to vertical plane) were 3D printed. Implant site preparation was performed using a robotic system, and the total force (Ft) and axial force along the drill (Fz) during the surgery were recorded by the haptic robotic arm. The actual initial breakthrough point (drill contacting sinus floor) and complete breakthrough point (drill penetrating the sinus floor) were defined visually (the actual IBP and the actual CBP). The theoretical initial breakthrough point (the theoretical IBP) and the theoretical complete breakthrough point (the theoretical CBP) defined by the robot‐guided system and the CBCT were determined by real‐time force feedback and imaging distance measurement, respectively. The distance from the bottom of the resin model to the actual IBP and the actual CBP was defined as Di and Dt, respectively.The difference in Fz began to increase significantly at 70°, while the difference in Ft became significant at 60°. When the angle was greater than 70°, there was no significant difference in the discrepancy between the actual and theoretical perforation points. Compared to judging the breakthrough point by CBCT, real‐time force feedback TSFE under robotic surgery achieved more accurate initial breakthrough point detection.The smaller the angle, the larger the breakthrough force for the drill. The real‐time force feedback of haptic robotic system during TSFE could provide reliable reference for dentists. More clinical studies are needed to further validate the application of robotic surgery assisted TSFE. [ABSTRACT FROM AUTHOR]

Objective Materials and Methods Results Conclusions The SafetyCrown workflow facilitates the immediate restoration of posterior single sites with the one‐abutment/one‐time concept. This randomized clinical trial aimed to assess the direct effect of immediate restoration on dental patient‐reported outcomes (dPROs), feasibility, implant accuracy, and time.Participants with a single posterior edentulous site for late implant placement underwent optical impressions, shade selection, and cone beam computed tomography. After virtual treatment planning, they were randomized into the test group and the control group. For the test group, individual definitive hybrid abutments were prefabricated. The next step was a fully guided surgery with printed guides. After the implant was placed using guided surgery, the abutment was inserted. A chairside CAD/CAM workflow was used to provide the patient with a provisional restoration. Implants in the control group were left submerged to heal. Oral health‐related quality of life (OHRQoL) was assessed using the OHIP‐G14, and dPRO was measured using a 10‐item visual analog scale (VAS) questionnaire. Additional measurements of implant accuracy and time were performed. Follow‐up was performed 7 to 10 days after implant placement.Thirty‐nine participants with 45 restorations were included (test group: 23, control: 22). Immediate restoration was successful in 21 out of 23 implants (91.3%) in the test group. Both groups exhibited decreased OHRQoL without significant intergroup differences, while patient satisfaction was high overall. Test group participants perceived higher benefits and satisfaction with immediate loading than participants in the control group. Implant accuracy averaged 0.60 mm at the shoulder and 0.95 mm at the apex. Operative time was longer in the immediate loading group (61.9 min) than in the control group (32.1 min) (p < 0.001).Considering the limitations, the immediate restoration of late placed posterior implants using the described workflow proved feasible in 21 out of 23 cases. Both groups achieved high patient satisfaction with no differences in OHRQoL during the first week. Patients who received immediate loading rated the benefits very highly and were satisfied with the provisional restoration during the healing period. [ABSTRACT FROM AUTHOR]

Objective and Aim Materials and Methods Results Conclusion Challenging defect configurations and dimensions arise from severe, localized vertical alveolar ridge defects caused by trauma or prior surgery. This study aims to analyze three‐dimensional bone gain, assess marginal bone stability in such defect configurations, and evaluate the impact of grafting outside the bone contour on the overall outcome, with a focus on iliac crest block grafts as a valid treatment option.The prospective cohort study evaluated patients who required vertical block grafting due to localized bone defects in the maxilla or mandible and who had received iliac grafts. Three‐dimensional bone gain was analyzed using cone beam computed tomography (CBCT) after 3 months of bone healing for each treated site and implant position. A comparison between bone grafts inside and outside the bone contour was conducted. Marginal bone stability was measured using intraoral radiographs during routine annual follow‐up visits.Seventy patients with 89 treated sites were evaluated. After 3 months of graft healing, the mean vertical bone gain was 11.03 ± 3.54 mm, the mean horizontal bone gain was 7.18 ± 2.00 mm, and the mean graft length was 28.19 ± 11.01 mm. A total of 217 implants were placed in the augmented regions. On implant level, a mean vertical bone gain of 10.44 ± 3.44 mm and a mean horizontal bone gain of 6.54 ± 1.86 mm were measured. Over a 43‐month observation period, mesial and distal marginal bone loss averaged 0.44 ± 0.92 mm and 0.49 ± 1.05 mm, respectively. Eight implants were diagnosed with periimplantitis, resulting in the loss of four implants, while no early implant losses were reported.Within the limitations of this study, vertical bone grafts with iliac crest block grafts were found to be a dependable treatment option for dental implant placement, and placing block grafts outside the bone contour did not lead to inferior outcomes. [ABSTRACT FROM AUTHOR]

Objective: To compare collected bone weight and the frequency of autologous bone harvesting from the flutes of surgical drills used for implant bed preparation using two different drilling techniques. A comparative evaluation of radiographic bone density and bone quality was also made. Materials and Methods: A randomized clinical trial was made of 66 dental implants in patients with a single posterior edentulous site. The compared drilling techniques were high‐speed drilling with irrigation (control group) and low‐speed drilling without irrigation (test group). The bone collected in both groups was dried and weighed with a precise electronic balance. The frequency of harvesting was calculated. The median radiographic bone density of each implant site was measured using cone‐beam computed tomography (CBCT) pixel values. Patient sex, age, implant position and dimensions, as well as the last drill diameter were analyzed as independent variables. The level of significance was 5%. Results: The harvesting of bone chips from drill flutes proved possible in 51.5% of the procedures in the control group and in 100% in the test group (p < 0.001). There were also statistically significant differences in bone weight between the control group (6.7 ± 10.6 mg) and the test group (41.9 ± 30.3 mg) (p < 0.001). The CBCT pixel values were directly correlated with the collected bone weight in both groups. The median radiographic bone density, arch and last drill diameter were significantly associated with harvesting bone frequency and collected bone weight (p < 0.05). Conclusions: Our findings suggest that the frequency and weight of autologous bone harvested from drills are greater with low‐speed drilling without irrigation than with high‐speed drilling with irrigation. Radiographic bone density, arch and last drill diameter also significantly influenced the harvesting outcomes. [ABSTRACT FROM AUTHOR]

Objectives Materials and Methods Results Conclusions To assess navigation accuracy for complete‐arch implant placement with immediate loading of digitally prefabricated provisional.Consecutive edentulous and terminal dentition patients requiring at least one complete‐arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre‐operative and post‐operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T‐tests were performed to investigate the potential effect of the registration algorithm (fiducial‐based vs. fiducial‐free), type of references for the fiducial‐free algorithm (teeth vs. bone screws), site characteristic (healed vs. post‐extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p‐value <0.05.Twenty‐five patients, 36 complete‐arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post‐extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single‐axis deviations were reported for the type of jaw (y‐axis at implant platform and apex), registration algorithm (y‐axis platform and z‐axis deviations), and type of references for the fiducial‐free algorithm. No statistically significant differences were found in relation to implant angulation.Within the study limitations navigation was reliable for complete‐arch implant placement with immediate loading digitally pre‐fabricated FDP. AI‐driven surface anatomy identification and calibration protocol made fiducial‐free registration as accurate as fiducial‐based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post‐extractive. Live‐tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).This protocol involves the acquisition of three‐dimensional (3D) patient data through intraoral scanning (IOS) and cone beam computed tomography (CBCT). These data are loaded into AI software which automatically segments and aligns the patient's 3D models. These 3D models are loaded into MR software and used for planning implant surgery through holography. The files are then exported and used to design surgical guides via open‐source software, which are 3D printed and used to prepare the implant sites through static computer‐assisted implant surgery (s‐CAIS). The case is finalized prosthetically through a fully digital protocol. The accuracy of implant positioning is verified by comparing the planned position with the actual position of the implants after surgery.As a proof of principle, the present protocol seems to be to be reliable and efficient when used for planning simple cases of s‐CAIS in partially edentulous patients. The clinician can plan the implants in an authentic 3D environment without using any radiology‐guided surgery software. The precision of implant placement seems clinically acceptable, with minor deviations.The present study suggests that AI and MR technologies can be successfully used in s‐CAIS for an authentic 3D planning. Further clinical studies are needed to validate this protocol. [ABSTRACT FROM AUTHOR]

Introduction: Patients with mucosal cysts in the maxillary sinus require special consideration in patients who require implant therapy for the restoration when undergoing implant therapy for the restoration of the posterior maxillary dentition. Treatment strategies for these clinical situations remain controversial in the literature. Thus, this study seeks to describe a safe and effective therapeutic strategy for sinus augmentation in patients with pre‐existing maxillary antral cysts. Methods: A total of 15 patients and 18 sinuses were consecutively enrolled in this cohort study and underwent maxillary antral cyst treatment by needle aspiration and simultaneous maxillary sinus augmentation (MSA). During surgical procedures, threeimplants (Zimmer Biomet, Indiana, USA) were positioned in 11 sinuses and two implants (Zimmer Biomet, Indiana, USA) were positioned in 5 sinuses. Results: Overall implant success and survival rates were 100% and 97.8%, respectively at 1 year and 5‐year follow‐ups. Crestal bone resorption averaged 0.3 ± 0.2 mm 5‐year post‐loading, showing bone stability. Implant survival rate at 5‐year follow‐up expressed predictability of the technique comparable to historical data when MSA was performed alone. Crestal bone resorption averaged 0.3 ± 0.2 mm 5 years post‐loading and shows bone stability utilizing mucosal cyst aspiration with concomitant MSA procedures. Quality of life evaluation at 1‐week post‐op showed similar results to published historical data. In 81% (13 sinuses), the CBCT examination at 5‐year follow‐up showed no cyst reformation, in 19% (3 sinuses) cyst reformation was visible, but smaller in size when compared to the pre‐op CBCT evaluation, and all the patients were asymptomatic. Conclusions: Maxillary sinus mucosal cyst aspiration with concomitant MSA, may be a viable option to treat maxillary sinus cyst. [ABSTRACT FROM AUTHOR]

Aims: (1) To assess the effectiveness of the Sausage Technique™ when applied for lateral bone augmentation by multiple experienced clinicians; (2) To identify risk indicators for a poor outcome and to assess the need for adjunctive surgery. Materials and Methods: All patients who had been treated with the Sausage Technique™ for lateral bone augmentation by three experienced surgeons between January 2019 and December 2021 were included in a retrospective case series. The Sausage Technique™ technique includes the use of autogenous bone chips and deproteinized bovine bone mineral (1:1 ratio), covered with a stretched and pinned collagen membrane. The increase in alveolar width between the pre‐operative situation and 9 months was assessed at different levels on superimposed cone‐beam CT scans. Results: Twenty‐five augmentations performed in 25 patients (17 males, 8 females, mean age 51 years) were available for evaluation. Mean alveolar width increased from 4.35 to 7.43 mm at 3 mm below the crest. The mean increase of 3.08 mm (95% CI 2.10–4.06; p < 0.001) was significant. The outcome of non‐containing single implant sites was significantly worse than the outcome of other sites (MD 2.67 mm; p = 0.008). The need for regrafting was 4% and the need for soft tissue augmentation was 48%. Twenty percent of the patients needed soft tissue augmentation due to a lack of keratinized mucosa width, and 32% due to a lack of buccal convexity. The former was mainly needed at multiple implant sites, whereas the latter was mainly required at single implant sites. All implant survived and remained healthy until the final follow‐up. Conclusion: The Sausage Technique™ is an effective bone augmentation technique. Non‐containing single implant sites were associated with a poor outcome and adjunctive soft tissue augmentation was needed in about half of the patients. [ABSTRACT FROM AUTHOR]

Objectives: The current guidelines recommend that immediate implants be placed in patients with thick (>1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption. Materials: The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score. Results: Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results. Conclusion: Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long‐term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes. https://classic.clinicaltrials.gov/ct2/results?cond=&term=NCT04731545&cntry=EG&state=&city=&dist= [ABSTRACT FROM AUTHOR]

Background: A peri‐implant cystic lesion is a rare finding, and to date most investigators have considered that its pathogenesis is caused by trauma and infection related to dental implantation. However, the pathogenesis of these cysts remains unclear and is recognized to have multifactorial origins. Case presentation: In February 2021, a 75‐year‐old male patient underwent implant restoration due to mobility of the left maxillary central incisor. The implant achieved good osseointegration and was successfully restored. However, in March 2023, the patient sought treatment due to mobility of the dental implant. Clinical examination showed that the implant had loosened in three directions (vertical, mesial‐distal, and labial‐lingual), and the peri‐implant mucosa was slightly red and swollen. Radiographic examination (cone beam computed tomography) showed a large radiolucent area with clear boundaries involving the cervical and middle portions of the dental implant, and white bone lines were observed at the edge of the low‐density shadow. Intraoperatively, we removed the patient's implant, performed a complete debridement, and conducted bone augmentation surgery in the area of bone defect. Postoperatively, the patient recovered well. The final histopathological result confirmed an epidermoid cyst. Conclusions: Peri‐implant epidermoid cyst is a rare complication that affects the long‐term outcome of implant therapy. This case serves as a warning to clinicians to avoid involving epithelial tissue in the implant site during implant surgery, in order to prevent the potential occurrence of a peri‐implant epidermoid cyst, thereby creating better conditions for the patient's recovery and the long‐term efficacy of the implant. [ABSTRACT FROM AUTHOR]

Introduction: Oro‐control communication is one of the complications associated with dental extraction and oral surgeries. This case report presents a minimally invasive surgical approach for bone regeneration at the site of oro‐antral communication utilizing a prefabricated computer‐aided design and computer‐aided manufacturing (CAD‐CAM) allogenic bone block. Methods: A 20‐year‐old healthy female, nonsmoker, with a badly destructed upper right first molar was referred for dental implant placement after extraction. Cone beam computerized tomography images revealed the presence of a large bone defect associated with oro‐antral communication with the maxillary sinus and insufficient bone for dental implant placement. A prefabricated CAD‐CAM allogenic bone scaffold was fabricated. After surgical exposure, the scaffold was secured in place and covered with a non‐resorbable membrane. A dental implant was placed after 5 months, and a trephining biopsy was processed for histological evaluation. Results: Closure of the oro‐antral communication was clinically observed. The average width of the alveolar bone was 12 mm, and the average height was 11 mm. Histological analysis at 5‐month intervals showed thin newly formed bone trabeculae encircling remnants of graft material surrounded by osteoid tissue. The newly formed bone percentages were 32 ± 18% and 28 ± 17% volume remained after the biodegradation of the scaffold. Specific immune‐histochemical staining by anti‐vascular epithelial growth factor expression index value was 32.06%. Conclusions: A prefabricated CAD‐CAM scaffold was successfully used to seal a large oro‐antral communication and regenerate sufficient bone to place a dental implant. [ABSTRACT FROM AUTHOR]

Objectives: To assess both the radiographic and profilometric outcomes of early implant placement with or without alveolar ridge preservation (ARP) (using two different ARP techniques) after 1 year of loading. Materials and Methods: Seventy‐five patients with a failing single tooth in the anterior maxilla were randomly allocated to three groups (1:1:1): (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM‐C) covered by a collagen matrix (CM), (b) ARP using DBBM‐C covered with a palatal graft (PG), and (c) unassisted socket healing (control). Eight weeks after tooth extraction, early implant placement was performed in all patients. Cone‐beam computed tomography (CBCT) and impressions were taken 8 weeks after tooth extraction (ARP/unassisted healing) prior to implant placement and 1‐year post‐loading. Radiographic and profilometric outcomes were evaluated. Results: Out of the 70 patients available for re‐examination at 1‐year post‐loading, 55 datasets could be assessed (ARP‐CM 19; ARP‐PG 17; Control 19). The need for additional guided bone regeneration (GBR) at implant placement amounted to 31.6% (ARP‐CM), 29.4% (ARP‐PG), and 68.4% (unassisted healing). Adjusted models revealed that residual buccal bone height and additional GBR at implant placement significantly influenced the magnitude of the alveolar changes at 1 year (p < 0.05). In patients with ARP (group ARP‐CM or ARP‐PG) without additional GBR, the presence of bone convexity amounted to 36.0% (9/25) at 1‐year post‐loading. For patients that received ARP and additional GBR at implant placement, the frequency of bone convexity increased to 72.7% (8/11) (p = 0.042). Regarding profilometric measurements, a tendency toward agreement with radiographic outcomes was observed. Conclusions: Early implant placement with ARP can attenuate alveolar ridge changes at 1‐year post loading by minimizing both radiographic and profilometric alterations. However, early implant placement with simultaneous GBR consistently yields superior radiographic and profilometric outcomes, regardless of whether ARP is performed. [ABSTRACT FROM AUTHOR]

Aim: To explore the features of and potential landmarks that predict crestal ridge remodeling after immediate implant placement and provisionalization (IIPP) with thin buccal plate phenotype in the anterior maxilla. Materials and methods: Patients requiring IIPP of single maxillary incisor with thin buccal bone plate (<1 mm) were recruited. Cone‐beam computed tomography (CBCT), performed before and 6 months after the intervention, were three‐dimensionally superimposed. A virtual line connecting the bony emergence points of adjacent teeth was drawn as a reference. The facial–coronal alveolar crest of the extraction socket and healed ridge were located in mesial, middle and distal cross‐sectional planes, and linear ridge reductions were measured. The correlation between ridge reduction and local factors was analyzed. Results: Fifty patients were included. From the extraction socket to healed ridge, the alveolar crest underwent linear bone reduction of 1.50 ± 0.50, 1.54 ± 0.66 and 1.65 ± 0.73 mm in the mesial, middle, and distal regions in an apical–palatal direction. The middle region had significantly higher horizontal (facial–palatal) but lower vertical (coronal–apical) bone reduction than the mesial and distal areas (P < 0.01). The facial–coronal ridge crest of the healed ridge located close to the reference line. Ridge reduction positively correlated with the distance between the initial facial–coronal crest of the extraction socket and the reference line (P < 0.01). Conclusions: Alveolar crest of the socket lost its curvature and tended to attain a flat profile after IIPP due to inconsistent ridge reduction in middle, mesial and distal areas. The reference line may be a potential landmark for predicting the ridge crest after remodeling. [ABSTRACT FROM AUTHOR]

This case report presents the use of haptic robotic technology in one patient with six implants placed in the maxilla and five implants in the lower mandible with the goal of individual single implant supported crowns to be placed over each implant after 6 months. All implants were placed using a flapless technique, with one immediate implant placement after extraction. All implants were placed with a high degree of accuracy relative to the pre‐operative plan as determined by post‐op CBCT analysis with an average angular deviation of 2.58° and positional deviations at the coronal and apical aspects of the implant around 1 mm (0.93 and 1.06 mm, respectively). Total surgical time of less than 2 h. Haptic robotics physically guides the location, orientation, and depth of the tools during both drilling and implantation and thus allows for accurate placement as well as the intra‐operative flexibility to change the plan as necessary while providing excellent visualization and irrigation. This robotic technology provides a treatment that focuses on accuracy and safety providing the best chance at excellent surgical outcomes for the patient. [ABSTRACT FROM AUTHOR]

Aims: To compare the accuracy of the Yakebot dental implant robotic system with that of fully guided static computer‐assisted implant surgery (CAIS) template in edentulous implantation. Materials and Methods: Thirteen patients with edentulous were recruited and divided into two groups: the Yake robotic system group (experimental) (n = 5) and the CAIS group (control) (n = 8). Postoperative cone‐beam computed tomography (CBCT) was performed immediately, and the 3‐dimensional positions of implants were obtained and compared with that in the preoperative design. The comparison showed platform, apical, depth, and angular deviations. A value of p < 0.05 was considered statistically significant. Results: A total of 84 implants (36 in the robotic group and 48 in the CAIS group) were placed. The mean deviation at the implant platform, apex, depth, and angle in the CAIS group was 1.37 ± 0.72 mm, 1.28 ± 0.68 mm, 0.88 ± 0.47 mm, and 3.47 ± 2.02°, respectively. However, the mean deviation at the implant platform, apex, depth, and angle in the robotic group was 0.65 ± 0.25 mm, 0.65 ± 0.22 mm, 0.49 ± 0.24 mm, and 1.43 ± 1.18°, respectively. Significant differences in the four types of deviation (p < 0.05) between the two groups were observed. Conclusion: The accuracy of robotic system in edentulous implant placement was superior to that of the CAIS template, suggesting that robotic system is more accurate, safe, and flexible, can be considered a promising treatment in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Alveolar ridge preservation (ARP) is a technique that aims to maintain bone volume and minimize resorption after tooth extraction. Objective: This study aimed to compare the effectiveness of injectable platelet‐rich fibrin (I‐PRF) versus hyaluronic acid (HA) in combination with xenografts for ARP. Methods: This randomized controlled trial included 36 patients (20 females and 16 males) who required implant placement in the upper arch. The patients were randomly allocated to one of three groups (n = 12 each): I‐PRF with xenografts, HA with xenografts, or xenografts alone. All patients underwent ARP, and the extraction sockets were sealed with a free gingival graft harvested from the palate, a total of 36 implants were inserted. Cone‐beam CT scans were performed before and 4 months postoperatively to measure radiographic bone gain as the primary outcome. Clinical parameters, including soft tissue thickness and clinical bone width, were evaluated preoperatively, and at 4 months and 1 year postoperatively. Additionally, histological assessment of core bone biopsies was performed 4 months postoperatively using histomorphometric analysis to determine the percentages of newly formed bone, mature bone, and residual grafts. Results: Regarding the radiographic bone gain 4 months postoperative the HA group exhibited the highest value (9.78 ± 0.87), which was significantly greater than the values observed in the I‐PRF and control groups (8.60 ± 1.27 and 7.99 ± 0.89, respectively) (one‐way ANOVA, p = 0.007). Crestal bone loss was significantly higher in the control group (−0.98 ± 0.18) than in the I‐PRF group (−0.53 ± 0.11) and HA group (−0.33 ± 0.15) groups (one‐way ANOVA, p < 0.001). In the histomorphometric analysis, the mean area fraction of newly formed bone trabeculae was significantly higher in the HA group (56.66 ± 7.35) than in the I‐PRF group (28.74 ± 5.15) and the control group (24.05 ± 3.64) (repeated measures ANOVA, p < 0.001). Additionally, the mean area fraction of residual graft material was higher in the I‐PRF group (6.76 ± 2.59), followed by the control group (2.71 ± 1.24), while the HA group had the lowest value (2.63 ± 1.27) (Repeated measures ANOVA, p < 0.001). Conclusion: The combination of HA with xenografts yielded better radiographic and histological outcomes in terms of new bone formation and degree of bone maturation than the I‐PRF and control groups. Furthermore, I‐PRF improved soft tissue thickness. Please note that clinical trial registration was not completed prior to participant recruitment and randomization. The registration link for this trial is https://clinicaltrials.gov/ct2/show/NCT05781529. [ABSTRACT FROM AUTHOR]

Introduction: The present investigation compared the stability and volumetric changes of two different grafting material used for lateral window sinus floor augmentation (LWSFA). Methods: Sixteen patients with a total 20 maxillary sinuses in need of LWSFA were included in the present study. The sinuses were grafted with either 100% anorganic bovine bone mineral (ABBM) alone (Group 1) or a mixture (0.8:1 ratio) of ABBM and mineralized cortical allograft (MCA) (Group 2). Cone beam computer tomography (CBCT) was obtained pre‐operatively, and at 2‐weeks, and 6‐months after LWSFA to perform linear measurements including lateral window dimensions, sinus anatomy, residual bone height/thickness (RBH/RBT), and Schneiderian membrane thickness (SMT), among others. Three‐dimensional segmentation analysis was used to evaluate changes of bone graft volume/height (GV/GH). Results: A total of 10 sinuses per group were included in the analysis. No statistically significant difference was found in between groups regarding mean reduction of GV (Group 1: 14.87% ± 16.60%, Group 2: 18.06% ± 9.81%, p = 0.33). Among the linear measurements, only SMT revealed a significant increase after 2‐weeks more pronounce in Group 1 (8.70 mm) when compared with Group 2 (5.70 mm) with plausible effect upon LWSFA outcomes. Sinus width showed weak positive correlation with GH reduction after 6 months. Conclusion: This study demonstrated that both ABBM alone and ABBM + MCA represent suitable alternatives for LWSFA with adequate graft stability as they revealed similar volumetric and linear dimensional changes 6 months postoperatively. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical outcome of the transalveolar approach with the small segmentation method for inclined maxillary sinus floor elevation. Methods: Sixty‐one patients with an inclined maxillary sinus floor (tilt angle ≥ 10°) and insufficient residual bone height in the posterior maxilla were included and grouped according to the tilt angle of the sinus floor, with group A having patients with the tilt angle ≥ 10° and ≤ 30° and group B having patients with the tilt angle > 30°. After completing sinus membrane elevation and bone augmentation using bone substitute materials, the implants were inserted at the same appointment, and the restoration was completed after 5–6 months of osseointegration. The preoperative sinus floor level and sinus floor elevation achieved postoperatively were assessed and recorded. At pre‐ and post‐operative timepoints, the sagittal plane of the cone beam computed tomography was used to evaluate the bone height changes at the peak, middle and valley points in the slope segment intended for implant implantation. Results: Osseointegration was evident in all 61 patients, and the final restoration was completed with functional loading. After assessing the normality and homogeneity of variance, two‐sample t‐test or nonparametric tests were employed to estimate the differences in the bone height changes. The degrees of freedom (df) for this analysis were 59. The elevation attained at the middle point in groups A and B were 6.71 ± 1.38 and 5.75 ± 1.56 mm, respectively, demonstrating a significant difference (p < 0.05). Furthermore, at the peak and valley points, group A exhibited bone height changes of 5.79 ± 1.74 and 6.06 ± 1.45 mm, respectively, compared to group B with changes measuring 4.63 ± 2.18 and 5.58 ± 2.39 mm, respectively, with no significant difference in the two groups (p ≥ 0.05). The prevalence of intraoperative sinus membrane perforation was assessed using the chi‐square test. It was found that four cases in group A and five cases in group B experienced sinus membrane perforation, with no significant difference in the two groups (p ≥ 0.05, df = 1). Conclusion: The transalveolar approach using the small segmentation method suggests a promising approach for elevating the inclined maxillary sinus floor. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the ridge alterations and esthetic outcome 1 year after immediate implant placement using the dual‐zone (DZ) technique versus the bone shielding concept in patients with intact thin‐walled sockets in the esthetic zone. Material and Methods: This randomized clinical trial included 26 patients with nonrestorable maxillary teeth in the esthetic zone who were randomly assigned to two groups (n = 13 each) to receive immediate implants using either the bone shielding concept or DZ. Definitive restorations were delivered after 2 months. Pink esthetic scores (PESs), vertical soft tissue alterations, and bucco‐palatal ridge dimensional changes were measured and assessed using intra‐oral digital scans at baseline and 1 year post‐procedure. Labial bone thickness was measured using cone beam computed tomography scans at baseline and after 1 year. Results: The bone shielding group provided bucco‐palatal ridge thickness stability after 1 year (9.43 mm) compared to baseline values (9.82 mm), while DZ showed a significant loss in the bucco‐palatal ridge thickness after 1 year (7.83) compared to baseline values (9.49). No significant difference was reported in the baseline bucco‐palatal ridge thickness between the two groups (p = 0.6). After 1 year, the bone shielding group demonstrated 0.38 mm ridge shrinkage which was statistically significant (p = 0.0002) compared to 1.67 mm ridge shrinkage in the DZ group. In addition, the average total PES in the bone shielding group was 12.04 versus 10.28 in the DZ group. No significant difference was reported in the mesial papilla length between the DZ and the bone shielding group after 1 year (p > 0.05). However, the midfacial gingival margin (p = 0.026) and distal papilla were significantly higher in the DZ group (p = 0.0025). There was no significant difference in the mean ± SD mm bone gain at the apical level between the two studied groups after 1 year (p = 0.06) showing 0.85 ± 0.23 and 0.64 ± 0.32 mm, respectively. However, the bone shielding concept showed a statistically significant more bone gain mm (p < 0.001) at the (0.56 ± 0.43) and crestal (0.03 ± 0.8) levels after 1 year compared to DZ which revealed 0.18 ± 0.5 and 0.38 ± 0.29 mm bone loss, respectively. Conclusion: The bone shielding concept might offer a reliable alternative for restoring thin‐walled sockets by minimizing postextraction ridge dimensional alterations effect following immediate implant placement in the esthetic zone. Nevertheless, the study suffers from confounding bias since there are two systematic differences between the groups, the barrier membrane type, and the level of bone filling. "This clinical trial was not registered prior to participant recruitment and randomization." Clinical Trial Registration: NCT05381467. [ABSTRACT FROM AUTHOR]

Objectives: Lateral ridge augmentation (LRA) is a surgical technique to gain bone prior to implant placement. Performing cone‐beam computed tomography (CBCT) pre‐ and post‐surgery allows for quantitative comparison of the buccal–lingual width and the vertical height of the edentulous ridges. This study used CBCT images to evaluate the bone regeneration following surgery. Methods: A total of 30 cases from adult patients who underwent LRA and had high‐quality CBCT images taken pre‐ and post‐surgery from the same CBCT scanner were available for the retrospective study. Study data included linear measurements of the bone ridge width and height obtained from the middle of the edentulous ridge and a volumetric measurement of bone growth at the edentulous site observed on the CBCT scan. Results: The reliability of the measurements was excellent as indicated by Intra‐Class Coefficient values of 0.974 or higher. There was a significant mean bone increase from pre‐surgery compared to post‐surgery for both the linear and volumetric measurements. The linear bone gain ranged from 1.5 to 2.5 mm and volumetric gain from 250 to 750 mm3. However, two patients did not gain any bone. Multivariate regression showed the strongest predictors of bone gain post‐surgery were the pre‐surgery bone volume and a surgical site being in the mandible. For maxillary surgical sites, particularly anterior areas, the LRA surgeries were the least successful. Conclusions: LRA before implant placement helped to increase bone for the majority of patients, particularly for surgical sites in the mandible. The quantitative analyses in the CBCT images showed excellent intra‐examiner agreement. [ABSTRACT FROM AUTHOR]

Objectives: The main purpose of this retrospective study was to assess the difference in the incidence of peri‐zygomatic complications (PZCs) when zygomatic implants (ZIs) penetrate or do not penetrate the external surface of zygoma. Materials and Methods: This study included 32 patients with edentulous maxillae or potentially edentulous maxillae undergo zygomatic implantation. The patients were divided into the penetration group (P‐group) and the non‐penetration group (N‐group) according to whether the apex of implants penetrated the external surface of zygoma in postoperative CBCT. The extension length, the penetration section of the implants, and the skin thickness at the corresponding position were simultaneously measured. Clinical follow‐up was conducted regularly until 2 years after surgery. The occurrence of PZCs (including peri‐zygomatic infection, skin numbness, non‐infectious pain, and foreign body sensation) was recorded. A mixed effect logistic model was used to compare the difference of complication rate between the P‐group and the N‐group, and odds ratio (OR) was calculated. Then identify the impact of the extension length, penetration section and skin thickness in P‐group with the same model. Results: A total of 71 ZIs were implanted in 32 patients, including 37 implants in the P‐group and 34 implants in the N‐group. During the 2‐year follow‐up, a total of 13 implants occurred PZCs, with an overall complication rate of 18.3%. Thereinto, the incidence rate was 29.7% in the P‐group, and 5.9% in the N‐group (OR = 6.77). In P‐group, there was a significant difference in complication rate of different extension lengths, while the penetration section and skin thickness had no statistical significance on the complication rate. Conclusion: Under the limitation of this study, to minimize the risk of PZCs, ZI should be placed in a manner that avoids the apex penetrating the external surface of the zygoma. [ABSTRACT FROM AUTHOR]

Objective: To evaluate radiographic bone gain after alveolar ridge augmentation with two different designs of autogenous block graft harvested from the mandible. Materials and Methods: Alveolar ridge defects were evaluated by preoperative cone beam computed tomography (CBCT) and grafted in a staged approach using intraoral block grafts. The ridge augmentation was either performed using the full‐block technique (group 1) or the split‐block technique (cortical plate with autogenous bone chips) (group 2). After 4 months of bone healing, a further CBCT scan was performed before implant placement. Horizontal and vertical bone gain were measured. Results: In this retrospective study, 91 patients were grafted with block grafts (36 patients with full‐block grafts; 55 patients with split‐block grafts) resulting in 171 block grafts in total. The mean horizontal bone gain was 3.37 ± 0.71 mm in group 1 and 5.79 ± 2.20 mm in group 2. A linear mixed‐effect model also showed a statistically significant group difference (p < 0.001, estimate: 3.455, 95% CI: [2.082–4.829]). The mean vertical bone gain was 2.85 ± 0.73 mm in group 1 and 7.60 ± 1.87 mm in group 2. A linear mixed‐effect model also showed a statistically significant group difference (p: 0.029, estimate: 3.126, 95% CI: [0.718–5.557]). Mean marginal bone level was 0.33 ± 0.37 mm (group 1) and 0.17 ± 0.29 mm (group 2). Conclusion: The split‐block technique resulted in a greater bone gain than the full‐block technique. This effect was observed in both the vertical and the horizontal dimensions. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effects of zygomatic implant placement on the maxillary sinus using radiographic and clinical indicators. Methods: Patients with an atrophic maxilla who underwent zygomatic implant placement were included. The thickness and morphology of the Schneiderian membrane (SM), infundibular obstruction, and posterior bone wall of the maxillary sinus were analyzed. The generalized estimating equation and chi‐square tests were performed to compare the measurements. Results: Fifty patients with 100 maxillary sinuses were included. In total, 148 zygomatic implants and 105 regular implants were placed in the maxilla. Overall, the mean pre‐ and postoperative SM thickness was 2.79 ± 3.26 mm and 3.97 ± 5.45 mm, respectively (p = 0.063). In sinuses with two zygomatic implants, the SM thickness increased significantly from 2.12 ± 2.14 mm preoperatively to 4.07 ± 6.14 mm postoperatively (p = 0.026). The number of sinuses with type IV morphology (fully radiopaque) increased from zero preoperatively to six (13%) postoperatively. Sinuses with a single zygomatic implant showed no difference in the pre‐ and postoperative SM thickness. Postoperatively, six sinuses had infundibulum obstructions. Postoperative osteitis of the bilateral sinuses was found in two patients. Conclusions: We have proposed a new imaging evaluation method and system for evaluating the maxillary sinus response. Preoperative infundibulum obstruction combined with mucosal thickening and double zygomatic implant placement are more likely to induce postoperative maxillary sinus mucositis and osteitis. [ABSTRACT FROM AUTHOR]

Background: The preservation and reconstruction of alveolar ridge volume in extraction sockets of molars affected by severe periodontitis is a critical challenge that requires clinical attention. Purpose: This randomized controlled clinical trial was designed to evaluate the efficiency of autogenous partially demineralized dentin matrix (APDDM) for alveolar ridge preservation (ARP) in severely periodontally compromised sockets compared to spontaneous healing (SH) on radiographic and histomorphometric outcomes. Materials and Methods: Thirty‐two patients with 32 periodontally compromised molars were randomized into either the test group, which received ARP using APDDM covered with a collagen sponge, or the control group, which underwent SH. Linear and volumetric changes were assessed using superimposed cone‐beam computed tomography (CBCT) acquired pre‐extraction and after a 4‐month healing time. Histomorphometric evaluation was performed on trephine cores harvested during implant placement. Results: All sites healed uneventfully. The ridge width at 1 mm apical to the bone crest increased by 5.03, 4.50, and 5.20 mm in the mesial, middle, distal area in the APDDM group, while decreasing by −1.98, −2.19, and −1.98 mm in the SH group, respectively (p < 0.05). The height increase of the central bone was significantly higher in the APDDM group than in the SH group (p < 0.05). The height decrease of the buccal (mesial, middle, distal) bone plate was lower in the APDDM group than in the SH group (p < 0.05). After a 4‐month healing time, bone volume increased by 37.07% in the APDDM group and by only 2.33% in the SH group (p < 0.05). Histomorphometric analysis revealed that APDDM particles were surrounded by newly formed bone, with partially absorbed residual APDDM materials observed. New bone, APDDM remnants, and connective tissue occupied 39.67 ± 8.28%, 23.66 ± 9.22%, and 36.67 ± 17.05% of the areas in the APDDM group, respectively. Conclusions: ARP using APDDM was effective, resulting in a significant increase in both linear and volumetric changes in severely periodontally compromised extraction sockets compared to SH. These findings suggest that APDDM may serve as a promising new clinical option for the reconstruction of alveolar ridge dimensions. [ABSTRACT FROM AUTHOR]

Objectives: To retrospectively evaluate whether implants placed simultaneously with lateral sinus floor elevation (LSFE) in severely atrophic maxilla (residual bone height [RBH] ≤3 mm) could achieve long‐term survival and comprehensively analyze the factors influencing their survival rates. Materials and Methods: A total of 123 patients receiving LSFE and simultaneous implant placement from 2010 to 2019 and their 123 implants in sites with RBH ≤3 mm were included in this study. Basic characteristics of patients and implants were collected from the medical record system and cone‐beam computed tomography (CBCT) images. Kaplan–Meier survival curves were applied to estimate cumulative survival rates (CSRs) and Cox proportional hazards regression models were used to detect factors influencing implant survival. Results: The 6‐year and 12‐year CSR of implants placed in sites with RBH ≤3 mm were 95.7% (95% confidence interval [CI]: 92.1%–99.5%) and 76.6% (95% CI: 58.1%–100%), respectively. Eight patients presented late implant failure. Univariate and multivariate Cox regression analyses demonstrated that RBH ≤2 mm (hazard ratio [HR]: 20.63, p = 0.000) and smoking habit (HR: 6.055, p = 0.024) were significantly associated with long‐term implant survival. Specifically, the 10‐year CSR of implants in sites with RBH ≤2 mm (53.3%, 95% CI: 27.5%–100%) was dramatically lower than those in sites with RBH >2 mm (92.9%, 95% CI: 81.7%–100%, p = 0.000). Conclusions: Implants placed simultaneously with LSFE in sites with RBH ≤3 mm can achieve long‐term survival. However, caution is required especially for implantation in sites with RBH ≤2 mm. Besides, the smoking habit is also considered a risk factor jeopardizing long‐term implant survival. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate changes in alveolar bone width around dental implants and identify the anterior nasal spine (ANS), posterior nasal spine (PNS), and floor of the nasal cavity that can be used as reference landmarks for standardizing the orientation of different cone‐beam computed tomography (CBCT) scans. Materials and methods: We enrolled two groups that comprised 30 implants. Two CBCT scans from the same patient after implant surgery in the first group were obtained to determine differences in the relative distance and angle between the ANS and apex of the dental implant. Then we compared the second group of patients' presurgical and postsurgical CBCT images to evaluate changes in alveolar bone width after dental implant surgery by the aforementioned bony landmarks. Results: In the first group, no statistically significant differences were detected in the mean distance between the ANS, PNS and implant tip in different directions. In the second group, bone width increased at 1 mm (p = 0.020) and decreased at 4 mm (p < 0.001) and 7 mm (p < 0.001) below the alveolar bone crest after implant surgery. Conclusions: Within the limitations of the present study, the ANS, PNS, and floor of the nasal cavity can be useful in standardizing the orientation of CBCT scans and alveolar bone remodeling after implant surgery varied depending on the height and direction from the alveolar bone crest based on the three landmarks. [ABSTRACT FROM AUTHOR]

Background: The long‐term clinical outcome of mini dental implants (MDIs) to support an overdenture is underreported especially in severely atrophic maxillae and when installed flaplessly. Purpose: The current report is a 5‐years follow‐up of the previously published 2‐ and 3‐years clinical outcome of MDIs supporting a maxillary overdenture in narrow alveolar ridges. MDI survival, marginal bone level, peri‐implant health, technical complications, and oral health related quality of life (OHIP) and respective changes over time are reported. Materials and methods: Subjects aged 50 years or older, in need of improvement of maxillary denture retention, were included. The MDIs were 2.4 mm diameter one‐piece tapered implants, Class 4 pure Titanium, and lengths 10 or 11.5 mm. Under local anesthesia, 5–6 MDIs were placed in atrophic maxillae with a free‐handed flapless approach. One week postoperative the denture was adapted with a retentive soft reliner. The final prosthetic connection was established after 6 months with a metal‐reinforced horse‐shoe denture. Clinical outcome after 5 years was assessed with probing pocket depts (PPD), bleeding on probing (BoP), and additional cone beam computed tomography (CBCT) MDI bone level measurements were performed. Oral Health‐Related Quality of Life (OHRQoL) investigated with OHIP‐14 was assessed preoperative, during provisional loading, and after final prosthetic connection up to 5 years. Results: Initially, 31 patients (14 females and 17 males) with mean age 62.30 underwent treatment. In the provisional loading interval, 16 patients encountered 32/185 MDIs failures, resulting in a failure of 17.3%; 170 MDIs were functionally loaded in 29 patients. Additionally, 14 implants were lost in three patients, all of whom had had already previous failures. Reimplantation of 17 MDIs were performed during the provisional loading and 2 MDI after functional loading. After 5 years, the absolute implant failure rate was 46/204 (22.5%), corresponding to a cumulative failure rate of 23.2%. Prosthetic failure was observed in four patients due to implant loss and in two patients related to excessive one‐piece implant ball attachment wear, making the 5‐years prosthetic success 80.0%. The mean PPD and absence/presence of BoP for 149 implants at 5 years was 4.3 and 0.2 mm, respectively. Average mesial‐distal‐vestibular‐palatal bone loss in the interval 2–5 years was 0.08 mm. No statistically significant difference in marginal MDI bone loss between male or female (p = 0.835), smoking and nonsmoking (p = 0.666) was observed. The five‐years total measured CBCT interdental bone level (mesial and distal) correlates with the 5‐years PPD (Pearson 0.434; p = 0.01). After 5 years, OHRQoL with the treatment procedure was assessed in 27/31 participants. Decreasing mean total OHIP‐14 scores with improved OHRQoL, was observed in 27/31 participants, with values of 21.3 at baseline to 15.6 at the time of provisional loading which significantly (p = 0.006) decrease to 7.3 at the final prosthetic connection. The next 3–5 years further decrease was observed with 6.5 and 4.96, respectively. Conclusions: Maxillary MDIs for overdentures are an accessible and acceptable treatment option. Although after 5 years between one fifth and one fourth of the MDIs were lost, prosthetic success remains 80.0% and high OHRQoL could be achieved. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the dimensional changes after horizontal and vertical guided bone regeneration (GBR) without membrane fixation using the retentive flap technique. Methods: This study retrospectively examined two cohorts that received vertical or horizontal ridge augmentations (VA or HA groups). GBR was performed using particulate bone substitutes and resorbable collagen membranes. The augmented sites were stabilized using the retentive flap technique without any additional membrane fixation. The augmented tissue dimensions were assessed using cone‐beam computed tomography at preoperative, immediately postoperative (IP), 4 months (4M), and 1 year (1Y). Results: Postoperative vertical bone gain in 11 participants of VA group amounted to 5.96 ± 1.88 mm at IP, which decreased to 5.53 ± 1.62 at 4M and to 5.26 ± 1.52 mm at 1Y (intragroup p < 0.05). The horizontal bone gain at IP in 12 participants amounted to 3.98 ± 2.06 mm, which decreased to 3.02 ± 2.06 at 4M and to 2.48 ± 2.09 mm at 1Y (intragroup p < 0.05). The mean implant dehiscence defect height after 1Y was 0.19 ± 0.50 mm in the VA group, and 0.57 ± 0.93 mm in the HA group. Conclusion: GBR without membrane fixation using the retentive flap technique seems to preserve the radiographic bone dimensions of vertically augmented sites. This technique may be less effective at preserving the width of the augmented tissue. [ABSTRACT FROM AUTHOR]

Background: Screening ultrasonography was proposed for monitoring periodontal soft tissues in the early 1960s, owing to its nonionizing, real‐time, and cost‐effective properties. Studies have provided convincing preliminary evidence for the use of ultrasound (US) in implant dentistry. Purpose: To assess the feasibility of ultrasonography (US) for measuring the buccal thickness of periodontal and peri‐implant tissues. The secondary objective was to evaluate the reliability of US measurements compared to classic techniques, such as CBCT and directly measurements. Materials and Methods: An electronic literature search was conducted by three independent reviewers through February 2023. The inclusion criteria were articles investigating at least five patients/cadavers with US measurements in periodontal or peri‐implant buccal tissues. Compliance with methodological reporting standards and risk of bias was assessed using EULAR and QUADAS‐C tools, respectively. Random‐effects meta‐analysis was conducted, using Bland–Altman analysis. Certainty of the evidence was assessed using GRADE. Results: The final selection included 12 studies examining 458 patients and 13 cadavers, with a total of 226 implants, 1958 teeth and 60 edentulous sites. The body of evidence was assessed as partially compliant with methodological reporting standards for US studies and had an unclear to high risk of bias. Meta‐analysis of five comparative studies showed no evidence of clinically significant bias between US and direct measurements (very low certainty), and between US and CBCT (very low certainty) for soft‐tissue thickness. Likewise, for bone thickness, there is no evidence of clinically significant bias between US and CBCT (low certainty). Conclusions: Compared to the CBCT and direct measurements, ultrasonography might be a reliable approach for monitoring on periodontal and peri‐implant phenotype. However, there is uncertainty about estimates of the actual effect, so further standardized and larger sample size of clinical research is needed. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this cone beam computed tomography (CBCT) study was to determine the frequency percentage of screw‐retained crown using angulated screw channel (ASC) abutment for single immediate implant placement and provisionalization (IIPP) in the esthetic zone. Methods: The CBCT images of 200 patients without disease and without metal restorations in maxillary anterior teeth were evaluated. The mid‐sagittal‐sectional CBCT images of maxillary anterior teeth (#6–#11) were created in an implant planning software, screen‐captured, and transferred to a presentation program. Template of tapered implants with diameter of 3.5 mm (for central and lateral incisors) and 4.3 mm (for central incisors and canines) and lengths of 13, 15, and 18 mm were applied to the sagittal images to identify the IIPP cases. To qualify for IIPP, the implant must engage >35% bone with at least 1 mm of surrounding bone and no perforations. The IIPP cases were further divided into straight screw channel (IIPPSSC) abutment or 25‐degree angulated screw channel abutment (IIPPASC), based upon its restorability. The frequency percentages of possible IIPP, IIPPSSC, and IIPPASC were reported and compared among all maxillary anterior teeth. Results: A total of 1200 maxillary anterior teeth sagittal images from 200 patients (88 male and 112 female) with a mean age of 51.3 years (range 20–83 years) were evaluated in this study. The overall frequency percentages of IIPP, IIPPSSC, and IIPPASC possibility were 84% (74%–92%), 14% (10%–24%), and 75% (66%–87%), respectively. Conclusion: Within the limitations of this CBCT study, 90% of single IIPP in the esthetic zone can be restored with screw‐retained crown when utilizing ASC. In addition, the possibility of using a screw‐retained restoration following IIPP increases about five times with ASC abutment compared to the SSC abutment. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the efficacy of endoscope‐controlled sinus floor augmentation through a mini‐lateral window, compared with traditional lateral window approach. Materials and Methods: This retrospective research included 19 patients and 20 augmented sinuses using lateral window approach with simultaneous implant placement (test group: a 3–4 mm round osteotomy; control group: a 10 × 8 mm rectangular osteotomy). Preoperatively (T0), immediately after surgery (T1), and 6 months postoperatively (T2), cone‐beam computed tomography (CBCT) scans were obtained. Residual bone height (RBH), lateral window dimension (LWD), endo‐sinus bone gain (ESBG), apical bone height (ABH), and bone density were measured. Intraoperative and postoperative complications were recorded. Patients' evaluation of pain first day after surgery and a week later was assessed by visual analog scale (VAS). Results: No significant difference was found in ESBG, ABH between the two groups at T1, T2 or their changes from T1 to T2. However, the increase of bone density value in the test group was significantly higher than control group (356.28 ± 149.59 vs. 242.99 ± 129.54; p < 0.05). The sinus perforation rate of test and control group was 10% and 20%, respectively. The VAS score of the test group at the first day after surgery was significantly lower than control group (4.20 ± 1.03 vs. 5.60 ± 1.71; p < 0.05). Conclusions: Endoscope‐controlled maxillary sinus floor augmentation through a mini‐lateral window yield similar result with traditional approach in terms of bone height gain. The modified approach could facilitate new bone formation, reducing sinus perforation rate and postoperative pain. [ABSTRACT FROM AUTHOR]

Objectives: To radiographically analyze the effects of tenting screw technique (TS) and onlay bone grafts (OG) in horizontal bone augmentation. Materials and Methods: Patients receiving horizontal bone augmentation by TS or OG were selected. The clinical outcomes and cone beam computed tomography (CBCT) data were documented pre‐grafting, immediately post‐grafting, before and after implantation. The survival rates, clinical complications, alveolar bone width, and volumetric bone augmentation were evaluated and statistically analyzed. Results: A total of 25 patients and 41 implants were involved in this study, with no grafting failures observed in either the TS group (n = 20) or the onlay group (n = 21). Volumetric bone resorption rate in the TS group (21.34%) was significantly lower than that of the OG group (29.38%). In addition, significant horizontal bone gain was achieved in both groups (TS: 6.15 ± 2.12 mm; OG: 4.86 ± 1.40 mm) during the recovery period, with higher gain in the TS group. No apparent statistical difference in terms of volumetric bone gain was observed between the TS (748.53 mm3, 607.47 mm3) and OG group (811.77 mm3, 508.49 mm3) immediately post‐grafting or after the recovery period. Conclusion: Both TS and OG achieved satisfactory bone augmentation effects, yet TS resulted in more bone augmentation and better stability than OG, with a reduced use of autogenous bone. Overall, the tenting screw technique can serve as an effective alternative to autogenous bone grafts. [ABSTRACT FROM AUTHOR]

Background: Customized computer‐aided‐design/computer‐aided‐manufacturing (CAD/CAM) titanium meshes have been adopted for alveolar bone augmentation. But the inaccuracies between planned and created bone volume/contour are quite common, and the surgical placement of the customized mesh was considered as the first critical factor. However, the evaluation of surgical placement accuracy of customized mesh is currently lacking. Purpose: The aim of this study was to evaluate the accuracy of the surgical placement of customized meshes. Methods: A total of 30 cases, 20 without the screws‐position‐guided template and 10 with the screws‐position‐guided template, were included in this study. The cone beam CT (CBCT) data sets of pre‐ and postoperative were converted into 3D models and digitally aligned. Then the actual placement of customized mesh and retainer titanium screws was compared to the virtual one to assess the surgical placement accuracy of customized mesh. At least 6 months after surgery, a new CBCT was taken and converted into 3D models. Planned bone volume, created bone volume, vertical bone augmentation, healing complications rate, pseudo‐periosteum rate, exposure rate, and infection rate were all evaluated. Results: The 3D digital reconstruction/registration analysis showed that the average difference between actual placement and planned one of customized mesh in positive and negative directions was 2.69 ± 0.70 mm and −1.41 ± 0.90 mm, respectively, without the screws‐position‐guided template. And the mean difference values between the actual and planned placement of the screws on the X and Y axes were 0.74 ± 0.85 mm and 0.89 ± 0.84 mm. In contrast, with the screws‐position‐guided template, the results were 2.38 ± 0.69 mm and −1.30 ± 1.13 mm. Accordingly, the mean difference values of screws were 0.76 ± 0.84 mm and 0.94 ± 0.72 mm. There was no statistical difference between the two groups, and the noninferiority of the control group compared to the test group was also confirmed by the comparative analysis. Conclusion: It can be concluded that there is a certain deviation between the planned surgical placement and actual one of customized mesh, and using screws‐position‐guided template is of limited help for its accurate placement. Further research is needed to achieve precise surgical placement of the customized mesh to achieve precise alveolar bone augmentation. [ABSTRACT FROM AUTHOR]

Introduction: Immediate implant in postextraction sockets requires managing the postextraction alveolar resorption. This randomized clinical trial examined vertical and horizontal changes 1‐year following flapless immediate implant with and without xenograft at sites with thin labial plate. Methods: Forty patients with hopeless teeth in maxillary esthetic zone were randomly assigned to receiving either one immediate implant without bone graft (control) or with bone graft (intervention). Cone beam computed tomography (CBCT) scans were obtained pre‐extraction and 1‐year postoperatively to measure thickness and dimensional changes of the labial bone. Results: Cone beam computed tomography measurements revealed that a xenograft, when compared to no xenograft, led to 0.2 mm increased fill of the horizontal gap (95% confidence interval (CI): −1.1, 0.7). In both groups, there was a significant reduction in the labio‐palatal bone width after 1 year compared to baseline (P ≤ 0.05). There was no significant difference (P > 0.05) between the xenograft when compared to no xenograft regarding the labio‐palatal bone collapse % at 0 mm (−0.2, 95% CI: −4.8, 4.5) and 2 mm apical to the labial crest (1.9, 95% CI: −1.8, 5.6). While at 5 mm the ridge was significantly reduced (P ≤ 0.05) in the no xenograft when compared to xenograft (4.5, 95% CI: 0.7, 8.2). The xenograft when compared to no xenograft, led to 1.1 mm less vertical bone changes (95% CI: 0.4, 1.9). Both groups revealed significant positive correlation between labio‐palatal socket dimension and bone formed labial to the implant (P ≤ 0.05). [Correction added on 7 February 2023, after first online publication: In the 8th line of this section, the word "collapse" was changed to "ridge" in this version.] Conclusion: This investigation suggested that immediate implants with or without grafting the labial gap preserved alveolar bone dimension and that bone formation labial to the implant was related to initial labio‐palatal socket dimension. [ABSTRACT FROM AUTHOR]

Objective: Anterior maxillary immediate implant placement has become a popular procedure. It has aesthetic and functional risks. A prerequisite for success is sufficient alveolar bone for primary stability. Many cone‐beam computed tomography (CBCT) studies have assessed alveolar bone dimensions in the anterior maxilla, with varying results. More accurate information on the alveolar bone dimensions in the anterior maxilla is required. The objective of the present study was to evaluate bone dimensions in the anterior maxilla using micro‐CT, a high‐resolution imaging tool. Materials and Methods: Seventy‐two human skulls were scanned using micro‐CT at the South African Nuclear Energy Corporation. Specialized software was used for 3‐D rendering, segmentation, and visualization of the reconstructed volume data. Axial planes were created over each alveolus/tooth from canine to canine. Buccal and palatal bone dimensions were measured at crestal, 3 mm, 6 mm, and 9 mm levels. Results: Buccal bone rarely exceeded 0.5 mm, consisting of bundle bone only for all investigated teeth at all levels. Up to a third of teeth showed buccal fenestrations. Alveolar bone on the palatal side was thicker than buccal and increased from <1 mm at crestal level up to 3.77 mm, 4.56 mm, and 5.43 mm for centrals, laterals, and canines at the 9 mm level, respectively. Conclusions: Immediate implants in the anterior maxillae has anatomical risks. Alveolar bone on the buccal aspect is very thin, with fenestrations in certain positions. Therefore, a thorough planning and individual approach are needed to avoid possible complications and achieve stable aesthetic and functional results in the long‐term. [ABSTRACT FROM AUTHOR]

Background: Polycaprolactone (PCL) is a synthetic aliphatic polyester widely used in biomedical applications with biodegradability in the body and promotes cell proliferation and differentiation. A newly developed bilayered PCL membrane was developed for possibly being used as a membrane in guided bone regeneration (GBR). Purpose: To compare the clinical efficacy between a newly developed bilayered PCL membrane with a Cytoplast™ RTM collagen membrane for GBR with simultaneous implant placement. Materials and Methods: Twenty‐four patients were randomized to PCL or RTM group, and a total of 24 dental implants were placed. Primary outcomes were patient mean buccal bone thickness (BBT) immediately postimplantation and at 6 months using cone‐beam CT and soft tissue surface dimensional changes (STC) at crown insertion, 6 months, and 1 year after loading using intraoral scanner. Secondary outcomes included success rate, clinical parameters, healing index, implant stability, pink esthetic score, and marginal bone levels. Results: The percentage of reduced BBT at 6 months was 32.38%, 25.94%, and 23.96% in the test group and 34.42%, 14.75%, and 6.34% in the control group at the corresponding levels. The mean difference of changed BBT associated with PCL membrane, when compared to collagen membrane, at 6 months was −0.02 ± 0.18 mm (95% confidence interval [CI]: −0.40 to 0.35), 0.29 ± 0.28 mm (95% CI: −0.29 to 0.87), and 0.62 ± 0.38 mm (95% CI: −0.17 to 1.42) at 0, 2, and 4 mm from implant shoulder. Minimal loss of STC was observed in both groups up to 1 year of loading. The mean difference loss of surface dimensional change associated with PCL membrane, when compared to collagen membrane, at 1 year of loading was 0.31 ± 0.19 mm (95% CI: −0.07 to 0.70), 0.22 ± 0.26 mm (95% CI: −0.33 to 0.76), and 0.17 ± 0.30 mm (95% CI: −0.45 to 0.78) at 0, 2, and 4 mm from implant shoulder. None of these differences were statistically significant (unpaired t‐test, degrees of freedom [df] = 22; p > 0.05). Conclusion: Within the limits of this trial, both barrier membranes resulted in comparable outcomes for GBR with implant placement after 1 year in function. Further research is necessary with a larger sample size. [ABSTRACT FROM AUTHOR]

Introduction: The effect of primary wound closure (PC) on alveolar ridge preservation (ARP) in periodontally damaged sockets has yet to be fully discovered. Methods: Periodontally damaged sockets were allocated to one of the following groups: (1) ARP with PC (group PC), and (2) ARP without PC (group secondary wound closure [SC]). Following tooth extraction and flap elevation, granule‐type xenogeneic bone substitute material and a collagen barrier were applied. Ridge change was evaluated using cone‐beam computed tomographic (CBCT) scans immediately after ARP and at 4 months. Core biopsy specimens were examined histomorphometrically. Results: A total of 28 patients were included in the analysis (13 in group PC, 15 in group SC). Histomorphometrically, the percentage of newly formed bone was 26.2 ± 17.7% and 24.6 ± 18.4% in groups PC and SC, respectively (independent t‐test, degree of freedom [df] = 25, p > 0.05). Horizontal ridge changes on CBCT were −4.9 ± 3.1 mm and − 4.2 ± 2.5 mm in groups PC and SC at the 1 mm level below the ridge crest, respectively (independent t‐test, df = 26, p > 0.05). Approximately half of the sites required additional bone augmentation at implant placement. Conclusions: ARP with/without PC yielded similar new bone formation and radiographic ridge change. This clinical trial was not registered prior to participant recruitment and randomization (https://cris.nih.go.kr/cris/search/detailSearch.do/19718). [ABSTRACT FROM AUTHOR]

Purpose: To evaluate image quality and diagnostic accuracy of buccal bone thickness assessment in maxillary and mandibular anterior region using cone‐beam computed tomography (CBCT) and 3‐dimensional double‐echo steady‐state (DESS) MRI for preoperative planning of immediate dental implants in healthy individuals. Methods: One hundred and twenty teeth in 10 volunteers were retrospectively evaluated for image quality and artifacts using Likert scale (4 = excellent to 0 = decreased). Buccal bone thickness was measured at three measurement points (M1 = 2 mm from the cementoenamel junction, M2 = middle of the root, and M3 = at the root apex) for each tooth in the maxillary (13–23) and the mandibular anterior region (33–43). Descriptive statistics and two‐way ANOVA with Tukey's Post‐hoc test were performed to evaluate the significant differences (α = 0.05) between both imaging modalities. Results: Image quality showed little to no artifacts and enabled confident diagnostic interpretation (CBCT (3.72 ± 0.46); MRI (3.65 ± 0.49)), with no significant differences between both imaging modalities (p > 0.05). Regarding the assessment of buccal bone thickness at M1‐M3 for the teeth 13–23 and 33–43, no significant differences were noted (p > 0.05). MRI demonstrated slight, nonsignificant overestimation of thickness with the canines having mainly a thick buccal bone wall, where thin buccal wall was evident for the central incisors. Conclusion: Black bone MRI sequences, such as 3D‐DESS MRI, for immediate implant planning provided confidential diagnostic accuracy in bone thickness assessment without significant disadvantages compared to CBCT. Thus, the implementation of no‐dose protocols for dental rehabilitation using an immediate loading approach seems promising and could further improve the treatment strategy for dental rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Cholesterol granuloma is typically a benign granulomatous growth seen mostly in the mastoid process and the petrous temporal bone. Although cholesterol granuloma in maxillary sinus was first reported in the scientific literature in 1978, the occurrence is very rare and it is usually clinically and radiographically manifested ambiguously as maxillary sinusitis. Purpose: The presence of cholesterol granuloma in the maxillary sinus in association with a dental pathology or prosthesis has been scarcely known. In this case report, we present a case of cholesterol granuloma in the maxillary sinus of a middle‐aged male who had previously undergone dental implant placement in relation to that anatomical location. Materials and Methods: A 64‐year‐old man reported to the Dental OP with a chief complaint of oral malodor, swelling, and tenderness over the right middle third of the face for the past 3 months. A cone beam computed tomography scan showed a well‐defined radio‐opaque lesion along with sclerosis and thinning of bone within the right maxillary antrum in relation to the dental implant placed in the 16 regions. The left maxillary sinus appeared normal. The Caldwell‐Luc procedure was performed and a solitary soft lesion with yellowish‐gray contents was evident within the right maxillary sinus. Histopathological examination revealed cholesterol clefts surrounded by foreign body giant cell reaction and granulation tissue formation, along with the presence of old and recent hemorrhage. A final diagnosis of cholesterol granuloma was made based on the histopathological examination report. Conclusion: Based on the evidence available in the present case, we hypothesize that the localized trauma and hemorrhage initiated by implant placement in this particular anatomical location could have plausibly resulted in the occurrence of cholesterol granuloma in our patient. [ABSTRACT FROM AUTHOR]

Aim: To 3‐dimensional radiographically assess the effect of titanium plate in guided bone regeneration (GBR) for the treatment of peri‐implant ridge defects in esthetic zone. Material and Methods: Nineteen patients with buccal peri‐implant defects in the maxillary esthetic zone were treated with GBR using xenograft, autogenous bone, and collagen membrane. Subjects were divided into two groups: control (conventional GBR, 10 patients with 16 implants) and test (GBR with an adjunctive titanium plate; nine patients with 15 implants). Cone‐beam computed tomography (CBCT) images obtained immediately after and 5–7 months following GBR were used to assess buccal crestal bone level (BBL) and buccal bone thickness (BBT) at different implant levels. Results: Thirty‐one implants in 19 patients were evaluated. Titanium plate exposure occurred in three cases (33.33%) of the test group. After 5–7 months, the mean BBL was located 1.48 ± 0.71 mm coronal to the platform in the test group and 0.90 ± 3.03 mm coronal to the platform in the control group (p = 0.03). The mean over all BBT (BBT‐M) was 4.16 ± 0.48 mm in the test group and 2.38 ± 0.97 mm in the control group (p < 0.01). More resorption occurred in the control group than in the test group regarding mean BBL (3.00 ± 3.11 mm vs. 0.78 ± 0.79 mm, respectively; p = 0.04), BBT‐M change (1.87 ± 1.59 mm vs. 0.56 ± 0.33 mm, respectively; p = 0.02), and percentage change in BBT‐M (40.69 ± 24.01% vs. 11.53 ± 5.86%, respectively; p < 0.01). Conclusion: In the short‐term, titanium plate‐enhanced GBR maintained ridge dimensions better than conventional GBR did. [ABSTRACT FROM AUTHOR]

Objectives: The lingual foramen is a risk factor for implantation and other mandibular surgeries, but there are few systematic studies on the anatomical and distribution characteristics of the lingual foramen in the entire mandible. Materials and Methods: A retrospective study was performed using 405 CBCT images. The anatomical characteristics and symmetrical distribution of the mandibular lingual foramen were analyzed. Results: All patients had at least one lingual foramina. According to the positional relationship between the mandibular lingual foramen and the root apex of tooth, the mandibular lingual foramen is divided into the upper lingual foramen and the lower lingual foramen. Upper lingual foramen were divided into three types according to its running direction, namely Type 1 (Enters the mandible and descend in the direction of the lower edge of the mandible), Type 2 (Enters the mandible and descends in the direction of the lower edge of the mandible with branches), and Type 3 (It enters the mandible and divides into two branches, one ascends toward the crest of the alveolar ridge, and the other descends toward the lower edge of the mandible). And their respective prevalence are 84.0% [95% Tolerance Limit (TL) 81.2%–86.8%], 9.9% [95% TL 7.6%–12.1%], and 6.1% [95% TL 4.3%–8.0%]. In addition, the 81.8% [95% TL 79.0%–84.7%] of the upper lingual foramen is distributed in the central incisor area. Lower lingual foramen were divided into three categories according to the running direction, namely Category 1 (Enters the mandible and ascends toward the buccal bone plate), Category 2 (Enters the mandible and descends toward the buccal bone plate), and Category 3 (Go straight into the mandible toward the buccal bone plate). And their respective prevalence are 29.6% [95% TL 26.4%–32.7%], 50.9% [95% TL 47.5%–54.4%] and 19.5% [95% TL 16.8%–22.3%]. The frequency of lower lingual foramen distributed anteriorly to the mental foramen is 55.8% [95% TL 52.3%–59.2%], mid‐mental foramen is 21.4%[95% TL 18.5%–24.2%], and posterior to the mental foramen is 22.8% [95% TL 20.0%–25.8%]. Conclusion: Both the upper and lower lingual foramina should be evaluated in the anterior, middle, and posterior regions of the mental foramen before implant surgeries. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate 1‐year stability and maintenance of peri‐implant soft and hard tissues after guided bone regeneration (GBR) with L‐shaped collagenated bone substitute and subepithelial connective tissue graft (CTG) in the maxillary anterior region using profilometric, volumetric, and esthetic analyses. Methods: Fourteen peri‐implant defects were grafted with L‐shaped collagenated bone substitute, and 5 months after implant placement with GBR, reentry surgery in combination with CTG was performed in all participants. CBCT scans and STL files were acquired at baseline (after implant surgery, T1), reentry surgery (T2), and 1‐year follow‐up (T3). The profilometric and volumetric changes of the peri‐implant tissues were measured, and the pink esthetic score (PES) was assessed at T3. Results: One year after GBR and CTG at the buccal aspect of the maxillary esthetic zone, the mean thickness of the hard tissue (HT) decreased (HT0: −0.87 ± 0.67 mm, HT1: −0.74 ± 0.75 mm, HT2: −0.92 ± 0.48 mm, 45‐HT: −0.87 ± 0.73 mm) and the corresponding thickness of the soft tissue (ST) increased (ST0: 0.96 ± 1.06 mm, ST1: 0.85 ± 0.95 mm, ST2: 0.38 ± 0.82 mm, 45‐ST: 0.12 ± 0.62 mm), and as a result, there was no statistically significant difference in the total tissue thickness between T1 and T3 (p < 0.05). The mean volumetric changes of the peri‐implant tissues increased after 1‐year of implant surgery (T1–T2: 1.52 ± 0.83 mm, T2–T3: −0.88 ± 1.04 mm, T1–T3: 0.64 ± 0.90 mm), and a statistically significant difference was shown in all compared time periods (p < 0.05). The mean PES score was 8.07 ± 1.54 at T3 (range, 6–10). Conclusion: Within the limitations of this 1‐year follow‐up study, GBR with an L‐shaped collagenated bone substitute and subepithelial CTG in the maxillary esthetic zone was beneficial for stable and maintainable peri‐implant hard and soft tissues. [ABSTRACT FROM AUTHOR]

Objective: In the anterior region, the resorption of the buccal plate of bone after tooth extraction leads to contraction of the overlying soft tissues, resulting in an esthetic problem. In the socket shield technique, the buccal root section of the tooth is maintained, to preserve the buccal bone for immediate implant placement. The aim of this randomized clinical trial was to investigate the effect of leaving a gap or not between implant and retained root fragment on bone dimensions and soft tissue esthetics. Methods: This was a two armed parallel group randomized clinical trial with allocation ratio 1:1. Patients were eligible in case they needed immediate implant replacing teeth in esthetic zone with sufficient buccal bone support. CBCT was performed immediately after the intervention and 12 months later. Results: Forty six patients (26 females and 20 males) were enrolled in the study with 23 of them placed in contact with shield and 23 were placed palatal leaving a gap to graft with a xenograft. After 12 months, excellent soft tissue stability was reported (mean pink esthetic score at placement group A: 12.00 ± 1.60 after 12 months 12.90 ± 1.69, group B 12.62 ± 2.07 and after 12 months 12.38 ± 2.20) Using both surgical techniques. Radiographic crestal bone level changes mean for group A was −0.26 ± 0.52 and for group B ‐0.34 ± 0.31. There was a strong positive correlation between clinical and radiographic bone width values which was statistically significant (r = 0.782, p < 0.001). Width and thickness of keratinized gingiva showed no significant difference between values measured in both groups. Nonsignificant difference between studied groups according to the labial plate of bone clinical and radiographic changes after immediate implantation. Conclusion: Within the limitations of this study, the present data seem to support that the clinical outcome of the socket shield technique with immediate implant placement placed in contact or leaving a gap gave excellent esthetic results. [ABSTRACT FROM AUTHOR]

Introduction: There are several factors that greatly influence implant stability with implant design being a paramount factor; however, few studies investigate its impact. Aim: To investigate the implant stability in relation to two different implant designs, a cylindrical shaped single‐threaded design (CS/ST) and a tapered shaped double‐threaded design (TS/DT) using resonance frequency analysis over the first 8 weeks after implantation. Materials and Methods: Twenty‐eight implants were randomly allocated using computer‐generated random numbers into two groups and were placed as single tooth implant in the posterior arch in human jaw as specimens. iCAT™ CBCT scan (Hatfield, PA) was used to determine the bone density according to Misch's Bone classification. The osseotomy sites were prepared and implants were placed with guided surgical template by inexperienced surgeons which were prepared with the same implant planning software (3shape® implant studio). The implant stability was measured using the resonance frequency analysis Osstell® ISQ (Osstell AB, Sweden) on the implant level over the first 8 weeks at three different time intervals. A mean implant stability quotient (ISQ) value was recorded at each measurement time points. The first ISQ of each implant recorded at the time of implant placement were considered as baseline and were the so‐called primary stability. Results: All 28 dental implants were analyzed. A similar pattern of implant stability changes was observed in both implant designs. A significant decreased was found at the first 4 weeks after implantation (p < 0.05) before ascending to maximum cumulative stability by the eighth week (p < 0.05). Between the two groups, TS/DT group had a higher mean ISQ values than that of the CS/ST group at all three observation periods but did not reach statistical significance (p = 0.69). Regarding different types of bone, TS/DT showed a significant difference in mean ISQ values in D4 bone. To date, all 28 implants are in function with no failure/and or complications. Conclusions: The difference in implant design did not significantly influence the implant stability. TS/DT shows superiority over CS/ST when placed in D4 bone and offer a significant advantage due to their positive bounce back of the ISQ values by the eighth week after implant installation. Clinical Trial Registration: TCTR20211020005. [ABSTRACT FROM AUTHOR]

Objective: This study was aimed to evaluate bone healing after jaw cyst enucleation with or without bone substitutes by cone beam computed tomography, and to analyze potential influence factors for bone formation as well. Materials and Methods: Sixty seven jaw cyst patients were randomly assigned to two groups. Thirty three patients in control group accepted cystectomy without any filling material. The rest 34 bone cavities which filled with xenograft (DBBM, Bio‐Oss®) and covered by absorbable membrane (Bio‐Gide®) were included in the guided bone regeneration (GBR) group. All patients were examined with cone bean computerized tomography before operation, 3 and 6 months after surgery. Linear regression analysis was applied to evaluate the influence factors of bone healing. Results: There was no significant difference in bone formation rate at 3 months after enucleation, with shrinkage rate (SR) of cystic lesion in control group and GBR group of 26.43 ± 14.98% and 20.78 ± 10.80%, respectively (p > 0.05). Larger shrinkage area in GBR group was detected on postoperative radiographs after 6 months with SR of 60.11 ± 19.23%, when compared to those in patients without filling (6 months SR: 48.63 ± 19.39%, p = 0.018, <0.05). Linear regression analysis showed that cyst size was negatively correlated with bone formation. Conclusion: GBR with bovine xenograft and absorbable membrane showed considerable bone regeneration property in the healing of jaw cystic defects after enucleation of radicular cysts. Cyst size showed a suppressive influence on bone formation. [ABSTRACT FROM AUTHOR]

Background: The effect of the buccal gap width on the clinical outcome of socket graft and immediate implant placement (IIP) at maxillary central incisor sites has not been investigated. Thus, the aim of the present study was to evaluate the effect of the width of the buccal gap on the thickness of the newly formed buccal wall. Methods: Forty‐two patients and 51 maxillary central incisor sites treated with IIP and ridge preservation by means of graft of the buccal gap at the maxillary central incisor region were included in the study. The width of the buccal gap was measured and filled with deproteinized bovine bone mineral. Implant sites were divided into two groups: wide gap (WG, >2 mm; n = 34) and narrow gap (NG, ≤2 mm; n = 17). After at least 1 year in function (5 ± 4), CBCT scans were obtained and assessed by a calibrated examiner. The thickness of the buccal and palatal bone walls, the percentage of the implant height covered by bone in the buccal and palatal aspects and the position of the buccal and palatal crests were compared between the two groups. A linear regression model was performed to assess predictors of the thickness of the buccal bone. Results: The buccal bone was significantly thicker in the WG group than the NG group at all levels observed (overall 1.9 ± 0.9 mm and 0.5 ± 0.6 mm, respectively). The thickness of the palatal bone was similar between both groups (>2 mm). The percentage of the implant height covered by bone at the buccal aspect was significantly higher in the WG group (95 ± 16.6%) than in the NG group (59.4 ± 42.3%). The position of the buccal crest in relation to the implant shoulder was significantly more coronal (0.3 ± 2.2 mm) in the WG group than in the NG group (−4.7 ± 5.6 mm). The regression analysis model indicated that the width of the buccal gap was the only predictor of the thickness of the newly formed buccal bone wall (p < 0.001). Conclusion: Grafting of >2 mm‐wide buccal gaps following IIP promoted a thicker buccal bone wall. [ABSTRACT FROM AUTHOR]

Background: Implant placement in maxillary molar sites with severe height deficiency often requires multiple surgeries, which was time‐consuming, invasive, and subject to serious postoperative complications. Purpose: To introduce and assess a three‐in‐one technique (extraction, alveolar ridge preservation [ARP], and sinus elevation) for augmenting deficiency maxillary molar alveolar ridges. Material and Methods: Fourteen patients with severe posterior maxillary ridge height deficiency underwent extraction, sinus elevation via an intrasocket window and ARP using sticky bone and then covered with acellular dermal matrix (ADM). Primary closure was intentionally not obtained. Cone‐beam computed tomography and periapical radiography were used to measure dimensional ridge changes over time. Bone biopsies were taken at implant placement 7–21 months after surgery, which proceeded without additional grafting. Peri‐implant soft tissue was assessed after 8–12 months of functional loading. Results: Maxillary molar sites (13 first molars, 1 second molar) with a mean sinus floor height of 1.73 ± 0.86 mm and mean buccal plate thickness of 1.62 ± 1.15 mm were elevated and grafted. Immediately after surgery, the mean sinus floor height was 14.03 ± 1.97 mm and the alveolar thickness at virtual implant platform level was 12.99 ± 1.88 mm. After 5–9 months healing, those measurements decreased by 2.45 ± 1.73 mm (p = 0.000) and 3.88 ± 3.95 mm (p = 0.006), respectively. Healed ridges were composed of 18.74% ± 4.34% mean vital bone and 19.08% ± 9.10% mean residual graft. After 8–12 months of functional loading, the peri‐implant tissue appeared healthy, and there was a mean marginal bone loss of 0.12 ± 0.11 mm. Conclusions: For maxillary first molar sites with severe sinus floor height deficiency, this minimally invasive three‐in‐one treatment allows for uncomplicated implant placement and short‐term functional stability. [ABSTRACT FROM AUTHOR]

Background: Dynamic navigation approaches are widely employed in the context of implant placement surgery, with registration being integral to the accuracy of such navigation. Relatively few studies to date, however, have compared different registration approaches, and such a comparison has the potential to guide the development of more accurate and reliable clinical registration methodology. Purpose: This study was developed to compare the accuracy of dynamic navigation‐based dental implant placement conducted using either U‐tube or cusp registration methods. Materials and Methods: Medical records from all patients that had undergone implant surgery between August 2019 and October 2020 in the First Clinical Division of the Peking University Hospital of Stomatology were retrospectively reviewed, with 64 patients and 99 implants ultimately meeting with study inclusion criteria. Implant placement accuracy was gauged via the superimposition of the planned implant position in preoperative cone‐beam computed tomography (CBCT) images with the true postoperative implant position in postoperative CBCT images. Accuracy was measured based upon the angular deviation, entry deviation (3‐dimensional [3D] deviation in the coronal aspect of the alveolar ridge), and apex deviation (3D deviation in the apical area of the implant) when comparing these two positions. Results: The angular deviation, entry deviation, and apex deviation of all analyzed implants were 3.29 ± 0.17°, 1.29 ± 0.07 mm, and 1.43 ± 0.08 mm, respectively, while in the cusp registration group these respective values were 3.25 ± 1.58°, 1.28 ± 0.60 mm, and 1.34 ± 0.63 mm as compared to 3.35 ± 1.78°, 1.30 ± 0.78 mm, 1.55 ± 0.9 mm in the U‐tube group, respectively. No significant differences in accuracy were observed when comparing these two registration techniques. Conclusion: Dynamic computer‐assisted surgical systems can facilitate accurate implantation, and both the U‐tube and cusp registration methods exhibit similar levels of accuracy. As the cusp registration technique can overcome some of the limitations of the U‐tube strategy without the need for an additional registration device, it may be more convenient for clinical use and warrants further research. [ABSTRACT FROM AUTHOR]

Aim: To determine whether vertical ridge augmentation (VRA) can be obtained through guided bone regeneration (GBR) using exclusively resorbable collagen membranes and particulate bone substitutes without additional stabilization. Materials and Methods: This study retrospectively examined 22 participants who underwent VRA with staged or simultaneous implant placement. The vertical defects of all participants were filled with particulate bone substitutes and covered with resorbable collagen membranes. The augmented sites were stabilized with unfixed collagen membranes and the flap without any additional fixation. The augmented tissue height was assessed using cone‐beam computed tomography at baseline, immediately after surgery, and at annual follow‐ups. Results: The vertical bone gain of the 22 augmented sites amounted to 6.48 ± 2.19 mm (mean ± SD) immediately after surgery and 5.78 ± 1.72 mm at 1‐ to 7‐year follow‐up. Of the 22 augmented sites, 18 exhibited changes of less than 1 mm, while the other 4 showed changes of greater than 1 mm. Histological observation of three representative cases revealed new bone apposition on the remaining material. Conclusion: The present findings indicate that GBR procedures using exclusively collagen membranes and particulate biomaterials without any additional fixation are feasible options for VRA. [ABSTRACT FROM AUTHOR]