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The success of dental implant placement and prosthetic reconstruction relies on sufficient bone volume at the implant site. Contemporary implantology integrates prosthetic planning with implant placement, emphasizing the importance of pre-established prosthetic goals. Guided Bone Regeneration (GBR) techniques have become crucial for bone reconstruction. This study explores the use of custom-made GBR membranes, designed through CAD-CAM technology, in 10 patients with severe bone defects. Patients underwent meticulous preoperative planning, in which digital diagnostic wax-ups and RealGUIDE™ software for implant positioning were used. The custom-made membranes, which were designed based on the individual defects, exhibited successful adaptation. Surgical phases involved membrane placement, bone grafting, and subsequent implant placement. Clinical–radiographic follow-ups demonstrated favorable bone gain outcomes, which enabled prosthetic rehabilitation. Despite membrane exposure occurring in 30% of cases, it did not compromise overall success. The study underscores the potential of custom-made GBR membranes in achieving prosthetic goals, though challenges like exposure and the need for a second surgery require further investigations. The results indicate a promising alternative for predictable bone regeneration in complex cases, shedding light on the prosthetically guided approach for optimal functional and aesthetic outcomes.

Background and Objectives: Functional rehabilitation in patients with hemimandibulectomy remains a challenge no matter what method of reconstruction is chosen by physicians. In this paper, we aim to evaluate the feasibility of an acceptable occlusal restoration in patients who have undergone hemimanidublectomy without the reestablishment of mandibular continuity. Materials and Methods: Data were collected retrospectively on 10 patients with varying degrees of mandible resection. The greatest challenge in the restoration of an acceptable occlusion form is the natural latero-deviation that occurs in patients whose mandibular continuity was not restored. This causes an unbalanced and uncoordinated occlusal plane. Based on our research, this deviation is highly dependent on three main factors: the presence of teeth (which allow for a proprioceptive stimulus that counteracts the deviation), the extension of the defect and the presence or lack of the coronoid process. Results: Based on the presence of dental elements or lack thereof, patients were either rehabilitated with implant-supported dentures or removable partial dentures. Although the gold standard of care for these patients remains the restoration of mandible continuity through use of bone grafts, an acceptable rehabilitation of occlusion and therefore function may be acquired in non-grafted patients. Conclusions: Both physicians and patients must manage their expectations carefully and be eager to find a compromise to provide the best possible solution given the challenges of the premises.

Bone density at the implant site is correlated to the success of osseointegration. The objective of this in vitro study was to evaluate the efficacy of osseodensification burs in increasing bone density using a solid polyurethane foam block model. The osseodensification burs kit was used to perform 48 osteotomies on a rigid polyurethane foam test ground. Burs were utilized on a TMM2 implant motor for data collection. The osteotomies were divided into two study groups (A and C) in which implant sites, extended 12 and 14 mm deep, respectively, were prepared using the drills to a compaction rotation; two control groups, B and D, represented the osteotomies for which the drills were used in cutting direction. A 3.8 × 12 mm conical implant was inserted into each site; for each implant, data were collected on the peak torque (Cp), mean torque (Cm), and integral depth curve (I). The implants underwent resonance frequency analysis (RFA) to assess the implant stability quotient (ISQ). Correlation analysis was performed between I, Cm, Cp and ISQ. One-way analysis of variance (ANOVA) was used to identify statistically significant differences between groups. Group C, representing osteotomies prepared at 14 mm with osseodensification burs, showed a significantly higher value for each parameter. Implants at sites obtained with osteocondensation drills and prepared at greater depth for autologous particle grafting showed significant increases in each implant stability parameter.

The correction of malocclusions with severe skeletal deformity generally requires surgery combined with orthodontic or prosthodontic treatment; partially or totally edentulous patients, and patients with a prosthetic fixed crown, represent treatment restrictions and, therefore, challenges. The purpose of this study is to show a complete multidisciplinary approach and the planning involved (pre-, intra-, and post-operative) for a patient with a class-II or -III dento-skeletal malformation, who presents a total or partial edentulism or a fixed-type rehabilitation and, therefore, requires a combined orthognathic surgical treatment with prosthetic rehabilitation. Orthognathic surgery can be performed on an edentulous or prosthodontic patient to correct discrepancies between the jaws, followed by the placement of implants or a mobile prosthesis to rehabilitate the maxillary bones maxillary Different surgical approaches and technical variations have been proposed; however, the key to the success of such treatments lies in the multidisciplinary nature of the entire diagnostic, programmatic, and therapeutic path, which, therefore, necessitates close collaboration between different specialists—in particular, the maxillofacial surgeon, the orthodontist, and the prosthetist.

Background: Most children with ASD require orthodontic treatment to correct a malocclusion, to restore masticatory function, and for cosmetic reasons. The use of orthodontic devices, however, could lead to a distortion of the child’s routine, causing mood alterations, on the one hand, and a worsening of their oral hygiene status, on the other. The aim of this study is to evaluate the impact of orthodontic therapy on the daily management and level of collaboration of children with ASD determined using the Frankl scale. Materials and methods: An anonymous questionnaire was administered to 20 pairs of parents of children in which they were asked to evaluate any behavioral changes and/or difficulties encountered at the beginning of orthodontic treatment as well as their degree of satisfaction with the level of information received from medical personnel. Results: In about half of the sample, there were behavioral changes and difficulties in managing the treatment. Most of the responses received indicated parental satisfaction both with regard to the emotional impact on the children with respect to the introduction of the treatment and with regard to the attention received from the medical staff. Furthermore, there was a statistically significant increase (p = 0.001) in the Frankl scale score after treatment. Conclusions: Home management, which has always been the most difficult obstacle to overcome, with the support of a competent team can not only improve the quality of life of patients affected by ASD but also improve their collaboration and state of oral health without altering their emotionality.

Introduction: The number of people with migrant status living in Europe is proliferating. Most of the refugees in Italy come from war zones, and many of them denounce having been victims of persecutory acts in their country of origin. Highly cultured migrant populations have shown better results and oral health behaviour than those who were poorly cultured. The PROTECT project aimed to build a network for the early management of head and neck pathologies among refugees and migrants, promoting the dissemination of correct information about the prevention and treatment of these pathologies. Materials and methods: A national cross-sectional study among the refugees and migrant population in the Lazio region, Italy, from February 2018 to September 2021 was performed. The oral health of 3023 participants was investigated within a network of 56 reception centres and cultural associations. Data collected via an oral health survey questionnaire gathered information on participants’ demographic factors, migration status and dental behaviours and clinical examinations of the participants with the help of mouth mirrors, periodontal probes and artificial light. Results: The mean age was 31.6 ± 13.1, and among all the subjects, 2058 were male (68.1%) and 965 were women (41.9%). Most participants were born in Nigeria, followed by Bangladesh, Pakistan, Somalia, Mali and Senegal. The overall oral pain prevalence was 48.2%. The prevalence of patients claiming poor oral hygiene was 32.4%; 36.2% of the subjects consumed high amounts of sugar; and 26.7% saw their dentist for a check-up in the last year. At the clinical examination, 68.9% of patients had caries experience (considering decay of deciduous teeth, and caries of permanent teeth and teeth with fillings), with 32.2% showing pulpal involvement. Low levels of oral hygiene were also found at the clinical examination, with 46.5% of patients presenting plaque and calculus. The trend of the DMFT index was found to be 5.41. Good periodontal health (CPI = 0) was present in approximately 33.5% of patients. The CPI = 1 index reported bleeding from gingivitis in 37% of patients; tartar was found in 27% of patients (CPI = 2). The percentage of patients with CPI = 3 was 3.6%. Just over half (52.2%) of the migrants examined had malocclusion, and only 0.7% had a malocclusion in treatment. Conclusions: The goal to be achieved is to develop education and prevention programs for head–neck diseases, and perhaps even more. The first step towards this goal can be removing the obstacles migrants encounter in accessing health care.

The present short communication described a new procedure for the reconstruction of the horizontal severely resorbed edentulous maxilla with custom-made deproteinized bovine bone block, fabricated using three-dimensional imaging of the patient and computer-aided design/computer-aided manufacturing (CAD/CAM) technology. The protocol consisted of three phases. In the diagnosis and treatment planning, cone-beam computed tomographic scans of the patient were saved in DICOM (digital imaging and communication in medicine) format, anatomic and prosthetic data were imported into a dedicated diagnostic and medical imaging software, the prosthetic-driven position of the implants, and the graft blocks perfectly adapted to the residual bone structure were virtually planned. In the manufacturing of customized graft blocks, the CAD-CAM technology and the bovine-derived xenohybrid composite bone (SmartBone® on Demand - IBI SA - Industrie Biomediche Insubri SA Switzerland) were used to fabricate the grafts in the exact shape of the 3D planning virtual model. In the surgical and prosthetic procedure, the maxillary ridge augmentation with custom-made blocks and implant-supported full-arch screw-retained rehabilitation were performed. The described protocol offered some advantages when compared to conventional augmentation techniques. The use of deproteinized bovine bone did not require additional surgery for bone harvesting, avoided the risk of donor site morbidity, and provided unlimited biomaterial availability. The customization of the graft blocks reduced the surgical invasiveness, shorting operating times because the manual shaping of the blocks and its adaptation at recipient sites are not necessary and less dependent on the clinician’s skill and experience.