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Introduction: This study aims to advance evidence-based implant dentistry through a meticulous assessment of clinical and radiographic outcomes of two implant techniques, providing valuable insights for clinicians and researchers on their long-term success. Materials and Methods: A 5-year, split-mouth, randomised, double-blind clinical trial with 40 volunteers compared Group A (flapless technique) and Group B (standard flap technique) across 40 sites each. Clinical and radiographic assessments were conducted, and data were analysed using SPSS Version 22.0 with a significance level of P < 0.001. Results: Participants aged 21–49 years showed that Group A (flapless) had higher baseline marginal bone loss but significantly less bone loss from 1 to 5 years compared to Group B (P < 0.001). Group A also had lower Visual Analogue Scale scores and analgesic intake from day 0 to day 5 (P < 0.001). Both groups had a 100% implant survival rate at 5 years, but Group A had higher patient satisfaction (P < 0.001). The diverse cohort of 40 participants included 50% from urban areas and 17.5% with high professional qualifications, all showing good oral hygiene. Discussion: Flapless implant surgery aligns with minimally invasive dentistry, reducing surgical trauma, improving aesthetics, shortening surgery time and enhancing patient satisfaction. It is suitable for various patient groups and represents a strategic shift in practices, especially in sites with favourable soft- and hard-tissue conditions. [ABSTRACT FROM AUTHOR]

Background: Dental implant surgery has become a standard procedure for replacing missing teeth, boasting high success rates. However, complications can occur, affecting treatment outcomes. Understanding the nature and frequency of these complications is essential for optimizing patient care. Objective: To assess the prevalence and types of complications associated with dental implant surgery through retrospective research. Methods: Patient records were reviewed, focusing on demographics, medical history, surgical details, implant characteristics, and postoperative complications. Complications were categorized, and statistical analysis was performed to identify associations. Results: Among 150 cases, infection (15.3%), implant failure (8.0%), and peri-implantitis (12.0%) were the most common complications. Complication rates varied significantly across age groups (P < 0.05), with younger patients experiencing higher rates. Conclusion: Complications in dental implant surgery, including infection, implant failure, and peri-implantitis, are prevalent. Age appears to influence complication rates. Strategies to mitigate complications and optimize treatment outcomes are crucial.

Purpose: Cone beam computed tomography (CBCT) is considered both reliable and safe and provides reproducible results in guided dental implant planning procedures. However, it has weaknesses in soft tissue contrast and is associated with radiation exposure. Recent studies showed promising results with magnetic resonance imaging (MRI) as a possible noninvasive, radiation-free, alternative imaging modality for dental indications. The purpose of this study was to evaluate the quality of 1.5 T MRI with a dedicated dental signal-amplification coil in comparison to CBCT for dental implant planning procedures. Materials and Methods: Sixteen subjects undergoing preoperative MRI (3D HR T1w TSE and 3D HR T1w FFE) and CBCT were included in this prospective study. All imaging data were used for dental implant planning procedures using commercially available software. Two experts scored the planning as “ideal,” “improvable,” or “unacceptable.” Furthermore, quantitative distances according to EuCC recommendations were collected. Finally, discrepancies between CBCT and 3D HR T1w TSE were analyzed. Statistical analysis was performed using the Mann-Whitney U test and analysis of variance (ANOVA). Results: The dental implant planning procedure was technically feasibly using all imaging data. CBCT allowed for “ideal” placement in all cases. Ratings for 3D HR T1w TSE and 3D HR T1w FFE were 81.9%, 18.1%, and 0% and 54.2%, 30.0%, and 15.3% for ideal, improvable, and unacceptable, respectively, identifying 3D HR T1w TSE as superior compared with 3D HR T1w FFE. Head-to-head comparison between CBCT and 3D HR T1w TSE revealed no significant differences regarding the apical position of the implant of 1.2 ± 0.7 mm and 1.3 ± 0.5 mm coronally, respectively (P = .287). The deviation of the planed angle was 3.0 ± 1.2 degrees. In these merged data sets, the distance to the mandibular canal was significantly higher with 1.3 ± 0.8 mm, indicating better utilization of the existing bone. Conclusion: Within the limits of this pilot study, it can be reported that the dental image planning procedure is feasible using 1.5 T MRI with a dedicated dental coil and specific MRI sequences. [ABSTRACT FROM AUTHOR]

Aim: Telemedicine has emerged as a potential solution to enhance postoperative follow-up care after dental implant surgery, offering the convenience of remote monitoring and reduced need for in-person visits. Materials and Methods: Participants were randomly assigned to either the telemedicine group (n = 15) or the in-person group (n = 15). In the telemedicine group, patients received remote follow-up care through virtual consultations, during which they could communicate their concerns and share images of the surgical site. The in-person group received standard in-person follow-up visits. Patient satisfaction was measured using a standardized survey, with responses collected on a Likert scale. Results: Telemedicine group exhibited comparable levels of patient satisfaction (mean satisfaction score ± standard deviation: 4.6 ± 0.3) to the in-person group (4.7 ± 0.2). Moreover, clinical outcomes, including wound healing assessment, were similar between the two groups. No significant differences were observed in the incidence of postoperative complications or the need for additional interventions. Conclusion: In conclusion, this pilot study demonstrates that telemedicine is an effective alternative to traditional in-person follow-up care for postoperative dental implant surgery patients. It offers comparable patient satisfaction and clinical outcomes while proving to be more cost-effective.

Background: There is insufficient evidence for pain control in preemptive analgesia (PA) after dental implant surgery, signaling the need for further studies. The objective of this study was to evaluate the efficacy of PA in single dental implant surgeries (SDIS), seeking to identify among the etoricoxib (ETOR), ibuprofen (IBU), nimesulide (NIME), and acetaminophen (ACETA)], which one has the higher efficacy effectiveness in relieving postoperative pain and reducing the use of rescue medication compared to placebo. Methods: In this triple‐blind, parallel, randomized controlled clinical trial, 135 individuals with a mean age of 57.6 years (±11.7), both genders, were randomly divided into five groups according to the test drug: I—PLACEBO; II—IBU (600 mg); III—NIME (100 mg); IV—ACETA (750 mg); and V—ETOR (90 mg). The occurrence, duration, and intensity of pain were analyzed using the Chi‐square, Fisher's exact and ANOVA tests, and the generalized estimating equation models, when appropriate. Results: Test drugs provided a reduction in postoperative pain scores and lower use of rescue medication when compared to placebo. The ETOR group presented significantly lower pain scores, when compared to other active treatments. The IBU group showed the highest mean number of rescue medication used. Conclusions: All test drugs provided a beneficial preemptive effect demonstrated by the reduced postoperative pain and reduced use of rescue medication. The ETOR group presented lower pain scores, and the IBU group showed the highest mean number of rescue medication used among the test groups. [ABSTRACT FROM AUTHOR]

Painful post-traumatic trigeminal neuropathy (PTTN) is a known complication of dental implant therapy. Patients with PTTN develop sensory abnormalities in the orofacial region, which may be a psychosocial aspect, and dentists should assess somatosensory testing and psychosocial factors. The patients were assessed using quantitative sensory testing (QST). A 64-year-old female presented with allodynia of the left lower lip that occurred after a surgical implant procedure. Persistent pain started 4 months after the placement of two dental implants in the mandible. Sensory testing of these areas revealed warm hyposensitivity and mechanical hypersensitivity of the mandibular region. We also assessed PTTN-related perceived injustice using the Injustice Experience Questionnaire. The patient refused medication therapy such as pregabalin; therefore, autogenic training was adopted as an alternative management strategy. We conclude that for expensive dental procedures, such as implant placement, sufficient consensus should be obtained preoperatively before proceeding with surgery.

The successful use of surgical and medical methods of jaw bone tissue restoration has been convincingly confirmed in clinical practice. At the same time, technologies are being developed to improve the osseointegration of dental implants in patients with osteoporosis. The use of various implant coatings, as well as systemic therapy, demonstrate the emergence of new directions in the treatment of patients with partial or complete secondary edentulism with concomitant osteoporosis. This trend is relevant in modern medicine . Information was obtained from the PubMed database, using the keywords «osteoporosis» and «osseointegration» and «dental implantation» and «zoledronic acid» from 2016 to 2022. Articles were selected based on experimental work. Numerous studies have shown that bone tissue is an effective indicator of osteoporotic changes. The main changes in bone tissue in osteoporosis are emphasized - a decrease in bone volume, deterioration of the microarchitecture of the trabecular bone and processes that prevent osseointegration - loss of bone mass, a significant decrease in the percentage of contact in the implant-bone complex. Methods of dealing with the negative impact on the operation of dental implantation have been identified. In a review of studies on the systemic administration of drugs based on bisphosphonates, an increase in the osseointegration of dental implants was revealed, the systemic administration of zoledronic acid preparations significantly increased the formation of new bone, which in turn contributed to the elimination of such a negative effect of osteoporosis as bone resorption. In addition to the systemic administration of bisphosphonates, experimental studies describe the topical application of bisphosphonates in the form of various implant coatings. Topical application of bisphosphonates also contributed to increased osseointegration. Microstructured coated implants showed less marginal bone loss compared to uncoated implants. Conclusion. The use of dental implants with modified macro- and microrelief, as well as systemic drug therapy, remains the main direction of scientific research that contributes to the optimization of osseointegration of dental implants.

For robot-assisted dental implant surgery, it is necessary to feed the instrument into a specified position to perform surgery. To improve safety and efficiency, a preoperative planning framework, including a finite-parameter surrogate model (FPSM) and an automatic instrument-placement method, is proposed in this paper. This framework is implemented via two-stage optimization. In the first stage, a group of closed curves in polar coordinates is used to represent the oral cavity. By optimizing a finite number of parameters for these curves, the oral structure is simplified to form the FPSM. In the second stage, the FPSM serves as a fast safety estimator with which the target position/orientation of the instrument for the feeding motion is automatically determined through particle swarm optimization (PSO). The optimized feeding target can be used to generate a virtual fixture (VF) to avoid undesired operations and to lower the risk of collision. This proposed framework has the advantages of being safe, fast, and accurate, overcoming the computational burden and insufficient real-time performance of complex 3D models. The framework has been developed and tested, preliminarily verifying its feasibility, efficiency, and effectiveness. [ABSTRACT FROM AUTHOR]

Aim: Telemedicine has emerged as a potential solution to enhance postoperative follow-up care after dental implant surgery, offering the convenience of remote monitoring and reduced need for in-person visits. Materials and Methods: Participants were randomly assigned to either the telemedicine group (n = 15) or the in-person group (n = 15). In the telemedicine group, patients received remote follow-up care through virtual consultations, during which they could communicate their concerns and share images of the surgical site. The in-person group received standard in-person follow-up visits. Patient satisfaction was measured using a standardized survey, with responses collected on a Likert scale. Results: Telemedicine group exhibited comparable levels of patient satisfaction (mean satisfaction score ± standard deviation: 4.6 ± 0.3) to the in-person group (4.7 ± 0.2). Moreover, clinical outcomes, including wound healing assessment, were similar between the two groups. No significant differences were observed in the incidence of postoperative complications or the need for additional interventions. Conclusion: In conclusion, this pilot study demonstrates that telemedicine is an effective alternative to traditional in-person follow-up care for postoperative dental implant surgery patients. It offers comparable patient satisfaction and clinical outcomes while proving to be more cost-effective. [ABSTRACT FROM AUTHOR]

Painful post-traumatic trigeminal neuropathy (PTTN) is a known complication of dental implant therapy. Patients with PTTN develop sensory abnormalities in the orofacial region, which may be a psychosocial aspect, and dentists should assess somatosensory testing and psychosocial factors. The patients were assessed using quantitative sensory testing (QST). A 64-year-old female presented with allodynia of the left lower lip that occurred after a surgical implant procedure. Persistent pain started 4 months after the placement of two dental implants in the mandible. Sensory testing of these areas revealed warm hyposensitivity and mechanical hypersensitivity of the mandibular region. We also assessed PTTN-related perceived injustice using the Injustice Experience Questionnaire. The patient refused medication therapy such as pregabalin; therefore, autogenic training was adopted as an alternative management strategy. We conclude that for expensive dental procedures, such as implant placement, sufficient consensus should be obtained preoperatively before proceeding with surgery. [ABSTRACT FROM AUTHOR]

Abstract At present, dental implant surgery mainly relies on the clinical experience of the doctor and the assistance of preoperative medical imaging. However, there are some problems in dental implant surgery, such as narrow space, sight obstruction, inaccurate positioning, and high requirements of doctors' proficiency. Therefore, a dental implant robot system (DIRS) guided by optical navigation is developed in this study, with an x-shaped tool and an irregular pentagonal tracer are designed for spatial registration and needle tip positioning strategy respectively. The coordinate system of each unit in DIRS is unified through system calibration, spatial registration, and needle tip positioning strategy. Then the surgical path is planned on the computed tomography (CT) images in the navigation software before operation. The automatic positioning method and the auxiliary positioning method can be used in the operation to achieve accurate positioning and assist doctors to complete the operation. The errors of spatial registration, needle tip positioning strategy, and the overall accuracy of the system were evaluated respectively, and the results showed that they all met the needs of clinical surgery. This study preliminarily verified the feasibility of the precise positioning method for dental surgery robots and provided certain ideas for subsequent related research.

Purpose: The aim of this study was to investigate a guided implant surgery procedure performed without any manual processes, by assessing the in vivo results following a digital planning and placement of dental implants using surgical templates. Materials and Methods: Eligible patients were screened and enrolled in this prospective clinical study. A cone beam computed tomography (CBCT) scan was acquired, and the remaining dentition and soft tissues were recorded by an intraoral scanner after enrollment. The CBCT data and intraoral scan were fused in the planning software. The prosthetic reconstructions were digitally designed by a prosthodontist, and the ideal position of the dental implants was determined. The surgical template was digitally designed based on this plan, and a guide design was exported and manufactured in a stereolithographic process. The entire surgical procedure was performed with the aid of the template. An intraoral scan was performed 10 days after stage-two surgery using scan bodies placed on the implants. Digital preoperative and postoperative models were compared, and the metric difference between the planned and achieved implant positions was calculated. Results: Twenty-seven implants were placed in 20 patients using tooth-supported surgical templates after a digital planning procedure. No implants were lost during the study period. The mean lateral deviation measured at the coronal point was 1.05 mm (SD: 0.59; range: 2.74 to 0.36). The mean lateral deviation measured at the apical point was 1.63 mm (SD: 1.05; range: 5.16 to 0.56). The mean depth displacement was + 0.48 mm (SD: 0.50; range: 1.33 to -0.52). The mean angle deviation was 3.85 degrees (SD: 1.83; range: 8.6 to 1.25). Conclusion: A simplified full digital planning procedure yields results comparable to conventional guided implant surgery. The main deviation between the planned and achieved implant positions in this prospective clinical study was angular. More clinical studies are needed to verify the procedure further. [ABSTRACT FROM AUTHOR]

Odontogenic sinusitis (ODS) is more common than historically thought, representing 25% to 40% of all maxillary sinusitis. Due to a lack of widely accepted diagnostic criteria and a specific international diagnostic code, a true overall prevalence is unknown. ODS may be caused by either a multitude of infectious dental pathologies or complications after dental procedures. The most common dental etiologies causing ODS are apical periodontitis (endodontic) and oroantral communication or fistula after dental extraction. Less commonly, ODS can evolve after dental implant or maxillary sinus bone grafting surgeries, infection of odontogenic cysts, or advanced periodontitis., Competing Interests: Disclosure The author has received or receives honoraria for lecturing by the following companies. Straumann, Geistlich, Bego, BFS, Hess Dental, Nobel Biocare, and Quintessence., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Abstract Background Microbial biofilm accumulation is the main cause of peri-implantitis. The majority of surgical peri-implantitis treatment protocols suggests adjunctive use of systemic antibiotics to target specific putative bacteria. The aim of this systematic review was to critically evaluate the adjunctive use of systemically administered antibiotics in surgical treatment of peri-implantitis by reviewing previously published systematic reviews and primary studies. Methods A systematic literature search was conducted in four electronic databases (MEDLINE, The Cochrane Library, EMBASE, and Web of Science) for randomised controlled trials, cohort studies, case–control studies, and systematic reviews reporting surgical treatment of peri-implantitis with and without adjunctive systemically administered antibiotic therapy. The included systematic reviews and primary studies were qualitatively assessed using AMSTAR and GRADE, respectively. No restrictions were set for date of publication, journal, or language. Results The literature search identified 681 papers. Only seven systematic reviews and two primary studies met the inclusion criteria. Four out of seven included systematic reviews concluded that no evidence exists for use of systemic antibiotics to improve the clinical outcomes in surgical treatment of peri-implantitis. One review did not estimate the level of evidence, one did not clearly state any beneficial effect, whereas one reported a limited adjunctive effect. Further, the two included primary studies did not show a long-term significant benefit of adjunctive use of systemically administrated antibiotics. However, one study reported a short-term adjunctive effect in patients with modified surface implants. Due to heterogeneity in study design, low number of included primary studies, and grade of bias, no meta-analysis was performed. Conclusion The use of systemically administered antibiotics as an adjunct to surgical interventions of peri-implantitis cannot be justified as a part of a standard treatment protocol. A pervasive problem is the lack of uniform diagnosis criteria for peri-implantitis, deficient information about patient characteristics, absence of high quality long-term randomised controlled trials, and authors’ declaration on conflict of interest.

At present, dental implant surgery mainly relies on the clinical experience of the doctor and the assistance of preoperative medical imaging. However, there are some problems in dental implant surgery, such as narrow space, sight obstruction, inaccurate positioning, and high requirements of doctors' proficiency. Therefore, a dental implant robot system (DIRS) guided by optical navigation is developed in this study, with an x-shaped tool and an irregular pentagonal tracer are designed for spatial registration and needle tip positioning strategy respectively. The coordinate system of each unit in DIRS is unified through system calibration, spatial registration, and needle tip positioning strategy. Then the surgical path is planned on the computed tomography (CT) images in the navigation software before operation. The automatic positioning method and the auxiliary positioning method can be used in the operation to achieve accurate positioning and assist doctors to complete the operation. The errors of spatial registration, needle tip positioning strategy, and the overall accuracy of the system were evaluated respectively, and the results showed that they all met the needs of clinical surgery. This study preliminarily verified the feasibility of the precise positioning method for dental surgery robots and provided certain ideas for subsequent related research. [ABSTRACT FROM AUTHOR]

This article explores the significance of 3D-printed surgical guides in dental implant surgery and their impact on treatment outcomes. Through a comprehensive literature review, the benefits and advancements of utilizing 3D-printed surgical guides are analyzed, highlighting their role in enhancing precision, efficiency, and success rates in dental implant procedures. [ABSTRACT FROM AUTHOR]

Purpose: Dental implant surgery is an effective method for remediating the loss of teeth. Robot is expected to increase the accuracy of dental implant surgery. However, most of them are industrial serial robot, with low stiffness and non-unique inverse kinematic solution, which may reduce the success rate and safety of robotic surgery. Compared to serial robot, parallel robot is more stiffness and has unique inverse kinematic. However, its workspace is small, which may not meet surgical requirements. Therefore, a novel hybrid robot dedicated to dental implant is proposed. Methods: The hybrid robot is composed of three translation joints, two revolute joints, and Stewart parallel manipulator. Stewart is used for performing surgical operation, while the joints are used for enlarging the workspace of Stewart. In order to ensure the safety of robot motion, physical human–robot interaction based on a variable admittance controller is applied in the robotic system. In addition, considering the small workspace of Stewart, an optimal model is proposed to minimize the joint movement of Stewart in adjusting the orientation of drill bit. Results: Phantom experiments were carried out based on the prototype robot. In the experiments, the optimal model could be solved after 20 iterations, finding an ideal joint configuration. The proposed variable admittance controller could enhance comfort level effectively. The accuracy of robot is evaluated by angle, entry and exit deviation, which are 0.74 ± 0.25°, 0.93 ± 0.28 mm, and 0.96 ± 0.23 mm, respectively. Conclusion: The phantom experiments validate the functionality of the proposed hybrid robot. The satisfactory performance makes it more widely used in the practical dental implant surgery in the future. [ABSTRACT FROM AUTHOR]

Background: Microbial biofilm accumulation is the main cause of peri-implantitis. The majority of surgical peri-implantitis treatment protocols suggests adjunctive use of systemic antibiotics to target specific putative bacteria. The aim of this systematic review was to critically evaluate the adjunctive use of systemically administered antibiotics in surgical treatment of peri-implantitis by reviewing previously published systematic reviews and primary studies. Methods: A systematic literature search was conducted in four electronic databases (MEDLINE, The Cochrane Library, EMBASE, and Web of Science) for randomised controlled trials, cohort studies, case–control studies, and systematic reviews reporting surgical treatment of peri-implantitis with and without adjunctive systemically administered antibiotic therapy. The included systematic reviews and primary studies were qualitatively assessed using AMSTAR and GRADE, respectively. No restrictions were set for date of publication, journal, or language. Results: The literature search identified 681 papers. Only seven systematic reviews and two primary studies met the inclusion criteria. Four out of seven included systematic reviews concluded that no evidence exists for use of systemic antibiotics to improve the clinical outcomes in surgical treatment of peri-implantitis. One review did not estimate the level of evidence, one did not clearly state any beneficial effect, whereas one reported a limited adjunctive effect. Further, the two included primary studies did not show a long-term significant benefit of adjunctive use of systemically administrated antibiotics. However, one study reported a short-term adjunctive effect in patients with modified surface implants. Due to heterogeneity in study design, low number of included primary studies, and grade of bias, no meta-analysis was performed. Conclusion: The use of systemically administered antibiotics as an adjunct to surgical interventions of peri-implantitis cannot be justified as a part of a standard treatment protocol. A pervasive problem is the lack of uniform diagnosis criteria for peri-implantitis, deficient information about patient characteristics, absence of high quality long-term randomised controlled trials, and authors' declaration on conflict of interest. [ABSTRACT FROM AUTHOR]

The knowledge of nerves and vessels in the maxillofacial region, particularly the anatomical structures in the maxilla, mandible, tongue muscles, and salivary glands, is essential for dental surgeons. In addition, the structures in the mandibular canal, palate, and maxillary sinus should be understood well. The arteries and nerves in the maxillofacial region were observed in this study. Some variations in the origin of the inferior alveolar artery were found. Notably, the variations in the origin of the inferior alveolar artery from that of the external carotid artery and a double origin of the inferior alveolar artery were observed. Thus, the maxillary artery may originate from the external carotid and stapedial arteries. The following points are important. (1)The greater palatine artery is always located deeper than the greater palatine nerve. (2)The posterior superior alveolar artery often runs through the compact bone of the maxilla. Using CT scans, the canal of the artery can be observed. (3)Variations in origins of the inferior alveolar artery have been observed. The origin of the inferior alveolar nerve may differ depending on the course of the maxillary artery. Dental practitioners should, therefore, have a comprehensive knowledge of the anatomy of the maxillofacial region and its variations. Without this knowledge, they should not operate on patients. [ABSTRACT FROM AUTHOR]

This review aims to identify and summarise the findings of published qualitative studies relating to patients' experiences of dental implant surgery, by means of textual narrative synthesis. A comprehensive two-stage electronic and manual search of the literature identified relevant qualitative studies up to January 2020. Included primary studies (n = 15) used qualitative research methods including interviews and focus groups to investigate patients' experiences of dental implant treatment. They looked at the experience of tooth loss, the decision making process, the pre-implant experience, motivating factors and barriers for treatment and the post-implant experience with the prosthesis. There is a deficiency in the exploration of the patients' intraoperative dental surgical experience and the adjunctive effects of conscious sedation. The included studies give considerable insight into patients' experiences of the dental implant journey, which in the main, had overall positive consensus. The limited information available regarding patients' experience of the intra operative dental implant surgery with or without conscious sedation warrants further investigation. This information is a fundamental step to understanding the patients' preferences, needs and values and ultimately enhancing the quality of patient care. [ABSTRACT FROM AUTHOR]

Introduction There is general agreement that a thick zone of the keratinized tissues around implants promotes accurate prosthetic procedures, permits oral hygiene maintenance, resists recession, and enables esthetic blending with surrounding tissues. A new procedure called Choukroun's technique has been suggested, and it consists of a combination of horizontal apical mattress suture with regular suture to increase the keratinized tissue in the mandibular arch during the first stage after implantation. The proposed procedure has not been evaluated yet in a cohort of patients. Therefore, this prospective study aimed to evaluate the impact of Choukroun's technique on the width and thickness of the keratinized gingiva after oral surgery. Materials and methods A one-group prospective cohort study was conducted on patients referred to the Department of Oral and Maxillofacial Surgery at the Dental College of Al-Wataniya Private University who had been referred to undergo dental implant surgery. The inclusion criteria for the study group were as follows: patients with mandibular missing teeth, good oral health, good general health, 18-70 years old, at least 1 mm thickness of keratinized gingiva, and at least 1 mm width of the attached gingiva. A total of 14 patients aged 27-67 years were included in the study. After inserting the dental implants, the suturing was accomplished according to Choukroun's method. The width and thickness of the keratinized gingiva were assessed before surgery and at one and two months post-surgery. Repeated measures analysis of variance (ANOVA) was applied to detect significant differences between assessment times. Results The study sample comprised 14 patients, of which four were females (28.6%) and 10 were males (71.4%). Patients' ages ranged from 27 to 67 years, with a mean age of 54.86 ± 11.73 years. The surgical procedure was performed in three different regions: the upper posterior teeth with four patients (28.6%), the upper anterior teeth with three patients (21.4%), and the lower posterior teeth with seven patients (50%). The mean gingival width before surgery was 5.78 mm, whereas the mean gingival thickness was 2.82 mm. There was no significant difference between the three evaluation times in the mean gingival width (P=0.222), and there was a significant difference between the three evaluation times in the mean gingival thickness (P<0.001). The mean mean gingival thickness one month after surgery was significantly greater than its mean value before surgery (mean difference: 0.749 mm). Additionally, the mean gingival thickness two months after surgery was significantly greater than its mean value before (mean differences: 0.636 mm). Conclusions Using horizontal apical mattress sutures (Choukroun's technique) does not provide any advantage in increasing the width of the keratinized gingiva. However, it does lead to an increase in the thickness of keratinized gingiva in the surgical area. Therefore, the use of horizontal apical mattress sutures is recommended., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Local Research Ethics Committee of Al-Wataniya Private University issued approval ID: 88/b/8/2022. The study protocol was approved by the Local Research Ethics Committee of Al-Wataniya Private University (ID: 88/b/8/2022). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Abou-Agwa et al.)

Abstract Background Patients with type 1 diabetes mellitus (DM) have poor glycemic control owing to extreme impairments in glucose tolerance. There are few reports regarding dental implant surgery in patients with type 1 DM. We describe herein the perioperative glycemic management in an outpatient with type 1 DM who experienced a rare case of severe hypoglycemia during dental implant surgery. Only one such case has previously been reported. Case presentation A 60-year-old male patient diagnosed with type 1 DM was scheduled for dental implant primary surgery. Premedication with peroral antibiotics was carried out to prevent possible systemic infection as a complication of DM. The patient was treated to control intraoperative hypertension with diligent attention to cardiovascular conditions by using a bolus administration of nicardipine and diltiazem. During surgery, he abruptly complained of hypoglycemic symptoms and had a blood glucose level of 32 mg/dL. Following oral administration and electrolyte-combined infusion of glucose, he immediately recovered from the critical situation. The surgical procedure, involving a lower jaw implant fixture placement, was performed as planned and resulted in less invasion, limited to the area of implant fixture placement within the right mandibular region of the two molars, compared to implant surgery that spans the entire lower jaw. Conclusions The present case suggests that it is essential to promptly monitor possible signs of hypoglycemia-precipitated acute symptoms in patients with DM. In addition, it is also necessary to appropriately administer insulin with an electrolyte-combined infusion of glucose for deliberate glycemic control; this is particularly true in patients with type 1 DM undergoing relatively highly-invasive oral surgical manipulation such as commonly performed dental implant surgery spanning the entire jaw.

Purpose: The purpose of the present study was to determine whether intravenous sedation during dental implant surgery contributed to stabilization of hemodynamics. Materials and Methods: Two hundred fiftyfive consecutive patients treated with dental implants were randomly assigned to receive either intravenous sedation with local anesthesia (sedation group, n = 123) or local anesthesia only (nonsedation group, n = 132). Midazolam and propofol were used synergistically as sedative agents. Systolic blood pressure, diastolic blood pressure, and pulse rate were measured every 2.5 minutes during dental implant surgery. On the basis of these data, the coefficient of variation, percentage of change, maximum values, and incidences of a larger increase were analyzed and expressed as cardiovascular changes. Results: A comparison of percentages of change, maximum values, and incidences of a greater increase showed that systolic and/or diastolic blood pressure were significantly higher in the nonsedation group than in the sedation group. The combination of midazolam and propofol sedation prevented excessive increases in blood pressure. The circulatory suppression induced by the intravenous sedation regimen not only reduced mental stress arising from the state of sedation but also exerted a pharmacologic effect. The application of this intravenous sedation regimen stabilized hemodynamics and contributed to the safety of the patient in dental implant surgery. Conclusion: The application of intravenous sedation had a beneficial effect for hemodynamic changes during dental implant surgery. Int J Oral Maxillofac Implants 2011;26:1303-1308 [ABSTRACT FROM AUTHOR]

The objective of this article was to review the different factors and limitations influencing the accuracy of computer-aided implant surgery. In vitro and in vivo accuracy studies of articles and congress proceedings were examined. Similar results using bur tracking as well as image-guided template production techniques have been reported, and both methods allow for precise positioning of dental implants. Compared to the conventional technique, this sophisticated technology requires substantially more financial investment and effort (computerized tomographic imaging, fabrication of a registration template, intraoperative referencing for bur tracking, or image-guided manufacturing of a surgical template) but appears superior on account of its potential to eliminate possible manual placement errors and to systematize reproducible treatment success. The potential for the protection of critical anatomic structures and the esthetic and functional advantages of prosthodontic-driven implant positioning must also be considered. However, long-term clinical studies are necessary to confirm the value of this strategy and to justify the additional radiation dose, effort, and costs. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) printing is an emerging manufacturing technology in dentistry with a range of applications. Digital dentistry presented in cone beam CT scan radiographs is a revolution that improved surgical outcomes by optimizing accurate diagnosis and analysis of the surgical sites before surgery. A periodontist can modify the treatment plan, surgical techniques, and incision design based on bone defects seen on cone beam CT scans. Block grafting has been a technique of choice when wound stability is required for guided bone regeneration. There was no significant difference between the different surgical procedures for reconstruction and choice should be given to the simpler and less invasive procedure. A xenograft or allograft block can work as an alternative to the autogenous bone block to reduce the surgery time and patient morbidity. Preparation and shaping of block graft during surgery time to match the defect shape can prolong the operative time, reduce the treatment success, and increase postoperative complications. In this case report, a sterilized 3D-printed mandibular jaw was utilized to visualize the defect size and shape. A bovine xenograft block was then prepared, shaped, and adapted on the 3D-printed jaw 30 minutes before the surgery. The block graft was then transferred and well-fitted on the surgical defect. Handling experience was greater and surgery time and postoperative pain were reduced ., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Othman et al.)

Background: The use of a preoperative single dose of antibiotics as routine in conjunction with implant surgery is controversial, in light of the unclear effect on early implant failure rate and risk for development of resistant bacterial strains. Purpose: This randomized clinical trial compared the early implant failure rates in two different patient cohorts: One group receiving a single dose of preoperative antibiotics (AB group) and one group receiving no antibiotics, prior to implant surgery (noAB group). Materials and Methods: Patients were referred for treatment at four specialist clinics in the county council of West Sweden, Vastra Gotaland and randomly assigned into one of the two groups. A total of 447 patients received 963 implants were included in the study. Of these, 223 patients (535 implants) belonged to the AB‐group and 224 patients (428 implants) to the noAB‐group. Four commercial implant brands were utilized, albeit one system was only represented with four implants. The outcome was evaluated after 4 months using either a one‐stage or two‐stage procedure. The surgical procedures were performed by experienced implant surgeons and the surgical protocol for implant placement follows standard. Failure was defined as removal of an implant for any reason. The study outcomes were statistically analyzed to evaluate the differences between the two groups. Results: Twelve implants failed in 11 patients for the AB group, and 32 implants failed in 29 patients for the noAB group. Preoperative antibiotics, AB group, had significantly (P < 0.0011) lower implant failure 2.2% compared to 7.5% in the noAB group analyzed on implant level adjusted for dependence within patients, OR = 0.30, 95% confidence interval (0.14‐0.62). Conclusion: Administration of a single dose of antibiotics in conjunction with implant placement surgery resulted in a statistically significant lower early implant failure rate compared to when no antibiotics were used. [ABSTRACT FROM AUTHOR]

Post-extraction alveolar ridge resorption is unavoidable phenomenon ending with insufficient ridge width. Bone grafting, osteotome ridge expansion and ridge splitting were used to expand narrow ridges but they are either expensive, associated with higher morbidity or require longer treatment time. Therefore the use of screw expansion was introduced as an option for managing deficient ridge width enhancing ridge density, facilitating immediate implant placement and is not associated with potential complication. The aims were to evaluate of the efficacy of bone screw expanders in widening narrow ridges, measuring bone gain and assessing possible complications. This clinical prospective study was performed between October 2015 & October 2016. Twenty four patients with 45 potential sites were involved. Preoperative clinical examination and radiographic assessment with OPG were performed for all cases. ITL bone expander kit was used after initial osteotomy to expand the narrow ridges. Osstell ISQ was utilized to measure the primary implant stability. After 16 weeks, patients were recalled again for the second stage surgery and Osstell was used again to measure the secondary stability. Patients then were referred to the prosthetic department for completion of final prosthesis after sufficient time for healing abutments in place. Twenty four patients were participated with 45 implants inserted. Female to male ratio was 2.4:1 with a mean age of 43.12 year ranging between 18–65 years. The original mean bone width (Mean±SD) prior to expansion was 3.3±0.56 mm & after expansion associated with dental implant insertion was 5.09±1.05 mm and there was statistical significance in possible mean bone gain by 1.79 mm from baseline. The overall survival rate was 91.1% with the anterior parts of both jaws having the highest percentages. Intraoperative complications involved cracks which were observed in 15 sites (39.5%) and cortical malfractures which were seen in 7 sites (15.6%). In conclusion, screw expansion is an easy solution for expanding narrow ridges with least possible complications and allow for simultaneous implant placement.

The use of antibiotics in implant treatments is controversial. The purpose of this research was to study the behaviors of Santo Domingo dentists who prescribe antimicrobials to patients for the placement of dental implants. A total of 99 dentists participated in the study. A share of 1.2% of dentists prescribed antimicrobials solely in the preoperative period, 8.6% after surgery, 44.4% before and after, 19.8% only in specific situations, and 25.9% did not prescribe at all. Amoxicillin was the predominant antimicrobial of choice. A cross-sectional, observational, survey-based study was conducted. The items studied were demographics, self-assessment of knowledge about antibiotics and when they are used, as well as their recommended dosage and duration, in healthy and non-allergic patients. Notable variability was found in the prescription behaviors of antimicrobials. Bridging gaps in knowledge on the subject could help to standardize prescription guidelines.

Background Photobiomodulation techniques, particularly low-level laser therapy (LLLT), have gained traction due to their ability to accelerate osseointegration by stimulating cellular metabolism and promoting tissue healing. This study explores the effectiveness of LLLT around dental implants at various intervals after placement. Using resonance frequency analysis (RFA), the implant stability quotient (ISQ) was measured to assess implant stability. Methodology This split-mouth, randomized, single-blinded clinical trial included 20 participants undergoing dental implant placement. The test group received LLLT while the control group had no laser treatment. Implant stability was assessed using RFA at one, two, four, and twelve weeks post-implant placement. Statistical analysis involved descriptive statistics, repeated-measures analysis of variance (ANOVA), and t-tests. Results The repeated-measures ANOVA analysis showed significant differences in the ISQ values between the LLLT group and the control group at two weeks and three months post-implant placement. The LLLT group exhibited higher ISQ values, indicating greater implant stability and improved osseointegration compared to the control group. These findings suggest the potential benefits of LLLT in enhancing dental implant outcomes. Conclusions LLLT shows promise in improving dental implant outcomes, with enhanced stability and osseointegration. Further research is needed to validate these results and integrate LLLT into routine dental implant procedures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Shenoy et al.)

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: In the dental implant surgery, there are inevitable risks due to the anatomically complex operation in the cranio-maxillofacial region. Therefore, there is a trend to use computer-aided technology to simulate the process of the implant surgery. In this study, we present a haptic simulator for trainees to study and rehearse the drilling performance of dental implant surgery. Materials and methods: The dental implant surgery simulator (DISS) is developed based on the haptic force-feedback device Omega.6, and some free open-source software libraries such as Computer Haptics and Active Interface (CHAI3D), Qt and Visualization Toolkit. To achieve the desired effects of drilling, the meshes are subdivided with a recursive algorithm which breaks down a triangular patch into 4 sub-triangles. The drilling operation can be implemented at any specified location of the model. Once the drilling direction is determined, the position and rotation of the haptic device tool are constrained to the orientation through a dimension reduction algorithm. The driller diameter and drill speed are tunable to implement stepwise drilling for the patient-specific models.Results: A patient-specific drilling simulator based on virtual reality for dental implant surgery is presented. The simulation of stepwise drilling was conducted, and three patient-specific models reconstructed by Computed Tomography data were employed to help the novices to find the suitable drilling parameter.Conclusion: The obtained results showed that the haptic-based DISS could simulate various dental implant surgeries with different driller diameter and drill speed which takes patient-specific models as input. The evaluation of the DISS proves its good performance and it could provide an effective method to improve the skills and experiences of trainees. [ABSTRACT FROM AUTHOR]

Copyright of Implant Dentistry is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Long-standing loss of natural teeth in the mandible can lead to severe jaw atrophy and even mandibular fracture. There is no consensus on the best pre-prosthetic surgical treatment to reconstruct the atrophic edentulous mandible. The purpose of this review was to provide an overview of the existing literature and to give an evidence-based recommendation for bone grafting and future research. This systematic review was conducted according to the PRISMA statement. A literature search was performed in online databases Pubmed and Cochrane library for articles published between January 1980 and September 2017. The search was conducted using Medical Subject Heading terms: alveolar ridge augmentation; mouth, edentulous and mandible. Eligible articles were included according to in- and exclusion criteria and assessed on quality. Dental implant survival and bone stability were the primary outcomes. Secondary outcomes were complications. Twenty-four text articles matched the criteria and were included. Eleven articles were assessed to be of adequate quality for analysis. Graft stability seems to be higher in vertical distraction and tent-pole grafting, but as the dental implant survival is high (91.7% or higher) regardless of the procedure used for bone augmentation, this is of no clinical relevance. The survival rate of dental implants is high, regardless of the bone augmentation procedure used. High-quality clinical trials are needed to support the current evidence and guidelines on pre-i mplant bone grafting. Reporting of future research should include proper baseline characteristics and treatment description, as well as uniform outcome rendering. [ABSTRACT FROM AUTHOR]

The anterior loop of the inferior alveolar nerve (IAN) is an important landmark in the anterior mandible that must be considered during the placement of dental implants. We measured the length and prevalence of loops of the IAN in 188 consecutive, dentate patients using reformatted computed tomography (CT). A total of 158/188 (84%) had at least one anterior loop; 111/188 (59%) had bilateral loops. The mean (SD) length of the loops in the third quadrant was 1.4 (0.7) mm; 95% CI 1.3 to 1.6; (range 0.3 – 4.0 mm). The mean (SD) length of the loops in the fourth quadrant was 1.5 (0.9) mm; 95% CI 1.4 to 1.6; range 0.3 – 5.5 mm. In total 42/188 (22%) had loops that were longer than 2 mm in quadrants three and four. CT images that have been reformatted with specialised software may be useful to identify loops in the IAN, particularly when recent cone-beam CT images are not freely available. The prevalence of these loops is high while their length varies, which makes meticulous assessment necessary before the placement of implants. [ABSTRACT FROM AUTHOR]