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The aim of this study was to compare the clinical results of combining a pedicle connective palatal flap coupled with the trapezoid buccal flap against the buccal flap alone in the closure of the oroantral fistula. Individuals with oroantral communication were consecutively included and eventually randomly allocated into 2 groups. In the group test, oroantral fistula was treated with the association of a buccal flap with a pedicle palatal connective tissue flap; in group control, a classic buccal sliding flap was performed. Patients' outcomes were recorded at 48 hours, 1 week, 2 weeks, and 1 month after surgery for assessment of primary (success rate) and secondary endpoints, such as experienced pain, discomfort, and complications. The success rate was 96.6% for the test group and 86.6% for the control group. No significant difference between the 2 groups could be observed regarding discomfort and pain. More pronounced pain was detected in the test group during the early healing period. This surgical procedure was demonstrated to be successful, with a high success rate and low patient discomfort., (Copyright © 2023 by Mutaz B. Habal, MD.)

The design of the implant prosthesis-abutment complex appears crucial for shaping healthy and stable peri-implant soft tissues. The aim of the present animal study was to compare two implants with different healing abutment geometries: a concave design (TEST) and a straight one (CTRL). Transmission electron microscopy (TEM) was used to quantify the three-dimensional topography and morphological properties of collagen at nanoscale resolution. 2 swine were included in the experiment and 6 implants per animal were randomly placed in the left or right hemimandible in either the physiologically mature bone present between the lower canine and first premolar or in the mandibular premolar area, within tooth extraction sites. Each CTRL implant was positioned across from its respective TEST implant on the other side of the jaw. After 12 weeks of healing, 8 specimens (4 CTRL and 4 TEST) were retrieved and prepared for histological and TEM analysis. The results showed a significantly higher percentage of area covered by collagen bundles and average bundle size in TEST implants, as well as a significant decrease in the number of longitudinally oriented bundles with respect to CTRL implants, which is potentially due to the larger size of TEST bundles. These data suggest that a concave transmucosal abutment design serves as a scaffold, favoring the deposition and growth of a well-organized peri-implant collagen structure over the implant platform in the early healing phase, also promoting the convergence of collagen fibers toward the abutment collar.

Significant alveolar bone resorption follows tooth extraction. Immediate implant placement alone is not sufficient to prevent this phenomenon. The present study aims at reporting the clinical and radiologic outcome of an immediate implant with a custom healing abutment. In this clinical case, a fractured upper first premolar was replaced by an immediate implant and a customized healing abutment designed on the perimeter of the extractive alveolus. After 3 months, the implant was restored. The facial and interdental soft tissue was maintained with appreciable success after 5 years. The pre-and 5-year post-treatment computerized tomography scans showed bone regeneration of the buccal plate. Use of an interim customized healing abutment helps prevent hard- and soft-tissue collapse and promotes bone regeneration. This technique is straightforward and may represent a smart preservation strategy when there is no indication for adjunctive hard or soft tissue grafting. Given the limited nature of this case report, further studies are needed to confirm the present findings.

Abstract: This study aims to verify that the craniofacial plastic surgery robot with piezosurgery is more accurate and safer than traditional operations in genioplasty. This study chose data from the Digital Plastic Surgery of Plastic Surgery Hospital in the Chinese Academy of Medical Sciences and Peking Union Medical College. The CT data of the patient's skull were reconstructed in the software, and the authors designed the measurement index. The surgical plan was designed as an ideal scheme (control group). Patients underwent traditional surgery according to the preoperative surgery plan (clinical group). Guided by surgical navigation, the osteotomy was operated on patients' same size plaster model using the surgery robot equipped with a piezosurgery (robot group). At last, the accuracy was calculated by CT data. There was no significant difference between the robotic group and control groups in the postoperative measurement index (P < 0.05). There was no significant difference between the robotic group and the control group ( P > 0.05) in the line of osteotomy, but there was a significant difference between the clinical group and the control group in the line of the osteotomy., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by Mutaz B. Habal, MD.)

The healing process of the tooth extraction socket often leads to significant resorption of the alveolar bone, eventually causing clinical difficulties for future implant-supported rehabilitations. The aim of the present animal study was to evaluate alveolar bone remodeling after tooth extraction in a rabbit model, either with or without the use of a plain collagen plug inside the socket, by means of micro-computed tomography. The study included the micro-tomography analysis of 36 rabbits' incisor extraction sockets, either left empty or filled with a collagen plug. All animals were euthanized in a staggered manner, in order to address molecular, histologic, and radiographic analyses at different time-points, up to 90 days after surgery. The three-dimensional evaluation was carried out using micro-computed tomography technology on excised bone blocks including the alveolus and the contralateral bone. Both linear and volumetric measures were recorded: the percentage of bone volume change (ΔBV) within the region of interest was considered the primary endpoint of the study. The micro-CT analysis revealed mean volumetric changes of -58.1% ± from baseline to 3 months for the control group, and almost no bone loss for the test group, -4.6%. The sockets treated with the collagen plug showed significantly less dimensional resorption, while the natural-healing group showed an evident collapse of the alveolar bone three months after extraction surgery.

Background: Hyaluronic acid and amino acids play an important role in the wound healing process, stimulating the development of the connective tissue and the activity and proliferation of fibroblasts. The aim of the present controlled clinical study was to evaluate the clinical efficacy of a topical gel formula containing hyaluronic acid and amino acids in terms of wound closure rate, painkiller intake, and patients' reported pain and edema., Methods: This study included patients in need of a single tooth extraction. Patients were randomized into two groups with differing post-operative care regimens. Patients in the test group used the amino acid and hyaluronic acid-based gel, while the control group did not use any product. Each parameter was measured in both groups at different time points: immediately after surgery, and after 7, 14, 30, and 60 days., Results: A total of 40 patients (46.52 ± 9.84 years old) completed the observational period, and 40 extraction sockets were examined. After 7 days, the edema was significantly lower in the test group. The reported pain was lower in the test group without a significant difference, except for the first time point at 7 days. With the follow-up questionnaire, patients declared to have taken painkillers mainly during the first 7 days after surgery; however, the test group showed a lower need for painkillers than the control group., Conclusion: The post-operative and domiciliary use of an amino acid and hyaluronic acid-based gel for the management of soft tissue closure after tooth extraction is a valid coadjutant to reduce swelling, pain, and the need for painkillers. Additional studies are required to support the results of the present study.

Objective: Management of mucositis is essential for the long-term maintenance of dental implants. This study determined the efficacy, in terms of clinical parameters, of an adjunctive domiciliary agent paired with non-surgical periodontal therapy (NSPT) for patients with peri-implant mucositis., Materials and Methods: Patients involved in a periodontal maintenance program were randomly distributed to the domestic use of a chlorhexidine toothpaste and mouthwash (control) or a hypochlorite-based formula brushing solution (test) after diagnosis of peri-implant mucositis. A modified approach towards NSPTwas performed after 10 days of domestic use of the assigned maintenance product in both groups. Clinical and patient-related outcomes were recorded during a 90-day follow-up period., Results: Forty patients completed the three-month study (20 patients per group). Both groups showed relevant clinical and patient outcome improvements after the NSPT (T2) and between T1 and T2 (p < 0 0.01), except for PPD. For the test group, the clinical improvement was significantly greater than that for the control group at the seventh-day evaluation (T 1 ) in the gingival index (0-3) and FMBS (%). Favorable outcomes were maintained during the entire follow-up period., Conclusion: The present study showed that the modified NSPT paired with the domestic use of nitradine-based formula helps resolve peri-implant mucositis and that nitradine might represent an alternative to chlorhexidine in these cases., Clinical Relevance: The gold standard for nonsurgical maintenance is full-mouth disinfection. A previous decontamination of the oral cavity with chlorhexidine or nitradine domiciliary for 10 days could reduce plaque and inflammation, resulting in a painless operative session. This protocol may help reduce airborne contamination and the risk of cross-infection, and during the pandemic, the protocol is safer for clinicians. In the same clinical cases, nitradine may be more efficient than chlorhexidine, and the former has no side effects such as discolouration., (© 2021 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Background: The aim of this retrospective study was to document the long-term clinical efficacy of a surgical-prosthetic technique (the flat one-bridge technique) involving the immediate restoration of both postextraction and nonpostextraction implants supporting full-arch restorations., Methods: Implants were placed by adapting the axis to the available bone. Flat definitive abutments were connected during surgery and never disconnected to compensate for eventual implant disparallelism. Bone grafting was performed when needed. The patients received a screw-retained provisional restoration within 48 h of surgery and a final screw-retained prosthesis within 1 year., Results: Sixty-six patients received 494 implants distributed in 75 prostheses. The median follow-up was 86 months (range 82-168 months). Only three implants had failed at the last follow-up. Implant survival was 99.6%., Conclusion: The flat one-bridge prosthetic protocol is a viable procedure with excellent long-term outcomes. No difference in clinical success could be observed between postextractive and nonpostextractive implants., (© 2021. The Author(s).)

Introduction: Rehabilitating a severely atrophic maxilla is a complex procedure. In case of severe resorption, zygomatic implants are indicated and loading of the implants at the end of the surgery is desirable. We present a new method by means of guided surgery for the placement of zygomatic implants, using specially designed metal templates that should be supported by bone., Methods: The treatment planning for completely guided prosthetic rehabilitation of the maxilla with zygomatic implants was digitally performed. A radiographic template was designed for the prosthetic treatment planning. A surgical template was used to replicate the digitally planned steps in vivo., Results: The procedure ended with the positioning of a custom-made temporary prosthesis. This method can reduce the surgery duration, simplify the procedure, and optimize the outcome. It requires equal cooperation among technicians, prosthodontists, and surgeons. Nineteen out of twenty patients included in the study presented successful implants and prosthesis at the moment of analysis., Conclusions: The present approach addressed the needs for zygomatic-implant surgery. The surgical and prosthetic plan, position, emergence, the shape of the implants, the position of the temporary prosthesis, the inter-arch relationships, and surgical templates were designed in a completely virtual environment and performed by the surgeon on stereolithographic models beforehand. Consequently, the surgical procedure was considerably simplified., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

Background: Periodontal infection may contribute to poor glycemic control and systemic inflammation in diabetic patients. The aim of the present study is to evaluate the efficacy of non-surgical periodontal treatment in diabetic patients by measuring oxidative stress outcomes., Methods: Sixty diabetic patients with periodontitis were enrolled, treated with scaling and full-mouth disinfection, and randomly prescribed chlorhexidine mouthwash, antioxidant mouthwash, or ozone therapy. Reactive oxygen metabolites (ROMs), periodontal parameters, and glycated hemoglobin were measured at baseline and then at 1, 3, and 6 months after., Results: At baseline, all patients presented with pathologic levels of plasmatic ROM (388 ± 21.36 U CARR), higher than the normal population. Probing depth, plaque index, and bleeding on probing values showed significant clinical improvements after treatment, accompanied by significant reductions of plasma ROM levels ( p < 0.05). At the 6-month evaluation, the mean ROM relapsed to 332 ± 31.76 U CARR. Glycated hemoglobin decreased significantly (∆ = -0.52 units) after treatment. Both the test groups showed longer-lasting improvements of periodontal parameters., Conclusion: In diabetic patients, periodontal treatment was effective at reducing plasma ROM, which is an indicator of systemic oxidative stress and inflammation. The treatment of periodontal infection might facilitate glycemic control and decrease systemic inflammation.

The lateral sinus lift procedure has been extensively investigated and described as a reliable surgical solution aimed at facilitating implant placement and rehabilitation when the posterior upper maxilla is atrophic. The standard technique consists in a lateral antrostomy, the careful raising of the sinus membrane, and following apposition of a bone substitute between the membrane and the sinus floor. The present technical note illustrates a new conservative technique enabling lateral sinus lift without the use of bone substitutes and with predictable outcomes.

Bone change after tooth extraction has been well documented by different studies. Tooth extraction is followed by loss in height and width of the alveolar process. After tooth loss, the natural healing process is governed by the formation of the blood clot, which is stabilized by a fibrin bridge, the starting structure for new bone apposition. The hematoma is then replaced by the granulation tissue which is rich in fibroblasts that synthesize the extra-cellular matrix. The adjoining of wound edges requires further contraction of the healing tissue which is exerted by myofibroblasts. Excessive myofibroblasts contraction at the early stage of healing might explain, in part, the pathophysiology of alveolar bone resorption. The authors advocate the use of collagen right after tooth extraction to sustain the soft tissue and releasing the tension at the most coronal portion of the wound, thus preventing excessive detrimental myofibroblasts contraction., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background/purpose: Blade implants account for one of the most debated dental implants design in scientific literature. They have been reconsidered by clinicians since their re-classification by Food and Drug Administration in 2014., Materials and Methods: The present study aimed to evaluate the outcome of newly manufactured extension implants in the treatment of moderate atrophic posterior maxillae. All the patients enrolled in the present retrospective case series study showed a moderate bone atrophy in the posterior maxilla with a maximum residual height ranging between 4 mm and 8 mm. Implants were inserted with the aid of an electro-magnetic device, and then they covered with screws and left healing. Three months after, implants were exposed and loaded., Results: Difference between the marginal bone level at the 3-month evaluation (5.57 ± 0.67 mm) and that at baseline (5.67 ± 0.55 mm) appeared to be not significant (p-value = 0.63). At the 12-month evaluation, the marginal bone level (4.95 ± 0.45 mm) underwent significant decrease respect to baseline value as proven by significant change at marginal bone level (-0.62 ± 0.51 mm with a p-value = 0.01)., Conclusion: The results of the present study suggested a positive 12-month outcome for extension implants in the rehabilitation of the moderate atrophic maxilla, without the need of extensive reconstructive surgeries and grafting procedures., Competing Interests: The authors claim to have no financial interest, either directly or indirectly, in the products or information listed in the paper., (© 2020 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.)

Chemotherapy usually causes complications affecting several tissues such as oral mucosa. In this case report, a soft palate oral ulcer caused by chemotherapy was treated by ozone gas. This kind of treatment is known for its antimicrobial, regenerative and analgesic proprieties. The results show a complete resolution of the lesion within 2 weeks of treatment. Ozone therapy demonstrates greater effectiveness with respect to this kind of oral lesion compared to traditional therapy. Considering this evidence, ozone therapy should be considered as a useful tool for the adjuvant therapy of oral complications in oncologic patients., Learning Points: Intensive chemotherapy can have side effects, particularly affecting tissue with higher turnover. Therefore, there is a clinical need to prevent or to treat such complications.Ozone therapy could improve oral mucosa healing and have anti-inflammatory, antioxidant and antibacterial effects to prevent suprainfections. To date, there are no reported cases of oral ulcers in oncologic patients being completely resolved using ozone in the literature.Medical and dental doctors should collaborate with regards to complex patients to prevent such types of complications, discovering these clinical cases that are unknown in the literature and treating patients in a more comprehensive way., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interest, (© EFIM 2020.)

After tooth extraction, the alveolar bone tends to shrink in volume, especially on the vestibular side. The role of myofibroblasts in bone remodeling has not been sufficiently investigated. The aim of the present study was to explore the gene expression related to myofibroblasts presence and activity during a 90-day healing period after tooth extraction. The study included 36 rabbits, and a single tooth extraction was performed on each rabbit. The extractive sockets were randomly distributed to natural healing or to scarification of the wound. The sacrifices were staggered in such a manner that animals contributed with sockets representing 2, 7, 15, 30, 60, and 90 days of healing. Nanostring technology was used to evaluate the expression of a wide panel consisting in 148 genes related to the activation, induction, and suppression of myofibroblasts, socket microenvironment, and autophagy. We found that the expression profile of this custom panel was time-related. The post-extractive socket was subjected to significant gene expression changes after 15 days: the genes involved in the induction of myofibroblasts were up-regulated in the first 15-day period and down-regulated during the rest of the follow-up. The study suggested that myofibroblasts play a major role in the immediate 15-day period following tooth extraction.

Aim: The aim of this study was to determine the impact of different full-mouth decontamination (FMD) protocols on the effectiveness of an intrapocket anesthetic gel in periodontal maintenance patients., Methods: Patients undergoing the periodontal maintenance program and with the need for FMD participated in this study. Patients were randomly allocated to non-surgical periodontal therapy (NSPT) with either a preparatory 15-day decontamination phase, including chlorhexidine mouth rinse and domiciliary hygiene instructions (modified FMD: test group), or without it (FMD: control group). In both groups, NSPT was performed with the aid of a non-injectable anesthetic gel. Clinical and patient-related outcomes were recorded during a 6-month follow-up period., Results: Sixty patients completed the 6-month study. Both groups experienced relevant clinical improvements after NSPT, but the test group showed a significant change in periodontal parameters already after the initial 15-day preparatory period, and overall significantly better results in periodontal outcomes when compared with the control group at the last 6-month follow up: the gingival index was 2.07 ± 1.25 in the control group and 1.13 ± 0.51 in the test group. Less pain and dental-related anxiety were perceived by patients in the test group showing a 6-month mean visual analog scale of 2.13 ± 1.25 in the control group and 1.13 ± 0.83 in the test group., Conclusion: The present study suggested that the modification of the standard FMD could improve the clinical efficacy of non-injectable anesthetic, along with patients' short- and mid-term appreciation and compliance., (© 2019 The Authors. Journal of Investigative and Clinical Dentistry published by John Wiley & Sons Australia, Ltd.)

Background: Recurrent or occasional aphthous lesions represent a painful oral condition with high prevalence. Since the etiology is still unclear and most likely related to a dysfunction in the local immune system, several treatment strategies have been proposed, including systemic agents, local agents, and laser therapy, to reduce the pain and discomfort for the patient without acting on the causes., Materials and Methods: The purpose of the present randomized study was to assess the clinical efficacy of a new topical gel with mucoadhesive property to reduce the pain and the dimension of the aphthosis lesions. Fifty patients presenting at least one minor ulcer were randomized to a control group (placebo prescription), a first test group (topical agent with laser), and a second test group (topical agent only). The healing rate, the visual analog scale (VAS) score for pain, and the diameter reduction were monitored for 10 days., Results: Both test groups showed better results than control group, significant clinical efficacy, and a median total reduction time of 4 days with no significant adjunctive benefit from the use of laser., Conclusion: The clinical results are encouraging; nevertheless other studies are needed to valid this kind of treatment., Clinical Significance: The present randomized clinical study suggested that the use of topical mucoadhesive agents could represent a valid therapy for minor aphthous lesions. How to cite this article: Giammarinaro E, Cosola S, Oldoini G, et al. Local Formula with Mucoadhesive Property: A Randomized Clinical Trial of a Therapeutic Agent for the Treatment of Oral Aphthous Ulcers. J Contemp Dent Pract 2019;20(11):1249-1253.

Introduction: Osteonecrosis of the jaw has been consistently reported in the literature associated to the high-dose intravenous bisphosphonate therapy. However, osteonecrosis can also occur in patients who have other risk factors., Case Description: An unusual case of ONJ in a patient being treated with esomeprazole is reported., Discussion: The probable association between proton pump inhibitor intake and osteonecrosis of the jaw should alert clinicians. Collaborations between medical and dental doctor and an early diagnosis might prevent or reduce the morbidity resulting from advanced destructive lesions of the jaw bone., Learning Points: Osteonecrosis of the jaw (ONJ) can occur in patients treated with bisphosphonates and corticosteroids and is associated with oral surgical procedures involving bone.Antacid drugs commonly used to treat gastro-oesophageal reflux could affect bone metabolism although no cases of ONJ in patients using proton pump inhibitors have been reported.Medical and dental practitioners should collaborate to prevent ONJ, identify previously unreported drug interactions, and treat patients in a more comprehensive manner., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interest, (© EFIM 2019.)

Background: Early peri-implant bone loss has been associated to long-term implant-prosthetic failure. Different technical, surgical, and prosthetic techniques have been introduced to enhance the clinical outcome of dental implants in terms of crestal bone preservation. The aim of the present cohort study was to observe the mean marginal bone level around two-part implants with gingivally tapered abutments one year after loading., Methods: Mean marginal bone levels and change were computed following radiological calibration and linear measurement on standardized radiographs., Results: Twenty patients who met the inclusion criterion of having at least one implant with the tapered prosthetic connection were included in the study. The cumulative implant success rate was 100%, the average bone loss was -0.18 ± 0.72 mm, with the final bone level sitting above the implant platform most of the time (+1.16 ± 0.91 mm)., Conclusion: The results of this cohort study suggested that implants with tapered abutments perform successfully one year after loading and that they are associated with excellent marginal bone preservation, thus suggesting that implant-connection macro-geometry might have a crucial role in dictating peri-implant bone levels.

Aim: The aim of the present study was to compare the clinical efficacy of chlorhexidine and ozonised water in the oral hygiene maintenance of orthodontic patients., Materials and Methods: Study design: This is a prospective clinical study. Thirty patients with orthodontic brackets were selected at the Versilia General Hospital (Lido di Camaiore, Italy). Patients were randomly allocated to one of two groups: standard oral hygiene session followed by prescription of either chlorhexidine mouth-rinse or ozonated water. At each moment of the follow-up, the following parameters were recorded: pocket probing depth (PPD), full-mouth plaque index (FMPI), and full mouth bleeding score (FMBS)., Statistics: Sample size was computed according to previously published data. Significance level was set at 0.05 for all analyses, and non-parametric Wilcoxon signed rank test was used for comparisons., Results: At baseline, mean PPD was 1.89 ± 0.13 mm for the control group and 1.95 ± 0.10 mm for the test group. Mean FMPI was 63.9 ± 16.5% and 68.7 ± 10.33% respectively. Mean FMBS was 31.5 ± 15.6% and 32.8 ± 8.85 respectively. One month after treatment (T2), both groups showed a significant improvement of FMPI and FMBS. Mean FMPI was 42.8 ± 14.3% and 24.3 ± 6.41% respectively. Mean FMBS was 19.5 ±12.6% and 4.70 ± 3.56% respectively. The test group treated with ozone exhibited a greater improvement of FMPI and FMBS., Conclusions: Ozone yielded better outcomes than chlorhexidine in the management of gingivitis in orthodontic patients. Ozone should be further investigated in longitudinal studies with larger samples.

Objectives: The purpose of this study was to evaluate a nonsurgical approach toward peri-implantitis by means of mechanical debridement and local detoxification leaving granulation tissue into the peri-implant pockets., Materials and Methods: An analysis was performed on the outcomes of 2 nonsurgical protocols: mechanical debridement plus chemical detoxification with 0.2% chlorhexidine and chlortetracycline hydrochloride (test), and mechanical debridement alone (control). Measures were collected at baseline, 3, 24, and 36 months after treatment., Results: Seventy-five implants with peri-implantitis were included. At a 36-month evaluation, mean pocket probing depth was 3.15 ± 0.32 mm for the test group and 5.97 ± 0.90 mm for the control group, the difference being significant. An improvement of marginal bone level was recorded for the test group, whether the control group showed a further marginal bone loss. Treatment success was 100% in the test group and 31.4% in the control group., Conclusion: Nonsurgical implant debridement alone seemed not efficient in the treatment of peri-implantitis. Further longitudinal studies are required to evaluate the efficacy of mechanical debridement with chemical detoxification and removal of granulation tissues against mechanical debridement with chemical detoxification alone.

Purpose: The purpose of the present cohort study was to investigate the 3-year efficacy and clinical performance of implant-supported rehabilitations in posterior mandibles augmented with the sandwich osteotomy technique., Materials and Methods: Twenty-three partially edentulous patients who developed atrophy of the posterior mandible (residual ridge height, 3 to 7 mm) were treated (32 surgical sites) with vertical bone augmentation using interpositional equine cancellous bone blocks and porcine corticocancellous bone particulate. All implants were placed 4 months after augmentation and were loaded with fixed dental prostheses. One side per patient was selected and followed for 3 years, and the patient was the unit of analysis. Linear radiographic vertical bone gain and peri-implant marginal bone loss were assessed; secondary outcomes-complication rates after surgery, prosthesis and implant failure rates, width of keratinized mucosa, and patient satisfaction-were evaluated., Results: All patients reported postoperative paresthesia that resolved over a period of 2 months after the augmentation procedure. The mean vertical bone gain was 5.6 mm after 4 months. Ninety-one dental implants were positioned into the augmented areas. The global 3-year survival rate was 95.5%. The mean peri-implant marginal bone loss around implants was 1.06 ± 0.37 mm 3 years after loading, whereas the width of keratinized mucosa had an overall increase of 0.39 ± 0.36 mm., Conclusion: The results of the present 3-year study suggested high success rates for implants placed in areas augmented with the osteotomy sandwich technique. This surgical approach could be helpful in the presence of a low residual vertical height in the posterior mandible before implant placement., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Consistent bone changes occur after tooth removal, often compromising the success of implants placed within the socket left to natural healing The long-term effect of ridge preservation on implant outcomes is still unclear., Purpose: The aim of the study was to assess success and survival rates of implants placed in extraction sockets, with spontaneous healing, or grafted with cortical porcine bone, or collagenated corticocancellous porcine bone., Materials and Methods: Ninety patients in need for a single premolar/molar tooth extraction and an implant treatment were selected for the present study. Patients were randomly distributed among 3 groups: sites that healed naturally (ctrl), or sites that received ridge preservation with either cortical (cort) or collagenated corticocancellous porcine bone (coll). Three months after, all the experimental sites were reentered to insert implants. Marginal bone levels were recorded; soft tissues were analyzed and summarized with the Pink Esthetic Score (PES). Forty-two patients out of 90 (initial cohort study) completed the entire follow-up of 4 years., Results: Cumulative survival and success rates for all implants were 100% at a 4-year evaluation. Mean marginal bone loss (MBL) was 1.14 ± 0.23 mm in the cort group, 1.13 ± 0.29 mm in the coll group, and 1.92 ± 0.07 mm in the ctrl group. There were no significant differences between the 2 grafting materials but MBL was significantly greater in the nongrafted sites (P value < .001). The PES resulted significantly better (9.42 ± 0.75) for the cort group than for the coll group (8.53 ± 1.18) and ctrl group (6.07 ± 1.89) at 4-year evaluation., Conclusions: Ridge preservation was more effective than natural healing in preserving marginal bone and in achieving better esthetic outcomes around implants 4 years after placement. The cortical porcine bone showed better clinical outcomes than collagenated corticocancellous porcine bone., (© 2018 Wiley Periodicals, Inc.)

Background: Patient-centered outcomes are being given great attention by the dental scientific community. The Oral Health Impact Profile -14 questionnaire (OHIP-14) has been introduced to address patients' success criteria when describing the impact of oral rehabilitations on quality of life (OHrQoL)., Methods: Thirty-five patients wearing a full-arch implant-prosthesis being in place between 4 and 6 years before this analysis were considered eligible and then enrolled in the present retrospective study. According to their prosthetic anamnesis, two groups were defined: delayed loading group (IL-group) and immediate loading group (IL-group). At the moment of analysis, clinical and radiographic parameters were collected, and patients were asked to complete the Oral Health Impact Profile -14 questionnaire (OHIP-14) in order to measure their OHrQoL., Results: Independent t-test showed total OHIP-14 scores to be not significantly different between groups; however, the domains "functional limitation" and "physical disability" resulted significantly higher in patients within the DL-group. On the contrary, social disability was higher in the IL-group. When the comparison was performed taking sex into account, no significant differences between groups were highlighted. Instead, the stratification for years of follow-up led to significant evidences. When the follow-up was shorter (less-than-5 years), the functional limitation reported scores were higher., Conclusions: Within the limitations of this study, the analysis supports the absence of significant differences between immediate loading and delayed loading full-arch protocol in term of clinical, radiological parameters and OHrQoL.

Background: Periodontal diseases are characteristic for the excessive release of oxidant free-radicals by the host. The aim of the present study was to evaluate the efficacy of an anti-oxidant-based formula containing propolis and herbs as an adjunctive therapy to standard non-surgical periodontal treatment (NSPT) when compared to the domiciliary use of chlorhexidine-based formulae., Methods: Forty patients were enrolled in the present study and randomly allocated to either a control (NSPT plus chlorhexidine gel formula) group or a test (NSPT plus anti-oxidant gel formula) group. Clinical parameters for the assessment of the periodontal status were evaluated at baseline, one month, and three months after NSPT, and the salivary antioxidant capacity as well., Results: There were no significant clinical differences between the two groups (P>0.05). However, patients within the test group (propolis) achieved better results in terms of oxidative stress reduction (P<0.05)., Conclusions: In the present study, propolis was comparable to chlorhexidine in the clinical management of gingivitis. Further studies are needed to investigate its potential as a redox modulator for the oral microbiome.

Background: Implant stability is commonly related to insertion torque. Recently, it has been suggested that higher insertion torque may lead to greater bone resorption., Purpose: The aim of the present randomized clinical study was to evaluate the role of different insertion torque values in terms of implant success, marginal bone loss, and facial soft tissues recession., Materials and Methods: Patients requiring a single dental implant were recruited and randomized to receive one of two implants with the same macro-geometry but different cutting designs. First group consists of a 90 degrees cutting groove know as self-tapping implant, and the second group known as Blossom™ cutting groove. (Intra-Lock, Boca Raton, Florida). The insertion torque (IT) was assessed and two groups followed: high-IT (≥50 Ncm) group and regular-IT (<50 Ncm) group. After 3 months, all the implants were restored. At baseline, buccal bone thickness (BBT) was recorded. During the 3-year survey, the following outcomes had been registered: implant failures and success, radiographic marginal bone level around dental implant (MBL) and facial soft tissue level (FSTL)., Results: A hundred and sixteen implants were placed in healed sites. The overall survival rate after 3 years was 96.5%. The Cumulative Success Rate was 91.3% for the High IT group and 98.2% for the Regular IT group. The mean marginal bone loss and facial soft tissue recession, at a 3-year evaluation, were significantly greater for the High-IT group and in the mandible than that reached in the Regular-IT group and in the maxilla., Conclusion: Present findings showed that implants placed with higher insertion torque in mandible led to greater bone resorption and mucosal recession than that registered for implants placed with a regular IT. Moreover, sites with a thick buccal bone wall (≥1 mm) showed smaller recession at the facial soft tissue level after 3 years., (© 2018 Wiley Periodicals, Inc.)

Bone shaping is often a necessary procedure prior to implant insertion in mandibular full-arch rehabilitations. Adopting guided surgery procedures is necessary to use two distinct templates: one for bone shaping, a second for guided implant insertion. The present report describes the case of a 60-year-old patient requiring a full-arch, immediately loaded implant-supported mandibular rehabilitation. A CAD/CAM-bone supported surgical template for osteoplasty was used to develop a template for guided implant during an all-on-six immediate-loaded computer-aided implant surgery. The report describes the feasibility, accuracy and usefulness of this double, CAD/CAM developed, surgical template.

Background: The placement of implants immediately after tooth extraction has proven to be a predictable treatment strategy with a very high success rate., Purpose: The aim of the present 7-year prospective single cohort study was to evaluate the success rate, marginal bone level (MBL), soft tissue stability of implants placed in fresh extraction sockets and immediately restored., Material and Methods: This prospective cohort study included 37 implants in 32 patients (19 females and 13 males) with an average age of 40.1 ± 13.3 (range: 21-63 years) who received immediate implants and immediate single unit restorations. Outcome evaluations were: implant failures, complications, MBL, width of keratinized gingiva, facial soft tissue (FST) levels, modified Plaque Index and modified Bleeding Index., Results and Conclusions: The cumulative survival rate was of 94.6% at 7-year visit. The mean MBL was -0.6 ± 0.49 mm at baseline and 1 ± 0.2 mm after 7 years. The FST Level was 0.4 ± 0.69 mm at baseline and 0.02 ± 0.70 mm at the 7-year follow-up. The Width of Keratinazed Gingiva was 3.8 ± 0.47 mm at baseline and 3.1 ± 0.42 mm at 7-year follow-up. Implants placed immediately after tooth extraction and immediately restored showed predictable clinical outcomes in this prospective study., (© 2016 Wiley Periodicals, Inc.)