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Computer assistance has become indispensable in the reconstruction of the orbit and midface. Although these are key areas of an individual’s esthetic appearance, defects or deformities of the midface, especially those of the orbit, are treated diversely.

Defects and bone loss in the maxilla and mandible pose significant challenges for dental rehabilitation. This paper focuses on complex cases of bimaxillary dental rehabilitation, where traditional dental implant protocols were not feasible in at least one jaw. Four patients were examined conceptually, where conventional dental implant placement (n = 20) was combined in either the same or opposite jaw with a patient-specific subperiosteal implant (n = 5). This study evaluates aspects such as primary stability, prosthodontic restoration, complications, and soft tissue management over the observation period. None of the five patient-specific subperiosteal implants (IPS Implants® Preprosthetic; KLS-Martin Group, Tuttlingen, Germany) experienced failure or showed any loosening of screws, with the longest observation period extending to 68 months. These implants were securely fixated away from the posts, without any biomechanical restrictions on loading from the time of insertion. Planning and manufacturing, including the initial suprastructure, followed a fully digital workflow. The number of screws required for multivector fixation ranged from 13 to 22. All dental implants placed remain functional, definitive prosthodontic restoration has been performed, and no stability loss or peri-implantitis has been observed. The IPS Implants® Preprosthetic emerges as a valuable consideration when conventional implant dentistry protocols encounter limitations. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine whether tightening or loosening the abutment screw results in torque loss and whether there is a difference in this respect between original screwdrivers and universal screwdrivers. Materials and Methods: For the purpose of the study, two groups were formed, with the original screwdriver used in group 1 and the universal screwdriver used in group 2. One Straumann implant and one BEGO implant were each inserted into a stationary torque transducer. The next step was to screw 13 abutments into each implant with 13 original abutment screws, using the screwdriver assigned to the group with the torque specified by the manufacturer. To establish whether the torque transmitted to the abutment screw via the screwdriver is also transmitted to the implant rather than causing deformation of the screw head or being transmitted to the surrounding area, the actual torque transmitted from the screw to the implant was measured and recorded electronically during the experiment. Results: There was no loss of torque in the transmission of the tightening torque to the Straumann implant with either screwdriver (P > 0.05). There was a loss of torque in the transmission of the tightening torque to the BEGO implant when using the universal screwdriver but not with the original screwdriver (P < 0.01). Relative to the previously applied tightening torque, a loss of torque when loosening the screw was found with both screwdrivers, both Straumann (P > 0.05) and BEGO (P < 0.05). Conclusion: Using universal screwdrivers can result in loss of torque. The loosening torque is thus decreased, which in turn increases the likelihood of complications such as screw loosening. [ABSTRACT FROM AUTHOR]

Odontogenic keratocysts are not uncommon in dental practice. Besides the removal of the cyst, regular follow-up checks are also important, as they facilitate early diagnosis and treatment of recurrent cysts. The successful removal of the cyst is followed by prosthetic rehabilitation. The focus should be on the objectives of restoring the patient's ability to chew and on resolving any issues affecting speech. Using templates for the implantation procedure ensures the correct positioning of the implants. If a template is used, any additional augmentation that may be required can be performed precisely at the site of the planned implantation, thus preventing over-augmentation. [ABSTRACT FROM AUTHOR]

Subperiosteal implants have experienced fluctuating popularity since their inception. Initially introduced in the mid-20th century, they were overshadowed by the development and success of endosteal implants, which are now the standard in dental implantology. Modern subperiosteal implants are typically custom-made using computer-aided design and computer-aided manufacturing technologies, which ensure a precise fit to the patient's bone anatomy. A meta-analysis was conducted to evaluate the success rates, complications, and patient satisfaction associated with subperiosteal implants. Studies were selected based on predefined inclusion criteria, focusing on clinical trials and observational studies that reported on the long-term outcomes of subperiosteal implants., Competing Interests: Disclosure The authors received speaker’s honoraria from DePuys Synthes, West Chester, PA, USA, Brainlab AG, Munich, Germany, and KLS Martin Group, Tuttlingen, Germany., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Trial Design: This controlled in vivo experimental study examines the impact of two periosteum preparation techniques on microcirculation during bone augmentation with isogenic bone grafts in rats., Methods: Twenty female Lewis rats were divided into two groups (n=10 each). In one group, the periosteum was prepared with a conventional periosteal elevator; in the other, a piezoelectric device was used. After graft implantation at calvarial sites, intravital microscopy was performed post-operation (day 0) and on days 3, 8, and 28 immediately to assess microvascular parameters: functional capillary density, blood flow velocity, and vessel diameter. Statistical analysis was conducted using ANOVA on ranks with p<0.05., Results: The piezoelectric device group showed higher mean values for functional capillary density, blood flow velocity, and vessel diameter than the conventional instrument group, though differences were not statistically significant., Conclusions: This study suggests that periosteum preparation with a piezoelectric device does not significantly differ from conventional methods regarding microcirculatory outcomes. Either method appears viable for preserving microcirculatory integrity during bone augmentation. Further research in larger models and clinical contexts is recommended to confirm these findings., Competing Interests: We declare that there are no conflicts of interest.

Often, midfacial defects are not only relevant regarding functional aspects but also esthetics of such congenital or acquired deformities impair significantly the patients' quality of life. Reconstructions of the midface do not only include replacing lost or non-developed tissue but moreover to achieve predictable results with regard to esthetics as well as function for the individual patient. Digital planning modalities including different surface and volume data in combination with modern additive manufacturing techniques for biomodel and implant production and intraoperative support by using real and virtual 3D volume data for navigation and intraoperative imaging, but also securing the outcome based on postoperative analysis have been implemented in modern midface reconstruction and represent new standards for medical care. The objective of this paper is to describe modern options of patient-specific midfacial reconstruction with integration of computer-assisted planning and production techniques., Competing Interests: Prof. Gellrich und Dr. Rahlf haben Vortragstätigkeiten für Gebrüder Martin GmbH mit Honorarvergütung., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)