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Purpose: To evaluate bone preservation and esthetic recovery between the socket-shield technique (SST) with different labial bone plate thicknesses and the conventional immediate implant technique (CIIT). Materials and Methods: Patients who underwent immediate implant placement in the anterior region were divided into three groups: the SST with a thickwall phenotype (> 1 mm; SSTA group), the SST with a thin-wall phenotype (< 1 mm; SSTB group), and the CIIT with a thickwall phenotype (> 1 mm; CIIT group). Radiologic images and clinical photos were collected before surgery, immediately postoperatively, and 6 months postoperatively. The labial bone width, labial bone width change (BWC), labial bone volume change (BVC), pink esthetic score (PES), and complication rate were evaluated among the three groups. Statistical analysis was performed using SPSS software. Results: A total of 60 patients (n = 20/group) were enrolled in this 6-month retrospective study. The BWC in the SSTA group (0.22 to 0.30 mm) and the SSTB group (0.18 to 0.33 mm) was less than that in the CIIT group (0.61 to 0.80 mm; P < .004). The SSTA group and the SSTB group had a lower BVC (24.08 vs 21.14 vs 54.81, respectively; P = .004) and greater PES (11.75 vs 11.65 vs 10.65, respectively; P = .009) than the CIIT group. No complications occurred among these patients. Conclusions: With the limitations of this study, it can be concluded that the SST is a reliable method for preserving bone and achieving satisfactory esthetic outcomes. The labial bone plate phenotype associated with the SST has minimal impact on both clinical and radiologic outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the soft tissue response to the placement of additively manufactured subperiosteal jaw implants (AMSJI) in the severely atrophic maxilla and to identify possible risk factors for soft tissue breakdown. Materials and Methods: An international multicenter study was conducted, and 15 men (mean age: 64.62 years; SD: ± 6.75) and 25 women (mean age: 65.24 years; SD: ± 6.77) with advanced maxillary jaw resorption (Cawood and Howell Class V or more) were included in this study. General patient data were collected, and all subjects were clinically examined. Inclusion criteria were patients who underwent bilateral AMSJI placement in the maxilla at least 1 year prior. Exclusion criteria were patients who did not have patient, surgeon, or dentist consent to participate in the study before their inclusion. Results: A total of 40 patients were enrolled, with a mean follow-up period of 917 days (SD: ± 306.89 days). Primary implant stability was achieved postoperatively in all cases, and all implants were loaded with a final prosthesis. At the time of the study, only 1 patient showed mobility (> 1 mm) of the bilateral AMSJI. Due to mucosal recession, exposure of the framework was seen in 26 patients (65%) and was mainly in the left (21.43% of 26) and right (18.57% of 26) midlateral region. A thin biotype and the presence of mucositis were found to be risk factors (P < .05). Although not significant, smokers had a risk of developing a recession that was nearly seven times (odds ratio: 6.88; P = .08) greater than that of nonsmokers. Conclusions: Twenty-six (65%) patients presented with a recession in one (or more) of the seven regions after oral rehabilitation with bilateral AMSJI placement. Several risk drivers were evaluated. The collapse of soft tissues around the AMSJI that led to caudal exposure of the arms was correlated with a thin biotype and the presence of mucositis. [ABSTRACT FROM AUTHOR]

Purpose: To identify pressure areas using an impression technique and to evaluate whether adjustment of dentures prior to installation can decrease ulcer frequency, reduce the number of adjustments, and improve satisfaction with treatment. Materials and Methods: A total of 50 complete denture users were selected and randomly divided into two groups. Pressure areas were identified in 25 subjects using the impression technique with fluid silicone, and the denture base in these areas was adjusted before installation. A total of 25 patients received new complete dentures without adjustments before installation. The number of ulcers observed was registered at 1, 7, 15, and 30 days after installation. Patient satisfaction was registered before installation and 1 month after installation. The number of necessary postinstallation adjustments was considered. Comparisons between the groups with respect to the number of ulcers and adjustments and patient satisfaction were performed using the Mann-Whitney test. Results: Identification of pressure areas reduced the number of ulcers after installation of the new prostheses. These results were observed in the 1- (P = .004) and 7-day (P = .002) adjustments for the maxilla and in all the adjustments for the mandible. The technique improved patient satisfaction (P = .031) and reduced the number of postinstallation adjustments (P ≤ .001). Conclusions: A reduction in the incidence of ulcers and number of adjustments and improvement in patient satisfaction could be observed with the use of the impression technique. [ABSTRACT FROM AUTHOR]

Purpose: To review experimental peri-implantitis studies using rat models and summarize different peri-implantitis induction techniques and evaluate their effectiveness. Materials and Methods: Electronic searches were conducted by two independent examiners to address the following issues. Meta-analyses explored the marginal bone loss (MBL) of four types of peri-implantitis induction methods in rats. The detailed induction tactics--such as the implant design, implant size, surgical process, time cost, induction methods, and endpoint measurements--were summarized. Results: Of the 18 included studies, 38.9% of the studies placed implants at the maxillary first molar, and 44.4% placed them at the alveolar ridge region anterior to the maxillary first molar. As for the induction method, the numbers of published studies on ligature methods, bacterial inoculation, and bacterial lipopolysaccharide inoculation were equally high among all selected studies. The total implant survival rate at the end was 160 out of 213 implants (75.11%). Eight studies with high pooled heterogeneity (I2 = 98, P < .01) in the meta-analysis reported an overall MBL (µ-CT) of 0.47 mm (95% CI = 0.14 to 0.81). A subgroup analysis estimated an MBL of 0.31 mm (95% CI = 0.12 to 0.50) for bacterial inoculation and 0.66 mm (95% CI = 0.07 to 1.26) for the ligature method. Histopathologic analysis revealed that peri-implantitis in rats was similar to peri-implantitis lesions in humans. Conclusions: Implant placement at the maxillary first molar with bacterial inoculation and the silk ligature method to build peri-implantitis rat models is reliable to use for research on peri-implantitis. [ABSTRACT FROM AUTHOR]

Purpose: To assess the handling properties and clinical function of a new class of material, a so-called mineral-organic bone adhesive (Tetranite; TN), which as yet has no precedent in orthopedic or oral and maxillofacial surgery, for clinically unstable implants placed in immediate extraction sockets and immediately temporized in the anterior maxilla. Materials and Methods: A cohort of up to 15 patients requiring between one and four immediate dental implants placed into maxillary extraction sockets from canine to canine were eligible for inclusion. Implants had to be unstable with an insertion torque of < 15 Ncm. Implants were then stabilized using TN, which was allowed to set before reassessing stability using both torque and resonance frequency measurements. Implant stability quotients (ISQs) taken after TN setting were compared to ISQs taken prior to its application, and the implants had to demonstrate resistance to a forward torque of 20 Ncm to be considered stable. ISQs were monitored at 1 week and 1, 3, 7, and 12 months postplacement. In addition, peri-implant tissue health was monitored, adverse events were recorded, and implant success was determined at 1 year postplacement. Results: Eleven patients received a total of 14 implants. Three out of the first six implants failed within 1 month (50%), and thus a protocol amendment was made to remove steps considered potentially destructive to the bonding process. As a result of these amendments, only one further failure was experienced for the next eight implants placed (12.5%). Mean ISQ data averaged for buccolingual and mesiodistal measurements demonstrated a baseline value before TN application of 59.1 Ncm (SD: ± 9.7; range: 40.5 to 73.0). After final setting of the TN, mean ISQ measured 71.9 Ncm (± 6.5; 56.0 to 80.0). At 3 months, just prior to restoration placement, mean ISQ measured 71.0 Ncm (± 6.6; 57.0 to 78.0). Thereafter, the mean ISQ continued to increase at both the 7- and 12-month follow-ups with scores of 78.9 (± 4.6; 72.0 to 84.5) and 80.3 (± 3.8; 74.5 to 85.0), respectively. The surviving 10 implants went on to be fully restored and remained in function beyond the end of the study period to yield a final success rate of 71.4%. Conclusions: The purpose of a first-in-human study is to demonstrate an extrapolation of preclinical data into the controlled human clinical arena. It is an opportunity to learn what does and does not translate well from experimental data. In that regard, the current pilot study can be deemed a complete success. The implant survival rate of 71.4%, while disappointing, should be considered in light of the protocol amendments identified, the user handling experience learned, and the opportunity to modify the material to better perform in the human patient, as all represent important lessons learned. The notable increase in ISQ sheds light on the nature by which the glue was substituted for bone to yield a stable implant by the end of the study period. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to describe a novel protocol for a minimally invasive pocket elimination surgery (MI-PES) in the posterior maxilla and mandible, which consists of the combined use of (1) an access flap based on an internally beveled gingivectomy with minimal to no papilla mobilization at the buccal aspect, and (2) a resective procedure with an apically positioned flap on the lingual aspect. The interproximal bone defects were accessed with a single (lingual) flap, and the bone architecture was modified by the adoption of piezoelectric inserts for controlled bone recontouring associated with fiber retention. Mean probing depth (PD) was 5.5 ± 0.8 mm before surgery and 2.7 ± 0.6 mm at the 6-month reevaluation. All treated pockets showed a postsurgical PD < 4 mm. Gingival recession (REC) was 0.3 ± 0.5 mm at baseline and increased to 1.6 ± 0.8 mm at 6 months. When buccal and lingual pockets were analyzed separately, a trend toward a similar PD reduction, less REC increase, and greater clinical attachment level gain was recorded for buccal pockets. These preliminary observations seem to support the use of MI-PES as a valuable option for pocket elimination, at least when residual pockets are associated with a shallow interproximal osseous crater in the posterior maxilla or mandible. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the process of early oral osseointegration of titanium (Ti) implants in diabetic 129/Sv mice through microCT and histologic and immunohistochemical analysis. Materials and Methods: A group of 30 male 129/Sv mice was equally subdivided into two groups: (1) nondiabetic (ND), in which mice did not undergo systemic alterations and received a standard diet, and (2) diabetic (D), in which mice were provided a high-fat diet from the age of 6 weeks until the conclusion of the study and received two intraperitoneal (IP) injections of streptozotocin (STZ) at a concentration of 100 mg/Kg each. Each mouse underwent extraction of a maxillary first molar, and customized Ti screws (0.50 mm diameter, 1.5 mm length) were placed in the residual alveolar sockets of the palatal roots. At 7 and 21 days after implant placement, the animals were euthanized for maxilla and pancreas collection. Maxillae containing Ti implants were analyzed with microCT, histology, and immunohistochemistry for cells that were positive for F4/80, CD146, runt-related transcription factor 2 (Runx2), and proliferating cell nuclear antigen (PCNA). Pancreata were histologically analyzed. Quantitative data were statistically analyzed with a significance level at 5% (P < .05). Results: ND mice presented successful healing and osseointegration, with a significantly higher fraction of bone volume compared to D mice, both at the alveolar sockets (53.39 ± 5.93 and 46.08 ± 3.18, respectively) and at the implant sites (68.88 ± 7.07 and 44.40 ± 6.98, respectively) 21 days after implant placement. Histologic evaluation revealed that the ND mice showed a significant decrease in inflammatory infiltrate and a significant increase in newly formed bone matrix at 21 days, whereas peri-implant sites in the D mice were predominantly encapsulated by fibrous tissue and chronic inflammatory infiltrate. Immunohistochemical characterization revealed higher Runx2 osteoblast differentiation and higher cell proliferation activity in the ND mice at 7 days, while higher amounts of macrophages were present in D mice at 7 and 21 days. Interestingly, no differences were found in CD146-positive cells when comparing ND and D mice. Conclusions: This study evaluated the effects of immediate dental implant placement in 129/Sv diabetic mice by using specific healing markers to identify changes in cellular events involved in early oral osseointegration. This approach may serve as tool to evaluate new materials and surface coatings to improve osseointegration in diabetic patients. [ABSTRACT FROM AUTHOR]

The Custom Alveolar Ridge Splitting (CARS) technique was recently reported as a less-invasive treatment option for augmentation of the maxillary anterior area in cases where alveolar width deficiency exists due to bone resorption and remodeling. This technique creates an intraosseous defect to improve success when horizontal ridge augmentation is attempted. The purpose of the present case report was to demonstrate implant placement in an atrophic posterior mandibular site using the CARS technique. This technique was used in the mandibular right second premolar area, followed by placement of a single implant. The restored implant showed stable soft and hard tissue outcomes at 6 months postloading. [ABSTRACT FROM AUTHOR]

This study clinically and histologically evaluated the outcome of a porcineapatite xenograft used to elevate the maxillary sinus floor in a severely atrophic ridge. A two-stage crestal window sinus elevation protocol was conducted in 24 patients with crestal bone ≤ 2 mm. Highly porous porcine carbonate apatite moistened with saline solution was placed in the elevated sinus cavity as the sole grafting material. Bone core biopsy samples were taken at 6, 9, and 12 months after sinus augmentation surgery (at implant placement). Treatment outcomes were assessed using microCT (μCT) and histologic analysis. Statistical analysis was performed using nonparametric Kruskal-Wallis test, followed by post-hoc Dunn multiple comparison test. At 6 months after implant placement, all implants achieved good primary stability (insertion torque ≥ 30 Ncm) and successfully osseointegrated. The residual graft amount (mean ± SE) was low (11.91% ± 1.99%) at 6 months and further decreased (6.11% ± 2.64%) by 12 months. On the contrary, the amount of new bone detected was 18.94% ± 4.08% at 6 months and was significantly (P < .05) increased (40.16% ± 5.27%) at 12 months. Histologic assessment revealed osteoclasts actively resorbing the graft as well as osteoblasts actively forming new bone. In the severely atrophic maxilla, the porcine-apatite xenograft promotes new bone formation while being slowly absorbed. Within the limited sample size, the porcine-apatite xenograft seems to be a good graft material for crestal window sinus augmentation. [ABSTRACT FROM AUTHOR]

The traditional configuration of four maxillary implants to restore full-arch maxillary fixed implant prostheses is not without pitfalls. Intraoperative variability, such as bone quality and quantity, may lead to unexpected intraoperative challenges that may not allow for execution of the original treatment plan. Additionally, extensive maxillary sinus pneumatization may inhibit posterior spread and lead to a shortened dental arch or excessive cantilever forces. The PATZi protocol is a systematized algorithm for maxillary full-arch implant treatment planning that addresses such intraoperative surprises and achieves full arch length in the planned prosthesis. PATZi also assigns a numbering classification to each implant configuration, which leads to uniform communication and grading of surgical difficulty, as well as predictable planning for developing future salvage plans. By using the PATZi protocol as a guideline, the surgeon may improve composite torque value and anteroposterior (AP) spread, eliminate distal cantilever forces, and ultimately improve the predictability of the prosthetic treatment plan. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 3-year success and survival rates of fixed prostheses supported by 4-mm extra-short implants splinted to 10-mm implants in patients with shortened maxillary arches and low maxillary sinus floors. Methods: A total of 11 patients with reduced alveolar bone heights due to low maxillary sinus floors received two or three titaniumzirconium tissue-level implants: one or two extra-short (4 mm) implants, and one implant 10 mm in length. After 6 months, prosthetic rehabilitation with splinted crowns connecting the 4- and 10-mm implants was performed. Follow-up visits and maintenance protocols were implemented every 4 to 6 months. Results: The 11 patients were treated with 11 10-mm implants and 17 4-mm implants. One extra-short implant failed and was removed before loading, and its planned design was modified from three splinted crowns to a bridge between the 10- and 4-mm implants. After 36 months, all (11/11) prosthetic rehabilitations connecting the 10-mm (11/11) and 4-mm (16/16) implants were functional. At the 10-mm implant sites, the median (interquartile range [IQR]) probing depth and marginal bone loss measured 2.9 mm (2.3 to 3.2) and 1.3 mm (1.0 to 1.5), respectively. At the 4-mm implant sites, the median (IQR) probing depth and marginal bone loss measured 2.9 mm (2.4 to 3.1) and 0.3 mm (0.1 to 0.5), respectively. Conclusion: Prosthetic rehabilitation with splinted crowns connecting 4-mm and 10-mm implants showed promising outcomes in shortened maxillary dental arches after 3 years. Additional studies are needed to further validate these findings. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate via CBCT the anatomical variations of the maxillary teeth and associated major anatomical cavities, the maxillary sinus and nasal fossa. Material and Methods: CBCT scans of 221 patients were used to examine maxillary sinus variations, the posterior superior alveolar artery (PSAA) course, nasal septum variations, middle and inferior conchameatus variations, canalis sinuosus, infraorbital ethmoid cell, infraorbital canal, anterior nasal spina, and nasopalatine canal. Results: The incidence of anatomical variations was 32.6% for maxillary sinus septa, 50.9% for PSAA, 23.1% for nasal septum deviation, 6.3% for nasal septum spur and pneumatization, 3.6% for paradoxical middle concha, 14.9% for middle concha hypertrophy, 39.6% for middle concha bullosa, 0.45% for bifid inferior concha, 0.9% for paradoxical inferior concha, 60.1% for inferior conch hypertrophy, 1.8% for inferior concha bullosa, and 40.3% for the infraorbital ethmoid cell. The study mainly observed group 2 anterior nasal spina with a rate of 35.7%, group 1 nasopalatine canal with a rate of 37.1%, and infraorbital duct type 2 with a rate of 70%. In 20.4% and 47% of cases, canalis sinuosus was located in the right and left sides of the maxilla, respectively. Conclusions: Maxillary sinus variations, PSAA prevalence and localization, nasal septum and concha variations, anterior nasal spina subgroups, nasopalatine canal subgroups, canalis sinuosus prevalence, and localization and infraorbital ethmoid cell prevalence were found to be consistent with the literature. Moreover, a rare case of the lower bifid concha was identified. The nasomaxillary complex and related dental structures, which are a multidisciplinary study area, should be carefully examined in the presence of pain of unknown origin and the planning of surgical procedures. [ABSTRACT FROM AUTHOR]

The article discusses research published in the 2021 issue of the "International Journal of Environmental Research and Public Health" which evaluated the use of short dental implants compared to standard dental implants. The research reviewed studies on short implants and standard-length implants placed in augmented and nonaugmented edentulous sites, short implant survival, stability and marginal bone levels, and implants placed in the posterior maxilla and in medically compromised patients.

Purpose: To evaluate the gain in peri-implant keratinized mucosa (KM) using a combination of a free gingival graft (FGG) strip with a xenogeneic collagen matrix (XCM) and compare it to that of an FGG alone. Materials and Methods: This randomized controlled clinical study included a total of 30 patients with a minimal amount of peri-implant KM (= 1 mm) in the maxillary and mandibular anterior regions (including the premolars). The study population was divided into two groups using a randomization protocol; group A (n = 15) received a combination of FGG strip and XCM, and group B (n = 15) received FGG only to augment the KM. Clinical parameters included width of KM (WKM) measured at baseline, 1 month, and 6 months; a customized pink esthetic score (PES) measured at baseline and 6 months; and patient morbidity using visual analog scale (VAS) at days 1, 7, and 14 postoperatively. Results: After 1 month, both groups showed statistically significant gain in KM that reduced slightly by the 6-month follow-up but remained statistically significant when compared to baseline. When the gain was compared between the two groups, the difference was not statistically significant. Better esthetic outcomes and lower morbidity were reported in group A compared to group B, and this difference was statistically significant. Conclusions: Within the limitations of the study, it can be concluded that the combination of FGG strip with XCM is a viable alternative to the use of FGG in augmenting peri-implant KM. [ABSTRACT FROM AUTHOR]

Purpose: To assess the literature comparing histologic levels of osseointegration for titanium vs zirconia dental implants. Materials and Methods: This systematic review was conducted following the PRISMA guidelines and was registered in PROSPERO (CRD42021236781). Electronic and manual searches were carried out through the PubMed/MEDLINE, PubMed Central, and Embase databases with a platform-specific search strategy combining controlled terms (MeSH and Emtree) and text words. The articles were selected by two independent investigators who evaluated the articles based on the criteria for eligibility. Results: A total of 17 articles were included. All were preclinical studies. The populations included dogs (27.55%), minipigs (14.28%), rats (14.28%), and rabbits (43.89%); and the implantation site varied among the mandible (36.82%), maxilla (9.04%), tibia (17.64%), skull (10.70%), and femur (25.80%). A total of 370 titanium (Ti) implants and 537 zirconia (Zr) implants were evaluated. The average osseointegration (% bone-to-implant contact) for Zr was 55.51% (17.6% to 89.09%), and for Ti was 58.50% (23.2% to 87.85%). There was no statistical difference between studies at the 2-month follow-up (P = .672), but this difference was significant at 1 and 3 months (P < .001). Conclusions: Within the limitations of this review, Zr implants had a similar level of osseointegration compared to Ti implants. Nonetheless, because these findings are based on preclinical research, all data must be carefully examined. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the hard and soft tissue alterations of immediate implant placement and provisionalization with customized definitive abutments in the esthetic zone. Materials and Methods: Single unsalvageable maxillary anterior teeth were replaced with immediate implant placement and provisionalization with definitive abutments in 22 participants. Digital impressions and CBCT images were obtained presurgery, immediately after surgery, and 6 months after surgery. Horizontal and vertical buccal bone changes in thickness and height (HBBT, VBBH), vertical changes for the gingiva margin, mesial and distal papilla height, and horizontal changes for soft tissue (HCST) were analyzed using a 3D superimposition method. Results: Twenty-two participants completed the study. No implant failed, and there were no mechanical or biologic complications for any patients. At 6 months after surgery, the mean HBBT changes at 0, 1, 2, 3, 5, 7, 10, 11.5, and 13 mm were -0.92 ± 0.73, -0.83 ± 0.53, -0.82 ± 0.49, -0.70 ± 0.64, -0.65 ± 0.47, -0.50 ± 0.51, -0.15 ± 0.45, -0.10 ± 0.57, and -0.00 ± 0.64 mm, respectively. The mean VBBH change was -0.61 ± 0.76 mm. The mean HCSTs at -3, -2, -1, 0, 1, 2, and 3 mm sub- and supra-implant shoulder were -0.65 ± 0.54, -0.70 ± 0.56, -0.65 ± 0.51, -0.61 ± 0.56, -0.47 ± 0.54, -0.47 ± 0.59, and -0.46 ± 0.59 mm, respectively. The mean gingiva margin recession was -0.38 ± 0.67 mm. The mean mesial papilla height recession was -0.03 ± 0.50 mm. The mean distal papilla height recession was -0.12 ± 0.56 mm. Conclusion: The definitive abutment used with immediate implant placement and provisionalization could potentially maintain the buccal bone thickness and height. For the facial soft tissue, it also benefited the maintenance of the midfacial gingival margin position and papilla height during the 6-month follow-up. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether immediate implant placement and loading renders different outcomes from delayed loading with respect to midfacial mucosal level in the maxillary esthetic area. Materials and Methods: A literature search was conducted in four electronic databases (PubMed, Web of Science, Embase, and Cochrane), identifying eligible clinical studies published prior to December 2021. Only randomized controlled trials (RCTs) comparing immediate implant placement with or without immediate loading in the maxillary esthetic zone with a mean follow-up of at least 12 months were selected for qualitative analysis and meta-analysis. The Cochrane Risk of Bias tool was adopted to assess the quality of the evidence. The heterogeneity between the pooled literature was analyzed through the chi-square test (P < .05) and quantified by the I2 index. A mixed-effects model was applied if it appeared that there was noteworthy heterogeneity; otherwise, a random-effects model was chosen. For continuous outcomes, the estimate of relative effect was presented to display the standardized mean differences (SMDs) and 95% CIs. For dichotomous variables, the Mantel-Haenszel statistical method was applied with effect sizes expressed as risk ratios (RRs) and 95% CIs. This study is registered on PROSPERO with number CRD42017078611. Results: Out of 5,553 records, 8 RCTs were involved, providing data for 324 immediately placed implants (immediate implants subjected to immediate loading [IPIL]: 163; immediate implants subjected to delayed loading [IPDL]: 161) that had been in function within 12 to 60 months. Meta-analyses revealed significantly lower midfacial mucosal level changes for IPIL compared with IPDL, pointing to 0.48 mm (95% CI: -0.84 to -0.12; P = .01), as well as more significant papillary recession after IPDL (SMD -0.16; 95% CI: -0.31 to 0.00; P = .04). The differences regarding implant survival and marginal bone loss between the two loading groups showed no statistical significance. The result of metaanalyses revealed similar plaque score (SMD 0.03; 95% CI: -0.22 to 0.29; P = .79) and probing depth (SMD -0.09; 95% CI: -0.23 to 0.05; P = .21) for IPIL and IPDL. On the other hand, IPIL induced a trend toward more bleeding on probing (SMD 0.22; 95% CI: 0.01 to 0.42; P = .04) and less change in facial ridge dimension (SMD 0.94; 95% CI: -1.49 to --0.39; P < .01). Conclusion: After a follow-up ranging from 12 to 60 months, midfacial mucosa level change was 0.48 mm lower following IPIL compared with IPDL. Immediate implant placement and loading is conducive to the preservation of physiologic soft and hard tissue architecture, appearing to offer considerable benefits in the anterior zone. In summary, IPIL should be considered in the esthetic zone if the primary implant stability permits. [ABSTRACT FROM AUTHOR]

Purpose: To examine and compare stress values of implants, highest tensile and compressive values, and their distribution in cortical and trabecular bone near and around the implant region using different materials (aramid fiber, glass fiber, polyethylene fiber, carbon fiber, and cobalt-chromium [Co-Cr] alloy). Four dental implants were placed in the maxillary crest with two different location scenarios, and the 3D finite element analysis method was used to evaluate stress characteristics. Materials and Methods: Two maxillary models were created in which the implants were placed in different locations (lateral and first premolar, canine and second premolar). Four implant-supported overdenture prostheses were reinforced, applying Co-Cr alloy, glass fiber, aramid fiber, and carbon fiber. Static loads of 200 N were applied on the first molar region using the food stuff method. Stresses around the implants and denture-bearing areas and compression and tensile stresses on the cortical and trabecular bone were evaluated. Results: In all tested models, the highest von Mises stresses on implants and prostheses were observed in aramid fiber--reinforced overdentures. This was followed by glass fiber, Co-Cr alloy, and carbon fiber groups, respectively. It was observed that the lowest tensile and highest compression stress values in cortical and trabecular bone occurred in prostheses supported with carbon fiber. In all infrastructure materials, the design in which the implants were placed bilaterally in the lateral teeth and the first premolar region was found to be advantageous in terms of stress levels and distribution. Conclusion: High elastic modulus fiber--reinforced overdenture prostheses transmitted less stress to implants and surrounding tissues than Co-Cr alloy. Anteriorly placed implant design illustrated lower stress values in the prosthesis, implant, and cortical and trabecular bone, and this placement design may increase the survival rates of both dental implants and overdentures. In light of this study, fibers can be recommended for clinical use and securely applied as an alternative material to metal support. [ABSTRACT FROM AUTHOR]

Purpose: To compare the outcomes of maxillary horizontal alveolar ridge augmentation in the esthetic area, using either pericardium membrane or titanium mesh, clinically, radiographically, and histologically. Materials and Methods: A randomized clinical study was performed on 20 patients with insufficient edentulous ridge width. Subjects were equally allocated into two groups. For both groups, autogenous tenting bone blocks were harvested from the symphysis area. Bone block was covered by an equal mixture (1:1) of particulate graft of inorganic bovine bone and autogenous bone matrix. The barrier membrane used in group 1 (PM) was bovine pericardium membrane, and in group 2 (TM), it was titanium mesh. Results: Both groups had a clinically statistically significant difference in buccopalatal alveolar ridge dimension between baseline and after 4 months. Radiographically, at both intervals, there was no significant difference in 3D volume between both groups. Within both groups, there was a significant volume increase postoperatively. Histologically, the PM group had a lower area fraction of the mean value of newly formed bone than the TM group, yet the difference was not significant. The PM group had a higher mean osteocyte count than the TM group, but again, the difference was not significant. Conclusion: Guided bone regeneration using either pericardium membrane or titanium mesh is a reliable treatment for horizontal augmentation of insufficient maxillary alveolar ridge width. No significant differences between both treatment modalities were noticed clinically and histologically. However, percentage change in radiographic volumetric measurements using TM was significantly higher than that of PM. [ABSTRACT FROM AUTHOR]

A 12-month prospective consecutive case series study was conducted to evaluate the effectiveness of a novel porcine collagen matrix to correct moderate to severe buccogingival recession defects. A total of 10 healthy patients (8 women and 2 men; age range: 30 to 68 years) with 26 maxillary and mandibular recession gingival defects > 4 mm deep were included. Healthy maturation of gingival tissues with natural color and texture matching the adjacent soft tissue areas were observed at all reevaluation visits. Complete root coverage was not achieved in all cases, possibly due to severe buccal bone loss in most of the selected cases, which negatively impacted the results. Nevertheless, when a novel porcine collagen matrix was used, a mean root coverage of 63.15% was achieved, and gains in clinical attachment level and keratinized tissue height were seen. Future randomized clinical trials are needed to further explore the potential of porcine collagen matrix for treatment of localized gingival recession defects. [ABSTRACT FROM AUTHOR]

The histologic findings and histomorphometric analysis of peri-implant tissues from nine functionally loaded implants from an adult cadaver were analyzed. Despite the presence of peri-implant bone loss, all implants were found to have a high degree of osseointegration, with the bone-implant contact (BIC) ranging from 69% to 88%. The mean BIC was 83.2% ± 4.3% (range: 76.5% to 87.7%) for maxillary implants and was 74.4% ± 7.1% (range: 69.4% to 84.9%) for mandibular implants, which were comparable. Relatively prominent bone remodeling and resorption with soft tissue ingrowth were observed in the vertical bony defects compared to the areas without intrabony components, which might represent the sequence of bone loss around the implants. [ABSTRACT FROM AUTHOR]

Purpose: To compare the biomechanical behaviors of different surgical options that are preferred for implant-supported fixed prosthetic rehabilitation of the atrophic edentulous maxilla. Materials and Methods: A 3D finite element analysis (FEA) model was generated from the computed tomography data of a patient with an atrophic edentulous maxilla. Four scenarios were created in the atrophic maxilla. In model 1, the maxilla was reconstructed with an onlay bone graft harvested from the anterior iliac crest, and sinus augmentation procedures were performed. Standard dental implants were placed in the lateral incisor, first premolar, and first molar regions on each side. In model 2, the anterior part of the atrophic maxilla was reconstructed with an onlay bone graft harvested from the mandibular ramus, and zygomatic implants were placed in the posterior part of the maxilla. In models 3 and 4, two-piece subperiosteal implants made of titanium and polyether ether ketone (PEEK) materials, respectively, were placed in the atrophic maxilla. All implants were loaded with 150-N and 50-N forces in vertical and lateral directions, respectively. Stress accumulation on bones, implants, abutments, and prosthetic frameworks was investigated. Results: The tensile stress in both cortical and trabecular bone was highest in the iliac bone grafting group under vertical loading. The compressive stress in both cortical and trabecular bone was the highest in the PEEK subperiosteal implant model, and the compressive stress value on the trabecular bone exceeded the strength of the trabecular bone. The highest von Mises stress in the implants was obtained in the iliac bone grafting group under vertical loading. The highest stress value in the abutments was detected for the titanium subperiosteal implant. The highest von Mises stress in the prosthetic framework was detected in the titanium subperiosteal implant group, under both vertical and lateral loading. Conclusion: Based on the stress accumulation results of the four different scenarios, it can be seen that there is no ideal treatment modality for the fixed implant-supported prosthetic rehabilitation of the atrophic edentulous maxilla. Various intraoperative and prosthetic modifications are suggested to decrease the risk of biomechanical complications during long-term follow-up. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the deviations of implants with two different geometries placed with a bonesupported stereolithographic surgical template into the bone of Misch classification densities of D2, D3, and D4. Materials and Methods: Eight maxilla and eight mandible models were macrodesigned according to the jaw geometries. Bone densities of these models were created in parallel with the most frequently observed densities in the locations: D3 bone density in the anterior maxilla, D4 bone density in the posterior maxilla, D2 bone density in the anterior mandible, and D3 bone density in the posterior mandible. A bone-supported stereolithographic surgical template was prepared in accordance with the jaw models and planning and used to place 64 NobelParallel Conical Connection RP 4.3 × 13 mm and 64 NobelActive 4.3 × 13 mm implants on the models. Global deviation, lateral deviation, angular deviation, and depth deviation between planned and placed implants were calculated with Hypermesh. The Kruskal-Wallis test was used to analyze the differences between deviation data of the study groups, and the Mann-Whitney U test was used for pairwise comparisons of groups with significant differences. Significance was evaluated as P < .05. Results: The study groups showed statistical differences in terms of global, lateral, and depth deviation (P = .017, P = .044, and P = .012, respectively); no statistical difference was detected in terms of angular deviation (P > .05). When the data of all studies were evaluated, the deviation values for all maxillary and mandibular implants were examined regardless of bone and implant type; no statistical difference was found between the arches in terms of deviation type (P > .05). Conclusion: Regardless of the macrogeometry of the dental implants placed with the guide, no significant difference was observed between the deviation values of the different bone densities they were applied to. [ABSTRACT FROM AUTHOR]

Objectives: Necrotic lesions affecting the head and neck region are of significance to dental professionals as they pose challenges in diagnosis and management. Necrotic oral lesions manifest with symptoms like pain, burning, altered sensation, oral malodor, fistula, exposed bone, and pathologic fracture of the bone in extensive cases. The manifestation of necrosis is a definitive clinical sign which helps to narrow down the exhaustive list of causative conditions. This article provides a comprehensive review of the pathogenesis, causative conditions, and management aspects of various necrotic lesions affecting the maxillofacial region. The prompt identification of the cause helps in streamlining the management aspects of necrotic lesions thus reducing the morbidity caused by these conditions. [ABSTRACT FROM AUTHOR]

Purpose: To describe treatment of malpositioned implants in the esthetic area using the angulated welded abutment (AWA) approach together with peri-implant soft tissue surgery.Materials and Methods: A clinical case with extreme buccal angulation of two implants in the anterior maxilla was used to illustrate the AWA technique. After implant impressions, digital analysis of the ideal prosthetic angulation of the abutment and the ideal position of its screw-access hole in relation to the gingival margin of the adjacent teeth was undertaken. The AWA was designed in two combinable components that were meant to be welded together. Before the welding process, an angulated screw was included in the abutment. Since the angulated screw was inside the abutment, the screw-access hole could be designed as narrow as possible, and it was located where required. After periodontal and peri-implant surgery were carried out, the AWA was applied to the implants.Results: The AWA allowed for correction of the prosthetic axis. Moreover, relocation of the screw-access hole allowed the gingival tissue to creep over the abutment. In this way, a new esthetic restoration could be placed after the mucogingival surgery.Conclusion: The excessive implant misangulation in the present case was efficiently recovered. Further studies are needed to evaluate the long-term clinical success, and standardization of the technique is required for routine clinical use. [ABSTRACT FROM AUTHOR]

Purpose: To investigate and analyze the effects of different prosthetic protocols under different loading and occlusal conditions on the survival rates of single implants immediately placed into fresh extraction sockets of maxillary or mandibular premolars with single-stage surgery. Materials and Methods: Patients needing replacement of a single premolar in the maxilla or mandible were included and randomly divided into three groups based on the different loading protocols: group 1 = healing abutment; group 2 = provisional crown left out of occlusion without functional loading; and group 3 = provisional crown in functional occlusion in maximum intercuspation without contact in excursions. The hypothesis was that single implants inserted into fresh extraction sockets and immediately connected to a temporary crown under functional loading would demonstrate survival rates comparable to single implants placed in the same conditions connected to a healing abutment or to an immediate temporary crown left out of occlusion. Results: A total of 112 patients were treated, and 126 implants were placed (92 in the maxilla and 34 in the mandible). After a mean follow-up of 2.5 years (range 1 to 5 years), there were no failures in groups 1 or 2. Two implants failed in group 3 (one in the maxilla, one in the mandible). The cumulative survival rate was 98.5% across all groups, with 100% in groups 1 and 2 and 95% in group 3. Statistical analysis showed that group 3 displayed a survival rate comparable to groups 1 and 2 (P = .08). Conclusion: Within the limitations of this study, no significant differences were found in terms of implant survival rates between implants inserted into fresh extraction sockets without loading vs with immediate nonfunctional or functional loading. [ABSTRACT FROM AUTHOR]

The loss of teeth causes inevitable resorption of the alveolar bone. In the anterior arches, the curved anatomy further adds to the challenge of rehabilitation. These areas often require the shaping of membranes and multiple bone blocks through complex surgery to compensate for the curvature. The split bone block technique (SBBT) has been successfully used in complicated cases. However, the inability to create curves from the blocks means that larger quantities of bone or membranes are needed to compensate for this. Bone bending based on an ancient woodbending technique known as kerfing is proposed to shape rigid SBB plates to recreate the natural anatomy of anterior arches. Three patients presenting with bone destruction of the anterior maxilla underwent bone augmentation before implant placement using the SBBT combined with kerfing. The plates were successfully bent to the shape of each maxilla without any deleterious effects. All bone grafts healed uneventfully, and the bone curvature was successfully reconstructed. No complications were reported. Implant placement took place after 4 months and definitive restorations after 7 to 9 months. Clinical and radiographic assessments were performed at 1 year. Full customization of autogenous bone plates was possible through kerfing. This approach resulted in an ideal bone curve and shape in the facial and palatal aspects of the anterior maxilla. In addition, it enabled ideal implant placement with reduced bone harvesting volumes and decreased the need for soft tissue augmentation to recreate the curved shape. This technique promoted close-fitting autologous osseous plates that followed the anatomical curvature of the anterior maxilla, leading to optimal healing and excellent regeneration of the ridge width. This principle can be valuable when dealing with complex anatomical defects. [ABSTRACT FROM AUTHOR]

Background: CBCT is widely used in dentistry and is used for a variety of purposes. The presence of different artifacts can reduce the quality of images. Since the implants mainly contain metals, they can cause many artifacts in CBCT images. Due to the importance of CBCT and the effects of artifacts on the final image quality, this study was conducted to investigate the effect of FOV size on the artifacts. Methods: Three human skulls with unbroken mandible and maxilla were selected. CBCT images were prepared under normal exposure conditions and with three ranges of FOV (4 × 5 cm2, 5 × 8 cm2, 8 × 8 cm2). Then an implant was placed in the empty dental sockets in the incisor, canine, and premolar areas, and CBCT images were taken with similar conditions. The Hounsfield Unit obtained before and after implant placement was compared, and their difference was considered as metal artifact. Data were analyzed using two-factor variance analysis. Results: In this study, the mean difference of artifacts with a large FOV in both jaws and in the mandible for medium and small radiation ranges from the central to the premolar side was always decreasing. However, in the maxilla for the medium and small radiation ranges, the mean difference increased from the central side to the canine, but again decreased relatively significantly from the canine to the premolar. The mean interaction between the dental areas and the FOV sizes was not significant (p = 0.997), and it was found that the amount of artifacts in the studied areas does not change with changing the size of the FOV. Also there was no significant difference of artifacts between the three types of FOV size (p = 0.730), but there was a significant difference between the dental areas (p = 0.020). Conclusions: According to the findings of this study, it can be concluded that the amount of metal artifacts is not related to the size of FOV. However, it is related to the position of the implant in the jaws and the density of the surrounding tissues. [ABSTRACT FROM AUTHOR]

The objectives of this study were to evaluate the tooth movement tendency during space closure in maxillary anterior teeth by various combinations of retraction force and intrusive force in a double-archwire lingual orthodontic system. Mini-implant-double slot lingual orthodontics system models of the bilateral maxillary first premolar extraction cases were constructed. Three-dimensional finite element models of the maxilla were constructed with definite position mini-implants (8 mm) and power arms (6 mm). Different retraction forces(50gf、100gf、150gf)were applied with the help of a nickel-titanium closed coil spring on the plate side. Intrusive forces(0gf、50gf、100gf)were applied with the help of the mini-implant between the two central incisors, and the initial displacements of the maxillary anterior teeth were analyzed. Variable amounts of displacements like controlled tipping, uncontrolled tipping, lingual crown tipping, labial root tipping, extrusion and distal crown tipping were observed in all the models, and these tendencies increased as the magnitude of retraction force increased, and these tendencies decreased as the magnitude of intrusive force increased. When the intrusive force was greater than or equal to the retraction force, the maxillary central incisors showed the trend of lingual crown tipping and labial root tipping, resulting in uncontrolled tipping movement. In terms of horizontal changes, the increasing width of bilateral anterior teeth was observed, with canines showing the least increasing trend. Various combinations of retraction force and intrusive force in a double-archwire lingual orthodontic system provide a new choice for torque control of the anterior teeth. Although anterior mini-implants and elastics can achieve incisor intrusion and lingual root torque, they cannot achieve the expected torque without additional torque control methods. [ABSTRACT FROM AUTHOR]

Background: Understanding the tooth anatomy is crucial for ensuring effective endodontic treatment. This study investigated the root canal morphology of the second mesiobuccal (MB2) canal in maxillary first molars (MFMs) in a Chinese population using cone-beam computed tomography (CBCT). Methods: This study evaluated 486 MFMs with MB2 canals from 285 participants undergoing CBCT examination and determined the Vertucci's classification and position of the MB2 canal orifice. The prevalence of the MB2 canal was correlated with the sex, age, and tooth side. The correlations between the prevalence of the MB2 canal and sex and tooth side were assessed using the Fisher's exact test. The chi-square test was used for evaluating the correlation between the prevalence of the MB2 canal and age. Results: The number of type II, III, IV, V, VI, VII, and other root canals in the MFMs was 30.9%, 0.6%, 65.0%, 1.2%, 1.2%, 0.4%, and 0.6%, respectively. Among the 201 cases with bilateral inclusion, 87.6% showed consistent canal configuration. Results of the first clear apparent position (FCAP) of the MB2 canals showed that 434, 44, and 3 teeth had FCAP at the upper, middle, and bottom one-third of the root, respectively. The FCAPs of the MB2 canal in the MFMs with types II, IV, and VI, as well as types III and V canals showed significant differences (p<0.05). The horizontal distance between the MB1 and MB2 canal orifices in the type II canals of MFMs was significantly lesser than those in the type IV canals of MFMs (p < 0.01). The longitudinal distance between the pulp chamber floor plane and MB2 canal orifice significantly correlated with age (p < 0.05). Conclusions: The morphology of the mesiobuccal root canal in the MFMs is complex. Complete understanding of the anatomical morphology of the root canal combined with the CBCT and dental operating microscope is necessary for the accurate detection of the MB2 canal and consequently improved success rate of root canal treatment. Our study findings can help endodontists improve endodontic treatment outcomes. [ABSTRACT FROM AUTHOR]

Mucormycosis has been prevalent in the past few years with the COVID-19 pandemic largely affecting the maxilla due to its proximity to the respiratory corridor. Resection of the maxillary dentition along with the maxillary bone itself has a huge psychosocial impact on the patient. When seeking prosthetic rehabilitation, poor esthetics, difficulty in mastication, and social embarrassment are the patients' concerns. Hence, it becomes great responsibility for the clinician to restore the patient's natural teeth while causing him/her minimum discomfort. This article describes such a case of post-COVID-19 mucormycosis that has been provisionally restored by the means of all-on-four zygomatic implants. [ABSTRACT FROM AUTHOR]

Background: In complex teeth like maxillary premolars, endodontic treatment success depends on a complete comprehension of root canal anatomy. The research on mandibular premolars' root canal anatomy has been extensive and well-documented in existing literature. However, there appears to be a notable gap in available data concerning the root canal anatomy of maxillary premolars. This study aimed to explore the root canal morphology of maxillary premolars using cone-beam computed tomography (CBCT) imaging, considering age and gender variations. Methods: From 500 patient CBCT scans, 787 maxillary premolar teeth were evaluated. The sample was divided by gender and age (10–20, 21–30, 31–40, 41–50, 51–60, and 61 years and older). Ahmed et al. classification system was used to record root canal morphology. Results: The most frequent classifications for right maxillary 1st premolars were 2MPM1 B1 L1 (39.03%) and 1MPM1 (2.81%), while the most frequent classifications for right maxillary 2nd premolars were 2MPM1 B1 L1 (39.08%) and 1MPM1 (17.85%). Most of the premolars typically had two roots (left maxillary first premolars: 81.5%, left maxillary second premolars: 82.7%, right maxillary first premolars: 74.4%, right maxillary second premolars: 75.7%). Left and right maxillary 1st premolars for classes 1MPM1 and 1MPM1–2−1 showed significant gender differences. For classifications 1MPM1 and 1MPM1–2−1, age-related changes were seen in the left and right maxillary first premolars. Conclusion: This study provides novel insights into the root canal anatomy of maxillary premolars within the Saudi population, addressing a notable gap in the literature specific to this demographic. Through CBCT imaging and analysis of large sample sizes, the complex and diverse nature of root canal morphology in these teeth among Saudi individuals is elucidated. The findings underscore the importance of CBCT imaging in precise treatment planning and decision-making tailored to the Saudi population. Consideration of age and gender-related variations further enhances understanding and aids in personalized endodontic interventions within this demographic. [ABSTRACT FROM AUTHOR]

Objective: Pigs are emerging as a preferred experimental in vivo model for bone regeneration. The study objective was to answer the focused PEO question: in the pig model (P), what is the capacity of experimental alveolar bone defects (E) for spontaneous regeneration in terms of new bone formation (O)? Methods: Following PRISMA guidelines, electronic databases were searched for studies reporting experimental bone defects or extraction socket healing in the maxillae or mandibles of pigs. The main inclusion criteria were the presence of a control group of untreated defects/sockets and the assessment of regeneration via 3D tomography [radiographic defect fill (RDF)] or 2D histomorphometry [new bone formation (NBF)]. Random effects meta‐analyses were performed for the outcomes RDF and NBF. Results: Overall, 45 studies were included reporting on alveolar bone defects or extraction sockets, most frequently in the mandibles of minipigs. Based on morphology, defects were broadly classified as 'box‐defects' (BD) or 'cylinder‐defects' (CD) with a wide range of healing times (10 days to 52 weeks). Meta‐analyses revealed pooled estimates (with 95% confidence intervals) of 50% RDF (36.87%–63.15%) and 43.74% NBF (30.47%–57%) in BD, and 44% RDF (16.48%–71.61%) and 39.67% NBF (31.53%–47.81%) in CD, which were similar to estimates of socket‐healing [48.74% RDF (40.35%–57.13%) and 38.73% NBF (28.57%–48.89%)]. Heterogeneity in the meta‐analysis was high (I2 > 90%). Conclusion: A substantial body of literature revealed a high capacity for spontaneous regeneration in experimental alveolar bone defects of (mini)pigs, which should be considered in future studies of bone regeneration in this animal model. [ABSTRACT FROM AUTHOR]

Purpose: Cone-beam computed tomography (CBCT) was used in this study for evaluating the diameter, prevalence, spatial location, and risk factors of the accessory canal (AC) of the canalis sinuosus. Methods: A comprehensive assessment of the incidence rate, diameter, three-dimensional (3D) spatial location, and direction of travel of AC was performed on 1003 CBCT images. The CBCT data were used to reconstruct a 3D model of the maxilla to determine the alveolar bone volume. The obtained data were further analyzed and processed. Results: AC was present in 50.1% of images. Male patients more frequently had ACs than female patients did (P < 0.01) and was positively correlated with the maxillary alveolar bone volume (P < 0.001, OR 1.532). Age or nasopalatine canal diameter were not significantly associated with the occurrence of AC (P > 0.05). Among the 502 patients with AC, AC was present on the left side, right side, and bilaterally in 189, 98, and 215, respectively. The maximum number of ACs observed per individual was eight. The average AC diameter was 0.89 ± 0.26 mm (minimum, 0.5 mm; maximum, 2.02 mm). Conclusions: As the prevalence of AC and its trajectory display considerable variation among individuals, surgeons must consider the possibility of the presence of AC when devising surgical plans involving the anterior maxillary region. [ABSTRACT FROM AUTHOR]

This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone‐level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health‐related quality of life (OHRQoL), and patient satisfaction at a 2‐year follow‐up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone‐level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant‐supported screw‐retained complete porcelain‐fused‐to‐metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2‐year follow‐up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone‐level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition. [ABSTRACT FROM AUTHOR]

Purpose: Successful microlaryngeal surgery relies on an adequate laryngeal exposure. Recognizing the likelihood of challenging exposure prior to microlaryngeal surgery may assist in selecting the appropriate surgical approach and even prompt consideration of alternative treatment options. We aim to apply the mini-Laryngoscore, a preoperative assessment tool, to our study population and incorporate novel variables to optimize the prediction model. Methods: This single-center prospective cohort study included 80 consecutive patients undergoing elective microlaryngeal surgery, from January 1, to June 30, 2023. Each patient underwent a presurgical evaluation of 15 parameters and an intraoperative scoring of the anterior commissure visualization. These parameters were assessed for their association with difficult laryngeal exposure, using multiple logistic regression analysis. We created a novel prediction model for DLE and compared it with the existing model, the mini-Laryngoscore. Results: Out of 80 patients, 24 (30%) patients had difficult laryngeal exposure, including 3 cases (3.8%) in which visualization of the anterior commissure was not possible. A large neck diameter (OR, 1.4; CI 1.1–1.9) and the presence of upper teeth (OR, 8.9; CI 1.3–62.8) were independent risk factors for a difficult laryngeal exposure, while a larger interincisors gap was the only independent protector factor (OR, 0.3; CI 0.1–0.8). The logistic regression model combining these three independent risk factors displayed a high discriminative value AUC = 0.89 (CI 0.81–0.97). The predictive performance of the mini-Laryngoscore was 0.73 (CI 0.62–0.85). Conclusion: Combining two parameters from the mini-Laryngoscore (upper jaw dental state and interincisors gap distance) with neck circumference measurement can accurately predict the risk of difficult laryngeal exposure. [ABSTRACT FROM AUTHOR]

The fully aquatic Japanese giant salamander (Andrias japonicus) is a member of the Cryptobranchidae, and is currently distributed in western Japan, with other members of this group restricted to China and North America. Their feeding behaviour is characterized by a form of suction feeding that includes asymmetric movements of the jaw and hyobranchial apparatus. Previous studies on the North American species, Cryptobranchus alleganiensis, have suggested that this specialized jaw movement is produced by a flexible quadrate‐articular joint combined with a loosely connected lower jaw symphysis including two small fibrocartilaginous pads. However, little is known about this feeding behaviour in the Asian species, nor have the three‐dimensional asymmetric jaw movements been fully investigated in any member of Cryptobranchidae. In this study, we explore the asymmetric jaw movements in A. japonicus using three methods: (1) dissection of musculoskeletal structures; (2) filming of feeding behaviour to understand in which situations asymmetric feeding is used; (3) analysis of 3D movement of jaws and skull. In the third component, fresh (from frozen) specimens of A. japonicus were manipulated to replicate asymmetric and symmetric jaw movements, with the specimens CT scanned after each step to obtain the 3D morphology of the jaws at different positions. These positions were combined and their Euler angles from resting (closed) jaw position were calculated for asymmetric or symmetric jaw positions. Our filming revealed that asymmetric jaw movements are linked to the position of the prey in relation to the snout, with the jaw closest to the prey opening asymmetrically. Moreover, this action allows the salamander to simultaneously grasp prey in one side of the mouth while ejecting water on the other side, if the first suction attempt fails. The asymmetric jaw movements are performed mainly by rotation of the mandible about its long axis, with very limited lateral jaw movements. During asymmetric and symmetric jaw movements, the posterior ends of the maxilla and quadrate move slightly. The asymmetric jaw movements are permitted by a mobile quadrate‐articular joint formed by wide, round cartilages, and by two small fibrocartilage pads within the jaw symphysis that act as cushions during jaw rotation. Some of these soft tissue structures leave traces on the jaws and skull, allowing feeding mode to be reconstructed in fossil taxa. Understanding cryptobranchid asymmetric jaw movement thus requires a comprehensive assessment of not only the symphysial morphology but also that of other cranial and hyobranchial elements. [ABSTRACT FROM AUTHOR]

Background: Unbalanced alterations of temporomandibular joint morphology were associated with unilaterally masticatory habits. Objective: This study aimed to investigate the effect of unilateral mastication on the remodelling of the temporomandibular joint using dynamic joint space. Methods: Twelve volunteers with non‐maxillofacial deformity and healthy temporomandibular joints were recruited. The 3D models of the mandible and the maxilla were reconstructed according to computed tomography. The subjects were asked to masticate French fries and peanuts unilaterally, which was recorded by a 3D motion capture system. The dynamic joint space during unilateral mastication was analysed. Results: During early closure, the joint space reduction on the non‐masticatory side was significantly greater than on the masticatory side (p <.05). During later closure, the joint space reduction on the non‐masticatory side was significantly lower than that on the masticatory side (p <.05). The difference in joint space reduction between both sides was greater than the French fries while masticating the peanuts. Conclusions: Unilateral mastication resulted in a different major pressure area on the bilateral TMJs. Therefore, unilateral mastication might be an essential factor in the bilateral asymmetrical remodelling of the TMJ. [ABSTRACT FROM AUTHOR]

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Introduction: Epidermolysis bullosa (EB) is a rare genetic disorder characterized by skin fragility and blister formation. The phenotypic presentation is broad with four major types, being Recessive Dystrophic EB (RDEB) the most severe, including oral anomalies such as severe microstomia, ankyloglossia, vestibule obliteration and occlusal anomalies, turning orthodontic treatment into a challenge. Aim: This case report aims to present the comprehensive treatment of a patient with severe RDEB, including periodontal surgery, orthodontic fixed braces with mini‐screws and oral rehabilitation with anterior veneers. Case Report: A 27‐year‐old female patient with severe RDEB received orthodontic treatment in the upper jaw to improve malalignment and anterior crossbite. After 13 months of treatment with fixed appliances, miniscrews were placed in the anterior segment to intrude and procline the upper incisors. Oral surgery was performed to increase the vestibule depth of the upper lip. Once edge‐to‐edge occlusion was obtained, anterior veneers were placed to improve aesthetic and stabilize occlusion, especially with the lack of posterior support. Discussion: The multidisciplinary treatment approach, involving orthodontic treatment, periodontal surgery and oral rehabilitation, played a crucial role in achieving favorable results. This case highlights the successful use of miniscrews as a viable orthodontic approach for patients with severe RDEB. [ABSTRACT FROM AUTHOR]

Background: Difficulty in anesthetizing teeth that have been diagnosed with molar incisor hypomineralization (MIH) is a frequently reported clinical problem. The effects of low‐level laser application (photobiomodulation) on the efficacy of anesthesia during the dental treatment of patients with MIH have not yet been studied. Aim: To assess the effects of photobiomodulation therapy (PBMT) on the efficacy of anesthesia in maxillary permanent molar teeth with MIH. Design: This prospective, parallel‐arm control, randomized, triple‐blind clinical trial included children aged 7–12 years. Maxillary permanent first molar teeth with MIH that required pulpotomy treatment were included. Seventy participants were randomly divided into two groups: experimental (with PBMT) and control (placebo). In the experimental group, before the administration of local infiltration anesthesia, PBMT (diode laser: 940 nm; continuous mode; 0.5 W; 78 J/cm2) was applied to the oral mucosa for 60 s each. In the control group, the laser probe was channeled toward the mucosa but was not activated. Pain scores were evaluated during the access cavity preparation of the pulpotomy treatment (when using the dentin cutting handpiece and while entering into the pulp) using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Additional anesthesia requirements were assessed in both groups. The data obtained were analyzed for statistical significance (p <.05). The chi‐squared test was used to determine the effect of PBMT on categorical outcomes. Results: The no‐pain scores of the experimental group were higher than those of the control group (29% vs. 20%). Moderate‐to‐high pain was more frequent in the control group than in the experimental group (43% vs. 20%). While 31% of the experimental group required supplemental anesthesia, 49% of the control group required supplemental anesthesia during pulpotomy of the tooth with MIH. No statistical difference, however, was found between the two groups in terms of pain scores and the need for supplemental anesthesia (p =.235, p =.143). Conclusions: Anesthesia with and without PBMT caused no difference in pain during the treatment of maxillary molar teeth with MIH. [ABSTRACT FROM AUTHOR]

Introduction: Ameloblastoma is one of the most frequent benign odontogenic tumours of the jaw, accounting for approximately 10% of all tumours in the mandible and maxilla. It is a slow‐growing, locally invasive tumour that causes painless swelling of the jaw or maxilla. Diagnosis: Ameloblastoma is diagnosed through computerised tomography imaging and a biopsy. A biopsy can help distinguish ameloblastoma from other cancers, such as ossifying fibroma, osteomyelitis, giant cell tumour, cystic fibrous dysplasia, myeloma, and sarcoma. Treatment: Ameloblastoma is best treated with vigorous en bloc excision and concomitant repair. Ameloblastoma therapy has long been plagued by high recurrence rates and extensive tissue abnormalities. Recent molecular findings strongly imply that ameloblastoma patients may benefit from targeted treatment. We offer a case report of unicystic ameloblastoma with a step‐by‐step customised therapeutic plan that prioritises patients' desire. [ABSTRACT FROM AUTHOR]

Objective: To provide a comprehensive understanding of the pathophysiology of cleft palate (CP) and future perspectives. Design: Literature review. Setting: Setting varied across studies by level of care and geographical locations. Interventions: No interventions were performed. Main Outcome Measure(s): Primary outcome measures were to summarize our current understanding of palatogenesis in humans and animal models, the pathophysiology of CP, and potential future treatment modalities. Results: Animal research has provided considerable insight into the pathophysiology, molecular and cellular mechanisms of CP that have allowed for the development of novel treatment strategies. However, much work has yet to be done to connect our mouse model investigations and discoveries to CP in humans. The success of innovative strategies for tissue regeneration in mice provides promise for an exciting new avenue for improved and more targeted management of cleft care with precision medicine in patients. However, significant barriers to clinical translation remain. Among the most notable challenges include the differences in some aspects of palatogenesis and tissue repair between mice and humans, suggesting that potential therapies that have worked in animal models may not provide similar benefits to humans. Conclusions: Increased translation of pathophysiological and tissue regeneration studies to clinical trials will bridge a wide gap in knowledge between animal models and human disease. By enhancing interaction between basic scientists and clinicians, and employing our animal model findings of disease mechanisms in concert with what we glean in the clinic, we can generate a more targeted and improved treatment algorithm for patients with CP. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare various formulas for idealized proportions of the maxillary incisors to the actual dimensions of natural teeth. The Mondelli formula 1 (MFl), Mondelli formula 2 (MF2), Albers formula (AF), esthetic proportion (EP) for width and height of anterior teeth, and golden ratio (GR) were calculated for a total of 50 dental students (30 women and 20 men) who participated in the study. The following measurements were obtained directly in the participant:s mouth with a digital caliper: the mesio- distal and incisogingival dimensions of the maxillary central proporincisors, lateral incisors, and canines: the intercanine distance; and the smile width. The participants were photographed, and the smile width was also measured on the photographs. The MFl and MF2 were each calculated twice, using both direct measurements and photographic measurements. The projected central incisor widths calculated using the MFl, MF2, and AF were compared among themselves and against the actual measurements using analysis of variance and Fisher test for multiple comparisons (a = 0.05). The EP and GR were analyzed using descriptive statistics. There was a statistically significant difference between all of the widths projected by the formulas and the actual widths of the central incisors (P < 0.05). Whether calculated from a direct or a photographic measurement, the incisor widths projected by the MFl and MF2 were statistically similar to each other (P > 0.05). The EP values were similar to those reported in the literature. Only 2% of the participants had an incisor width ratio (central incisor/ formulateral incisor) that matched the GR of 1.618, while 86% fell within the range of 1.2 to 1.4. Overall, the proportions calcu- lated with the MFl, MI:2, Ali EP, and GR did not exactly match the actual dimensions of natural teeth. The formulas and the formuproportions available in the literature can assist in esthetic planning, but the individual characteristics of each patient and expertise of the dentist should guide treatment for each case. [ABSTRACT FROM AUTHOR]

The ideal sagittal position of the maxilla is highly subjective in orthognathic surgical treatment planning. There is no consensus on an analysis to predict the ideal sagittal position of the maxilla. The objective of this study was to determine the preferred maxillary position in relation to the forehead shape, in the Southern Chinese population. The maxilla position of eight patients was simulated based on Steiner's analysis (SA), glabella vertical (GV), Andrews' Element II (AE2), and the Barcelona reference (BR). The simulations were then used in an electronic survey, where respondents ranked the images for each patient from to 1–4 (most to least attractive). A total of 128 responses were collected from dental professionals and laypersons. The most preferred to the least preferred simulation was as follows (mean rank scores for the male and female patients in parenthesis): BR (males 2.06; females 1.98), GV (males 2.11; females 2.21), SA (males 2.59; females 2.40), and AE2 (males 3.24; females 3.41). There was no significant difference in the results according to the sex, age group, or profession of the respondents. The Barcelona reference and glabella vertical are useful in predicting the ideal maxillary position in patients with a flat forehead, and the Barcelona reference is the most preferred in patients with a rounded forehead. [ABSTRACT FROM AUTHOR]

This case report describes an aneurysmal bone cyst in the maxilla of a young dog. It describes the clinical presentation, diagnostics, management, and successful outcome of this highly unusual case. Bone cysts are described as benign, cavitated lesions within bone that are lined by reactive tissues. There is no epithelial lining in the lesions. Bone cysts usually contain hemorrhage or serosanguinous fluid. They usually appear in the long bones, and present as a swelling with or without pain. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the accuracy of two different endodontic guides for fiber post removal. Methods: In this in vitro study, 54 maxillary canine fiber posts were mounted on 36 maxillary stone casts; 18 teeth were mounted unilaterally, and 36 teeth were mounted bilaterally. Static endodontic guides were fabricated according to baseline cone-beam computed tomography (CBCT) and intraoral optical scans using Blue Sky software. In the single-sleeve endodontic guides group (SSG), two anterior and two posterior teeth were included in a 5-unit guide. In the double-sleeve endodontic guides group (DSG) group, the guide was passed through the midline to include both canine teeth and extended by 2 teeth posterior to the canine teeth bilaterally (a 10-unit guide). After drilling, postoperative CBCT scans were taken and superimposed on the virtually designed path, and the maximum coronal deviation (MCD) at the marginal entry point of the tooth, maximum apical deviation (MAD) at 10 mm apical to the tooth margin, and maximum angular deflection (MAnD) of the drill were calculated. Results: The mean MCD, MAD, and MAnD were 0.34 mm, 0.6 mm, and 2.32 degrees, respectively, in the SSG and 0.31 mm, 0.7 mm, and 2.37 degrees, respectively, in the DSG. The two groups were not significantly different from each other in terms of MCD (P = 0.573), MAD (P = 0.290), or MAnD (P = 0.896). Conclusions: The accuracies of the two techniques, the extended double sleeve guide and the single sleeve guide, were comparable and thus DSG may be used for removal of fiber posts in adjacent or distant teeth. [ABSTRACT FROM AUTHOR]

Background: Dental casts made utilising digital workflow are becoming more common because to their speed and cost savings. However, studies on their dimensional accuracy over time with diverse designs are missing. Objective: The aim of this in vitro study was to assess the dimensional stability of 3D-printed edentulous and fully dentate hollowed maxillary models with 50-micrometer resolution over 1 day, 14 days, and 28 days using surface matching software. Methods: Scanned edentulous and fully dentate maxillary typodont models were used as references. The models were scanned by a desktop lab scanner of 15-micrometer accuracy (D900, 3Shape). Then, the files were used in designing software (Meshmixer, Autodesk) to create hollowed maxillary casts. Fifteen edentulous and 15 fully dentate (total of 30) models were printed using a DLP lab printer (Cara print 4.0, Kulzer). The 3D-printed models were scanned using the same desktop lab scanner of 15-micrometer accuracy at intervals of baseline days, 1 day, 14 days, and 28 days to assess the effect of aging (n = 120). The dimensional changes were quantified and compared using the root mean square (RMS) method, expressed in micrometres (µm). The study employed repeated measures analysis of variance (ANOVA) to assess and compare the root mean square (RMS) values across the variables. The data was analysed using SPSS (26, Chicago, Illinois, USA). Results: The RMS of the edentulous models rapidly increased from a mean value of 0.257 at the beginning of the study to 0.384 after twenty-eight days. However, the mean RMS values for the dentate models did not change much over the four intervals. It varied only from 0.355 to 0.347. The mean values for edentulous patients increased from 0.014 to 0.029 during the period from baseline to twenty-eight days. However, the mean average values decreased for the dentate models from 0.033 to 0.014 during this period. By utilizing ANOVA, mean RMS values increased insignificantly till one day but significantly to fourteen and twenty-eight days. Dentate model mean values differed insignificantly across four intervals. Repeated measures ANOVA for combined and separated data showed no significant differences across edentulous, dentate, and total models over times. Conclusion: The study revealed changes in the dimensions of 3D-printed edentulous models over a span of 3 and 4 weeks. Caution should be applied when using 3D-printed dental master models for constructing definitive prostheses on edentulous models over a period of 3 to 4 weeks. [ABSTRACT FROM AUTHOR]

Background: Root resorption of adjacent teeth due to impacted canines is common, and orthodontic treatment often leads to secondary resorption or even loss of adjacent roots. Clinical reports of long-term stability after treatment are rare. Case presentation: This study reports two cases of maxillary impacted canines resulting in severe root resorption of the adjacent lateral incisors. Surgical exposure, orthodontic retraction, and alignment of the impacted canines were successful in both cases, and the resorbed lateral incisors were stable with no significant loosening and normal pulp vitality after treatment and at the 5- and 10-year follow-up appointments. Conclusions: Light orthodontic force may be used to move adjacent teeth with root resorption due to tooth obstruction. The path and direction in which the teeth are moved must be specifically designed so that the adjacent roots are not resorbed and so long-term stability can be achieved. [ABSTRACT FROM AUTHOR]