Efficacy of a novel three-step decontamination protocol for titanium-based dental implants: An in vitro and in vivo study.

AIM: The aim of the study was to evaluate several mechanical and chemical decontamination methods associated with a newly introduced biofilm matrix disruption strategy for biofilm cleaning and preservation of implant surface features. MATERIALS AND METHODS: Titanium (Ti) discs were obtained by additive manufacturing. Polymicrobial biofilm-covered Ti disc surfaces were decontaminated with mechanical [Ti curette, Teflon curette, Ti brush, water-air jet device, and Er:YAG laser] or chemical [iodopovidone (PVPI) 0.2% to disrupt the extracellular matrix, along with amoxicillin; minocycline; tetracycline; H2 O2 3%; chlorhexidine 0.2%; NaOCl 0.95%; hydrocarbon-oxo-borate-based antiseptic] protocols. The optimal in vitro mechanical/chemical protocol was then tested in combination using an in vivo biofilm model with intra-oral devices. RESULTS: Er:YAG laser treatment displayed optimum surface cleaning by biofilm removal with minimal deleterious damage to the surface, smaller Ti release, good corrosion stability, and improved fibroblast readhesion. NaOCl 0.95% was the most promising agent to reduce in vitro and in vivo biofilms and was even more effective when associated with PVPI 0.2% as a pre-treatment to disrupt the biofilm matrix. The combination of Er:YAG laser followed by PVPI 0.2% plus NaOCl 0.95% promoted efficient decontamination of rough Ti surfaces by disrupting the biofilm matrix and killing remnants of in vivo biofilms formed in the mouth (the only protocol to lead to ~99% biofilm eradication). CONCLUSION: Er:YAG laser + PVPI 0.2% + NaOCl 0.95% can be a reliable decontamination protocol for Ti surfaces, eliminating microbial biofilms without damaging the implant surface.

Effect of Processing Methods of Human Saliva on the Proteomic Profile and Protein-Mediated Biological Processes.

The use of saliva as a protein source prior to microbiological and biological assays requires previous processing. However, the effect of these processing methods on the proteomic profile of saliva has not been tested. Stimulated human saliva was collected from eight healthy volunteers. Non-processed saliva was compared with 0.22 µm filtered, 0.45 µm filtered, and pasteurized saliva, by liquid chromatography-mass spectrometry. Data are available via ProteomeXchange with identifier PXD039248. The effect of processed saliva on microbial adhesion was tested using bacterial and fungus species and in biological cell behavior using HaCaT immortalized human keratinocytes. Two hundred and seventy-eight proteins were identified in non-processed saliva, of which 54 proteins (≈19%) were exclusive. Saliva processing reduced identified proteins to 222 (≈80%) for the 0.22 µm group, 219 (≈79%) for the 0.45 µm group, and 201 (≈72%) for the pasteurized saliva, compared to non-processed saliva. The proteomic profile showed similar molecular functions and biological processes. The different saliva processing methods did not alter microbial adhesion (ANOVA, p > 0.05). Interestingly, pasteurized saliva reduced keratinocyte cell viability. Saliva processing methods tested reduced the proteomic profile diversity of saliva but maintained similar molecular functions and biological processes, not interfering with microbial adhesion and cell viability, except for pasteurization, which reduced cell viability.

What is the impact of e-cigarettes on periodontal stem cells as revealed by transcriptomic analyses?

DESIGN: The research used an in vitro cell exposure model and multi-omics integration of transcriptome and epigenome profiling to compare the molecular effects of e-cigarettes and tobacco smoke on dental stem cells. AIM: The study aimed to compare the effects of e-cigarette and tobacco smoke on periodontal stem cells using a multi-omics approach to understand gene regulation. METHODS: This research studied primary human gingival mesenchymal stem cells (GMSCs) and periodontal ligament stem cells (PDLSCs) obtained from healthy donors. The cells were subjected to tobacco smoke, e-cigarette aerosol (both tobacco and menthol flavors), e-cigarette liquid (both tobacco and menthol flavors), or untreated conditions using an in vitro exposure system. RNA sequencing and bioinformatics analysis were used to profile the transcriptome and identify differential gene expression. Additionally, chromatin immunoprecipitation sequencing (ChIP-seq) was used to conduct genome-wide histone modification mapping for H3K27me3. Transcriptome profiling was combined with histone modification characterization to understand gene regulatory mechanisms. The study compared the effects of smoke versus e-cigarette, aerosol versus liquid exposure, and tobacco versus menthol flavor on gene expression and epigenetic landscapes in the two oral stem cell populations. RESULTS: The use of tobacco smoke caused damage to the DNA and nucleus in GMSCs, as well as mitochondrial dysfunction in PDLSCs. Regarding e-cigarettes, the aerosol and liquid affected non-coding RNA expression differently. The chemokine CXCL2 was found to be downregulated by aerosol but upregulated by liquid in GMSCs. An integrative analysis revealed that the upregulation of CXCL2 caused by e-liquid involved reduced H3K27me3 and activation of distal enhancers. On the other hand, aerosol exposure maintained H3K27me3 levels, while direct e-liquid exposure resulted in genome-wide reductions in H3K27me3, particularly in enhancer regions. Overall, the specific delivery methods and components of e-cigarettes caused unique changes in the transcriptome and epigenome of oral stem cells. CONCLUSIONS: E-cigarettes affect oral stem cells differently than tobacco smoke. Their aerosol and liquid have varying impacts on gene expression and regulatory landscapes in oral cells. Multi-omics approaches are important to understanding the molecular changes caused by e-cigarette components. This can help with toxicological assessments and determine their impact on periodontal health. Transcriptome and epigenome profiling are powerful tools to examine the unique molecular mechanisms involved in cellular responses to e-cigarettes.

Lateral static overload on immediately restored implants decreases the osteocyte index in peri-implant bone: a secondary analysis of a pre-clinical study in dogs.

OBJECTIVES: This animal study was conducted to evaluate the osteocyte index in the peri-implant bone around immediately restored implants under static lateral overload. MATERIAL AND METHODS: Seven mongrel dogs received three implants on each side of the mandible. Forty-two implants were distributed into three groups (14 implants per group); each animal received two implants connected to a 4.5-mm opened expansion device (experimental group); in the other mandible side, two implants were connected into an expansion device without activation (control group); one implant each side of the mandible was left submerged (unload group). After 4 months under daily mechanical and chemical plaque control, the animals were euthanized; dental implants and surrounding bone were removed and processed to obtain thin ground sections. Histomorphometry was used to evaluate the osteocyte index in the peri-implant bone contact to implant. RESULTS: A higher, statistically significant mean number of osteocytes × 10-5 µm2 (54.74 ± 23.91) was found in the control group compared with the test group (22.57 ± 22.55) (p = 0.0221). The correlation between percentage of bone-implant contact and osteocyte index for submerged implants was not statistically significant (p = 0.2667), whereas the value for immediately loaded implants was statistically significant (p = 0.0480). CONCLUSION: The lower number of osteocytes in the peri-implant bone around overloaded implants could be related to the need for functional adaptation of the bone tissue to overloading and to the hypothesized involvement of the osteocytes in the maintenance of the bone matrix in the control group. CLINICAL RELEVANCE: Osteocytes play a pivotal role in bone adaptation to mechanical loading, and the osteocyte network has been regarded as being the main mechanosensory mechanism.

The Proliferation and Differentiation of Adipose-Derived Stem Cells in Neovascularization and Angiogenesis.

Neovascularization and angiogenesis are vital processes in the repair of damaged tissue, creating new blood vessel networks and increasing oxygen and nutrient supply for regeneration. The importance of Adipose-derived Mesenchymal Stem Cells (ASCs) contained in the adipose tissue surrounding blood vessel networks to these processes remains unknown and the exact mechanisms responsible for directing adipogenic cell fate remain to be discovered. As adipose tissue contains a heterogenous population of partially differentiated cells of adipocyte lineage; tissue repair, angiogenesis and neovascularization may be closely linked to the function of ASCs in a complex relationship. This review aims to investigate the link between ASCs and angiogenesis/neovascularization, with references to current studies. The molecular mechanisms of these processes, as well as ASC differentiation and proliferation are described in detail. ASCs may differentiate into endothelial cells during neovascularization; however, recent clinical trials have suggested that ASCs may also stimulate angiogenesis and neovascularization indirectly through the release of paracrine factors.

Cytokine Levels and Human Herpesviruses in Saliva from Clinical Periodontal Healthy Subjects with Peri-Implantitis: A Case-Control Study.

This study evaluated the presence of cytokines (IL-1ß, IL-2, IL-4, IL-6, MCP-1, MIP-1α, MIP-1ß, and TNF-α) and human herpesvirus (HSV1, HSV2, EBV, CMV, VZV, HHV6, HHV7, and HHV8) in saliva samples taken from subjects with and without peri-implantitis. Forty-two periodontally healthy subjects were divided according to peri-implant condition: healthy and peri-implantitis groups. The clinical parameters as probing depth, clinical attachment level, plaque index, gingival bleeding, bleeding on probing, and suppuration were evaluated. For cytokine detection, multiplex analysis was performed, and PCR assay was used to identify herpesviruses. No significant differences were found in cytokine levels between groups (p > 0.05). The presence of herpesvirus was 1.97-fold higher in patients with peri-implantitis (odds ratio, CI 0.52-7.49). The association of the presence or absence of herpesvirus with the salivary markers was statistically significant for MIP-1ß (p = 0.0087) and TNF-α (p = 0.0437) only in the peri-implantitis group. The presence of herpesviruses in patients with peri-implantitis suggests the development of a proinflammatory environment, which is characterized by increased expression of MIP-1ß and TNF-α in saliva.

Short (6-mm) dental implants versus sinus floor elevation and placement of longer (≥10-mm) dental implants: a randomized controlled trial with a 3-year follow-up.

OBJECTIVES: To investigate whether short (6-mm) dental implants could be an alternative to sinus floor elevation (SFE) and placement of longer (≥10-mm) implants in the posterior maxilla. MATERIALS AND METHODS: Over a 3-year period, all patients presenting with partial edentulism in the posterior maxilla were considered for inclusion in this randomized controlled trial. Patients were randomly chosen either to receive short (6-mm) implants (test group [TG]) or to undergo SFE with simultaneous placement of standard-length (≥10-mm) implants (control group [CG]). SFE was performed using the lateral technique. In both groups, tapered implants (AnyRidge, MegaGen, Gyeongbuk, South Korea) were placed. All implants were loaded after 4 months of healing. At each annual follow-up session, clinical and radiographic parameters were assessed. Primary outcomes were implant survival, stability (measured with the implant stability quotient [ISQ]), marginal bone loss (MBL), and complications; secondary outcomes were patient satisfaction and treatment time and cost. RESULTS: Thirty-three patients were assigned to the TG and 20 to the CG. Forty-five implants were inserted in each group. At 3 years, implant survival rates were 100% and 95.0% for the TG and CG, respectively; this difference was not statistically significant (P = 0.38). The mean ISQ values of the TG and CG did not differ at placement (68.2 vs. 67.8, P = 0.1), at delivery of the final restoration (69.5 vs. 69.4, P = 0.9), and after 1 year (71.0 vs. 71.5, P = 0.1); at 3 years, the CG had a significantly higher mean ISQ than the TG (72.4 vs. 71.6, P = 0.004). Mean MBL was significantly higher in the CG than in the TG, both at 1 year (0.14 mm vs. 0.21 mm, P = 0.006) and at 3 years (0.20 mm vs. 0.27 mm, P = 0.01). A few complications were reported. Surgical time and cost were significantly higher in the CG than in the TG (P < 0.0001). Patient satisfaction was high in both groups. CONCLUSIONS: In this randomized controlled trial, results for short (6-mm) implants were similar to those for longer (≥10-mm) implants in augmented bone. Short implants might be preferable to SFE, because the treatment is faster and less expensive. Long-term randomized controlled trials are required to confirm these results.

The influence of three different apical implant designs at stability and osseointegration process: experimental study in rabbits.

OBJECTIVES: The aim of this study was to perform a histomorphometric and biomechanical comparison of three implants with different designs of the apical area to promote a better bone initial stability and its correlation with the osseointegration. MATERIAL AND METHODS: Fifty-four tapered implants with same length, diameter and surface properties but with three different apical configurations (Group I: MK4: Group II: C1 and Group III: MK7) were inserted in the tibia of rabbits. Implant stability and bone formation were evaluated by resonance frequency analysis measured at 0, 6, 8 and 12 weeks and by histomorphometric analysis performed at 6, 8 and 12 weeks. RESULTS: Statistical test to compare the stability through the implant stability quotient in the four times showed few differences between the groups and time periods proposed, with significance set at P < 0.05. In the bone-implant contact, by comparing the groups in the three times proposed, it was possible concluded that there is a similar behavior among the three implant design (P < 0.05). CONCLUSION: With the limitations of this animal study, it can be concluded that the design of the apical area influences the implant stability and the bone-to-implant contact.

Influence of osteoporosis on the osteocyte density of human mandibular bone samples: a controlled histological human study.

OBJECTIVES: Osteocytes have emerged as key regulators of skeletal and mineral homeostasis. The number of these cells could be influenced by the presence of osteoporosis and osteopenia. Hence, the aim this study was to evaluate the osteocyte density in patients with osteopenia, and in patients with osteoporosis treated with bisphosphonates. MATERIALS AND METHODS: Thirty-nine patients were selected for this study and divided into three groups: (A) nine healthy patients (control), (B) 15 patients with osteopenia, and (C) 15 patients with osteoporosis. During the surgical insertion of dental implants in the lower jaw, bone samples were retrieved and processed for histological analysis of osteocyte density, measured as number of osteocytes/bone tissue area (µm(2) ). RESULTS: Patients with osteopenia showed statistically higher values of osteocyte density than patients with osteoporosis (P < 0.05) No significant differences were detected between osteopenia and osteoporosis subjects vs. healthy patients (P > 0.05). CONCLUSIONS: Bone metabolism diseases (osteoporosis and osteopenia) do not seem to influence the osteocyte density; this could be due to the administration of bisphosphonates in patients with osteoporosis. This information could play a fundamental role in the diagnosis and treatment of patients in a postmenopausal stage.

Effect of lateral static load on immediately restored implants: histologic and radiographic evaluation in dogs.

OBJECTIVES: The aim of this study was to evaluate the effect of lateral static load in immediately restored implants in the canine mandible. MATERIAL AND METHODS: In 7 mongrel dogs, all premolars and the first molars were extracted bilaterally in the mandible. Two months after the extractions, 6 implants with sandblasted acid-etched surfaces were placed in each animal, 3 on each side. Randomly, two implants per side were immediately restored with an orthodontic expansion device that promoted lateral excessive static load (test group) or load (control) while the third implant of each side, remained submerged (unloaded group). These loaded devices were cleaned daily with chlorhexidine 0.12%, during the 4 months of study, when the animals were sacrificed and biopsies removed for histometric study. Intra-oral periapicals were made using positioners at the beginning and at the end of the study. RESULTS: Five implants from test group were lost in 3 dogs. Radiographically, there was a marginal bone loss of 3.68 ± 0.74 mm for the test group, 1.63 ± 0.2 mm for the control group and 0.45 ± 0.5 mm for the unloaded group. Histometrically, the percentage of bone-to-implant contact (BIC%) was 35.52 ± 7.32%, for the test group, 63.16 ± 5.16% for the control group and 42.33 ± 2.14% for the unloaded group. CONCLUSION: In conclusion, the excessive lateral static load negatively affected the behavior of peri-implant bone around immediate restored implants.

Impact of human maxillary sinus volume on grafts dimensional changes used in maxillary sinus augmentation: a multislice tomographic study.

PURPOSE: To assess the influence of complete maxillary sinus volume on the dimensional changes of different grafts used in maxillary sinus lift. MATERIALS AND METHODS: Analysis of 50 surgical procedures of maxillary sinus lift performed on 43 subjects using different grafting materials: fresh frozen allogenic particulated bone (11), hydroxyapatite (Endobon(®)) (17), 60% hydroxyapatite + 40% beta-tricalcium phosphate (Bone Ceramic(®)) (12) and Bone Ceramic(®) + Emdogain(®) (10). One hundred and fifty multislice tomographic images of the maxillary sinus were obtained using the software Syngo CT 2011 A VOLUME, measuring complete maxillary sinus volume (T0) and dimensional changes of different graft materials during periods of 15 days (T1) and 180 days (T2). The factor studied was the influence of maxillary sinus volume on the dimensional changes of different graft materials used in maxillary sinus lift in patients with posterior edentulism. Data obtained were assessed using the Student's t-test and Pearson's correlation coefficient. RESULTS: No correlation (r 0.112) between the total maxillary sinus volume and the dimensional changes of the different graft materials used in this study was observed (P > 0.05). CONCLUSION: This study demonstrated that there is no sufficient evidence to support the thesis that the volume of the maxillary sinus influences the contraction of the grafts, at least on sample or the biomaterials evaluated in this cohort study.

Effects of tobacco smoking on the survival rate of dental implants placed in areas of maxillary sinus floor augmentation: a systematic review.

OBJECTIVES: The objective of this systematic review was to evaluate the effects of smoking on the survival rate of dental implants placed in areas of maxillary sinus floor augmentation. MATERIAL AND METHODS: The Cochrane Oral Health Group's Trials Register (CENTRAL), MEDLINE and EMBASE were searched in duplicate up to, and including, October 2012 without language restrictions. Studies were considered eligible for inclusion if they involved the treatment of smokers and non-smokers with titanium implants and sinus floor elevation procedures. The Newcastle-Ottawa Scale and the Cochrane Collaboration's quality assessment tool were used for the assessment of the risk of bias in included studies. Random effects meta-analyses were used to assess the number of implants lost in smokers vs. number of implants lost in non-smokers. RESULTS: Of 3360 potentially eligible papers, eight studies were included. More than half (62.5%) of the studies found that smoking adversely affects implant survival in sites of sinus floor augmentation. Similarly, the pooled analysis indicated a statistically significantly increased risk of implant failure in smokers when the outcomes of all studies available to be included into meta-analysis were evaluated [RR: 1.87 (95% CI: 1.35, 2.58), P = 0.0001]. Conversely, a subgroup analysis including only prospective studies (3 studies) did not reveal significant differences in implant failure between smokers and non-smokers [RR: 1.55 (95% CI: 0.91, 2.65), P = 0.11]. CONCLUSIONS: Although smoking was associated with implant failure in most of individual studies and in the overall meta-analysis, the detrimental effect of smoking was not confirmed when only prospective data were assessed.

Volumetric dimensional changes of autogenous bone and the mixture of hydroxyapatite and autogenous bone graft in humans maxillary sinus augmentation. A multislice tomographic study.

PURPOSE: This multislice tomographic study evaluated the dimensional changes after maxillary sinus augmentation using autogenous bone or a mixture of hydroxyapatite and autogenous bone. MATERIALS AND METHODS: Ten selected patients, requiring a bilateral maxillary sinus augmentation, were divided, in a split mouth, design as follows: control group (CG n = 10 sinus grafted with autogenous bone) and test group (TG, n = 10 sinus grafted with a mixture of hydroxyapatite and autogenous bone at 80 : 20 w/w). Follow a healing period of 15 and 180 days, computed tomography (CT) measurements were taken by two blinded and calibrated examiners to verify the volumetric dimensional changes of the both groups. RESULTS: The interobserver agreement obtained ranged from good to excellent for both groups. Both groups presented significant dimensional changes after 180 days period healing (P < 0.05). The volumetric reduction in test group was lower (25.87%) when compared with the CG (42.30%) (P < 0.05). CONCLUSION: The both graft materials improved the bone volumetric ability to anchorage a dental implant. Moreover, the mixture of HA and autogenous bone graft showed lower degree of resorption and higher dimensional stability when compared with autogenous bone graft alone, at least at 180 days of healing. The CT exam protocol should be used as an important tool to measure bone grafts volumetric alterations.

Microbiological diversity of peri-implantitis biofilm by Sanger sequencing.

BACKGROUND AND OBJECTIVE: To examine the microbial diversity associated with implants with or without peri-implantitis and to identify differences between the bacterial communities in these clinical conditions. MATERIAL AND METHODS: Twenty subjects were assigned to a Control group consisting of subjects with healthy implants and a Test group consisting of subjects with peri-implantitis sites, as well as a healthy implant site (n = 10/group). In the Test group, subgingival biofilm samples were taken from the deepest sites of the diseased implant. In both groups, samples were collected from one site around a healthy implant. DNA was extracted and the 16S rRNA gene was amplified and sequenced, and the phylotypes were identified by comparison with known 16S rRNA sequences. RESULTS: The phylogenetic identity of 1387 16S rRNA gene clones was determined. Healthy implants demonstrated higher proportions of Actinomyces, Atopobium, Gemella, Kingella and Rothia and lower levels of Campylobacter, Desulfobulbus, Dialister, Eubacterium, Filifactor, Mitsukella, Porphyromonas and Pseudoramibacter (Mann-Whitney U-test; P < 0.05). Fusobacterium nucleatum, Dialister invisus, Streptococcus sp. human oral taxon (HOT) 064, Filifactor alocis and Mitsuokella sp. HOT 131 presented a higher mean proportion, while Veillonella dispar, Actinomyces meyeri, Granulicatella adiacens showed lower mean proportions in the peri-implantitis sites when compared with healthy implants in both the Control and Test groups (Mann-Whitney U-test; P < 0.05). CONCLUSION: Marked differences were observed in the composition of the subgingival biofilm between healthy and diseased implants. The biofilm associated with peri-implantitis harbored more pathogenic bacterial species from the orange complex and other "unusual" putative pathogens, such as F. alocis, D. invisus and Mitsuokella sp. HOT 131.

Evaluation of the peri-implant bone around parallel-walled dental implants with a condensing thread macrodesign and a self-tapping apex: a 10-year retrospective histological analysis.

The long-term high percentages of survival and success of dental implants reported in the literature are related mainly to new, innovative implant and thread designs, and new implant surfaces that allow to obtain very good primary and secondary stability in most anatomical and clinical situations, even in low quality and quantity of bone, promoting a more rapid osseointegration. The aim of this retrospective study was a histological and histomorphometrical evaluation of the bone response around implants with a parallel-wall configuration, condensing thread macrodesign, and self-tapping apex, retrieved from man for different causes. A total of 10 implants were reported in the present study, and these implants had been retrieved after a loading period comprised between a few weeks to about 8 years. Mineralized newly formed bone was found at the interface of all the implants, in direct contact with the implant surface, with no gaps or connective fibrous tissue. This bone adapted very well to the microirregularities of the implant surface. Areas of bone remodeling were present in some regions of the interface, with many reversal lines. High bone-implant contact percentages were found. In conclusion, both the macrostructure and the microstructure of this specific type of implant could be very helpful in the long-term high survival and success implant percentages.

Peri-implant bone tissues around retrieved human implants after time periods longer than 5 years: a retrospective histologic and histomorphometric evaluation of 8 cases.

Only rarely, it is possible to find in the literature histological reports of human retrieved implants, especially after several years of functional loading. These implants can help us in understanding the reactions of peri-implant bone. The aim of this study was to perform a histologic and histomorphometric analysis of the peri-implant tissues behavior and of the bone-titanium interface in titanium dental implants retrieved from patients after time periods longer than 5 years. The archives of the Implant Retrieval Center of the Dental School of the University of Chieti-Pescara, Italy were searched for human dental implants, retrieved after a loading period of more than 5 years. A total of 8 implants were found: 3 of these had been retrieved after 5 years, 1 after 6 years, one after 10 years, 1 after 14 years, 1 after 18 years, 1 after 22 years. Only the bone to implant contact in the three best threads was evaluated. Compact, mature, lamellar bone, with few and small marrow spaces, was present around the implants. Osteons with Haversian canals were present inside some threads, in close proximity to the interface, at both cortical and trabecular regions. Other osteons had a direction perpendicular to the direction of the long axis of the implants. Numerous reversal lines were present. At higher magnification, no gaps or fibrous, connective tissues were present at the interface. The BIC of the three best threads for all implants varied from 94 to 100 %.In conclusion, within the limitations of the present report histology showed that implants with different surfaces all presented the potential to maintain osseointegration over a long period, with a continuous remodeling at the interface, as indicated by the presence of reversal lines.

Digital Implant-Supported Restoration Planning Placed in Autologous Graft Using Titanium Implants Produced by Additive Manufacturing.

This clinical report presents a technique to reconstruct extensively resected mandibles using a combination of autologous bone grafts and additive manufacturing techniques. Mandibular defects, often arising from trauma, tumors, or congenital anomalies, can severely impact both function and aesthetics. Conventional reconstruction methods have their limitations, often resulting in suboptimal outcomes. In these reports, we detail clinical cases where patients with different mandibular defects underwent reconstructive surgery. In each instance, autologous grafts were harvested to ensure the restoration of native bone tissue, while advanced virtual planning techniques were employed for precise graft design and dental implant placement. The patients experienced substantial improvements in masticatory function, speech, and facial aesthetics. Utilizing autologous grafts minimized the risk of rejection and complications associated with foreign materials. The integration of virtual planning precision allowed customized solutions, reducing surgical duration and optimizing implant positioning. These 2 cases underscores the potential of combining autologous grafts with virtual planning precision and dental implants produced by additive manufacturing for mandible reconstruction.

Alveolar osteotomy associated with resorbable non-ceramic hydroxylapatite or intra-oral autogenous bone for height augmentation in posterior mandibular sites: a split-mouth prospective study.

BACKGROUND: The presence of the inferior alveolar nerve within the body of the mandible could jeopardize the placement of dental implants. Previous studies have shown that the interpositional osteotomy for posterior mandible ridge augmentation could be a predictable procedure. Nevertheless, there are few prospective, controlled, and randomized studies that evaluated this technique using different bone graft materials. PURPOSE: This prospective, controlled split-mouth study evaluated, using tomographic and Resonance Frequency Analyses (RFA), implants placed in the augmented mandibular area. MATERIAL AND METHODS: Alveolar augmentation osteotomies were performed bilaterally in 12 partially edentulous mandibular patients in a split-mouth design. The alveolar segmental osteotomies were assigned in two groups: test group, interpositional non-ceramic hydroxylapatite bone graft, and control group, interpositional intra-oral autogenous bone graft. After 6 months healing, implants were placed. The tomographic measurements of bone gain were recorded at baseline and 6 months after surgery, when the implants were placed. At 12 months after osteotomy, RFA were performed for each implant. RESULTS: The mean of bone gain 6.5 ± 2.4 mm and 7.0 ± 1.76 mm to control and test group, respectively (P > 0.05). RFA values between groups were similar at baseline and 12 months follow-up (P > 0.05). CONCLUSION: Alveolar osteotomies associated with sandwich interpositional bone graft, independently of bone graft, resulted in bone formation over a period of 12 months.

A histological and histomorphometrical evaluation of retrieved human implants with a wettable, highly hydrophilic, hierarchically microstructured surface: a retrospective analysis of 14 implants.

PURPOSE: Analysis of human-retrieved implants provides a unique opportunity to evaluate osseointegration processes. There is evidence that faster bone apposition is present at textured surfaces, with a very high success percentage. Aim of the present retrospective analysis was an evaluation of 14 human retrieved from humans implants with a wettable, highly hydrophilic, microstructured surface. MATERIALS AND METHODS: The archives of the Implant Retrieval Center of the Dental School, University of Chieti-Pescara, Italy, were searched, and a total of 14 implants FRIADENT plus surface (Dentsply Implants Manufacturing GmbH, Mannheim, Germany) retrieved after a loading period comprised between 4 and 8 weeks were found. RESULTS: Around all implants, newly formed bone was found in direct contact with the implant surface, with no connective fibrous tissue found at the interface. In all implants, no epithelial downgrowth was present. A very high bone-to-implant contact percentage was found. CONCLUSIONS: The efficacy of dental implants is related to biological and biomechanical stability and to the integration between the bone and the implant. This integration plays the key role in the fixation and anchoring of the implants.

Esthetic evaluation of single-tooth Morse taper connection implants placed in fresh extraction sockets or healed sites.

The aim of this study was to compare the esthetic outcome of single implants placed in fresh extraction sockets with those placed in fully healed sites of the anterior maxilla. This retrospective study was based on data from patients treated with single-tooth Morse taper connection implants placed in fresh extraction sockets and in fully healed sites of the anterior maxilla. Only single implant treatments were considered with both neighboring teeth present. Additional prerequisites for immediate implant treatment were intact socket walls and a thick gingival biotype. The esthetic outcome was objectively rated using the pink esthetic/white esthetic score (PES/WES). The Mann-Whitney U test was used to compare the PES and the WES between the 2 groups. Twenty-two patients received an immediate implant, and 18 patients had conventional implant surgery. The mean follow-up was 31.09 months (SD 5.57; range 24-46) and 34.44 months (SD 7.10; range 24-48) for immediately and conventionally inserted implants, respectively. No implants were lost. All implants fulfilled the success criteria. The mean PES/WES was 14.50 (SD 2.52; range 9-19) and 15.61 (SD 3.20; range 8-20) for immediately and conventionally placed implants, respectively. Immediate implants had a mean PES of 7.45 (SD 1.62; range 4-10) and a mean WES of 7.04 (SD 1.29; range 5-10). Conventional implants had a mean PES of 7.83 (SD 1.58; range 4-10) and a mean WES of 7.77 (SD 1.66; range 4-10). The difference between the 2 groups was not significant. Immediate and conventional single implant treatment yielded comparable esthetic outcomes.