[Determination of the presence of an antibiotic in implant-bone biopsy specimens by Raman spectroscopy in experiment]. / Opredelenie nalichiya antibiotika v implantato-kostnykh bioptatakh metodom ramanovskoi spektroskopii v eksperimente.

THE AIM OF THE STUDY: Was to determine the presence of an amoxicillin-based antibiotic in bone implant biopsies by Raman spectroscopy in an experiment. MATERIALS AND METHODS: Experimental animals (n=10, a miniature pig of the Svetlogorsk breed) were divided into 2 groups of 5 animals. Groups 1 and 2 were injected with amoxicillin 2 ml per 20 kg of body weight 30 minutes before dental implantation surgery, then group 2 was additionally injected with 1 ml per 20 kg of body weight for 5 days. Each animal has 6 implants installed. On the 1st, 3rd, 7th, 14th day, an implant-bone biopsy was removed from each animal, micro-preparations were made and Raman spectroscopy was performed to assess the peak matching of the Raman spectrum. RESULTS: In animals of the 1st and 2nd groups, the main peak of the Raman spectrum, which is closest to the values of the antibiotic spectrum of interest to us, is located closer to 1448 cm-1 and 1446 cm-1, respectively. At the same time, in both observations, the peaks relate to the spectrum of bone tissue, which cannot indicate the content of an antibiotic in the drug. CONCLUSION: No scattering spectra corresponding to the antibiotic molecule were found in any animal from both groups, regardless of the mode of administration and dosage of amoxicillin. The detected peaks corresponded to bone tissue without an antibiotic.

[Teeth autotransplantation as an alternative to dental implantation]. / Autotransplantatsiya zuba kak al'ternativa dental'noi implantatsii.

The stages of preoperative planning and surgical treatment of compromised teeth by the method of autotransplantation of a tooth are presented on the example of two clinical cases. The autotransplantation method can be considered an alternative to dental implantation when strictly adhering to the surgical protocol and careful selection of patients.

Deep learning-based approach for 3D bone segmentation and prediction of missing tooth region for dental implant planning.

Recent studies have shown that dental implants have high long-term survival rates, indicating their effectiveness compared to other treatments. However, there is still a concern regarding treatment failure. Deep learning methods, specifically U-Net models, have been effectively applied to analyze medical and dental images. This study aims to utilize U-Net models to segment bone in regions where teeth are missing in cone-beam computerized tomography (CBCT) scans and predict the positions of implants. The proposed models were applied to a CBCT dataset of Taibah University Dental Hospital (TUDH) patients between 2018 and 2023. They were evaluated using different performance metrics and validated by a domain expert. The experimental results demonstrated outstanding performance in terms of dice, precision, and recall for bone segmentation (0.93, 0.94, and 0.93, respectively) with a low volume error (0.01). The proposed models offer promising automated dental implant planning for dental implantologists.

Retrospective evaluation and descriptive analysis of the prevalence of anatomical structures and variations in CBCT images before dental implant planning in a group Turkish population, part I.

PURPOSE: The aim of this study is to emphasize the importance of using cone-beam computed-tomography in order to determine the anatomical structures and their variations before the treatment in patients who apply to the dentist clinic for implant treatment. METHODS: In the study, CBCT images of 500 adult patients (240 female and 260 male), aged between 21 and 82 years, who applied for implant treatment due to missing teeth, were retrospectively analyzed. Anatomical structures and variations such as nasopalatine canal(NPC), canalis sinuosus(CS), antral alveolar artery(AAA), were evaluated in multiplanar reformation(MPR) sections which are axial, sagittal and coronal can be viewed in consistence with each other. RESULTS: The incidence of anatomical variation of CS in the right region was similar according to gender. The "Funnel" appearance of the NPC shape was found most common shape in both female and male patients (n = 89; 37.1% for females and n = 71; 27.3% for males). CONCLUSION: CBCT has become the most popular 3D imaging method in dental practice especially for planning dental implants. Understanding the relationship with important anatomical structures before implant applications is crucial in dealing with potential complications that may arise afterward. Assessing significant anatomical structures by CBCT and taking precautions against possible risks facilitate the work of dentists during and after procedures.

[Application of machine vision image processing technology in dental implant surgery].

Machine vision image processing technology is extensively employed in the medical realm, particularly in dynamic navigation and robotic systems for oral implantology. It plays a pivotal role in assisting clinicians with precise implant placements, enhancing the predictability of implant restorations. The fundamental principles of machine vision image processing technology utilized in dynamic navigation and robotic systems for oral implantology primarily encompass spatial positioning and registration. However, due to variations in technical principles among different systems, their workflows and technical nuances exhibit distinctive characteristics. Therefore, commencing from the principles of spatial positioning and registration in machine vision image processing technology. This article delves into the current application landscape of machine vision in dynamic navigation and robotics for oral implantology. Its objective is to furnish valuable insights for the clinical implementation of machine vision-assisted implant technology.

Comparative Evaluation of Normal Saline Gel and Ozone Therapy on Soft and Hard Tissue Health in Dental Implant Surgery.

AIMS: To comparatively evaluate the effect of normal saline gel and ozonated saline-ozonated gel (ozone therapy) on pain, inflammation, soft tissue, and crestal bone loss in dental implant surgery. METHODS AND MATERIAL: Forty adult patients scheduled to undergo implant were randomized into two groups: Twenty patients (n = 20) received ozone therapy and controls (n = 20) received normal saline and gel during implant placement. Inflammation and pain were noted at days 1 and 7 and 3 month intervals by estimating C-reactive protein (CRP) levels and assessing visual analogue scale (VAS) scores. At 3 months, soft tissue outcomes were noted in terms of plaque index, gingival index, and pocket depth, while crestal bone loss was noted via a radiograph. RESULTS: Mean CRP levels were significantly higher in the control group as compared to that in the case group on day 1 and day 7 follow-ups (P < 0.05). Mean VAS scores for pain were also lower in the case group as compared to the control group at all follow-ups, but the difference was significant statistically only at day 1 (P = 0.061). The plaque index was significantly lower in the case group as compared to the control group (P = 0.011) at final follow-up. No significant difference between two groups was observed for crestal bone loss. CONCLUSIONS: Ozone therapy during implant placement was effective in reduction of pain, systemic inflammation, and plaque deposition in dental implant patients.

Selected osteointegration markers in different timeframes after dental implantation: findings and prognostic value.

The study aimed to determine the osteointegration markers after dental implantation and evaluate their predictive value. The study was performed on 60 practically healthy persons who needed teeth rehabilitation using dental implants. The conical-shaped implants (CI) and hexagonal implants (HI) were used. The content of Osteopontin (OPN), Osteocalcin (OC), Alkaline Phosphatase (ALP), Osteoprotegerin (OPG), and nitric oxide (NO) was determined in patients' gingival crevicular fluid (GCF) and peri-implant sulcular fluid (PISF), collected 1, 3, and 6 months after implantation. During the 3-6 months of observation level of OPN increased in patients with CIs (<50 years > 50 years) and HIs (<50 years) (CI: <50 years F = 36.457, p < 0.001; >50 years F = 30.104, p < 0.001; HI < 50 years F = 2.246, p < 0.001), ALP increased in patients with CIs (<50 years: F = 19.58, p < 0.001; >50 years: F = 12.01; p = 0.001) and HIs (<50 years) (F = 18.51, p < 0.001), OC increased in patients <50 years (CI: F = 33.72, p < 0.001; HI: F = 55.57, p < 0.001), but in patients >50 years - on the 3 days month (CI: F = 18.82, p < 0.001; HI: F = 26.26, p < 0.001), but sharply decreased at the end of sixth month. OPG increased during 1-3 months of the observation in patients <50 years (CI: F = 4.63, p = 0.037; HI: F = 2.8927, p = 0.046), but at the end of the sixth month returned to the initial level; NO content in PISF increased in patients with CI (>50 years) during 1-6 months of the observation (F = 27.657, p < 0.001). During the post-implantation period, age-related differences in osteointegration were observed. Patients <50 years old had relatively high levels of OPN, ALP, OC, and OPG in PISF, resulting in less alveolar bone destruction around dental implants and more intensive osteointegration. These indicators may be used as biological markers for monitoring implant healing. The process of osseointegration was more intense in CIs due to their comparatively high mechanical loading.

Robot-assisted surgery for dental implant placement: A narrative review.

OBJECTIVE: To determine the current status and accuracy of robotic computer-assisted implant surgery (CAIS) applications by examining the associated clinical and experimental outcomes. DATA AND SOURCES: PubMed, Medline, and Cochrane Library databases were searched for relevant studies published between January 2000 and November 2023, and focusing on robotic CAIS in dental implant surgery. All search results were then manually reviewed to identify only the pertinent articles. Only in vitro and clinical studies were included in this narrative review, with implant placement accuracy considered the main outcome. RESULT: Based on our inclusion and exclusion criteria, we included 21 studies (with 1085 implant sites); of them, 8 were clinical studies, 12 were in vitro studies, and 1 included both an in vitro study and a case series. The ranges of the mean implant shoulder, apical, and angular deviations were respectively 0.43-1.04 mm, 0.53-1.06 mm, and 0.77°-3.77° in the clinical studies and 0.23-1.04 mm, 0.24-2.13 mm, and 0.43°-3.78° in the in vitro studies, respectively. CONCLUSION: The accuracy of robotic CAIS in dental implant procedures appears to be within the clinically acceptable ranges. However, further relevant clinical trials validating the existing evidence are needed. CLINICAL SIGNIFICANCE: Robotic CAIS can achieve clinically acceptable implant placement accuracy. This innovative technology may improve the precision and success rates of dental implant procedures, with benefit for surgeons and patients.

The role of the general dental practitioner in the implant journey.

The relationship between referring dentist and implantologist can be crucial in making the treatment journey as efficient and effective as possible for patients. There are a number of considerations to discuss to allow effective communication of options with the patient, as well as the long-term management of these cases once returned to general practice.

Preoperative assessment of bone density for dental implantation: a comparative study of three different ROI methods.

BACKGROUND: Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images. METHODS: Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods. RESULTS: The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001). CONCLUSIONS: The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results. TRIAL REGISTRATION: This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study.

[Effects and techniques of soft tissue augmentation in immediate implant treatment].

Immediate implant placement can reduce the number of treatments and the time without teeth, but it carries a higher aesthetic risk. Soft tissue augmentation can reduce the risk of gingival recession to a certain extent, improve the predictability and long-term stability of immediate implant aesthetics, and is currently a hot research topic. A comprehensive understanding of the evidence-based medicine and surgical techniques using soft tissue augmentation in immediate implant surgery can assist in clinical diagnosis, treatment decisions and improve treatment outcomes. This article elucidates the changes in soft and hard tissues after immediate implant placement, aesthetic risks, and risk factors. It also discusses the advantages, timing, material selection, and commonly used clinical techniques of soft tissue transplantation in immediate implantation, aiming to provide reference for clinical doctors to improve the effectiveness of immediate implantation.

Free flap jaw reconstruction with dental implantation: A single-institution experience.

BACKGROUND: We sought to review our institution's experience with dental implant placement in free flap jaw reconstruction to determine factors impacting restoration of dental occlusion. METHODS: Exactly 48 patients underwent free flap jaw reconstruction with or without dental restoration from 2017 to 2022. Primary outcome was achievement of restored dental occlusion after jaw free flap reconstruction. RESULTS: A total of 48 patients with a mean age of 59.8 ± 16.4 years underwent jaw reconstruction from 2017 to 2022. Ten patients (20.8%) received osteointegrated dental implants. Two patients received a temporary dental prosthesis, 12 ± 4 months after initial reconstruction. Three patients received a final prosthesis, with a mean time to final prosthesis of 17.7 ± 12.4 months. Five patients did not receive any prosthesis despite placement of implants. CONCLUSION: A minority of patients received dental implant placement with free flap jaw reconstruction and only a small subset of these received a definitive dental prosthesis.

An in vitro analysis of the accuracy of static and robot-assisted implant surgery.

OBJECTIVES: Robot-assisted implant surgery (RAIS) is purported to improve the accuracy of implant placement. The objective of this study was to compare RAIS with static computer-assisted implant surgery (sCAIS) in a controlled environment. MATERIALS AND METHODS: A total of n = 102 implants were placed in the same modified typodont (n = 17 repeated simulated implant surgeries with each n = 3 implants per group) using robot-assisted or static computer-assisted implant surgery. The final implant positions were digitized utilizing cone-beam tomography and compared with the planned position. The angular deviation was the primary outcome parameter. 3D deviations at the implant platform level and the apex were secondary outcome parameters. Accuracy in terms of trueness and precision were assessed. Means, standard deviation, and 95%-confidence intervals were analyzed statistically. RESULTS: The overall angular deviation was 2.66 ± 1.83° for the robotic system and 0.68 ± 0.38° for guided surgery using static guides (p < .001), the 3D-deviation of the implant platform at crest level was for sCAIS 0.79 ± 0.28 mm and RAIS 1.51 ± 0.53 mm (p < .001) and at the apex for sCAIS 0.82 ± 0.26 mm and for RAIS 1.97 ± 0.79 mm (p < .001), respectively. CONCLUSIONS: Robotically guided implant surgery was less accurate in terms of trueness (planned vs. actual position) and precision (deviations among implants) than traditional static computer-assisted implant surgery in this in vitro study.

Explantación de implante mal posicionado en sector estético y regeneración posterior con injerto en bloque. Caso clínico / Explantation of a malpositioned implant in the aesthetic sector and regeneration with bone block grafting. Clinical case

La realización de una explantación en el sector estético produce un defecto óseo que en muchas ocasiones deja un área para la rehabilitación con implantes que debe ser regenerado a través de diferen tes procedimientos. El injerto en bloque puede ser una alternativa en los casos donde se precise regeneración ósea ver tical y horizontal de forma simultánea. En el presente caso clínico se muestra la explantación de un implante mal posicio nado en el sector estético, de imposible rehabilitación que debe ser retirado, regenerándose posteriormente el defecto para poder posicionar un nuevo implante, esta vez en una situación que permita una rehabilitación predecible y estéticamente satisfactoria (AU)

Performing an explantation in the aesthetic sector produces a defect that often leaves a bone loss that must be regenerated through different procedures. Bone block grafting can be an alternative in cases where simultaneous vertical and horizontal bone regeneration is required. In this clinical case we show the explantation of a poorly positioned implant in the aesthetic sector, impossible to rehabilitate, which must be explanted and the defect subsequently regenerated so that a new implant can be positioned, this time in a situation that allows us a predictable and aesthetically satisfactory rehabilitation (AU)

Comportamiento del injerto autólogo de diente en preservación alveolar: evaluación clínica, radiográfica e histomorfométrica de un caso clínico tras un año de seguimiento / Behavior of the autologous tooth graft in alveolar preservation: clinical, radiographic and histomorphometric evaluation of a clinical case after one year of follow-up

Introducción: tras las extracciones, se producen una serie de cambios dimensio nales en sentido horizontal y vertical de la cresta alveolar, los cuales pueden ser minimizados mediante algunas técnicas quirúrgicas, como la preservación alveo lar, que utiliza diferentes sustitutos óseos, entre los que se encuentra actualmente el injerto autólogo de diente. Caso clínico: se presenta el caso clínico de una mujer de 61 años, que acudió a consulta presentando dolor intenso en la zona del segundo premolar superior de recho (1.5). Se realizó la exodoncia del 1.5, usándose como diente donante para realizar una preservación del alveolo tras la extracción. Cuatro meses tras el proce dimiento, se colocó un implante y se tomó una biopsia para realizar un análisis histo morfométrico. Un año tras la carga del im plante se observaron buenos resultados clínicos y radiográficos. Discusión: el diente y el tejido óseo tie nen similitudes en su composición quími ca, tanto en sus componentes inorgáni cos y orgánicos como en la cantidad de agua. En cuanto al contenido orgánico destacan los factores de crecimiento, la proteína morfogenética ósea 2 (BMP-2) y el colágeno tipo 1, dotando al diente como biomaterial de la propiedad de os teoinducción. El empleo del diente como sustituto en preservación alveolar consi gue porcentajes altos de hueso neofor mado, variando entre 37,55% cuando se usa el diente completo, al 48,40% usando dentina desmineralizada. Además de los buenos resultados histomorfométricos, goza de una buena aceptación por parte de los pacientes, fundamentalmente en determinadas ra zas o culturas, y consigue una reducción de las dimensio nes óseas evaluadas mediante escáner de haz cónico. Sin embargo, requiere un tiempo de preparación, que aumenta si el diente tiene restauraciones o tratamientos de conduc tos asociados (AU)

Introduction: following tooth extraction, horizontal and vertical resorption of bone volume occurs, but they can be reduced by many surgical procedures, such as alveolar ridge preservation, which uses different bone substitutes, being one of them autogenous tooth-graft. Clinical case: a 61-year-old woman is presented, who came to private dental clinic presenting intense pain in the area of an upper bicuspid of the first quadrant (1.5). Exodontia of the 1.5 was performed, using it as a donor tooth to obtain the biomaterial to preserve its alveolus. After 4 months re-entry was performed and an implant was placed, harvesting a bone biopsy for histomorphometric analysis. One year post-loading, good clinical and radiographic results were shown. Discussion: human bone and tooth have similarities in their chemical composition, both in their inorganic and organic components and in the amount of water. The organic content, growth factors, bone morphogenetic protein 2 (BMP-2) and type 1 collagen stand out, give the tooth the property of osteoinduction. The use of the tooth as a substitute in alveolar preservation achieves high percentages of neoformed bone, varying between 37.55% when the whole tooth is used, to 48.40% using demineralized dentin. In addition, it is well accepted by patients, especially in certain races or cultures, and achieves a reduction in bone dimensions evaluated by cone beam computed tomography. However, it has a drawback, requiring a long preparation time, which increases if the tooth has associated restorations or root canals. Conclusions: Autologous tooth-graft has a high biocompatibility, a low rate of intraoperative complications and good patient acceptance. It requires 25 minutes for preparation, which increases if there are restorations, root canals and caries. The percentage of vital bone obtained in the present clinical case shows new bone formation of 20% 4 months after alveolar ridge preservation (AU)

Soft tissue dimensional change using customized titanium healing abutment in immediate implant placement in posterior teeth.

BACKGROUND: The morphologic and dimensional alveolar bone is significant for resorption in the first 3 months after tooth removal because they restrict treatment outcomes with respect to function and esthetic. Following teeth extraction, the width and height of the alveolar ridge contour are reduced in both the horizontal and vertical dimensions. Following implant placement, the gingival morphology should be changed minimally compared to pre-extraction. Surrounding natural-like tissue is also an ultimate goal of the dental implant treatment, which is correlated with the cervical third contour on the anatomical tooth, for comfortable cleansing, food impaction avoidance, and esthetics. PURPOSE: To evaluate the peri-implant soft tissue changes after immediate implant placement (IIP) with the use of a customized titanium healing abutment in the posterior teeth. METHOD: Digital impressions using the intraoral scanner (MEDIT i500) were taken from 30 patients. Customized titanium healing abutments were designed and milled before extraction. Flapless extractions were done using surgical guides, 32 immediate implants placement were done in posterior areas, and healing abutments were placed. Soft tissues were scanned during pre-operation, and post-surgery during the 1st, 3rd, and 6th months. A 3D analysis program (Final Surface) evaluated the gingival margin distance, height, contour width, and volume in each period. SPSS was used to analyze the data with a p-value = 0.05. The between-time interval comparisons were done and the analysis was done using a Multivariate test. RESULTS: Customized titanium healing abutments used in immediate implantation maintained optimal peri-implant mucosa. In intermittent periods, there was no significant reduction in all aspects of the margin distances and heights. During the entire period, the margin height reduction on the buccal, lingual, mesial, and distal was 0.63 mm, 0.93 mm, 0.08 mm, and 0.24 mm, respectively, and contour width reduction on the buccal, lingual, and buccolingual was 0.59 mm, 0.43 mm, and 1.03 mm, respectively. There was a significant reduction in the total buccolingual contour width in the 1st month and total volume in the 3rd to 6th months. CONCLUSIONS: Immediate implant placement with customized titanium healing abutment can achieve the optimal peri-implant mucosa and this protocol is an alternative for soft tissue management.

Implantes cortos y extracortos e inserción. Estudio retrospectivo con un seguimiento de 1 a 7 años / Short and extra-short implants in the maxilla and mandible with low insertion torque. Retrospective study with a follow-up of 1 to 7 years

Introducción: La realización de implantes cortos y extracortos en situaciones de extrema reabsorción maxilar y mandibular supone que la colocación del implante se realiza en condiciones de escaso volumen óseo residual y, por lo tanto. puedeser posible que el torque de inserción que se logre sea menor que en otras situaciones. En el presente artículo se investiga la posible relación que puede tener este bajo torque de inserción con la supervivencia del implante y la pérdida ósea crestal. Material y método: Fueron revisadas historias clínicas de forma retrospectivade los implantes insertados en el segundo semestre del año 2015 y primer trimestre del año 2021, para identificar implantes cortos y extracortos con torque de inserción < 20 N/cm. El implante fue la unidadde análisis para la estadística descriptiva en cuanto a la localización, dimensiones del implante, y mediciones radiográficas. El paciente fue la unidad de medida para el análisis de la edad, sexo y la historia médica. Las variables cualitativas se describieron mediante un análisis de frecuencias y las cuantitativas mediante media ydesviación estándar. La supervivencia de los implantes se calculó mediante el método de Kaplan-Meier.Resultados: Fueron reclutados 36 pacientes en los que se insertaron 40 implantes que cumplieron los criterios de inclusión marcados para el estudio. El torque de inserción de los implantes reclutados varió entre 5 y 15 Ncm, siendo 5 Ncm en el 37,5% de los casos, 10 Ncm en el 30% de los casos y 15 Ncm en el 32,5 % restante...(AU)

Introduction: The use of short, extrashort implants in situations of extrememaxillary and mandibular resorptionmeans that the implant is placed inconditions of low residual bone volumeand therefore it is possible that theinsertion torque achieved may be lowerthan in other situations. This article investigates the possible relationship thatthis low insertion torque may have with implant survival and crestal bone loss. Methods: Medical records of implants inserted in the second half of 2015 and first quarter of 2021 were retrospectively reviewed to identify short, extra-short implants with insertion torque < 20 N/cm.The implant was the unit of analysis for descriptive statistics in terms of location, implant dimensions, and radiographic measurements. The patient was the unit of measurement for the analysis ofage, sex and medical history. Qualitative variables were described by frequency analysis and quantitative variables by mean and standard deviation. Implant survival was calculated using the Kaplan Meier method. Results: Thirty-six patients were recruited and 40 implants were inserted that met the inclusion criteria for the study. The insertion torque of the recruited implants...(AU)

Reconstrucción maxilar con un implante subperióstico en un caso de atrofia severa. De la planificación a la rehabilitación siguiendo un protocolo totalmente digital. A propósito o clínico y revisión bibliográfica / Maxillary reconstruction with a subperiosteal implant in a case of severe atrophy. From planning to rehabilitation following a fully digital protocol. A clinical case report and literature review

Introducción: Los implantes subperiósticos personalizados de titanio, diseñadosa partir de un software de planificación yfabricación, constituyen una alternativaen la rehabilitación de atrofias severasen los maxilares, evitando cirugías de reconstrucción óseas y el de partes blandasmás complejas y disminuyendo los tiempos de cicatrización. El objetivo de este trabajo es presentar la rehabilitación enun caso clínico con una atrofia severa enmaxilar superior, utilizando una estructuracon implantes subperiósticos, medianteun protocolo digital.Descripción del caso: Se diseñó unaestructura subperióstica de titanio sinterizada con seis conexiones transepitelialesque fueron rehabilitadas con una prótesisfija inmediata implantosoportada fabricada en PMMA. Dos meses después, serealizó una estructura sinterizada en cromo-cobalto con bases mecanizadas recubierta con dientes de resina acrílica comorestauración final. En el seguimiento a unaño, el caso permanece estable.Conclusiones: Hoy en día, la rehabilitación con implantes subperiósticos constituye una herramienta alternativa en casosde cirugías complejas con grandes atrofias con la posibilidad, además, de realizar una carga inmediata. (AU)

Introduction: Customized subperiosteal titanium implants, designed from planning and fabrication software, constitute analternative in the rehabilitation of severe maxillary atrophy, avoiding more complex bone and soft reconstruction surgeries and reducing healing times. The aim of this article is to present the rehabilitation in a clinical case with severe atrophy in the upper jaw, using a structure with subperiosteal implants, by means of a digital protocol.Clinical Case: A subperiosteal sintered titanium structure was fabricated with six transepithelial connections that were rehabilitated with an immediate implant-supported fixed prosthesis made of PMMA. Two months later, a sintered Chromium-Cobalt framework with machined bases covered with acrylic resin teeth was fabricated as the final restoration. At one year follow-up, the case remains stable. Conclusions: Nowadays, rehabilitatin with subperiosteal implants is an alternative tool in cases of complex surgeries with large atrophies with the possibility of immediate loading. (AU)

Outcome measures and methods of assessment of soft tissue augmentation interventions in the context of dental implant therapy: A systematic review of clinical studies published in the last 10 years.

AIM: To identify and report outcome measures and methods of assessment on soft tissue augmentation interventions in the context of dental implant therapy reported in clinical studies published in the last 10 years. MATERIALS AND METHODS: The protocol of this Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review was registered in PROSPERO (CRD42021252214). A literature search was conducted to identify articles that met the pre-established eligibility criteria. Data of interest, with an emphasis on outcome measures, were extracted. For each outcome, specific methods and timing of assessment were described in detail. Following a critical qualitative analysis of the data, outcome measures were categorized. Primary outcomes were identified, and the frequency of reporting in the selected articles was calculated. Additionally, risk-of-bias assessments were performed for individual articles and primary outcomes. RESULTS: Ninety-two articles, of which 39 reported randomized controlled trials (RCTs), 20 non-RCTs, and 33 case series studies, were selected. Outcome measures were categorized into either investigator-evaluated outcome measures (i.e., clinical, digital imaging, aesthetic, histological, biomarker, and safety) or patient-reported outcome measures (PROMs). Clinical outcomes were the most frequently reported type of outcome. Considering all categories, the most frequently reported primary outcomes were facial mucosa thickness assessed with clinical methods (22.83%), facial keratinized mucosa width assessed with clinical methods (19.57%), facial mucosal margin position/recession assessed with clinical methods (18.48%), facial mucosa thickness assessed with digital imaging methods (11.96%), facial soft tissue volume assessed with digital imaging methods (9.78%), and supracrestal tissue height assessed with clinical methods (9.78%). No distinguishable patterns of association between specific types or quality (level of bias) of clinical studies and the choice of primary outcomes were observed. CONCLUSIONS: Clinical research on peri-implant soft tissue augmentation has progressively increased in the last 10 years. Although clinical outcome measures were the most frequently reported outcomes in the selected literature, trends in the field are indicative of a shift from traditional clinical assessment methods to the use of digital technologies. PROMs were generally under-reported but should be considered an integral methodological component in future clinical studies.