The usage of dental cone-beam computed tomography during the COVID-19 pandemic (from 2020 to 2022): A survey of a regional hospital in the northern Taiwan.

Background/purpose: In Taiwan, cone-beam computed tomography (CBCT) has already widely used in dentistry. This study explored preliminarily the usage of dental CBCT during the COVID-19 pandemic (from 2020 to 2022) through a survey of a regional hospital in the northern Taiwan. Materials and methods: This study used purposeful sampling to select a regional hospital in the northern Taiwan to survey its usage of dental CBCT during the COVID-19 pandemic. Results: In the surveyed hospital, the number of patients' visits for the usage of dental CBCT increased from 355 in 2020 to 449 in 2021 and further to 488 in 2022 with a growth rate of 37.46 %, while the growth rates compared to the previous year were 26.48 % in 2021 and 8.69 % in 2022, respectively. There were a total of 1292 patients' visits for the dental CBCT. The ages of the 1292 patients (573 males and 719 females) ranged from 4 to 89 years. The 50-59-year age group had the highest number of patients' visits (371, 28.72 %), followed in a descending order by the 60-69-year (293, 22.68 %) and 40-49-year (206, 15.94 %) age groups. The dental CBCT was used mainly for the assessment of dental implants, accounting for 1148 (78.85 %) of the total 1456 irradiations. Conclusion: During the COVID-19 pandemic, the medical services for dental care and treatments in Taiwan are still maintained normally, and the dental CBCT is also used widely and popularly by the dental patients of all ages, various dental procedures, and various dental specialties.

Evaluating the effect of functionally graded materials on bone remodeling around dental implants.

OBJECTIVES: This study evaluates the potential for osseointegration and remodeling of customized dental implants made from Titanium-Hydroxyapatite Functionally Graded Material (Ti-HAP FGM) with optimized geometry, using the finite element method (FEM). METHODS: The study utilized CT scan images to model and assemble various geometrical designs of dental implants in a mandibular slice. The mechanical properties of Ti-HAP FGMs were computed by varying volume fractions (VF) of hydroxyapatite (0-20%), and a bone remodeling algorithm was used to evaluate the biomechanical characteristics of the ultimate bone configuration in the peri-implant tissue. RESULTS: The findings of the FEA reveal that osseointegration improves with changes in the density and mechanical properties of the bone surrounding Ti-HAP implants, which are influenced by the varying VF of hydroxyapatite in the FGM. SIGNIFICANCE: Increasing the hydroxyapatite fraction improves osseointegration, and appropriate length and diameter selection of Ti-HAP dental implants contribute to their stability and longevity.

3D extraoral morphometric changes after implant surgery: an exploratory pilot study using stereophotogrammetry.

OBJECTIVE: This pilot study aimed to evaluate, for the first time, the changes in facial tissues following the placement of a single dental implant. METHODS AND MATERIALS: Patients were scanned with a 3D facial scanner (3dMD) before implant surgery, immediately after surgery (T1), at 7 days post-operatively (T2), and at the impression stage (T3). Acquired images were processed using 3dMDVultus software program and volume differences and linear depth measurements were calculated to determine the morphometric changes over time. A total of 11 patients were included in the analyses. Descriptive statistics were employed to analyze the data. RESULTS: The volumetric changes and maximum depth differences indicated an initial increase, followed by a progressive decrease in tissue volume after implant placement in the area of the surgery. The volume change values ranged between 2.5 to 3.9 cc for T1, whereas for T2, the volume change decreased to a range of 0.8 to 1.8 cc. Maximum depth differences ranged between 2.06 to 2.80 mm in the soft tissues right after the implant surgery and reduced to around 2.01 mm to 0.55 mm in the impression stage. The amount of painkiller used was not related to the magnitude of linear depth measurements at any assessed time point. CONCLUSION: The results from this report documented that there is a longitudinal decrease in soft tissue volume and depth difference in extra-oral soft tissues in the region of implant placement after surgery to 6 weeks. The use of a facial scanner is a promising non-invasive method to monitor 3D morphometric changes after implant surgery.

Inter and intra-operator reliability of Lekholm and Zarb classification and proposal of a novel radiomic data-driven clustering for qualitative assessment of edentulous alveolar ridges.

OBJECTIVES: The present study was conducted to evaluate the reproducibility of Lekholm and Zarb classification system (L&Z) for bone quality assessment of edentulous alveolar ridges and to investigate the potential of a data-driven approach for bone quality classification. MATERIALS AND METHODS: Twenty-six expert clinicians were asked to classify 110 CBCT cross-sections according to L&Z classification (T0). The same evaluation was repeated after one month with the images put in a different order (T1). Intra- and inter-examiner agreement analyses were performed using Cohen's kappa coefficient (CK) and Fleiss' kappa coefficient (FK), respectively. Additionally, radiomic features extraction was performed from 3D edentulous ridge blocks derived from the same 110 CBCTs, and unsupervised clustering using 3 different clustering methods was used to identify patterns in the obtained data. RESULTS: Intra-examiner agreement between T0 and T1 was weak (CK 0.515). Inter-examiner agreement at both time points was minimal (FK at T0: 0.273; FK at T1: 0.243). The three different unsupervised clustering methods based on radiomic features aggregated the 110 CBCTs in three groups in the same way. CONCLUSIONS: The results showed low agreement among clinicians when using L&Z classification, indicating that the system may not be as reliable as previously thought. The present study suggests the possible application of a reproducible data-driven approach based on radiomics for the classification of edentulous alveolar ridges, with potential implications for improving clinical outcomes. Further research is needed to determine the clinical significance of these findings and to develop more standardized and accurate methods for assessing bone quality of edentulous alveolar ridges.

Association of Peri-Implant Keratinized Mucosa Width and Mucosal Thickness with Early Bone Loss: A Cross-Sectional Study.

Objective: The objective of this study was to evaluate the effects of keratinized mucosa width (KMW) and mucosal thickness (MT) around dental implants on marginal bone loss (MBL). The evaluation was performed one year after loading by comparing clinical, radiographic, and biochemical parameters. Methods: The study included 87 implants in 87 patients undergoing regular follow-ups without hard or soft tissue augmentation one year after loading. Clinical measurements included plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing depth (PD), KMW, and MT. MBL was assessed with periapical radiography. The peri-implant crevicular fluid (PICF) was analyzed for tumor necrosis factor-alpha (TNF-α), receptor activator of nuclear factor-kB ligand (RANKL), osteoprotegerin (OPG), and microRNA-27a. Results: The MBL of implants with thin MT (<2 mm) was higher than that of implants with thick MT (≥2 mm) (p < 0.05). A significant negative correlation (r: -0.217) was established between MT and MBL. No significant association was found between KMW and MBL (p > 0.05). No significant associations was found between KMW and MT with TNF-α, RANKL, OPG and RANKL/OPG (p > 0.05), with the exception of increased microRNA-27a levels in implants with KMW ≥ 2 mm (p < 0.05). Conclusions: Implants with a thick MT had a lower MBL. There may be an association between adequate KMW and high miRNA-27a levels. The relationship between MBL and miRNA-27a remains unclear.

Fiber-Reinforced Composites for Full-Arch Implant-Supported Rehabilitations: An In Vitro Study.

Background: Fiber-reinforced composites (FRCs) have been proposed as an alternative to traditional metal alloys for the realization of frameworks in full-arch implant-supported prostheses. The aim of the present in vitro study was to evaluate the deflection under load of seven prostheses endowed with frameworks made of different materials, including different types of fiber-reinforced composites (FRCs). Methods: A master cast with four implant analogues in correspondence with the two lateral incisors and the two first molars was used to create full-arch fixed prostheses with the same shape and different materials. Prostheses were made of the following different materials (framework+veneering material): gold alloy+resin (Au+R), titanium+resin (Ti+R), FRC with multidirectional carbon fibers+resin (ICFRC+AR), FRC with unidirectional carbon fibers+composite (UCFRC+C), FRC with glass fibers+resin (GFRC+AR), FRC with glass fibers+composite (GFRC+C), and resin (R, fully acrylic prosthesis). Flexural tests were conducted using a Zwick/Roell Z 0.5 machine, and the deflection of the lower surface of the prosthesis was measured in order to obtain load/deflection graphs. Results: Greater rigidity and less deflection were recorded for UCFRC+C and GFRC+C, followed by Ti+R and Au+R. The greatest deformations were observed for resin alone, ICFRC+R, and GFRC+R. The results were slightly different in the incisal region, probably due to the greater amount of veneering material in this area. Conclusions: When used to realize full-arch frameworks, Au and Ti allow for predictable mechanical behavior with gradual deformations with increasing load. UCFRC also demonstrated good outcomes and less deflection than ICFRCs when loaded. The GFRC full-arch framework may be a valid alternative, although it showed greater deflections. Further studies are needed in order to evaluate how different prosthesis designs and material thicknesses might affect the outcomes.

Severe Maxillectomy Defect Rehabilitation with an Implant-Retained Obturator Prosthesis: A Case Report.

Conventional obturator prostheses might cause dissatisfaction in patients with hard or soft palate defects due to inadequate retention and function during speech, mastication, and swallowing. Thus, surgical reconstruction and implant-supported obturators are considered as alternative treatments for these patients. This case-report study describes the prosthetic reconstruction of an 88-year-old patient suffering from a hard palate defect after surgical resection of verrucous carcinoma in the left side of the hard palate. Fifteen months after radiotherapy, two implants were placed in the right side of the remaining ridge, in the second and third molar region. After the implant healing period, the implant-supported obturator prosthesis was fabricated. The patient was satisfied with the esthetics and function of the obturator at the 12-month recall visit and radiographs showed normal healing and no bone loss around the implants.

Echo-intensity characterization at implant sites and novel diagnostic ultrasonographic markers for peri-implantitis.

AIM: To apply high-frequency ultrasound (HFUS) echo intensity for characterizing peri-implant tissues at healthy and diseased sites and to investigate the possible ultrasonographic markers of health versus disease. MATERIALS AND METHODS: Sixty patients presenting 60 implants diagnosed as healthy (N = 30) and peri-implantitis (N = 30) were assessed with HFUS. HFUS scans were imported into a software where first-order greyscale outcomes [i.e., mean echo intensity (EI)] and second-order greyscale outcomes were assessed. Other ultrasonographic outcomes of interest involved the vertical extension of the hypoechoic supracrestal area (HSA), soft-tissue area (STA) and buccal bone dehiscence (BBD), among others. RESULTS: HFUS EI mean values obtained from peri-implant soft tissue at healthy and diseased sites were 122.9 ± 19.7 and 107.9 ± 24.7 grey levels (GL); p = .02, respectively. All the diseased sites showed the appearance of an HSA that was not present in healthy implants (area under the curve = 1). The proportion of HSA/STA was 37.9% ± 14.8%. Regression analysis showed that EI of the peri-implant soft tissue was significantly different between healthy and peri-implantitis sites (odds ratio 0.97 [95% confidence interval: 0.94-0.99], p = .019). CONCLUSIONS: HFUS EI characterization of peri-implant tissues shows a significant difference between healthy and diseased sites. HFUS EI and the presence/absence of an HSA may be valid diagnostic ultrasonographic markers to discriminate peri-implant health status.

Maxillary sinus floor augmentation with autogenous bone graft compared with composite grafts: A one-year single-blinded randomized controlled trial.

OBJECTIVE: The objective was to assess the one year implant treatment outcome and patient-related outcome measures (PROMs) following maxillary sinus floor augmentation (MSFA) with autogenous bone graft (ABG) from the zygomatic buttress (control) compared with 1:1 mixture of ABG and anorganic porcine bone mineral (APBM) (Test I) or biphasic bone graft material (BBGM) (Test II). MATERIALS AND METHODS: Sixty healthy patients (34 females, 26 males) were randomly allocated to either control or test groups. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of peri-implant tissue, peri-implant marginal bone loss, frequency of complications, and PROMs using Oral Health Impact Profile-14 combined with questionnaire assessing patient perception of peri-implant soft tissue, prosthetic solution, implant function, and implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was .05. RESULTS: All suprastructures and implants were well-functioning after one year of functional implant loading. There was no significant difference between control and test groups in any of the applied outcome measures. The implant stability significantly increased from implant placement to abutment connection within all groups (p < .001). High patient satisfaction and significant improvement in oral health-related quality of life was also reported within all groups. CONCLUSION: This study demonstrates that MSFA with composite grafts containing minimal amounts of ABG reveals comparable implant treatment outcomes as compared with ABG alone, after one year of functional implant loading. Extensive ABG harvesting in conjunction with MSFA therefore seems not to be needed.

Dental implant considerations in patients with systemic diseases: An updated comprehensive review.

BACKGROUND: Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM: The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS: The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS: In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION: In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.

A Comparative Analysis of Deep Learning-Based Approaches for Classifying Dental Implants Decision Support System.

This study aims to provide an effective solution for the autonomous identification of dental implant brands through a deep learning-based computer diagnostic system. It also seeks to ascertain the system's potential in clinical practices and to offer a strategic framework for improving diagnosis and treatment processes in implantology. This study employed a total of 28 different deep learning models, including 18 convolutional neural network (CNN) models (VGG, ResNet, DenseNet, EfficientNet, RegNet, ConvNeXt) and 10 vision transformer models (Swin and Vision Transformer). The dataset comprises 1258 panoramic radiographs from patients who received implant treatments at Erciyes University Faculty of Dentistry between 2012 and 2023. It is utilized for the training and evaluation process of deep learning models and consists of prototypes from six different implant systems provided by six manufacturers. The deep learning-based dental implant system provided high classification accuracy for different dental implant brands using deep learning models. Furthermore, among all the architectures evaluated, the small model of the ConvNeXt architecture achieved an impressive accuracy rate of 94.2%, demonstrating a high level of classification success.This study emphasizes the effectiveness of deep learning-based systems in achieving high classification accuracy in dental implant types. These findings pave the way for integrating advanced deep learning tools into clinical practice, promising significant improvements in patient care and treatment outcomes.

Influence of scanning protocol on the accuracy of complete-arch digital implant scans: An in vitro study.

OBJECTIVE: This in-vitro study assessed the influence of two intraoral scanning (IOS) protocols on the accuracy (trueness and precision) of digital scans performed in edentulous arches. METHODS: Twenty-two abutment-level master casts of edentulous arches with at least four implants were scanned repeatedly five times, each with two different scanning protocols. Protocol A (IOS-A) consisted of scanning the edentulous arch before inserting the implant scan bodies, followed by their insertion and its subsequent digital acquisition. Protocol B (IOS-B) consisted of scanning the edentulous arch with the scan bodies inserted from the outset. A reference scan from each edentulous cast was obtained using a laboratory scanner. Trueness and precision were calculated using the spatial fit analysis, cross-arch distance, and virtual Sheffield test. Statistical analysis was performed using generalized estimating equations (GEEs). Statistical significance was set at α = .05. RESULTS: In the spatial fit test, the precision of average 3D distances was 45 µm (±23 µm) with protocol IOS-A and 25 µm (±10 µm) for IOS-B (p < .001), and the trueness of average 3D distances was 44 µm (±24 µm) with protocol IOS-A and 24 µm (±7 µm) for IOS-B (p < .001). Cross-arch distance precision was 59 µm (±53 µm) for IOS-A and 41 µm (±43 µm) for IOS-B (p = .0035), and trueness was 64 µm (±47 µm) for IOS-A and 50 µm (±40 µm) for IOS-B (p = .0021). Virtual Sheffield precision was 286 µm (±198 µm) for IOS-A and 146 µm (±92 µm) for IOS-B (p < .001), and trueness was 228 µm (±171 µm) for IOS-A and 139 µm (±92 µm) for IOS-B (p < .001). CONCLUSIONS: The IOS-B protocol demonstrated significantly superior accuracy. Placement of scan bodies before scanning the edentulous arch is recommended to improve the accuracy of complete-arch intraoral scanning.

A randomized clinical trial on zirconia versus titanium implants in maxillary single tooth replacement.

OBJECTIVES: This RCT aimed to compare zirconia and titanium dental implants in the maxillary premolar region. The comparison was based on marginal bone level (MBL) changes, clinical parameters, aesthetic outcomes, and patient related outcome measures (PROMs) 1 year after prosthetic loading. MATERIALS AND METHODS: Fifty patients were randomly assigned to receive either a zirconia (ZrO2, n = 25) implant or a titanium (Ti, n = 25) bone-level implant. Implants were provided with a lithium disilicate crown 3 months after placement. Follow-up was at 1 month and after 1 year. The primary outcome pertained to changes in MBL. Reported secondary outcomes consisted of implant survival, peri-implant tissue health, aesthetics, and PROMs. RESULTS: Mean MBL change after 1 year was 0.01 mm (SD = 0.45; min = 0.72, max = 0.86) for ZrO2 and -0.09 mm (SD = 0.34; min = 0.53, max = -1.06) for Ti (p = .439). Scores for the other clinical outcome parameters and PROMs were generally favorable, with no significant differences. However, significant differences were found for the aesthetic outcomes regarding two criteria: (a) level of facial mucosa (p = .022), in favor of Ti, and (b) root convexity/soft tissue color and texture (p = .005) in favor of ZrO2. CONCLUSION AND CLINICAL IMPLICATIONS: The ZrO2 and Ti implant types used in this study, replacing a single missing maxillary premolar, show a comparable outcome in terms of MBL change after 1 year. Clinical and aesthetic parameters, as well as PROMs, are favorable and similar between both implant types after 1 year of prosthetic loading. These short-term study results suggest that both are suitable for clinical use.

Aspirin/amoxicillin loaded chitosan microparticles and polydopamine modified titanium implants to combat infections and promote osteogenesis.

It is known that titanium (Ti) implant surfaces exhibit poor antibacterial properties and osteogenesis. In this study, chitosan particles loaded with aspirin, amoxicillin or aspirin + amoxicillin were synthesized and coated onto implant surfaces. In addition to analysing the surface characteristics of the modified Ti surfaces, the effects of the modified Ti surfaces on the adhesion and viability of rat bone marrow-derived stem cells (rBMSCs) were evaluated. The metabolic activities of Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) biofilms on the modified Ti surfaces were also measured in vitro. Moreover, S. aureus was tested for its antibacterial effect by coating it in vivo. Using water as the droplet medium, the contact angles of the modified Ti surfaces increased from 44.12 ± 1.75° to 58.37 ± 4.15°. In comparison to those of the other groups tested, significant increases in rBMSC adhesion and proliferation were observed in the presence of aspirin + amoxicillin-loaded microspheres, whereas a significant reduction in the metabolic level of biofilms was observed in the presence of aspirin + amoxicillin-loaded microspheres both in vitro and in vivo. Aspirin and amoxicillin could be used in combination to coat implant surfaces to mitigate bacterial activities and promote osteogenesis.

Analysis of the Association of IL-1A, IL-1B and IL-1RN Polymorphisms with Peri-implantitis in a Portuguese Population.

PURPOSE: The aim of this study was to investigate whether genetic variations in cytokine genes involved in the pathogenesis of peri-implantitis, could be associated with its occurrence, an issue that remains controversial and may vary according to the population evaluated. MATERIAL AND METHODS: A cross-sectional analytical study was carried out on 102 Portuguese Caucasian individuals divided into two groups: 43 individuals with peri-implantitis and 59 individuals with peri-implant health. Samples from the buccal mucosa were obtained and genetic analysis was performed using the real-time polymerase chain reaction (PCR) technique for IL-1A and IL-1B and using PCR and restriction fragment length polymorphism analysis for IL-1RN. RESULTS: The IL-1A -889 C/T polymorphism showed a higher prevalence of the less common allele (T allele) in cases of peri-implantitis than in healthy cases (27.9% vs 16.9%, respectively), but without statistical significance (p = 0.060). For the IL-1B +3954 C/T and IL-1RN (variable number of tandem repeats) polymorphisms, the analysis revealed that the allele and genotype frequencies did not differ significantly between groups. There was a significant association between a history of periodontitis and peri-implantitis (p = 0.020). CONCLUSIONS: The genetic polymorphisms evaluated had no influence on the occurrence of periimplantitis in the population studied. Further research into genetic variations in different populations is needed to elucidate the role of genetic factors in the onset and progression of periimplant disease.

A new approach for vertical bone augmentation: Reconstructing bony peaks before GBR with a customized titanium mesh.

This image article presents a single patient receiving a reconstructed fibular bony peak (BP) for guided bone regeneration (GBR) with a customized titanium mesh. The patient was informed and understood the objectives and signed a written informed consent document before surgery.

Effect of bioceramic powder abrasion on different implant surfaces.

PURPOSE: Bioceramic coatings have been shown to promote bone repair, which aids in the early integration of implants. This study aimed to evaluate the influence of air abrasion with a bioceramic abrasive on the surface characteristics of different implant materials and surfaces. The dissolution of the applied treatment from the surfaces over 3 weeks was also assessed. MATERIALS AND METHODS: Discs of three alloys used for dental implants were studied and compared: two types of commercially pure titanium (CpTi)/ (CpTi SLActive) and titanium-zirconia (TiZr). The tested surfaces were: CpTi control (CpC), sandblasted (SB), sandblasted and acid-etched (SBE), and CpTi SLActive®, (TiZr) Roxolid®. Three discs from each group underwent air abrasion with apatite bioceramic powders, 95% hydroxyapatite (HA)/5% calcium oxide (CaO), and 90% hydroxyapatite (HA)/10% calcium oxide (CaO). The treated discs were surface characterized by optical profilometry to obtain surface roughness, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS) to compare element weight percentages of titanium, calcium, and phosphate. Dissolution was assessed using inductively coupled plasma optic emission spectrometry (ICP-OES). RESULTS: Bioceramic powders were deposited on all tested surfaces leading to changes in surface characteristics. The only statistically significant differences between the material groups for surface roughness were found with 95% HA/5% CaO powder in the Sp and Rp parameters (p = 0.03 and 0.04, respectively). There were no significant differences in the Ca and P wt% between all groups and powders 95% HA/5% CaO and 90% HA/10% CaO (p = 0.14, 0.18, and p = 0.15, 0.12, respectively). A non-uniform dispersion of the treatment on the surface layer was visible on all treated surfaces. The bioceramic powder continued to dissolute from the tested surfaces for 3 weeks. CONCLUSION: Bioceramic abrasion modifies implant surface characteristics, although the change in surface characteristics resulting from such treatment was not influenced by the implant material or surface treatment. Air abrasion with hydroxyapatite and calcium oxide bioceramics leaves powder deposits on the treated implant surfaces that could potentially influence the healing of implants affected by peri-implantitis.

Immediate loading on two adjacent single dental implants with definitive nonsplinted restorations: A proof of concept in the posterior zone.

OBJECTIVES: To evaluate clinical, clinician- and patient-reported outcomes (PROs) of two adjacent single posterior implants immediately loaded with definitive single crowns up to 1 year. Ten patients in need of two adjacent posterior single implants were included. All implants were placed applying a fully digital workflow. Definitive screw-retained single zirconia crowns were delivered within 72 h after implant placement. Clinical parameters, patient- and clinician-reported outcomes were assessed up to 1 year of follow-up. CLINICAL CONSIDERATIONS: Clinical outcomes remained stable, with no implant failures or technical and biological complications throughout the observation period. Patient satisfaction was very high at baseline (crown delivery) and remained consistently high at 6 and 12 months of follow-up. Crown insertion 3 days after implant placement was rated as an easy procedure by clinicians. CONCLUSIONS: Two adjacent single implants with immediate definitive restorations (<72 h) in the posterior region appear to be a viable and easy treatment option to shorten the overall treatment time and potentially enhancing patient satisfaction. However, randomized controlled trials are needed to confirm the advantages of this treatment protocol over a delayed loading approach. CLINICAL SIGNIFICANCE: In selected cases, immediate implant loading with definitive restorations in the posterior region appears a valuable and straightforward option to shorten the overall treatment time.

Digital planning and bone regenerative technologies: A narrative review.

OBJECTIVES: The aim of this narrative review was to explore the application of digital technologies (DT) for the simplification and improvement of bone augmentation procedures in advanced implant dentistry. MATERIAL AND METHODS: A search on electronic databases was performed to identify systematic reviews, meta-analyses, randomized and non-randomized controlled trials, prospective/retrospective case series, and case reports related to the application of DT in advanced implant dentistry. RESULTS: Seventy-nine articles were included. Potential fields of application of DT are the following: 1) the use of intra-oral scanners for the definition of soft tissue profile and the residual dentition; 2) the use of dental lab CAD (computer-aided design) software to create a digital wax-up replicating the ideal ridge and tooth morphology; 3) the matching of STL (Standard Triangulation Language) files with DICOM (DIgital COmmunication in Medicine) files from CBCTs with a dedicated software; 4) the production of stereolithographic 3D models reproducing the jaws and the bone defects; 5) the creation of surgical templates to guide implant placement and augmentation procedures; 6) the production of customized meshes for bone regeneration; and 7) the use of static or dynamic computer-aided implant placement. CONCLUSIONS: Results from this narrative review seem to demonstrate that the use of a partially or fully digital workflow can be successfully used also in advanced implant dentistry. However, the number of studies (in particular RCTs) focused on the use of a fully digital workflow in advanced implant dentistry is still limited and more studies are needed to properly evaluate the potentials of DT.

Sustained Release of Salicylic Acid for Halting Peri-Implantitis Progression in Healthy and Hyperglycemic Systemic Conditions: A Gottingen Minipig Model.

To develop a peri-implantitis model in a Gottingen minipig and evaluate the effect of local application of salicylic acid poly(anhydride-ester) (SAPAE) on peri-implantitis progression in healthy, metabolic syndrome (MS), and type-2 diabetes mellitus (T2DM) subjects. Eighteen animals were allocated to three groups: (i) control, (ii) MS (diet for obesity induction), and (iii) T2DM (diet plus streptozotocin for T2DM induction). Maxillary and mandible premolars and first molar were extracted. After 3 months of healing, four implants per side were placed in both jaws of each animal. After 2 months, peri-implantitis was induced by plaque formation using silk ligatures. SAPAE polymer was mixed with mineral oil (3.75 mg/µL) and topically applied biweekly for up to 60 days to halt peri-implantitis progression. Periodontal probing was used to assess pocket depth over time, followed by histomorphologic analysis of harvested samples. The adopted protocol resulted in the onset of peri-implantitis, with healthy minipigs taking twice as long to reach the same level of probing depth relative to MS and T2DM subjects (∼3.0 mm), irrespective of jaw. In a qualitative analysis, SAPAE therapy revealed decreased levels of inflammation in the normoglycemic, MS, and T2DM groups. SAPAE application around implants significantly reduced the progression of peri-implantitis after ∼15 days of therapy, with ∼30% lower probing depth for all systemic conditions and similar rates of probing depth increase per week between the control and SAPAE groups. MS and T2DM conditions presented a faster progression of the peri-implant pocket depth. SAPAE treatment reduced peri-implantitis progression in healthy, MS, and T2DM groups.