Search Results (81)

Background: Autologous tooth-derived grafts have recently gained attention as an innovative alternative to conventional biomaterials for alveolar ridge preservation (ARP) and augmentation (ARA). Their structural similarity to bone and osteoinductive potential support clinical use. Methods: This systematic review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420251108128). A comprehensive search was performed in PubMed, Scopus, and Web of Science (2010–2025). Randomized controlled trials (RCTs), split-mouth, and prospective clinical studies evaluating autologous dentin-derived grafts were included. Two reviewers independently extracted data and assessed risk of bias using Cochrane RoB 2.0 (for RCTs) and ROBINS-I (for non-randomized studies). Results: Nine studies involving 321 patients were included. Autologous dentin grafts effectively preserved ridge dimensions, with horizontal and vertical bone loss significantly reduced compared to controls. Histomorphometric analyses reported 42–56% new bone formation within 4–6 months, with minimal residual graft particles and favorable vascularization. Implant survival ranged from 96–100%, with stable marginal bone levels and no major complications. Conclusions: Autologous tooth-derived biomaterials represent a safe, biologically active, and cost-effective option for alveolar bone regeneration, showing comparable or superior results to xenografts and autologous bone. Further standardized, long-term RCTs are warranted to confirm their role in clinical practice. Full article

Successful health management in older adults requires adequate nutrition, which is often compromised by oral health issues like edentulism. Tooth loss can reduce masticatory function, especially when rehabilitation treatments fail. The present study aims to generate initial information on the potential effects of the placement of mandibular mini-implants in patients with complete maxillary and mandibular dentures on mandibular kinetics, electromyographic activity, and quality of life. Participants with complete dentures, adequate mandibular bone height, and good general health were recruited. All underwent cone beam computed tomography for diagnosis and planning to place two mandibular mini-implants. Mandibular movements were analyzed using electromagnetic articulography and electromyography before treatment and five months after implant placement. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-7sp at baseline and six months post-treatment. Five subjects were included (mean age 69.7 ± 10.8 years). All mini-implants demonstrated a 100% initial success rate. At five months, significant improvements were observed in the vertical range of maximum opening, as well as in the area, trajectory, and range of frontal and sagittal movement envelopes (p < 0.05)—along with increased movement symmetry. OHRQoL also improved, with greater esthetic satisfaction, communication, and social engagement. Mandibular mini-implants improved mandibular movements and prosthetic stability, enhancing patients’ oral health-related quality of life without altering muscle activity. Full article

Objectives: This study aimed to evaluate the available evidence on the use of orthodontic mini-implants (MIs) as temporary anchorage devices (TADs), with particular focus on how insertion angulation may influence clinical outcomes. A clinical case report was also included to complement the review findings. Methods: A systematic review was performed following PRISMA guidelines and a focused PICO question. Searches in PubMed, Web of Science, and Scopus, supplemented by manual screening of reference lists. Duplicates, systematic reviews, and studies outside the PICO scope were excluded. An observational analysis of CBCT and intraoral images, and a clinical case report, were evaluated with a standardized protocol for angulation classification based on anatomical landmarks and angular measurements. Results: Ten studies met the eligibility criteria. Most reported high survival rates, with stability defined by the absence of TAD mobility or loss. CBCT-derived data from two studies, together with one clinical case, demonstrated maintenance of alveolar bone. Improved outcomes were occasionally associated with changes in insertion angulation. Vertical positioning was more frequently linked to complications in shorter TADs, while horizontal placement preserved bone but introduced hygiene-related difficulties. Conclusions: TAD success and bone preservation may depend on insertion angulation, TAD size, and soft tissue conditions. Further standardized prospective studies are needed to validate these findings, particularly regarding intermediate diagonal insertion angles (between vertical and horizontal) extending from palatal to buccal, as observed in our clinical case, which is not yet reported in the literature. Full article

Introduction: Diabetes mellitus negatively influences oral health, significantly contributing to the worsening of odonto-periodontal pathology. Accurate diagnosis and monitoring of lesions are essential to prevent complications. CBCT (cone beam computed tomography) provides a detailed image of bone structures, being a valuable tool in this context. Materials and methods: Thisprospective observational comparative study included 120 patients with chronic periodontitis, divided into two equal groups: 60 with type 2 diabetes mellitus and 60 without systemic diseases. All were examined clinically and radiologically using high-resolution CBCT. Results: Diabetic patients presented a significantly higher mean bone loss (4.7 mm) compared to the non-diabetic patients (3.0 mm). Periodontal pockets >5 mm were more frequent in the diabetic group (75% vs. 50%). CBCT revealed vertical defects and extensive periapical lesions especially in patients with diabetes. Three-dimensional imaging allowed for detailed assessment and clear differentiation between the severity of cases. Conclusions: CBCT is essential in the early identification and evaluation of periodontal disease in diabetic patients. The use of this method significantly contributes to the correlation of clinical and imaging data, optimizing the diagnosis and treatment plan. Full article

Background and Clinical Significance: The retreatment of failed dental implants remains a challenging clinical scenario, particularly when complicated by peri-implantitis and as sociated bone loss. Successful management requires a comprehensive and predictable approach that addresses both hard and soft tissue deficiencies. Case Presentation: This case report illustrates a fully digital, prosthetically driven workflow for the rehabilitation of a posterior mandibular site following implant failure. A 44-year-old female patient underwent removal of a failing implant and adjacent tooth due to advanced peri-implantitis and periodontitis. After healing, a digital workflow—including intraoral scanning, cone-beam computed tomography (CBCT), and virtual planning—was employed to design and fabricate a customized CAD/CAM titanium mesh for vertical guided bone regeneration. The grafting procedure utilized a composite mixture of autogenous bone and anorganic bovine bone (A-Oss). After nine months of healing, two implants with a hydrophilic surface (SOI) were placed using a fully guided surgical protocol (OneGuide system). Subsequent soft tissue grafting and final prosthetic rehabilitation with monolithic zirconia restorations resulted in stable functional and aesthetic outcomes. Conclusions: This case highlights how the integration of modern digital technologies with advanced regenerative procedures and innovative implant surfaces can enhance the predictability and long-term success of implant retreatment in compromised posterior sites. Full article

Using ultra-short dental implants is a promising alternative to extensive bone grafting procedures for patients with atrophic posterior mandibles and vertical bone loss. However, the amount of insertion torque (IT) applied during implant placement significantly influences stress distribution in the peri-implant bone, which affects implant stability and long-term success. Materials and Methods: This study used finite element analysis (FEA) to examine how different insertion torques (35 N·cm and 75 N·cm) affect stress distribution in cortical and trabecular bone types D2 and D4 surrounding ultra-short implants. Von Mises equivalent stress values were compared with ultimate bone strength thresholds to evaluate the potential for microdamage during insertion. Results: The findings demonstrate that increasing IT from 35 N·cm to 75 N·cm led to a significant increase in peri-implant bone stress. Specifically, cortical bone stress in D4 bone increased from approximately 79 MPa to 142 MPa with higher IT, exceeding physiological limits and elevating the risk of microfractures and bone necrosis. In contrast, lower IT values kept stress within safe limits, ensuring optimal primary stability without damaging the bone. These results underscore the need to strike a balance between achieving sufficient implant stability and avoiding mechanical trauma to the surrounding bone. Conclusions: Accurate control of insertion torque during the placement of ultra-short dental implants is crucial to minimize bone damage and promote optimal osseointegration. Excessive torque, especially in low-density bone, can compromise implant success by inducing excessive stress, thereby increasing the risk of early failure. Full article

Background: The interdental papilla plays a critical role in maintaining both the esthetic and functional integrity of the periodontium. Although the relationship between the papilla presence and the contact point–bone crest distance is well established, the impact of vertical bone defect morphology—common in periodontitis—remains largely unexplored. Aim: To assess the relationship between the loss of interdental papilla height and three site-specific factors—vertical bone defect morphology, probing depth, and papilla base width—in patients with periodontitis. Materials and Methods: Ten periodontitis patients contributing 28 interdental papillae adjacent to vertical bone defects were included. The recorded parameters included probing depth, papilla base width, and loss of papilla height. Intraoperative measurements of defect depth, mesiodistal width, and buccolingual width were also obtained. Patient-level variables, such as age, sex, oral hygiene, and gingival phenotype, were not controlled or included in the analysis, due to the small number of participants and the study’s focus on defect-level characteristics. Spearman’s rank correlation was used due to non-normal data distribution. Results: A moderate positive association was observed between the probing depth and loss of papilla height (ρ = 0.353), approaching but not reaching statistical significance (p = 0.066). Weak, non-significant associations were found with the remaining parameters (p > 0.05). Conclusions: Although no statistically significant associations were found, observed trends may indicate site-specific influences on the loss of papilla height. These preliminary findings highlight the need for further research with larger, well-characterized cohorts to better understand the factors affecting papilla stability in periodontitis. Full article

Background: AI has been adopted in dentistry for diagnosis, decision making, and therapy prognosis prediction. This systematic review aimed to identify AI models in dentistry, assess their performance, identify their shortcomings, and discuss their potential for adoption and integration in dental practice in the future. Methodology: The sources of the papers were the following electronic databases: PubMed, Scopus, and Cochrane Library. A total of 20 out of 947 needed further studies, and this was encompassed in the present meta-analysis. It identified diagnostic accuracy, predictive performance, and potential biases. Results: AI models demonstrated an overall diagnostic accuracy of 82%, primarily leveraging artificial neural networks (ANNs) and convolutional neural networks (CNNs). These models have significantly improved the diagnostic precision for dental caries compared with traditional methods. Moreover, they have shown potential in detecting and managing conditions such as bone loss, malignant lesions, vertical root fractures, apical lesions, salivary gland disorders, and maxillofacial cysts, as well as in performing orthodontic assessments. However, the integration of AI systems into dentistry poses challenges, including potential data biases, cost implications, technical requirements, and ethical concerns such as patient data security and informed consent. AI models may also underperform when faced with limited or skewed datasets, thus underscoring the importance of robust training and validation procedures. Conclusions: AI has the potential to revolutionize dentistry by significantly improving diagnostic accuracy and treatment planning. However, before integrating this tool into clinical practice, a critical assessment of its advantages, disadvantages, and utility or ethical issues must be established. Future studies should aim to eradicate existing barriers and enhance the model’s ease of understanding and challenges regarding expense and data protection, to ensure the effective utilization of AI in dental healthcare. Full article

Background and Objectives: The goal of this study was to introduce a novel device, the iMPACT implant planer, designed to machine (create a complete smooth surface) contaminated implant surfaces intraorally, promoting peri-implant tissue healing and possible re-osseointegration, and the new Quadrant protocol, evaluating them in vitro and clinically. The null hypothesis was that there would be no improvement in the clinical parameters for the implants with peri-implantitis (PI) treated with the new protocol and tool. Materials and Methods: The Quadrant protocol was used in conjunction with the iMPACT tool, which primarily functions to remove biofilm and microbial contaminants from the exposed implant surface, while simultaneously preparing the surface through standardized implantoplasty, thereby enhancing the potential for re-osseointegration. An in vitro analysis was developed, and three medium/long-term cases were presented, detailing the procedures and outcomes. Results: The in vitro assessment showed smooth surfaces after treatment. Different areas presented minimal particles (<1 μm) on the implant surface, with a high content of titanium (Ti) and tungsten (W). In case 1, severe and advanced peri-implantitis around implants #46 and #47 was found. A combination of resective (Quadrant + iMPACT) and regenerative surgery was used for treatment, along with a buccal single flap (BSF). Significant clinical and radiographic improvements were observed at 14 and 43 months postoperatively, including vertical bone gain with re-osseointegration and stable probing depths (PDs). In the second case, a severe PI and prosthesis instability were observed. Resective (Quadrant + iMPACT) and regenerative procedures were applied. At 3 and 12 months postoperatively, clinical and radiographic evaluations demonstrated significant improvements with re-osseointegration, including PDs reduced to 0–1 mm and a vertical bone gain of approximately 6.5 mm. In case 3, mandibular implants from 42 to 47 exhibited inflammation, suppuration, and moderate-to-severe bone loss. Just resective surgery (Quadrant + iMPACT), without grafting, was performed. At 6- and 12-month follow-ups, clinical and radiographic assessments showed the resolution of inflammation, stable bone levels, and healthy peri-implant gingiva. Conclusions: Favorable outcomes were achieved using the iMPACT and Quadrant protocols in the three clinical cases, resulting in re-osseointegration when combined with regenerative procedures. The favorable medium/long-term outcomes achieved, despite the patient’s complex medical history and, at times, inconsistent oral hygiene, underscore the potential efficacy of such interventions. Full article

Background: Bone resorption following tooth loss poses significant challenges for dental implant success. Guided bone regeneration (GBR) techniques, particularly in vertically deficient ridges, often require complex procedures and soft tissue management. This case report introduces a modified occlusive barrier with a window, combined with tricalcium phosphate, to address these challenges. Methods: A 26-year-old female with significant bone loss in the mandibular anterior region underwent GBR using a digitally designed titanium occlusive barrier. The barrier was fabricated using CAD/CAM technology and secured with screws. A blood clot mixed with tricalcium phosphate was used to promote bone regeneration. Postoperative care included regular irrigation, de-epithelialization, and follow-up over six months. Implant placement and histological analysis were performed to evaluate outcomes. Case Presentation: The patient achieved 8.8 mm of vertical and 7.6 mm of horizontal bone regeneration. Histological analysis confirmed the presence of mature, mineralized bone, and keratinized gingiva. The implant was successfully placed, and a fixed prosthesis was restored after four months, with stable results at a three-year follow-up. Conclusion: This technique demonstrates effective bone and soft tissue regeneration in a single procedure, eliminating the need for autologous bone grafts and secondary surgeries. The use of a digitally designed occlusive barrier offers precision, reduces morbidity, and simplifies the surgical process, suggesting a promising advancement in GBR. Further studies are needed to validate these findings. Full article

Introduction: Although significant advancements have been made in surgical techniques for reconstructing severely resorbed alveolar bone, achieving predictable regeneration remains a considerable challenge. Many conventional ridge augmentation methods require extended edentulous healing periods and multiple surgical interventions. This clinical study introduces a simplified approach to advanced ridge augmentation using a wide-head tent-pole screw (WHTPS), aimed at enhancing procedural efficiency and achieving predictable clinical outcomes. Material and Methods: Thirteen patients with severely vertically resorbed mandibular segments or completely edentulous alveolar ridges—each presenting with a minimum vertical bone defect of 5 mm—were included in this study. A single WHTPS was placed at the most severe bone defect site, followed by bone grafting and coverage with a resorbable membrane. Postoperative panoramic radiographs were taken immediately after surgery and again on the day of WHTPS removal, following a healing period of 3 to 6 months. An additional follow-up radiograph was obtained after final prosthesis placement, with an average follow-up period of 5.5 months, to assess changes in the augmented bone. Patients were monitored clinically for a period ranging from 8 to 20 months (mean: 14.9 months). Results: The average vertical bone gain immediately after surgery was 8.86 mm (SD ± 2.59 mm), while an average bone resorption of 1.49 mm (17.79%) was observed during the follow-up period. Conclusions: A single WHTPS effectively stabilized the graft material in cases of severe alveolar bone loss, thereby preventing its resorption and displacement. Further clinical studies are necessary to validate its long-term effectiveness. Full article

Background: Alveolar ridge preservation (ARP) is widely used in clinical practice to prevent horizontal and vertical bone loss following tooth extraction. Conventional ARP uses a single coverage material with bone graft materials on a simple tooth extraction site. The objective of this study was to evaluate the clinical efficacy of a new double-layer ARP technique that additionally covers a collagen matrix at the top position, especially on the periodontally collapsed region following tooth extraction. Methods: In a clinical study process comparing our newly attempted ARP with the widely used conventional ARP, we discovered the clinical efficacy of our new ARP for specially selected cases. Because the extraction socket wall had collapsed and the entire ridge needed to be reconstructed, this procedure should be described as alveolar ridge augmentation. Results: Additional coverage of the collagen matrix protected the internal bone grafting and promoted external soft tissue regeneration and healing in sample cases. Conclusions: In conclusion, our procedure promotes the new generation of hard and soft tissues. It is particularly effective in regions requiring flapped surgery, such as areas with periodontal disease, long-span areas requiring multiple tooth extractions, and areas in which there is wide destruction of hard and soft tissues. Through this proof-of-concept case study, we aimed to standardize and evaluate this unprecedented surgical technique. Full article

Background and Objectives: Periodontal regeneration involves techniques intended at restoring the lost supporting tissue around a periodontally weakened tooth. These regenerative methods frequently utilize periosteal grafts to stimulate the evolvement of vital adjacent tissues. This paper intended to evaluate the use of autogenous periosteal grafts in treating grade II furcation defects (Glickman Classification 1953) in patients with chronic periodontitis. Materials and Methods: The databases MEDLINE (via PubMed), Cochrane, EBSCO, and Google Scholar were searched for papers published in English from January 1991 till December 2022. Three individuals examined the reclaimed articles according to the inclusion norms. Randomized controlled trials (RCTs) assessing the efficacy of autogenous periosteal grafts for treating Grade II furcation defects in chronic periodontitis patients were involved. Only four related studies were identified for data extraction, involving 80 patients aged 18 to 52 years. Outcome variables measured included horizontal bone loss (HD), vertical bone loss (VD), pocket depth (PD), clinical attachment level (CAL), bone height (BH), gingival recession (GR), plaque index (PI), and gingival index (GI). Data were examined using RevMan 5.4.1 software. Mean differences and 95% confidence intervals were employed to estimate effect sizes. Results: Both groups showed similar results for reductions in PI, GI, and BOP. However, The periosteal graft also yielded better outcomes for CAL gain, BH, and GR. The meta-analysis showed a significant overall effect of Periosteal Barrier Membrane (PBM) on horizontal and vertical bony change levels, but subgroup differences between unilateral and bilateral applications were not statistically significant due to high heterogeneity. Although the bilateral subgroup demonstrated significant benefits of PBM treatment, the overall findings across the clinical attachment level group remain inconclusive. Conclusion: Current evidence suggests that while PBM may benefit bilateral mandibular sites, and autogenous periosteal grafts offer no added advantage over OFD alone in Grade II furcation defects, the overall findings remain inconclusive. Full article

This review evaluates the application of artificial intelligence (AI), particularly neural networks, in diagnosing and staging periodontal diseases through radiographic analysis. Using a systematic review of 22 studies published between 2017 and 2024, it examines various AI models, including convolutional neural networks (CNNs), hybrid networks, generative adversarial networks (GANs), and transformer networks. The studies analyzed diverse datasets from panoramic, periapical, and hybrid imaging techniques, assessing diagnostic accuracy, sensitivity, specificity, and interpretability. CNN models like Deetal-Perio and YOLOv5 achieved high accuracy in detecting alveolar bone loss (ABL), with F1 scores up to 0.894. Hybrid networks demonstrate strength in handling complex cases, such as molars and vertical bone loss. Despite these advancements, challenges persist, including reduced performance in severe cases, limited datasets for vertical bone loss, and the need for 3D imaging integration. AI-driven tools offer transformative potential in periodontology by rivaling clinician performance, improving diagnostic consistency, and streamlining workflows. Addressing current limitations with large, diverse datasets and advanced imaging techniques will further optimize their clinical utility. AI stands poised to revolutionize periodontal care, enabling early diagnosis, personalized treatment planning, and better patient outcomes. Full article

Background: The extraction of impacted third molars presents anatomical challenges and surgical risks, prompting debate over prophylactic removal, particularly for impacted lower molars. Studies highlight associated pathologies and complications that influence treatment decisions. Objective: This study aims to systematically review and analyze the correlation between the angular positions of impacted lower third molars and their association with pathological changes, including periodontal defects, alveolar bone loss, and cystic degeneration. Methods: This systematic review was conducted according to PRISMA guidelines, including studies from 2000 to 2024. Studies reporting the angular position and associated pathologies of impacted lower third molars were included. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias. A meta-analysis of the proportion of pathological changes related to specific angular positions was performed. Results: Of the 2943 studies initially identified, six studies (including 2222 patients and 3276 impacted lower third molars) met the inclusion criteria and were included in the review, while four studies were included in the proportional meta-analysis. The most common angular positions observed were mesioangular (34.0–66.1%), followed by vertical (12.8–48.3%), horizontal (8.1–23.4%), and distoangular (3.2–14.0%). Pathological changes were reported in 8.1–75.0% of cases, with horizontal impactions demonstrating the highest correlation (41.1%, 95% CI: 20.9–63.0). Conclusions: The angular position of impactions of the lower third molars significantly influences the risk of pathological changes. Horizontal impactions exhibit the highest associated with pathological changes, whereas distoangular impactions show the lowest prevalence of complications. Standardized diagnostic and reporting practices are needed to improve clinical decision-making. Further research should focus on long-term outcomes and the impact of clinical management strategies. Full article