Search Results (1,349)

Little is known about the effects of orthodontic loading on dental implants used for orthodontic anchorage in patients with Stage IV periodontitis. This retrospective case–control study included 58 dental implants in 24 patients with treated Stage IV periodontitis. The dental implants were used for both chewing function and orthodontic anchorages. The outcome measures included peri-implant marginal bone loss and peri-implantitis. Pair t-test and Wilcoxon rank-sum test were used to analyze the impact of implants as orthodontic anchorage on marginal bone loss (MBL) and peri-implantitis. No implants were lost during the 17-year follow-up. There was no statistically significant difference in the MBL and incidence of peri-implantitis between implants used as orthodontic anchorage and non-anchorage controls. (p > 0.05). Poor oral hygiene (p = 0.05), one-piece implants (p = 0.05) and implants with a keratinized mucosa < 2 mm (p = 0.015) were associated with a higher risk of peri-implantitis. Results from the present long-term study indicated that dental implants could be successfully used as orthodontic anchorage in periodontal compromised patients. Full article

Background and Objectives: Transcatheter aortic valve implantation (TAVI) has become the mainstay of treatment for symptomatic aortic stenosis (AS) in patients over 70 years of age. It is also indicated for younger patients with significant comorbidities, for valve-in-valve interventions, and in selected patients with severe aortic insufficiency. We aimed to evaluate procedural and clinical outcomes of transfemoral TAVI performed over the course of 12 years by the same operators using different bioprosthetic valves. Materials and Methods: Between 2012 and 2023, 375 patients underwent TAVI in our clinic, with six types of bioprosthetic valves (Edwards Sapien XT, Medtronic Valves [CoreValve and Evolut R], Portico, Myval, Acurate Neo, and Direct Flow Medical). A transfemoral approach was used in all patients. The procedural and clinical outcomes were defined according to Valve Academic Research Consortium-3 (VARC-3) criteria. Results: The mean age of the patients was 78.4 ± 7.3, and their median STS score was 4.2 (2.9–5.9). Of the 375 patients, 361 had severe AS, 4 had severe aortic insufficiency, 5 were valve-in-valve, and 5 were valve-in-TAVI. Seven patients required a second valve implantation: four due to embolization of the prosthetic valve and three due to deep implantation of the prosthetic valve. Based on the VARC-3 criteria, the rates of technical success and device success were 90.4% and 85.3%, respectively. Major vascular complications were observed in 18 (4.8%) patients. Also, 42 (11.2%) patients required permanent pacemaker implantation. The incidence of moderate or worse paravalvular leak was 2.9%. The peri-procedural, 30-day, 1-year, and 5-year mortality rates were 5.1%, 4.3%, 15.2%, and 45.6%, respectively. STS scores (HR:1.129, 95%CI: 1.068–1.192, p < 0.001) and post-TAVI acute kidney injury (HR:3.993, 95%CI:1.629–9.785, p = 0.002) were detected as independent predictors of mortality in Cox regression analysis. Conclusions: This registry demonstrated the evolution of TAVI procedures at a single center over 12 years. A high level of collaboration between experienced operators and innovations in devices seem to be the key features for achieving high procedural success and low complication rates. Full article

Background: S3-level clinical practice guidelines represent the highest standard of evidence-based healthcare, integrating systematic reviews, formal evidence grading, and structured expert consensus. In periodontology, current S3-level guidelines provide robust recommendations for the management of stage I–III periodontitis. However, increasing clinical complexity, emerging diagnostic technologies, and the need for patient-centred and implementation-oriented care highlight important gaps that warrant further methodological refinement. Objective: This review aims to critically appraise the conceptual foundations, strengths, and limitations of existing S3-level periodontal guidelines and to propose a structured roadmap for the development of next-generation S3 guidance. Methods: A narrative and methodological review was conducted focusing on key European S3-level guidelines in periodontology and endodontics, with emphasis on guideline methodology, evidence grading, outcome prioritization, and consensus processes. Results: Current S3-level periodontal guidelines demonstrate strong methodological rigor but show limited coverage of stage IV periodontitis, peri-implant diseases, and endo–perio lesions. In addition, emerging domains such as biomarker-based diagnostics, artificial intelligence-assisted decision support, and implementation science are not yet systematically integrated. Conclusions: Future S3-level periodontal guidelines should incorporate clinical complexity, patient-reported outcomes, precision diagnostics, digital technologies, and real-world implementation strategies to enhance personalization, transparency, and clinical impact. Full article

Background: The global increase in orthopedic implant use—both for trauma fixation and arthroplasty—has profoundly transformed musculoskeletal surgery. As a consequence, fractures occurring in the presence of implants have become more frequent and clinically relevant. Yet, these injuries are currently described using highly heterogeneous terminology, including periprosthetic (fracture occurring in the presence of a prosthetic joint replacement) peri-implant (fracture occurring around an osteosynthesis or fixation device), implant-related, and hardware-related fractures (umbrella terms encompassing both prosthetic and fixation devices, used descriptively rather than classificatorily). This coexistence of multiple, context-specific terminologies hinders clinical communication, complicates registry documentation, and limits research comparability across orthopedic subspecialties. Because fractures occurring in the presence of orthopedic implants significantly alter load transfer, muscle force distribution, and musculoskeletal biomechanics, a clear and unified terminology is also relevant for muscle-focused research addressing implant–tissue interaction and functional recovery. Objective: This systematic review aimed to critically analyze the terminology used to describe fractures influenced by orthopedic implants, quantify the heterogeneity of current usage across anatomical regions and publication periods, and explore the rationale for adopting a unified umbrella term—“artificial fracture.” Methods: A systematic search was performed in PubMed, Scopus, and Web of Science from January 2000 to December 2024, following PRISMA guidelines. Eligible studies included clinical investigations, reviews, registry analyses, and consensus statements explicitly employing or discussing terminology related to implant-associated fractures. Data were extracted on publication characteristics, anatomical site, terminology employed, and classification systems used. Quantitative bibliometric and qualitative thematic analyses were conducted to assess frequency patterns and conceptual trends. Results: Of 1142 records identified, 184 studies met the inclusion criteria. The most frequent descriptor in the literature was periprosthetic fracture (68%), reflecting its predominance in arthroplasty-focused studies, whereas broader and more practical terms such as implant-related and peri-implant fracture were more commonly used in musculoskeletal and fixation-related research. Terminological preferences varied according to anatomical site and implant type, and no universally accepted, cross-anatomical terminology was identified despite multiple consensus efforts. Discussion and Conclusions: The findings highlight persistent heterogeneity in terminology describing fractures influenced by orthopedic implants. A transversal, descriptive framework may facilitate communication across subspecialties and support registry-level harmonization. Beyond orthopedic traumatology, this approach may also benefit muscle and musculoskeletal research by enabling more consistent interpretation of data related to muscle–bone–implant interactions, rehabilitation strategies, and biomechanical adaptation. Full article

Background/Objectives: Dental implant placement protocols including immediate (IIP) and delayed implant placement (DIP) are likely to affect bone tissue repair and regeneration after the surgery. Despite many benefits of IIP, it has remained unclear whether IIP demonstrates comparable healing processes and outcomes to those observed in DIP. This review aims to summarize and compare biological and clinical outcomes of IIP and DIP, focusing on success and survival rates, periodontal status, esthetics and radiographic outcomes, and biochemical markers. Methods: A literature search of electronic databases was conducted using PubMed/MEDLINE, Embase, and the Scopus databases (January 1983–February 2025). 109 articles published in English, consisting of in vitro, in vivo, and clinical studies met the inclusion criteria. Results: This review shows that both IIP and DIP show similar implant survival rates, but IIP may lead to a higher risk of mid-facial recession in esthetic areas. DIP, on the other hand, can result in better soft tissue and bone healing. Histological and radiographic evidence shows comparable bone to implant contact (BIC) between the two methods, although peri-implant bone loss tends to be higher with IIP. Lastly, although specific molecular markers are well-established in all phases of osseointegration following DIP, there is no available literature comparing differences in biomarkers during healing periods between IIP and DIP. Conclusions: This review highlights the similarities and differences in the outcomes of IIP and DIP, as well as the knowledge gaps that require further investigation, providing valuable insights for predicting treatment outcomes and managing complications associated with dental implant placement. Full article

Atlantoaxial instability (AAI) in toy- and small-breed dogs remains a significant clinical challenge, as the restricted anatomical space and risk of complications complicate the selection of implants. This study aimed to compare three patient-specific Ti-6Al-4V stabilizers for the C1–C2 region: a clinically used ventral C1–C3 plate, a shortened ventral C1–C2 plate, and a dorsal C1–C2 implant. Computed tomography, segmentation, virtual reduction, CAD/CAM design, and finite element analysis were employed to evaluate the linear-static mechanical behavior of each construct under loading ranging from 5 to 25 N, with a focus on displacements, von Mises stresses, and peri-screw bone strains. Additionally, cadaver procedures were performed in nine small-breed dogs using custom drill guides and additively manufactured implants to evaluate procedural feasibility and implantation time. Finite element models demonstrated that all stabilizers operated within material and biological safety limits. The C1–C3 plate exhibited the highest implant stresses, while the C1–C2 plate demonstrated an intermediate response, and the dorsal implant minimized implant stresses, albeit by increasing bone stresses. Cadaver experiments revealed that dorsal fixation required less implantation time than ventral fixation. Collectively, the findings indicate that all evaluated constructs represent safe stabilization options, and the choice of implant should reflect the preferred load-transfer pathway as well as anatomical or surgical constraints that may limit ventral access. Full article

Background: Peri-implantitis, a condition characterized by inflammation and progressive bone loss around dental implants, presents a significant challenge in contemporary dentistry. Conventional non-surgical treatments often fail to fully eliminate bacterial biofilms, particularly on complex implant surfaces. Laser therapies have emerged as potential adjuncts due to their antimicrobial and bio-modulatory properties. However, their microbiological effectiveness and suitability for individualized patient treatment planning remain unclear. Objective: Τhis study aims to systematically assess and synthesize the microbiological effects of various laser-assisted non-surgical treatments for peri-implantitis compared to conventional mechanical debridement. Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420251035354). Randomized controlled trials (RCTs) evaluating microbiological changes following laser-assisted non-surgical treatment of peri-implantitis, with a minimum follow-up of one month, were identified through searches in multiple databases and registries up to February 2025. The ncluded studies used lasers such as diode, Er: YAG, and photodynamic therapy (PDT) either alone or as adjuncts to mechanical debridement. Outcomes of interest included bacterial counts. Risk of bias was assessed using the RoB2 tool, and certainty of evidence was evaluated via GRADE. Quantitative synthesis used random-effects meta-analysis, with standardized mean differences (SMDs) calculated. Results: Eight RCTs involving 266 patients and 335 implants were included in the systematic review. Quantitative synthesis of three pathogens (counts of Fusobacterium nucleatum, P. gingivalis, T. denticola) across three studies displayed no statistically significant differences between laser and control groups at 3 and 6 months (p > 0.05 for all comparisons). When examining individual study findings, PDT, particularly in patients with diabetes or acute abscess, showed short-term reductions in red complex bacteria (e.g., Porphyromonas gingivalis and Treponema denticola). In contrast, diode and Er: YAG lasers demonstrated inconsistent or transient effects. The quality of evidence was rated as very low according to GRADE. Conclusions: Laser-assisted therapies, especially PDT, may provide targeted microbiological benefit in selected patient groups, supporting their adjunctive use within personalized treatment planning rather than as replacements for mechanical debridement, which remains the gold standard. Further high-quality RCTs incorporating well-defined patient risk profiles, such as systemic conditions and behavioral factors, and precision treatment algorithms are needed. Full article

Peri-implant infections pose a significant challenge in dental implantology. This study aimed to develop and characterize a chitosan–vancomycin coating for titanium surfaces, focusing on drug loading, release kinetics, antimicrobial performance, and cytocompatibility. Grade 4 titanium discs were coated with a chitosan film using the dip-coating technique and subsequently loaded with vancomycin through immersion in an aqueous solution. Coating morphology was examined by scanning electron microscopy (SEM). Vancomycin loading was quantified by spectrophotometry, and release kinetics were monitored over 144 h (6-day). Antimicrobial activity was assessed through agar diffusion assays against Staphylococcus aureus. Cytocompatibility was evaluated using human mesenchymal stem cells (hMSCs), whose metabolic activity, adhesion, and morphology were assessed over a 19-day culture period by resazurin assay and SEM. SEM analysis revealed a uniformly distributed, smooth, and crack-free chitosan film, which remained stable after drug loading. The coating exhibited a biphasic release profile, characterized by an initial burst followed by sustained release over six days, which maintained antimicrobial activity, as confirmed by inhibition zones. hMSCs adhered and proliferated on the coated surfaces, displaying normal morphology despite a transient reduction in metabolic activity on vancomycin-containing films. These findings support the potential of chitosan–vancomycin coatings as localized antimicrobial strategies for implant applications, warranting further in vivo and mechanical evaluations. Full article

Background/Objectives: Formation of tight contacts between oral soft tissue and dental implants is a significant challenge in contemporary implantology. An essential role in this process is played by oral epithelial cells. In the present study, we investigated how titanium and zirconia surfaces with different roughness influence various parameters of oral epithelial cells in vitro. Methods: We used the human oral squamous carcinoma Ca9-22 cell line and cultured them on the following surfaces: machined smooth titanium (TiM) and zirconia (ZrM) surfaces, as well as sandblasted and acid-etched titanium moderately rough (SLA) and zirconia (ZLA) surfaces. Cell proliferation/viability was measured by CCK-8 assay, and cell morphology was analyzed by fluorescent microscopy. The gene expression of interleukin (IL)-8, intercellular adhesion molecule (ICAM)-1, E-cadherin, integrin (ITG)-α6, and ITG-β4 was measured by qPCR, and the content of IL-8 in conditioned media by ELISA. Results: At the initial culture phase, cell proliferation was promoted by rougher surfaces. Differences in cell attachment were observed between machined and moderately rough surfaces. Machined surfaces were associated with slightly higher IL-8 levels (p < 0.05). Furthermore, both ZLA and SLA surfaces promoted the expression of (ITG)-α, ITG-β4, and ICAM-1 in Ca9-22 cells (p < 0.05). Surface material had no impact on the investigated parameters. Conclusions: Under the limitations of this in vitro study, some properties of oral epithelial cells, particularly the immunological and barrier function, are moderately modified by roughness but not by material. Hence, the roughness of the implant surface might play a role in the quality of the peri-implant epithelium. Full article

This study aimed to analyze the biomechanics of three abutment systems with distinct retention mechanisms and their impact on the implant–abutment interface (IAI). The finite element analysis method was used to model maxillary three-unit restorations with conventional cement-retained abutment (CRA), multi-unit abutment (MUA), and innovative cementless link-retained abutment (LRA) systems. Dental implants were positioned at 0°/0°, 15°/15°, and 25°/25° angulation combinations. Analyses were performed under 400 N vertical and 200 N oblique loading applied at a 45° angulation. The LRA system exhibited lower stress on the implants and abutments under both loading conditions, whereas the CRA system demonstrated the highest stress. In contrast, the maximum principal stresses within the peri-implant bone were the highest in the LRA system under both loading conditions. Despite greater IAI displacement in the molar region, no specific abutment system exhibited distinct superiority under different scenarios. Overall, an increase in implant angulation led to higher stress values across all parameters. The MUA and LRA systems demonstrated reduced stress concentration and more uniform load distribution compared with the CRA system under tilted implant configurations. The findings suggest that the innovative cementless LRA system may serve as a feasible alternative to conventional CRA and MUA systems, exhibiting superior biomechanical performance, particularly compared with the CRA system. Full article

Objective: The current gold standard for detection of implant-related infections is the intraoperative collection of tissue samples. However, false-negative results frequently occur, particularly in infections caused by biofilm-forming bacteria. As a complementary method, sonication has therefore been established for detecting implant-associated infections, especially in periprosthetic joint infections. In trauma surgery, this technique is still rarely used. The aim of this study is to evaluate the diagnostic significance of sonication after osteosynthesis. Methods: A retrospective single-center analysis was conducted on all patients who underwent plate osteosynthesis removal between 1 January 2019, and 1 May 2021, with both sonication and intraoperative tissue sampling performed. Patients with inlying arthroplasties or nail-less osteosynthesis systems were excluded. Pre- and postoperative infection parameters (leukocytes, CRP) were recorded, and preoperative clinical findings were used to classify suspected infection. Results: A total of 57 patients (30 men, 27 women; mean age 57.6 years, range 12–91) were included. The mean treatment duration was 20.1 days (range 1–152). Sonication was positive in 33 patients, tissue samples in 28, with 31 cases (54%) showing concordant results. In cases with preoperative suspicion of infection, sonication was positive in 21 of 26 cases (80.7%) and tissue samples in 18 of 26 (69.2%), whereas without suspicion, positivity rates were 38% and 31%, respectively. Sonication and tissue results matched in 14 of 26 cases; in the remainder, results were different or incomplete. Preoperative CRP elevation and the presence of an infection membrane influenced sensitivity: sonication generally detected more bacteria (59–81%) than tissue samples (49–73%), though discrepancies remained. Conclusions: Sonication represents a valuable complementary method for detecting implant-related infections. Due to its high sensitivity but limited specificity, it should not be used as a standalone diagnostic method. Full article

Objectives: Despite the increasing scientific evidence regarding the application of Cranberries in dentistry, a comprehensive understanding of their potential benefits, active constituents, and mechanisms of action remains lacking. Consequently, this narrative review aims to meticulously analyze and consolidate the existing scientific literature on the utilization of Cranberries for the prevention and treatment of oral diseases. Materials and Methods: Electronic databases (PubMed, Scopus, and Web of Science) were searched up to October 2025. This review included in vitro, in vivo, and clinical research studies. A two-phase selection process was carried out. In phase 1, two reviewers independently screened titles and abstracts to identify potentially eligible studies. In phase 2, the same reviewers performed the full-text assessments of the eligible articles. Results: Among the 93 eligible articles, most assessed Cranberry use in Cariology (n = 28) and Periodontics (n = 26). Biofilm and microbial virulence factors (n = 46) were the most frequently studied topics. Cranberry extract (n = 32) and high-molecular-weight non-dialyzable material (NDM) (n = 23) were the most evaluated Cranberry fractions. Overall, Cranberry-derived compounds were identified as non-toxic and demonstrated promising antimicrobial activity against dental caries-related microorganisms in preclinical studies (n = 20). Regarding periodontal and peri-implant diseases, Cranberry demonstrated host immune modulator effects, counteracting the inflammatory and destructive mechanisms (n = 8). Additionally, Cranberries presented benefits in reducing the inflammation associated with periodontal disease and temporal mandibular joint lesions (n = 1). Regarding dental erosion, Cranberry inhibited dentin erosion (n = 4); however, no effect was observed on enamel lesions (n = 2). As an antioxidant agent, Cranberry showed effectiveness in preventing dental erosion (n = 18). Beyond that, Cranberry neutralized reactive oxygen species generated immediately after dental bleaching, enhancing bond strength (n = 2) and counteracting the oxygen ions formed on the tooth surface following bleaching procedures (n = 3). In osteoclastogenesis assays, A-type proanthocyanidins inhibited bone resorption (n = 1). In osteogenic analysis, preservation of hydroxycarbonate apatite deposition and an increase in early and late osteogenic markers were observed (n = 2). Conclusions: Cranberry bioactive compounds, both individually and synergistically, exhibit substantial potential for diverse applications within dentistry, particularly in the prevention and management of oral and maxillofacial diseases. This review provides insights into the plausible incorporation of Cranberries in contemporary dentistry, offering readers an informed perspective on their potential role. Full article

Artificial intelligence (AI) is rapidly transforming the landscape of dental implantology by enhancing every stage of treatment, from diagnostics and digital planning to intraoperative navigation, outcome prediction, and long-term follow-up. This narrative review explores the current and emerging applications of AI technologies in implant dentistry, with a focus on machine learning, neural networks, and computer vision. It examines how AI is utilized in digital implant planning, surgical navigation, peri-implant disease monitoring, risk assessment, and the prediction of treatment outcomes such as peri-implantitis and implant failure. These innovations contribute to more efficient workflows, more personalized treatment strategies, and improved cost-effectiveness of care. Finally, future perspectives and educational implications of AI integration in clinical implantology are discussed. Full article

Gel-based depots are increasingly recognized as platforms to extend the intratissue residence of local anesthetics (LAs) while reducing systemic exposure. Hydrogels, organogels, and emerging bigels represent three distinct architectures defined by their continuous phases and drug–matrix interactions. Hydrogels provide hydrated polymer networks with predictable injectability, tunable degradation, and diffusion- or stimulus-responsive release, enabling sustained analgesia in perineural, peri-incisional, intra-articular, and implant-adjacent settings. Organogels, formed by supramolecular assembly of low-molecular-weight gelators in lipids or semi-polar solvents, strongly solubilize lipophilic LA bases and enhance barrier partitioning, making them suitable for dermal, transdermal, and mucosal applications in outpatient or chronic pain care. Bigels integrate aqueous and lipid domains within biphasic matrices, improving rheology, spreadability, and dual-solubilization capacity, although their use in LA delivery remains at the formulation stage, with no validated in vivo pharmacology. This narrative review synthesizes the design principles, release mechanisms, and translational evidence across these platforms, highlighting domain-specific advantages and barriers related to mechanical robustness, sterilization, reproducibility, and regulatory feasibility. We propose a platform-level framework in which depot selection is aligned with LA chemistry, anatomical context, and clinical objectives to guide the development of workflow-compatible next-generation LA depots. Full article

Background/Objectives: Hydroxyapatite (HAp)-based implants and HAp–titanium (HApTi) composites are widely used in orthopedic and dental applications, but their long-term success is limited by peri-implant bone loss. Local delivery of osteoactive molecules from implant surfaces may enhance osseointegration and reduce periprosthetic osteolysis. This study combined in silico modeling and experimental assays to compare calcium fructoborate (CaFb), sodium alendronate, and calcium alendronate as functionalization agents for HAp and HApTi implants. Methods: Molecular docking (AutoDock 4.2.6) and 100 ns molecular dynamics (MD) simulations (AMBER14 force field, SPC water model) were performed to characterize ligand–substrate interactions and to calculate binding free energies (ΔG_binding) and root mean square deviation (RMSD) values for ligand–HAp/HApTi complexes. HAp and HApTi discs obtained by powder metallurgy were subsequently functionalized by surface adsorption with CaFb or alendronate salts. The amount of adsorbed ligand was determined gravimetrically, and in vitro release profiles were quantified by HPTLC–MS for CaFb and by HPLC after FMOC derivatization for alendronates. Results: CaFb–HAp and CaFb–HApTi complexes showed the lowest binding free energies (−1.31 and −1.63 kcal/mol, respectively), indicating spontaneous and stable interactions. For HAp-based complexes, the mean ligand RMSD values over 100 ns were 0.27 ± 0.17 nm for sodium alendronate, 0.72 ± 0.28 nm for calcium alendronate (range 0.35–1.10 nm), and 0.21 ± 0.19 nm for CaFb (range 0.15–0.40 nm). For HApTi-based complexes, the corresponding RMSD values were 0.30 ± 0.15 nm for sodium alendronate, 0.72 ± 0.38 nm for calcium alendronate and 0.26 ± 0.14 nm for CaFb. These distributions indicate that CaFb and sodium alendronate maintain relatively stable binding poses, whereas calcium alendronate shows larger conformational fluctuations, consistent with its less favorable binding energies. Experimentally, CaFb exhibited the greatest chemisorbed amount and percentage on both HAp and HApTi, followed by sodium and calcium alendronate. HApTi supported higher loadings than HAp for all ligands. Release studies demonstrated a pronounced burst and rapid plateau for both alendronate salts, whereas CaFb displayed a slower initial release followed by a prolonged, quasi-linear liberation over 14 days. Conclusions: The convergence between in silico and adsorption–release data highlights CaFb as the most promising candidate among the tested ligands for long-term functionalization of HAp and HApTi surfaces. Its stronger and more stable binding, higher loading capacity and more sustained release profile suggest that CaFb-coated HApTi implants may provide a favorable basis for future in vitro and in vivo studies aimed at improving osseointegration and mitigating periprosthetic osteolysis, although direct evidence for osteolysis prevention was not obtained in the present work. Full article