Search Results (99)

Background/Objectives: Oral cancer resection often leads to maxillofacial defects and dentition loss, compromising patients’ quality of life. Implant-supported prosthetic rehabilitation offers a reliable solution to restore function, though factors such as bone reconstruction, radiotherapy, and timing of implant placement (immediate vs. delayed) may influence outcomes. This study aimed to evaluate long-term implant survival and rehabilitation timelines in oncologic patients, comparing two cohorts (2005–2014 and 2015–2024) to assess the impact of evolving clinical practices. Methods: A retrospective cohort study was conducted at Hospital General Universitario Gregorio Marañón (Madrid, Spain), including 304 patients who underwent ablative oral cancer surgery and subsequent implant-based rehabilitation between 2005 and 2024. Data on demographics, oncologic treatment, reconstruction, implant timing, and prosthetic rehabilitation were collected. Outcomes were compared using Kaplan–Meier analysis and appropriate statistical tests between the 2005–2014 (n = 122) and 2015–2024 (n = 182) cohorts. Results: A total of 2341 Ticare Implants^® were placed, supporting 281 prostheses. Implant placement during primary surgery increased from 41% to 71% (p < 0.001). The median time from surgery to prosthesis significantly decreased from 24 to 15 months (p < 0.001). Five-year implant survival was 95% in the early cohort versus 97% in the later cohort. Implant survival was comparable between irradiated and non-irradiated patients (~94–96%). Fixed prostheses became more frequent (92% vs. 79%, p = 0.002). Conclusions: Implant-supported rehabilitation in oncologic patients is highly feasible and durable, with improved timelines and functional outcomes associated with early implant placement and modern digital planning strategies. Full article

Background/Objectives: Dental implants represent a viable solution for replacing missing teeth; however, multiple disconnections and reconnections of intermediate abutments contribute to the apical displacement of the peri-implant connective tissue barrier, resulting in additional marginal bone loss. To the best of our knowledge, no definitive customized abutments currently exist that are specifically designed according to the morphology of the tooth to be replaced and its position within the dental arch, allowing for digital planning within the prosthetic implant design and insertion during the surgical procedure without subsequent disconnection. Methods: The First Biological Respect (FR) technique, described in this case report, enables the digital planning not only of the implant but also of the patented FR customized-shaped, definitive abutment and associated FR prosthetic components. The FR technique was applied to a case involving an immediate post-extraction implant in position 12. Results: With the limitations of a case report, the application of the FR protocol demonstrated stable crestal bone levels at the 1-year follow-up. Additionally, soft tissue volume was maintained at 6 months, reflecting the accuracy of the customized prosthetic components in supporting, guiding, and protecting peri-implant soft tissues. At the 1-year follow-up, an increase in soft tissue volume was observed, likely attributable to tissue maturation and the further customization of the definitive prosthetic elements. Conclusions: The FR technique represents a viable therapeutic alternative that, through its patented, fully customized components, allows for the digital planning of the implant, as well as the customized definitive abutment, coping, provisional, and final prosthetic framework. This facilitates a single-stage surgical and prosthetic approach. By eliminating the need for repeated abutment disconnections, this method supports the long-term stability of both hard and soft peri-implant tissues while also reducing overall treatment time for both clinician and patient. Further studies involving larger patient cohorts are necessary to validate this protocol. Full article

Background: The growing demand for innovative biomaterials with antimicrobial properties has driven research into natural and synthetic compounds, such as propolis and nanosilver, known for their antimicrobial efficacy. Methods: This study uses Google Trends data to analyze global search interest in five key terms—propolis, antimicrobial, antibacterial, nanosilver, and biomaterials—over a ten-year period (starting November 2014). The objective is to evaluate temporal variations, quantify correlations between the terms, and explore how external events, such as the COVID-19 pandemic, have influenced public and clinical interest in these topics. Search data were extracted, normalized, and analyzed using multivariate time series methods, including vector autoregression (VAR) modeling, Impulse Response Function (IRF) analysis, and forecast error variance decomposition (FEVD). Stability, causality, and inter-period relationships were assessed using statistical analysis, with results visualized through time series plots and impulse response coefficients. Results: Key findings reveal significant interdependencies between search terms, with surges in one often resulting in immediate or short-term increases in others. Notable trends include a marked increase in COVID-19 interest for nanosilver, propolis, and antibacterial, followed by a return to baseline levels, while antimicrobial maintained a sustained upward trajectory. Biomaterials experienced initial declines but later stabilized at elevated levels. Conclusions: These findings underscore the oscillating nature of public interest in antimicrobial and biomaterial innovations, highlighting opportunities for targeted research and commercialization. By adapting future material development to emerging trends and clinical needs, dentistry can use these insights to develop infection control strategies, improve restorative materials, and deal with persistent challenges such as antimicrobial resistance, peri-implantitis, and tooth caries treatment. Full article

Background: This retrospective clinical cohort study aimed to evaluate, over an 18-month follow-up period, implant survival rates, marginal bone loss, peri-implant parameters, and surgical and prosthetic complications in immediately loaded post-extraction implants used for single or partial implant-prosthetic rehabilitations. Methods: Ninety-nine met the inclusion criteria and received a total of 147 implants. Follow-up assessments were conducted at one week and at three, six, and twelve months after prosthesis delivery. Clinical and radiographic parameters were evaluated by three independent practitioners. The variables considered included smoking, systemic conditions, implant site, and prosthetic type. Results: The implant survival rate was 95.92% at 18 months. Failures were more frequent in smokers, patients with systemic diseases, and in the posterior maxilla. Marginal bone loss increased over time, with higher values in posterior regions and in patients with systemic conditions or smoking habits. Peri-implant clinical parameters values negatively increased in smokers. Surgical complications occurred only in smokers and patients with systemic conditions, more frequently in fixed bridge rehabilitations. Prosthetic complications were limited, more common in posterior regions and multi-unit restorations. Conclusions: Immediately loaded post-extraction implants demonstrated high reliability. Careful patient selection and structured follow-up are essential to reduce complications and ensure long-term success. Full article

Background: As the rehabilitation of the upper anterior maxilla primarily requires high predictability of successful aesthetic outcomes, procedures of immediate implant placement are frequently employed. The aim of this pilot study was to retrospectively evaluate the short-term outcomes of a protocol of immediate implant placement in fresh extraction sockets, followed by immediate non-functional provisional restorations. Methods: Patients were treated for the replacement of maxillary central or lateral incisors, or cuspid teeth with a single-crown locking-taper implant. Clinical and photographic records were retrospectively compared between the teeth prior to extraction (T0) and restorations one year after prosthetic loading (T1). Outcomes were analyzed using the Pink Esthetic Score (PES), according to the patient’s phenotype (thin/thick), with or without the use of connective tissue graft (CTG). Results: The overall mean PES of 25 implants treated was 9.24 ± 2.36 at T0 and 9.60 ± 1.70 at T1. Comparison of groups between T0 and T1 revealed significant PES variations (p = 0.04), with the best and the worst scores, respectively, registered for thin + CTG group (from 7.50 ± 1.91 to 9.75 ± 2.87) and thin group (from 11.33 ± 2.33 to 10 ± 0.89); moderate increases were assessed for thick group (from 8.44 ± 2.40 to 9.44 ± 2.12) and thick + CTG group (from 9.50 ± 1.04 to 9.33 ± 0.81). Conclusions: Within the limits of a short-term analysis of a small number of patients, immediate implant rehabilitation for aesthetic areas of the upper maxilla can be assumed as a safe and predictable protocol. Concomitant use of CTG seems to provide beneficial effects in thin phenotypes, not any additional value in thick phenotypes. Full article

Background: Immediate implant placement in fresh extraction sockets has become an accepted treatment in dentistry as a predictable procedure to restore failing teeth. One prerequisite for this immediate procedure in the anterior maxillary region is an intact facial wall. Unfortunately, the presence of fenestrations and dehiscences is very common. These defects occur due to the pathology responsible for the extraction of the teeth. Traditionally, hard and soft tissue grafting is necessary to repair these large bony defects before implant placement. However, there are many defects with facial wall deficiencies. Methods: This report reflects procedures used to provide successful functional outcomes using grafting techniques in conjunction with immediate implant placement in defective sockets. This clinical research study followed a qualitative methodology, and the results are based on observational outcomes of four patient surgical implant procedures. Each patient received the same protocol in an attempt to reach similar results. Results: Proper diagnosis, treatment planning, and clinical skills are key factors in achieving predictable results. With each of these four patients, the clinical soft tissue outcomes revealed that the midfacial gingival margin had minimal or no recession at two years with minimal pocket depths less than 3 mm. Conclusions: Although the procedure presented in this article has yet to be clinically validated, it is an available technique that can be used in the hands of an experienced practitioner and can provide excellent results for the patient. Full article

Background: Carotid web (CaW) usually presents as a shelf-like intimal flap at the beginning of the internal carotid artery. It has been proven that CaW is associated with ischemic stroke, particularly in young patients without other risk factors. This case report aimed to describe the carotid web that causes ischemic stroke due to embolic complications. Moreover, both pathologies were successfully treated with endovascular techniques in the presented case study. Methods: A 59-year-old male presented to the neurological department with motor aphasia, right-sided weakness, and hypoesthesia. Computer tomography (CT) of the head and computed tomography angiography (CTA) of the aortic arch and intracranial arteries were performed. Due to the unknown onset of the presented stroke symptoms, diagnostics were extended to magnetic resonance (MR), and based on this, the patient qualified for immediate mechanical thrombectomy (according to the DAWN trial protocol). Intraoperative digital subtraction angiography (DSA) revealed embolism material in the left middle cerebral artery (segment M1). The artery was recanalized via aspiration thrombectomy using the Penumbra system, and complete restoration of flow was obtained (according to the TICI scale). In addition, DSA revealed the presence of CaW changes in the left internal carotid artery (LICA). In the control CT scanning, an acute ischemic area in the left temporal lobe was found. After the treatment, the patient demonstrated complete neurological improvement from his initial presentation. He qualified for carotid artery stenting of the LICA, which was postponed to a later period due to the presence of an area of infarction. The angioplasty with stenting was performed 6 months later, and a carotid antiembolic “mesh” stent (Roadsaver, Terumo) was implanted into the LICA across the carotid web. Conclusions: CaW should be considered in the case of stroke resulting from unknown causes. The presented case study demonstrated that both carotid web and ischemic stroke pathologies can be effectively treated with emerging endovascular techniques. Full article

Background/Objectives: The socket-shield technique (SST) was developed to preserve the facial/buccal portion of a tooth root to prevent post-extraction ridge resorption. It has gained attention for use in anterior implant sites, but its application in posterior sites remains unexplored. The aim of this case report was to report a proof-of-principle case using SST in a lower molar site and evaluate its effectiveness in preserving tissues. Methods: A 34-year-old non-smoking patient with a non-restorable mandibular first molar (tooth #36) underwent immediate implant placement with the SST. The tooth’s crown was removed, and the buccal segments of the roots were retained as “shields” while the implant was placed in the center of the socket. Preoperative and postoperative cone-beam CT (CBCT) scans and clinical exams were used to assess outcomes up to 12 months. Results: The SST procedure was completed uneventfully. CBCT after 4 months and 12 months showed minimal horizontal bone loss: ~0.2 mm at 4 months; ~0.1 mm additional loss by 12 months. The peri-implant soft tissue profile remained stable, and the implant achieved osseointegration with high primary and secondary stability. Conclusions: In this clinical case, the socket-shield technique effectively preserved alveolar bone and soft tissue contours in a molar extraction site, avoiding the ridge collapse often seen post-extraction. This suggests SST may be a viable tissue preservation approach in posterior sites; however, long-term follow-up and further studies are needed to confirm sustained outcomes and validate the technique’s predictability. Full article

(1) Background: Early-stage bone resorption following implant placement can significantly impact the long-term success of implants. This study evaluates whether a fully digitally planned implant position based on the E-point concept, along with guided profiling of the supracrestal complex, contributes to improved stability of peri-implant bone levels. (2) Methods: 29 implants were placed in 27 patients utilizing both immediate (Group 1; n = 19) and delayed placement (Group 2; n = 10) protocols. Implant position and emergence profile were preoperatively determined and consistently executed through guided surgery and CAD/CAM-fabricated restorations. Due to the subcrestal positioning of the implant, a corresponding bone profiler with a guide pin was used to shape the emergence profile and prevent the provisional restoration from impinging on the proximal bone. Provisional restorations were immediately placed to support the emergence profile. Bone level changes were documented radiographically over a two-year period. The first Bone-to-Implant Contact Level (∆ fBIC), change in highest approximal Bone Level (∆ haBL), and formation of an emergence profile width (WEP) were measured. (3) Results: All implants and restorations survived after two years, no significant change in first Bone-to-Implant Contact Level (∆ fBIC = 0 ± 0.02 mm), no change in highest approximal Bone Level (∆ haBL) of −0.23 mm ± 0.71 mm, and formation of an emergence profile width (WEP) averaging 0.18 ± 0.19 mm. (4) Conclusions: Despite the initial stress on the bone caused by bone profiling, guided implant placement and bone shaping, supported by an immediate provisional, have a positive effect on peri-implant bone stability. Full article

Background: Women undergoing a mastectomy often suffer severely from the sequelae of losing one or both breasts. Implant-based breast reconstruction restores female body integrity but can result in significant postoperative pain. The use of paravertebral catheters has been shown to aid significantly in pain management during the postoperative recovery. However, the vasodilation that is induced by paravertebral blocks may lead to prolonged drainage fluid secretion, blood loss and increased likelihood of revision surgery. Therefore, we analyzed the effects of paravertebral blocks after combined mastectomy and immediate breast reconstruction. Methods: We analyzed 115 breast surgeries at the department of Plastic Surgery at the University clinic of St. Poelten between 1 August 2018 and 31 December 2022. Patients were analyzed regarding postoperative hemoglobin loss and drainage fluid volumes and their correlation with paravertebral blocks. Statistical analyses were performed using Levene’s Test for Equality of Variances within our cohort. Results: The postoperative hemoglobin loss did not differ significantly between our groups (p = 0.295). Furthermore, a paravertebral block did not increase the amount of postoperative drainage fluid volumes (p = 0.508). Women receiving paravertebral blocks also did not stay longer in hospitals (p = 0.276). No paravertebral block-associated complication was seen. Conclusions: In this study, we demonstrated paravertebral blocks to be safe adjuncts in breast reconstruction to minimize pain without leading to increased blood loss or seroma formation. This indicated that vasodilatation induced by paravertebral blocks did not negatively influence the postoperative recovery. In conclusion, postoperative pain management using paravertebral blocks can be a beneficial therapeutic adjunct in surgical management of breast cancer patients. Full article

Background: This case report outlines the clinical workflows for immediate implant placement for both maxillary central incisors and ceramic laminate veneers for the remaining teeth in the smile zone. Methods: The patient’s chief complaint was to improve her smile and address periapical infections with purulent exudate at the apex of her central incisors. Clinical and CBCT evaluations determined that the maxillary central incisors were non-restorable, while the lateral incisors and canines showed signs of incisal wear. Atraumatic extractions were performed for the central incisors, and immediate implants were placed with a 3D-printed surgical guide in conjunction with an autogenous soft tissue grafting procedure. Once the soft tissue between the central incisors was contoured with provisional implant restorations, minimally invasive veneer preparations were performed for porcelain laminate veneers. Final restorations were bonded under dental dam isolation. Results: Single immediate implants for maxillary central incisors can be successfully paired with ceramic laminate veneers on adjacent teeth in the smile zone to replace non-restorable teeth in the esthetic zone. Conclusions: Atraumatic tooth extraction, 3D implant planning with grafting procedures, and minimally invasive ceramic veneers can help in meeting patients’ esthetic and functional expectations. Total isolation using a dental dam maximizes the bonding performance of ceramic restorations. Full article

Background: Replacing a maxillary central incisor and immediately placing an implant represents a clinical challenge. Methods: This case report demonstrates a full digital workflow to achieve a predictable implant placement and esthetically pleasing restoration for a 35-year-old male patient who suffered a horizontal root fracture after a sports accident. The patient’s treatment included digital implant planning, minimally traumatic tooth extraction, computer-guided implant placement, soft tissue augmentation, and a provisional restoration to contour the augmented gingival tissues. The process began with cone beam computed tomography (CBCT) evaluation and patient consultation on treatment options, with the patient opting for implant therapy. Using a 3D-printed surgical guide, the implant was placed precisely, and a soft tissue graft was used to enhance the gingival architecture and volume. A provisional restoration was designed to support the emergence profile and condition the peri implant soft tissues. A final digital impression was made, and a screw-retained all-ceramic crown was fabricated uneventfully after healing. Results: This digital approach allowed accurate planning and allowed the efficient execution of a technique-sensitive procedure such as immediate implant placement, thus providing an esthetic and functional solution while minimizing treatment time. Conclusions: The case highlights that immediate implant therapy in the esthetic zone requires meticulous planning and execution, and that incorporating advanced digital tools and techniques is required to achieve favorable clinical outcomes. Full article

This study evaluated the clinical and tomographic outcomes of socket healing. Immediate implants were placed in the molar area, and the gap was filled with either deproteinized bovine bone mineral (B) or collagen matrix (BM), n = 14/group. Scores of epithelization healing, immunoassay for VEGF, IL-1β, and FGF from wound exudate, keratinized mucosa variation (ΔKM), and bone levels were evaluated. The B group had slower tissue maturation than BM (p < 0.05), but gingival epithelialization was similar (p > 0.05). At the restorative phase, the B group exhibited greater ΔKM at prosthesis installation—1 to 2 months of postoperative (increase of 0.29 mm) compared to the BM group (reduction of −1.5 mm) (p < 0.05). Inflammatory tissue responses as well as vertical and horizontal bone remodeling were similar (p > 0.05). Crestal bone remodeling was limited to less than 0.8 mm for both groups. Taken together, the B and BM groups behaved similarly and promoted stable conditions for biomaterial incorporation in the socket healing after immediate implant placement in molar areas. Full article

Background: Post-extraction ridge resorption is an inevitable phenomenon that cannot be eliminated but is significantly reduced using additional surgical techniques known as socket preservation. They aim to create favorable conditions for implant placement and prosthetic restoration. This study aims to assess the effect of socket sealing (SS) with free gingival grafts on the vertical resorption of socket walls at the premolar and molar regions over 3 months. Methods: This randomized two-arm controlled trial with parallel groups (1:1 allocation) was conducted at the Department of Oral Surgery, Medical University-Varna, Bulgaria, from 27 June 2022 to 20 April 2023. Forty patients aged 30–65 were equally and randomly allocated to the SS or the control groups. Atraumatic tooth extraction was performed. In the control group, the socket was left on secondary wound healing. In the SS group, the socket orifice was “sealed” with an FGG harvested from the hard palate or maxillary tuberosity. Results: Data analysis demonstrated that SS with an FGG is a successful method for reducing the post-extraction resorption of the socket walls. In addition, this study confirms that the thickness of the buccal wall is a significant factor in its vertical resorption. Conclusions: Socket sealing with an FGG is a valuable method that eliminates the need for flap reflection and compensates for the soft tissue deficit when immediate implant placement or bone augmentation is required. Further research is necessary to determine the role of different factors influencing bone resorption and compare the effect of different socket preservation methods. Full article

Background: A leadless pacemaker (LP) is a modern alternative to a transvenous pacemaker, allowing certain complications to be avoided; however, some cannot be eliminated. Aim: To highlight the essential role of advanced speckle-tracking echocardiography (STE) in diagnosing pacing-induced cardiomyopathy (PICM) caused by an LP. Clinical case: A 79-year-old male, after LP implantation a year earlier, was admitted due to heart failure (HF). Left ventricular ejection fraction (LVEF) was 40%, global longitudinal strain (GLS) was −10%, and interventricular mechanical delay (IVMD) was 42 ms. All these parameters were significantly better before the operation. Myocardial work indices confirmed dyssynchrony due to the right ventricular (RV) stimulation pattern, and PICM was considered. To verify the impact of RV pacing on the LV, measurements were taken after restoring the native rhythm, showing an improvement in LVEF (45%), GLS (−13%), IVMD (7 ms), and myocardial work indices. After the next HF exacerbation with further deterioration of the LV function, a decision to convert the LP to a standard CRT-P system was made, with immediate relief in clinical symptoms and improved echocardiographic parameters. Conclusions: This case highlights the essential role of STE echocardiography in identifying the detrimental impact of RV pacing, diagnosing PICM, and selecting the appropriate treatment for patients with LPs. Full article