Search Results (34)

This study aimed to evaluate the biomechanical behavior of different implant macrogeometries under immediate and delayed implantation protocols in a single maxillary anterior tooth model using three-dimensional finite element analysis. Six implant models from three different implant systems were analyzed, each including one aggressive and one passive macrogeometric design. In the immediate implantation models, implants were placed within the extraction socket, with the buccal gap filled using a xenograft material, whereas in the delayed implantation models, a fully remodeled healed bone condition was simulated. Stress and strain distributions were evaluated under a 120 N static oblique load representing functional occlusal forces in the anterior maxilla. Under immediate implantation conditions, aggressive designs demonstrated a more homogeneous stress distribution and reduced cervical stress concentration compared with passive designs, while maintaining comparable apical stress levels. Similarly, in delayed implantation models, aggressive macrogeometries exhibited lower stress concentrations in the cervical cortical bone relative to cylindrical designs. Overall, these findings suggest that aggressive implant macrogeometry may favorably balance cervical stress reduction and apical load transfer, supporting peri-implant bone preservation while maintaining primary mechanical anchorage. 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/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

Background and Objectives: Cement-retained implant restorations are widely used because they offer favorable esthetics and a passive fit. Their long-term performance is strongly influenced by cement selection and surface conditioning. This study compared the clinical performance of a resin-modified glass ionomer cement (Fuji Plus^®) with a provisional acrylic-urethane cement (DentoTemp™) in partial implant restorations. Materials and Methods: A retrospective cohort of 40 patients with three-unit implant-supported fixed dental prostheses was followed for at least three years. Restorations were fabricated from zirconia or metal-ceramic frameworks and cemented with either Fuji Plus^® or DentoTemp™. Clinical outcomes included retention, failure events, marginal adaptation, and peri-implant tissue response. In order to illustrate the impact of cement type and abutment height, mechanical testing was also carried out on standardized in vitro models; however, these tests were not powered for formal hypothesis testing. Although OCT images were included in this study only as illustrative examples from our clinical database and were not obtained from the analyzed cohort, OCT may be a useful tool for non-invasive assessment of marginal fit. Results: Zirconia restorations showed a retention rate of 95 percent, while metal-ceramic restorations reached 85 percent. All four failures occurred in cases cemented with DentoTemp™, giving an overall retention rate of 80 percent for this group. Fuji Plus^® achieved complete retention in all cases. Re-cementation with Fuji Plus^® successfully resolved the failures. Marginal adaptation was evaluated qualitatively because radiographic analysis did not enable accurate measurement of marginal gaps. When cement remnants were found, mild peri-implant inflammation was seen. Conclusions: Within the limitations of this small retrospective, non-randomized cohort, Fuji Plus^® demonstrated a tendency toward better peri-implant tissue response and longer-term retention than DentoTemp™. These findings should be interpreted as preliminary and exploratory rather than conclusive. Fuji Plus^® may be a suitable option for definitive cementation in partial implant restorations, while DentoTemp™ may be considered in selected situations where retrievability is important. Full article

Research on mammalian embryogenesis has been revolutionised by rapid technological and methodological advancements. This review seeks to synthesise historical and contemporary studies on mouse embryos to provide comprehensive conceptual frameworks of early embryogenesis. Key research findings from live-cell imaging, fluorescence staining, molecular, and sequencing analyses were reassessed, mainly focusing on in vivo and in vitro mouse embryo models. Through critical reassessment, this review first presents historical progress in mammalian models and culture systems for the study of embryogenesis. Subsequently, it elucidates the spatiotemporal progression of morphological events from pre- to peri-implantation across tissue, cellular, and molecular scales. The critical analysis in this review highlights that prevailing and alternative models for pre-implantation cell lineage specification are not mutually exclusive but, rather, describe complementary aspects of embryogenesis. While multiple factors in peri-implantation cell lineage specification are discussed, establishing integrative theoretical models requires further investigation into the crosstalk between different factors during lineage decision-making. Furthermore, this work identifies that precise spatiotemporal dynamics and mechanisms, particularly those governing the initiation, progression, and maintenance of morphological and lineage decisions, remain major knowledge gaps. Lastly, this review provides critical thinking frameworks for assessing current models and defining specific experimental pathways to address enduring unresolved knowledge gaps regarding early embryogenesis. Full article

Objective: This study aimed to compare two protocols for immediate implants with fixed provisional restoration, no grafting (trimodal approach = TA) versus grafting in both the osseous gap and peri-implant mucosa (a trimodal approach with modification of the bony and mucosal compartments = TAOM), by measuring soft tissue changes over time. The periodontal phenotype was noted to investigate the relationship between its thickness and the clinical outcomes. Methods: Thirty-one patients met the inclusion criteria (15 in the TA group and 16 in the TAOM group). The TA group was a historical control group. Measurements were taken using a digital caliper at T0 and 3, 6, and 12 months following the procedure (T3), (T6), and (T12), respectively, from reference points marked in a dental-supported stent. The periodontal phenotype was determined using an analogical caliper. Results: T12: Vertical midfacial change was −0.17 ± 0.37 in the TAOM group and 0.54 ± 0.33 in the TA group, respectively. Statistical significance (p = 0.0001) was found. Papilla vertical change in the TAOM group was −0.16 ± 0.45 mesially and 0.00 ± 0.44 distally. In the TA group, it was 0.55 ± 0.82 mesially and 0.86 ± 0.95 distally. Statistical significance (p = 0.0001) was also found. Conclusions: There were differences in soft tissue change between the two groups, and changes were related to the periodontal phenotype. Studies with more extended follow-up periods are needed to assess the long-term evolution of both protocols. Full article

Background/Objectives: This single-center, randomized controlled clinical trial evaluated the impact of two crown materials—lithium disilicate (LS2) and a polymer-infiltrated hybrid ceramic (HC)—on the marginal bone loss (MBL) and the technical complications in implant-supported single-tooth restorations over a three-year period. Methods: Sixty patients with posterior single-tooth gaps were randomly assigned to receive either LS2 or HC crowns on iSy (Camlog) implants. All of the restorations were fabricated as CAD/CAM-based hybrid abutment crowns bonded to prefabricated titanium bases. Standardized radiographs were taken at the baseline (T0) and at three years (T1) to assess the MBL using ImageJ software. The technical complications were prospectively recorded. The data analysis was descriptive and exploratory. Results: Fifty-eight cases were available for the final evaluation. The three-year implant survival rate was 100%. The mean marginal bone remodeling was minimal (mesial: LS2 0.15 mm, HC 0.08 mm; distal: LS2 0.13 mm, HC 0.12 mm), with no statistically significant intergroup differences. Bone apposition was observed in 74.1% of the cases. The male patients showed a significantly greater mesial bone loss (p = 0.024). Technical complications occurred more frequently in the HC group, including crown fractures (25%), decementation (17.9%), and screw loosening (14.3%). In the LS2 group, only screw loosening (12.5%) was observed. Conclusions: The lithium disilicate-based hybrid abutment crowns demonstrated a high clinical reliability with stable peri-implant bone and fewer technical complications over three years. In contrast, the hybrid ceramic crowns were associated with a higher rate of mechanical failure. Material selection should therefore be a key consideration in planning implant-supported single-tooth restorations. Full article

Background/Objectives: Evidence from transcriptomic and histopathologic studies has revealed that peri-implantitis lesions are characterized by deeper inflammatory infiltration, increased immune cell accumulation, and distinctive molecular signatures. This systematic review aimed to evaluate the diagnostic and pathophysiological potential of transcriptomic, metagenomic, and bioinformatic biomarkers in peri-implantitis by integrating findings from bioinformatics and machine learning-based studies. The dual objective was to identify biologically relevant markers and assess the accuracy of predictive models, addressing diagnostic gaps in peri-implant disease management. Methods: Eligible designs included cross-sectional, case–control, and cohort studies. Literature searches were conducted across PubMed, EMBASE, Scielo, and Scopus, with independent screening, data extraction, and quality assessment. Functional meta-synthesis was used to thematically organize biomarkers and pathways, while diagnostic meta-analysis pooled ROC-AUC values to assess model performance. Results: Eleven studies met the inclusion criteria. Functional synthesis revealed five recurring biomarker themes: innate and adaptive immune responses, immune cell infiltration, fibroblast activation, and ceRNA regulation. A meta-analysis of six studies reported a pooled AUC of 0.91 (95% CI: 0.88–0.93) with I² = 0%, indicating no heterogeneity, supporting the reliability of ML-based models in distinguishing peri-implantitis from healthy conditions. Sources of variation included differences in validation strategies and data preprocessing. Conclusions: Integrating transcriptomic, metagenomic, and bioinformatic biomarkers with machine learning may enable earlier and more accurate diagnosis of peri-implantitis. The identified biomarkers highlight molecular and microbial pathways linked to inflammation and tissue remodeling, underscoring their potential as diagnostic indicators and therapeutic targets with translational relevance. Full article

The rise of antibiotic resistance and the limitations of conventional therapies for managing biofilm-related oral infections highlight the urgent need for novel solutions, with low-temperature plasma (LTP) emerging as a promising alternative due to its potent antimicrobial effects, tissue-safety, and reduced risk of fostering resistance. This scoping review investigates the efficacy of LTP application for the management of oral biofilms associated with dental caries, peri-implantitis, endodontic infections, and oral candidiasis. This review was conducted in accordance with the PRISMA-ScR guidelines and registered with the Open Science Framework (OSF). Studies were identified through comprehensive searches of PubMed/MEDLINE, EBSCO (Medline Ultimate and e-journals), and Google Scholar, with no publication date restrictions, and were supplemented by manual reference screening. Eligible studies included original research, published in English, examining LTP’s effectiveness in oral biofilms. After systematically screening the literature, 51 studies were included in this scoping review, comprising mostly in vitro research, alongside ex vivo, in situ, and clinical studies. Data extraction revealed LTP’s broad-spectrum antimicrobial potential and promising clinical implications for dentistry. This review highlights key findings, identifies research gaps, and underscores the therapeutic potential of LTP in managing complex oral biofilm-related infections. Full article

Objective: A peri-implant gap or a “jumping gap” between an implant surface and the buccal bone can often complicate the successful integration of dental implants, impairing osseointegration and long-term implant stability. Although various techniques and materials are available for managing this gap, there is no consensus on the most effective approach. The current literature lacks standardized, evidence-based guidelines for selecting the optimal technique or material for managing peri-implant gaps, especially following immediate implant placement. This systematic review aims to evaluate the efficacy of various techniques and materials to manage the peri-implant gap to improve the implant stability, bone preservation, and esthetic outcomes using the PROSPERO registration number CRD42024508852. Methods: A comprehensive search of the MEDLINE, Embase, and Cochrane databases was conducted, and various studies were selected, including 11 randomized clinical trials that investigated different grafting materials and techniques for managing the gap between the implant and the buccal plate. The selected studies were assessed for the risk of bias, and the data were extracted based on primary outcomes such as implant stability, bone density, and esthetic parameters. Results: The findings indicate that xenografts and alloplastic grafts were superior in preserving bone volume compared to platelet-rich fibrin. Techniques like the socket shield and immediate provisional prothesis methods showed promise in maintaining soft tissue and bone integrity. However, heterogeneity across the studies limits definitive conclusions. Conclusions: Further high-quality research is needed to establish standardized guidelines for peri-implant gap management. The selection of techniques and materials should be tailored to individual patient needs. Full article

Objectives: The upper central incisors play a central role in esthetics, symmetry, and function. The purpose of this study is to evaluate the use of narrow-diameter implants (NDIs) for replacing single missing upper central incisors, addressing the gap in research regarding specific tooth types and their esthetic outcomes. Methods: This retrospective study included adult patients with a single missing upper central incisor replaced by NDIs. Exclusion criteria included patients who lost adjacent teeth during follow-up and patients with non-loaded implants. The primary outcome was peri-implant bone stability, while secondary outcomes included implant survival, technical complications, patient satisfaction, and esthetic evaluation using the Pink Esthetic Score (PES) and the White Esthetic Score (WES). Descriptive statistical analysis was performed. Results: A total of 64 NDIs were placed in 64 patients (mean age 55 ± 15 years; 40 females, 24 males). Implant diameters were 3.3 and 3.5 mm, with lengths ranging from 6.5 to 11.0 mm. The mean follow-up period was 42 ± 19 months. Marginal bone loss was −0.7 ± 0.9 mm mesially and −0.5 ± 0.7 mm distally. No implant failures were recorded. Esthetic outcomes were satisfactory, with a mean PES of 7.0 ± 2.6 and a mean WES of 7.9 ± 2.0. Conclusions: NDIs demonstrated high survival rates, marginal bone stability, and acceptable esthetic outcomes in the replacement of single upper central incisors. Full article

Background: In dental implants, micro-gaps at the fixation–abutment interface can cause peri-implantitis and/or loosening or loss of the fixation screw; therefore, three-dimensional imaging is widely used to examine different types of connections. In the present study, we focus on the analysis on biconometric connections to detect and (possibly) measure the presence of micro-gaps in the as-positioned state and after repeated loading and unloading. Methods: Seven biconometric dental implants were characterized using micro-computed tomography (micro-CT). In two specimens (group 1), the cap was inserted, and only the apical portion was imaged, to evaluate the cap–abutment connection; in the remaining five specimens (group 2), the fixture–abutment connection was analyzed. Two implants in group 2 were also subjected to load tests to verify whether stresses could induce the formation of micro-gaps as a consequence of preload loss. Results: Micro-CT analysis showed the absence of micro-gaps greater than 10 µm in both cap–abutment and abutment–fixture connections. This was verified, in the fixture–abutment connection, even after mechanical loading and unloading. The results were reproducible in all the investigated samples in the different experimental conditions. Conclusions: In the human force range during chewing, the conical connection showed a high level of resistance to micro-gap formation at the implant–abutment interface. The absence of micro-gaps, as demonstrated here, provides encouraging preliminary data regarding the stability of the biconometric connections, which will be further verified in follow-up studies on a larger sample size. Full article

Background: Immediate post-extraction dental implants are increasingly popular, but ensuring primary stability and managing peri-implant tissues remain challenging. Implant macro-design significantly impacts stability and osseointegration. This study used Cone-beam Computed Tomography (CBCT) to evaluate changes in alveolar bone following immediate placement of two implant designs, System 2P and Dura-Vit 3P, which feature semi-conical microgeometry and apical self-tapping portions for improved stability and bone regeneration. Methods: With a 1:1 allocation ratio, the current investigation was a two-arm parallel group randomized clinical trial. Patients qualified if they required immediate dental replacements with adequate buccal bone support. Two types of implants were placed: System 2P (cylindrical shape) and Dura-Vit 3P (more conical shape, with a particular architecture of threads). Following the intervention, CBCT was performed both immediately (T1) and six months later (T2). Measurements of CBCT horizontal bone level at apical, medial, and bevel height on the palatal/lingual and vestibular sides as well as the buccal vertical gap were the primary results. Complications, implant stability quotient (ISQ), and torque insertion were evaluated. The Mann–Whitney test was used to determine time-based differences within each group, while the Wilcoxon test was used to estimate differences between groups. The impact of baseline marginal gap dimension and gingival biotype was estimated using multiple regressions. Results: Thirty patients were recruited and randomized to treatments, with two lost to follow-up. One System 2P implant failed and two patients of the Dura-Vit 3P group dropped out. At T1, the Dura-Vit 3P group exhibited a lower mean insertion torque and a higher ISQ than the System 2P group. Furthermore, the Dura-Vit 3P group showed lower bone reduction compared to System 2P at horizontal and vertical measurements with significant differences for the vestibular and palatal base and medial level (p-values < 0.05). Regression models indicated a positive effect of thick biotypes on gap filling and dimensional bone reduction. No complications were observed in both groups. Conclusions: The Dura-Vit 3P implant exhibits high primary stability when inserted in post-extraction sites. Furthermore, this kind of implant stimulates higher bone stability on both the palatal and buccal side when compared to the System 2P implant. The present findings support the evidence that the macro-design of the Dura-Vit 3P implant promotes increased primary stability and reduces bone loss. Full article

Autogenous grafts remain the “gold standard” in bone tissue grafting procedures; however, limitations such as donor site morbidity, invasiveness, and limited availability have spurred research into alternative materials. Hydroxyapatite (HA), a widely used bioceramic, is known for its bioactivity and biocompatibility. Nonetheless, its inherent brittleness and porosity necessitate modifications to enhance its mechanical and functional properties. Ionic doping has emerged as a transformative strategy to improve the properties of HA by integrating ions such as strontium (Sr²⁺), magnesium (Mg²⁺), and zinc (Zn²⁺). These dopants influence HA’s crystal structure, morphology, and solubility, resulting in enhanced bioactivity, accelerated bone mineralization, and improved mechanical properties, such as increased fracture resistance and wear durability. Additionally, antimicrobial properties can be achieved through the inclusion of silver ions (Ag⁺), reducing the risk of peri-implant infections. This review focuses on the effects of ionic doping on the structure and functionality of hydroxyapatite, emphasizing advancements in tailoring its properties to clinical needs. By consolidating two decades of research, this study highlights how ionic doping bridges the gap between synthetic biomaterials and native bone, unlocking new potential in regenerative medicine and orthopedic applications. Full article

We hypothesized that the different post-implantation healing stages between the conventional and immediate implantations produce different amounts and tissue composition of the peri-implant bone. Thus, the objective of the current study was to examine whether the stability of dental implant systems is associated with characteristics of the interfacial bone area at different post-implanation healing periods. Mandibular molars were extracted from each beagle dog. After 10 weeks post-extraction, a screw-type titanium dental implant was placed in the molar location following a conventional dental implant (Con) procedure. Simultaneously, mandibular premolars were extracted and the same type of dental implant was placed in the distal site of the extracted premolar root following an immediate dental implant (Imm) procedure. The implant stability quotient (ISQ) values were not significantly different between Con and Imm groups at 0-, 3-, and 6-weeks post-implantation. However, 3D micro-computed tomography and 2D histological images confirmed that the Imm system had more gaps between the bone and implant than the Con system. On the other hand, the nanoindentation modulus value at the bone–implant interface was significantly higher for the Imm group than the Con group at both 3 weeks and 6 weeks post-implantation. The current results from multi-scale characterization suggest that the higher interfacial bone quality of the Imm system, despite its earlier post-implantation stage, plays a crucial role in maintaining stability comparable to that of the Con system. Full article