Early marginal bone loss around three different implant systems: prospective cohort study

AIM: To evaluate early bone loss around three different implant systems (Straumann Bone Level. Noble Biocare Replace, 3i Biomet Certain) and compare them to each other in a prospective clinical study using clinical and radiographic measurements. MATERIALS AND METHODS: Twenty-three patients were recruited for the study. Three implant systems were included in study design; one system was abandoned due to lack of subjects. Two implant systems (Nobel Biocare Replace n= 12, Straumann Bone Level n= 11) were evaluated. Periodontic residents placed the implants. Radiographic and clinical measurements were obtained at two different time points, at the time of implant placement and at the time of second stage surgery. RESULTS: Mean clinical bone loss was 0.14 ± 0.20 mm, and 0.72 ± 1.02 mm for Straumann and Nobel Biocare respectively. The mean change in the radiographic bone loss for Straumann and Nobel Biocare was 0.23 ± 0.26 mm and 0.53 ± 1.06 mm. There was no statistically significant difference between the two groups. CONCLUSION: Nobel Biocare Replace tapered implants showed a two and five times higher average bone loss in radiographic and clinical parameters respectively, compared to Straumann implants. However, this difference did not reach statistical significance in either the clinical or the radiographic measurement. It is suggested that study size should be increased

Inverted bone block for a mandibular lateral ridge augmentation: a case report

The purpose of this report is to describe an original technique for bone grafting using an inverted autogenous bone block taken from the same edentulous site that was to be implanted. A 54-year-old female presented for replacement of a missing lower premolar. Clinical and radiographical assessments revealed a deficiency in the width of the alveolar ridge. It was decided to expand the edentate area using an inverted bone block. The graft was harvested from the same edentate site that was to be implanted. The crestal bone width after nine months of healing was increased, and an implant was placed. An autogenous inverted bone block can be used as a bone grafting procedure to augment some bone-deficient sites prior to dental implantations. ---Continu

Effect of mechanical debridement with and without adjunct antimicrobial photodynamic therapy for the treatment of peri-implant disease in obese patients: A systematic review and meta-analysis of randomized controlled trials

Objective: The aim of the present systematic review and meta-analysis was to assess the effect of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) for the treatment of peri‑implant diseases in obese patients. Methods: The focused question is “Is MD with adjuvant aPDT more effective than MD alone for treating peri‑implant diseases in obese patients?” Indexed databases were searched without time and language barriers up to and including February 2025. Various keywords were used in different combinations using Boolean operators. A forest plot was generated to visually present the results of the meta-analysis. The risk of bias (RoB) within studies was assessed and GRADE analysis was performed. Results: Three randomized controlled trials (RCTs) were included. The number of participants ranged between 49 and 80 individuals. Patients in the test and control groups underwent MD with and without adjunct aPDT, respectively. In two studies, periimplantitis was treated with MD with and without adjunct aPDT, and in one, MD with and without MD was performed to treat peri‑implant mucositis. Follow-up ranged from 3 to 6 months. All RCTs showed that MD+aPDT is more effective in treating peri‑implant diseases than MD alone. The RoB was high and unclear in one and two RCTs, respectively. The meta-analysis showed that control intervention provided a more favorable outcome than experimental intervention. The certainty of evidence was low, and the strength of recommendation was weak in all RCTs. Conclusion: Role of aPDT as an adjunct to MD for treating peri‑implant diseases in obese populations remains unclear

Influence of Gingival Display on Smile Attractiveness Assessed by Saudi Arabian Laypersons and Dental Professionals

Abstract Objective: To evaluate the influence of changes in the gingival display of the maxillary teeth on smile attractiveness assessed by Saudi Arabian dental professionals and laypeople. Materials and methods: A total of 138 dental professional and 182 laypeople rated the attractiveness of male and female smiles in a computerized survey. Each smile was digitally altered to achieve different levels of gingival exposure. Each photo was accompanied by a visual analog scale (VAS) for rating. Results: Among dental professionals, 61% rated the female photo with a 1-mm low lip line as the most attractive smile (VAS score±SE, 7.3±3.18), while 52.7% of laypeople considered the smile with a 2-mm low lip line as the most attractive (6.7±3.4). Regarding male smile photos, 61.6% of dental professionals found the 1-mm low lip line the most attractive (7.3±3.18). The same rating was given by 48.3% of laypeople (6.1±3.6) (p≤0.009). The least attractive smile photo was the smile showing 4 mm of gingiva for male and female smiles. More than half of the laypeople believed that an attractive smile highly affects social life and communication. Conclusion: The Saudi Arabian population appears to be sensitive to the amount of gingival display. The difference in female smile assessment between dental professionals and laypeople highlights the importance of dentist-patient consensus regarding decisions for esthetic treatments. Clinical Relevance: Esthetic treatment is of a major concern for both dentist and patient. The careful assessment of smile pillars including gingival display must be tailored to each patient.</jats:p

Influence of gingival display on smile attractiveness assessed by Saudi Arabian laypersons and dental professionals

Abstract This study was undertaken to evaluate the influence of changes in the gingival display of the maxillary teeth on smile attractiveness assessed by Saudi Arabian dental professionals and laypeople. A total of 138 dental professional and 182 laypeople rated the attractiveness of male and female smiles in a computerized survey. A smiling photograph of a male and a female dental students were selected and digitally manipulated to create changes the amount of gingival display from 4 mm of gingival display to 4mm of gingival covered by the upper lip in 1 mm increments. Each photo was accompanied by a visual analog scale (VAS) for rating. Among dental professionals, 61% rated the female photo with a 1-mm low lip line as the most attractive smile (VAS score ± SE, 7.3 ± 3.18), while 52.7% of laypeople considered the smile with a 2-mm low lip line as the most attractive (6.7 ± 3.4). Regarding male smile photos, 61.6% of dental professionals found the 1-mm low lip line the most attractive (7.3 ± 3.18). The same rating was given by 48.3% of laypeople (6.1 ± 3.6) (p ≤ 0.009). The least attractive smile photo was the smile showing 4 mm of gingiva for male and female smiles. More than half of the laypeople believed that an attractive smile highly affects social life and communication. The Saudi Arabian population appears to be sensitive to the amount of gingival display. The difference in female smile assessment between dental professionals and laypeople highlights the importance of dentist-patient consensus regarding decisions for esthetic treatments. Esthetic treatment is of a major concern for both dentist and patient. The careful assessment of smile pillars including gingival display must be tailored to each patient

Prevalence of Dental Implant Positioning Errors: A Radiographic Analysis

Objectives Implant placement errors remain a persistent challenge, leading to complications such as peri-implant bone loss, neurosensory issues, and, in severe cases, implant failure. This study evaluates the prevalence and characteristics of dental implant positioning errors in patients treated at the Dental University Hospital. Methods: A sample of 500 cone-beam computed tomography (CBCT) scans was used to assess implants for positioning errors, including thread exposure, proximity to anatomical structures, and violations of inter-implant and implant&ndash;tooth distances. Results: A total of 56.6% of the implants exhibited positioning errors, with the maxillary posterior region being the most commonly affected area (51.6%). The most frequent errors observed were thread exposure (37.7%) and implant proximity to the maxillary sinus (27.7%). Statistical analysis revealed significant correlations between implant positioning errors and anatomical location, underscoring the need for meticulous preoperative planning and advanced imaging. While factors such as patient age, implant length, and diameter were analyzed, no statistically significant differences were found in error prevalence based on sex or demographic variables. Conclusions: This study highlights the importance of combining clinical expertise with advanced imaging modalities like CBCT to minimize implant positioning errors and improve patient outcomes. Future research should focus on refining surgical techniques and evaluating the impact of the implants&rsquo; design and patient-specific factors on the accuracy of placements

Factors Affecting Dental Implant Failure: A Retrospective Analysis

Objectives: This study aims to investigate the underlying causes of dental implant failure, focusing on implant-related complications and associated risk factors. Understanding these factors will help improve treatment planning and enhance implant success rates. Methods: A retrospective case-control study was conducted using clinical, medical, surgical, and radiographic records of patients who underwent dental implant removal due to complications. Key factors analyzed included patient-related variables (age, gender, medical conditions, periodontal disease), implant-related factors (implant site, implant system, restoration status), and procedural aspects (previous surgical interventions and reasons for implant removal). Results: The findings revealed that implant type (p = 0.004) and type of restoration (p = 0.001) significantly influenced implant survival. Gender (p = 0.001), medical conditions, smoking status (p = 0.004), and restoration status (p = 0.005) were significantly associated with specific failure mechanisms. Lack of osseointegration (36.4%) and absence of primary stability (22.4%) were the predominant causes of implant failure. Prior surgical interventions (p = 0.001) and decisions for re-implantation (p = 0.005) significantly affected implant removal frequency. Conclusions: Implant survival is influenced by multiple factors, with implant type, restoration type, and gender playing key roles in failure outcomes. Patient-specific risk assessment, particularly regarding medical conditions and smoking, meticulous surgical technique, and appropriate prosthetic planning, is vital for improving implant longevity and minimizing failure rates

Medication-Related Osteonecrosis of the Jaw (MRONJ): A Review of Pathophysiology, Risk Factors, Preventive Measures and Treatment Strategies

Medication-related osteonecrosis of the jaw (MRONJ) is a major problem that can occur in people taking certain medications such bisphosphonates and denosumab. It can be used to treat osteoporosis or cancer. Bisphosphonate exposure, dental diseases and procedures, age, sex, anatomical factors, medical issues, and hereditary factors are all variables that enhance the risk of MRONJ. Even though MRONJ and antiresorptive medications have a close association, the pathophysiology of MRONJ is unknown. Careful dental preparation and oral hygiene instructions significantly minimize the risk of osteonecrosis of the jaw (ONJ). It is ideal to start antiresorptive treatment after the completion of required dental treatment; it is not contraindicated and carries low risk in patients who are on oral antiresorptive medications for less than three years. Drug holidays are one proposed solution to address MRONJ. However, there is still inadequate evidence to support their effectiveness. The objectives of this literature review are to recognize the main diagnostic principles and risk factors and to review the pathophysiology, protective procedures and treatment modalities related to MRONJ.The following topics are covered in the review: epidemiology, diagnostic criteria, risk factors, pathogenesis and mechanism, MRONJ staging and symptoms, clinical and radiographic findings, treatment strategies, prevention and drug holiday