Journal Club Bottom Lines 2025-2026
Orthodontic Implant Site Development Using Labial Root Torque: A Case Series with CBCT Analysis.
Authors: Tanno T, Hasuike A, Naito K, Ishikura C, Funato A.
DOI: 10.11607/prd.7094. PMID: 38363184.
Purpose: To assess “Orthodontic implant site development with labial root torque” (OISD-LRT) technique for preparing tooth sites for dental implant non-surgically, in order to remedy thin labial bone.
Conclusions: OISD-LRT may be an effective method for preparing a tooth site with labial bone loss (Elian II/III) for implant placement.
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Decision Tree for Reconstructive Treatment of Peri-implantitis Defects.
Authors: Urban IA, Chen Z, Wang HL.
DOI: 10.11607/prd.7205. PMID: 38820277.
Purpose: The article proposes a decision tree for reconstructive therapy based on peri-implantitis defects morphology. Background: Previous classifications proposed by various authors highlight the role of defect morphology with circumferential defect yielding better result after regeneration therapy. GBR is the most frequently reported technique for addressing peri-implantitis defects. Healing approach is divided into either submerged and nonsubmerged protocol.
Conclusions: The decision tree may serve as a guide to help clinicians select treatment option based on defect morphology.
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The Laterally Stretched/Coronally Advanced Flap (LAST/CAF) with Connective Tissue Graf Variation to Treat Deep-Wide and Multiple Deep-Narrow Defects. Case Report and Technical Description
Authors: Carranza N., Bugiolachi J., Rojas M., Perrote A.
DOI: 10.11607/prd.7467
Purpose: To describe a hybrid technique combining lateral stretching (LS) of the apical flap portion with limited coronal advancement of the flap (CAF) to minimize graft exposure and avoiding excessive coronal displacement of the mucogingival junction (MGJ) for deep and wide gingival recessions.
Conclusions: The LA + CAF + CTG technique is a hybrid technique that allowed for an envelope flap approach to achieving root coverage on wide/deep single recessions and multiple contiguous deep-narrow defects while simultaneously augmenting the KTW and maintaining the MGJ.
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Abutment-free Tissue-Level Implants for Personalized Monolithic Zirconia Implant Crowns: A Retrospective Cohort Study
Authors: Ionescu A., Marin M., Bayrich N., Fennema P., Nicolescu MI., Jung RE., Dodi A.
DOI: 10.11607/jomi.11144.
Purpose: To assess peri-implant bone stability between abutment-free tissue-level implants and conventional tissue-level implants restored with Ti-base abutments over 12 months. Secondary aim: document patient-reported oral health outcomes.
Conclusions: Abutment-free tissue-level implants were non-inferior to conventional Ti-base restored tissue-level implants and may offer advantages in preserving buccal bone and ridge width over 1 year. Benefits may include reduced component complexity, number of micro-gaps, elimination of cementation, and improved digital customization. Long-term randomized trials are indicated to confirm these findings and assess complication profiles.
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Periodontal Regenerative Therapy with Double-Sided Entire Papilla Preservation (DEPP) Technique for Intrabony Defects: A Case-Series with 12-Month Follow-Up
Authors: Ogawa Y, Aslan S, Goto H, Kawanabe D, Nagai T, Maekawa S, Ishikawa T, Saito A, Cortellini P, Imamura K.
DOI: 10.11607/prd.7532.
Purpose: The purpose of this study is to present a case series using double-sided entire papilla preservation (DEPP) technique in periodontal regenerative therapy of intrabony defects.
Conclusions: The use of DEPP in combination with regenerative therapy can be used to effectively treat intrabony defects with successful outcomes of PD </=4mm and CAL gain of >3mm.
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Root coverage in deep recessions with apex involvement: Long-term case study.
Authors: César Neto JB, Lazarin R, Freitas VM, Matheus HR, Sekiguchi RT, Romito GA.
DOI: 10.1002/cap.10345.
Purpose: The purpose of this article is to describe the method of either a laterally sliding flap (LSF) or modified double papilla flap (MDPF) with combination with a subepithelial connective tissue graft (SCTG) and apicoectomy in cases included gingival recessions (GR) extending to the apex.
Conclusions: This study demonstrates that in the presence of deep GR, apex exposure, and pulpal necrosis, the use of SCTG and apicoectomy in combination with root coverage procedures can achieve root coverage in severe mucogingival defects.
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Changes in Osseous Morphology Following Non-Surgical Periodontal Therapy: A Possible Paradigm Shift for the Treatment of Intrabony Defects?
Authors: Nibali, et al.
DOI: 10.1111/jcpe.14141
Purpose: A review on expected outcomes from non-surgical periodontal therapy (NSPT) utilizing updated data.
Conclusions: NSPT can result in alveolar bone changes. A re-evaluation after NSPT should be completed as far as 6 months after NSPT, prior to moving forward with surgical treatment.
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Surface Decontamination on the Reconstructive Therapy of Peri-Implantitis: A Multicenter Randomized Clinical Trial
Authors: Monje, et al.
DOI: 10.1111/cid.70075
Purpose: The aim of this study is to compare two methods of mechanical decontamination for the process of reconstructive treatment of peri-implantitis-related intrabony circumferential defects, adjunctive hydrogen peroxide (HP) or electrolysis (GS).
Conclusions: Both electrolysis or hydrogen peroxide are effective in gaining radiographic marginal bone levels, resolving peri-implantitis, and are beneficial for improving peri-implant conditions along with surgical reconstructive therapy. When comparing GS in conjunction mechanical debridement it is found to be ~4× more effective than HP to achieve disease resolution in cases of peri-implantitis-related intrabony defect treatment via reconstructive methods (with disease resolution being no BOP or Suppuration).
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Comparison of the Histological Structure of an Anterior as well as a Posterior Biopsy From the Human Palate: A Comparative Study
Authors: Bienz S. et al.
DOI: 10.1111/jcpe.14133.
Purpose: To compare the histological composition of soft tissue biopsies obtained from the anterior (A) and posterior (P) areas of the human palate, to evaluate potential differences between donor sites for soft tissue grafting procedures
Conclusions: Although lamina propria thickness was similar across regions, distinct histological differences were observed between anterior and posterior palatal mucosa. The posterior palate exhibited a higher concentration of collagen fibers and a lower proportion of loose connective tissue, which may influence graft performance. These findings suggest that harvesting techniques such as single incision and trap door techniques should consider tissue composition, as increased submucosal content may negatively affect healing due to its glandular and fatty composition, potentially limiting plasmatic diffusion and vascularization.
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Interdisciplinary Management of Open Interproximal Embrasures
Authors: Ogawa Y. et al.
DOI: 10.1111/jerd.70015
Purpose: To discuss key etiological and risk factors associated with the onset and progression of Open interproximal embrasures (OIE) and propose a systematic interdisciplinary approach for their management.
Conclusions: Effective management of OIE requires a well-coordinated interdisciplinary approach involving accurate diagnosis and treatment planning. Success depends on integrating periodontal, orthodontic, and prosthetic strategies tailored to each patient. Although focused on natural dentition, the discussed principles can also apply to restorations involving pontics and implants. Further research is needed to validate these concepts and recommendations.
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Combined Effect of Abutment Height and Restoration Emergence Angle on Peri-Implant Bone Loss Progression: A Retrospective Analysis.
Authors: Misch, J., et. al.
DOI: 10.1111/clr.14408
Purpose: To assess the effect of abutment height in terms of peri-implant bone response around bone level implants with various emergence angles.
Conclusions: An abutment height >2mm significantly reduces PI and MBL related to REA >/=30 in bone-level implants. REA plays a significant role only when TmAH <2mm are used. An inverse relationship exists between TmAH and MBL > 0mm while no significant relationship was seen with REA.
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Premature Bone Resorption in Vertical Ridge Augmentation: A Systematic Review and Network Meta-Analysis of Randomised Clinical Trials.
Authors: Alotaibi, F., et al.
DOI: 10.1111/clr.14435
Purpose: To review the evidence on premature ridge resorption after different vertical ridge augmentation (VRA) techniques in staged implant placement cases.
Conclusions: VRA techniques that preserve the periosteum such as inlay, DO, and TET lead to less PBR. In techniques with full flap elevation, volume loss at re-entry is possible and higher graft volumes should be considered to compensate for this issue.
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Peri-implant tissue stability: The PROS concept
Authors: Misch J, Alrmali AE, Galindo-Fernandez P, Saleh MHA, Wang HL
DOI: PMID: 40047364
Purpose: To offer a structured approach to implant placement using prosthetic design features in order to achieve predictable peri-implant tissue outcomes.
Conclusions: The key principles of the PROS concept include platform switching, restorative abutment design, optimal (conical) implant-abutment connection, and subcrestal implant placement. These elements work together to promote peri-implant tissue stability, improve predictability of crestal bone preservation, and lower the risk of peri-implantitis leading to successful long-term clinical outcomes.
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Radiographic changes in the maxillary sinus following closed sinus augmentation
Authors: Simonsen JO, Mills MP, Mealey BL, Hachem LE, Geha H, Font K, Powell CA
DOI: 10.1002/jper.11376
Purpose: To assess how accurately 3D imaging detects graft changes compared to 2D imaging, and to evaluate graft material distribution and resorption from baseline to six months after implant placement and transcrestal sinus lift.
Conclusions: CBCT or a 3D model shows slightly improved performance compared to a 2D model like the PA radiograph. A significant reduction in the bone graft was observed 6 months post-op with CBCT revealing a slightly higher change compared to PA. Grafts remained stable at 6 months, but long-term clinical trials are needed to evaluate the dimensional stability of FDBA.
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Threshold for Implant Removal in Peri-Implantitis Defects. Is There Any?
Authors: Zimmer J., Misch J., Nava P., Sabri H., Calatrava J., Wang HL.
DOI: 10.1563/aaid-joi-D-24-00098
Purpose: To review the latest literature to devise guidance for peri-implantitis management, including explanation indications.
Conclusions: Implants affected by peri-implantitis are indicated for explantation due to poor prognosis if less than 50% bone remains, though other prosthetic and patient factors are to be considered. Any mobile implants are to be explanted.
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Do Intrabony Defects Have a Worse Clinical Response to Step 2 of Periodontal Therapy and Repeated Subgingival Instrumentation Compared to Suprabony Defects? A Systematic Review
Authors: Marini L., Cuozzo A., Mainas G., Antonoglou G., Pilloni A., Nibali L.
DOI: 10.11607/prd.7235
Purpose: The purpose of this systematic review was to elucidate whether intrabony defects, as compared with suprabony defects, have worse therapeutic outcomes after non-surgical periodontal therapy (NSPT).
Conclusions: Current literature on differences in treatment outcomes from NSPT for intra- and supra-bony defects are too few, too heterogenous, and too contradictory in results. In this review, NSPT was associated with worse clinical outcomes for intrabony defects compared to suprabony defects in two studies, with better outcomes in one study, and with no difference in another.
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Indications and Regenerative Techniques for Lateral Window Sinus Floor Elevation with Ridge Augmentation
Authors: Scaini, R., Saleh, M. H. A., Lai, H-C., Sangiorgi, M., Zucchelli, G., Testori, T.
DOI: 10.1111/cid.70007
Purpose: This article explores the multifactorial considerations influencing the success of lateral window sinus elevation, focusing on systemic and local conditions, surgical planning, procedural execution, and postoperative management.
Conclusions: The lateral window sinus elevation has proven effective for over 40 years and remains important despite newer, less invasive methods like the transcrestal approach. It has become simpler and can now be done in-office without the need for bone harvesting. This technique offers better access to anatomical challenges, allows for multiple implants in one surgery, and works regardless of bone height. It also enables immediate management of complications like membrane tears. To provide optimal care, practitioners should master various methods, keeping the lateral window approach essential in implant dentistry.
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Marginal Bone Changes at Bone-Level Implants With Narrow or Standard Diameter Abutments: 1 -Year Results of a Randomised Controlled Trial
Authors: Liñares, A., Maceiras, L., Nóvoa, L., González, A., Rodríguez, B., Batalla, P., Leira, Y., Blanco, J.
DOI: 10.1111/clr.70005
Purpose: The objective of this study was to examine implants restored with standard or narrow diameter transmucosal abutments and assess variations in the implant marginal bone levels over 12 months following placement of the final prothesis.
Conclusions: While there were limitations within the study, no statistically significant differences were noted among the narrow vs. standard diameter abutments during the 12-month follow-up period. In addition, no significant differences were noted clinically, regarding complications, or patient experienced outcomes.
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Does Retention of Periosteum at the Palatal Donor Site During Subepithelial Connective Tissue Graft Harvesting Influence Wound Healing and Morbidity? A Randomized Controlled Trial.
Authors: Yadav VS, Makker K, Haidrus R, Ali M, Dawar A, Pandey J, Sati HC, Khan MA.
DOI: 10.11607/prd.7814. Epub ahead of print.
Purpose: To evaluate the healing after subepithelial connective tissue graft (SCTG) is harvested using a single incision technique, depending on whether a deeper tissue layer (the periosteum) is included or left behind.
Conclusions: Within the limitation of the study, the two harvesting methods did not differ in terms of EHI. Also, method exhibited similar pain score. Therefore, the two method is comparable.
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The Slice Harvesting Technique for Tuberosity Soft Tissue Grafts: A Case Report.
Authors: Ronco V.
DOI: 10.11607/prd.7465.
Purpose: To describe CTG harvesting technique from the tuberosity tangentially to the ridge. Background: Author’s reasoning for the new tuberosity harvest technique: first, the trapezoidal shape of CTG harvested with the distal wedge technique is poorly suited for recession coverage and requires significant reshaping; second, because the technique completely removes the peak of the tuberosity, they prevent the tissue from fully regenerating, which may complicate future harvesting from the site.
Conclusions: The perpendicular tuberosity harvesting technique is a viable option for addressing recession coverage.
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Effectiveness of Restoration Strategies for Posterior Missing Teeth With Dental Implants: A Retrospective Study
Authors: Gao J., Tang X., Deng C., Zhao X., Qu Y., Yang X., Wu Y., Xiang L., Man Y.
DOI: 10.1111/clr.14444
Purpose: To assess the effectiveness of restoring only the first molar (M1) when both first and second molar (M2) teeth are lost.
Conclusions: [Extracted Metrics/Key Findings: Complication free survival rates were 65.5% and 75.8% for Groups 1 and 2, respectively | Group 1 (M1 and M2 restored) had a 16.2% incidence of peri-implantitis over 3 years.] Restoring only the first molar in cases of missing first and second molar may be an effective and cost-efficient treatment option.
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Surgical Strategies for Implantation in Cases of Large Incisive Foramen: A Pilot Case Series Study
Authors: da Rosa JCM, de Oliveira Rosa ACP., Urban I.
DOI: 10.11607/prd.7376
Purpose: To evaluate outcomes of a reconstructive technique utilizing autogenous bone grafting from the maxillary tuberosity (MT) for the management of extraction sockets adjacent to large incisive foramen (IF) in the anterior maxillary region. Specifically, to address the challenges associated with this implant placement.
Conclusions: [Extracted Metrics/Key Findings: IF enucleation and reconstruction of the damaged sockets resulted in no abnormal postoperative pain or altered sensation.] The use of autogenous bone graft from the MT is a simple and effective approach for managing extraction sockets adjacent to a large IF and complex scenarios in the anterior maxilla. It is associated with favorable PROMs
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Osseointegration in the Absence of Primary Stability: An Experimental Preclinical Mandibular Minipig Overpreparation In Vivo Model.
Authors: Gill T, Ooi H, Tezulas E, Petrie A, Rawlinson S, Roccuzzo M, Shahdad S.
DOI: 10.1111/clr.70006.
Purpose: The purpose of this study was to determine if implants with Implant Stability Quotient (ISQ) readings of low primary stability (ie from an oversized osteotomy) will osseointegrate, and if there is a histological difference in the quality of osseointegration between no and high primary stability achieving implants.
Conclusions: All implants placed in oversized osteotomies with a lack of primary stability (ISQ of 12 a.u.) were able to osseointegrate successfully, with significantly more coronal BIC and maintenance of bone volume at the coronal 2mm of implants in the overprepared group.
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Do systemic antibiotics offer benefits to the surgical treatment of peri-implantitis? A systematic review with meta-analyses.
Authors: Antonoglou, G., Papageorgiou, S., Carrillo de Albornoz, A., Payer, M., & Stavropoulos, A.
DOI: 10.1111/jcpe.70021.
Purpose: The purpose of this study was to evaluate the current evidence regarding the use of systemic antibiotics in conjunction to surgical peri-implantitis treatment and its effects on treatment outcomes. Furthermore, the influence of implant surfaces (ie turned vs modified) was also investigated in relation to disease resolution.
Conclusions: The use of systemic antibiotics in conjunction with surgical peri-implantitis treatment is associated with short-term improvements in clinical parameters and treatment success of modified surface implants.
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Convex Versus Concave Emergence Profile of Implant-Supported Crowns in the Aesthetic Zone: 3-Year Results of a Randomized Controlled Trial.
Authors: Endres, et al.
DOI: 10.1111/jcpe.70018
Purpose: To compare convex vs. concave emergence profiles of implant-supported restorations in relation to 3-year clinical and radiographic outcomes.
Conclusions: When comparing a concave vs. convex profile there is a significant difference in soft tissue stability with a concave profile being preferred in the esthetic zone in order to reduce the risk of mid-facial margin recession long term.
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A Comparative Study on the Accuracy of Implant Placement Using 3D-Printed and Milled Guides Without Metal Sleeves
Authors: Ballesteros, et al.
DOI: 10.1111/cid.70072
Purpose: To compare manufacturing processes and use of metal sleeves for static computer aided implant placement on the differences in accuracy of final implant positioning.
Conclusions: Creating a guide with or without a metal sleeve does influence the accuracy of the final implant position. The most accurate implants were those placed using a sleeve-free surgical guide in regard to 3D deviations at the crest and apex. Sleeve-free guides that were printed were overall better compared to those that were milled when looking at angular deviation.
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Peri-implant Tissue Changes Around Maxillary Anterior Immediate Tooth Replacement with and without Socket- Shield: 1-Year Randomized Controlled Clinical Trial.
Authors: Liao HC, et al.
DOI: 10.11607/jomi.11308.
Purpose: To compare facial mucosal and profile changes after maxillary anterior single immediate implant placement and provisionalization (IIPP) with or without the socket shield (SS) technique, while also assessing implant success, peri-implant tissue outcomes, and complications.
Conclusions: [Extracted Metrics/Key Findings: Marginal bone level changes were minimal in both groups, and facial mucosal level and papilla changes showed no significant differences. | While IIPP+SS may help limit buccal profile changes in cases of high buccal resorption, its clinical advantage appears limited.] IIPP+SS showed a slight advantage in preserving the facial mucosal profile, but both approaches yielded comparable, clinically satisfactory biological, functional, and esthetic outcomes.
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Treatment of Peri-implant Mucositis: An AAP/AO Systematic Review and Meta-analysis
Authors: Lin GH, et al.
DOI: 10.11607/jomi.2025suppl2
Purpose: to evaluate whether adjunctive therapies provide additional benefits over mechanical debridement alone in the treatment of peri-implant mucositis.
Conclusions: [Extracted Metrics/Key Findings: BoP alone should not define peri-implant mucositis | ; diagnosis must consider BoP in combination with other clinical signs (inflammation, | PD changes, absence of progressive bone loss).] Peri-implant debridement alone generally improves PD and BoP in peri-mucositis, while adjunctive therapies do not provide significant added benefit regardless of smoking status, and complete disease resolution remains inconsistent with any treatment.
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Efficacy of Nonreconstructive Surgical Treatment of Peri-implantitis: An AAP/AO Systematic Review and Meta-analysis of Access Flap Versus Osseous Surgery Procedures.
Authors: Saleh, M.H.A, et. al.
DOI: 10.11607/jomi.2025suppl3
Purpose: Compare access flap procedures to osseous procedures in the nonreconstructive surgical treatment of peri-implantitis.
Conclusions: [Extracted Metrics/Key Findings: 15 randomized controlled trials | All but one study involved non-surgical therapy before surgical treatment.] Both nonreconstructive surgical treatments (osseous and flap surgery) can effectively manage peri-implantitis, leading to improvements in PD and BOP. Changes in MBL are in slight favor of flap surgery. A weak inverse relationship was found between smoking and reduction in BOP and slightly higher MBL was found in patients with a periodontitis history. The results of this study failed to accumulate enough evidence showing a significant advantage of one approach vs the other.
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Surgical- and implant-related factors and onset/progression of peri-implant diseases: An AO/AAP systematic review
Authors: Monje, A., et al.
DOI: 10.1002/JPER.24-0083
Purpose: To highlight surgical- and implant-related factors involved in the onset and progression of peri-implant diseases.
Conclusions: [Extracted Metrics/Key Findings: . Implant malpositioning in relation to the bone and adjacent teeth/implants was associated with peri-implantitis, | One study found that when inter-implant distance was <3mm, there was an. 8.6x higher chance of peri-implantitis compared to distances >/=3mm. | The benefit of connective tissue grafting to prevent peri-implant disease has been demonstrated, however some studies report a significant effect, while others show only benefits | for peri-implant mucositis and not peri-implantitis. | guided implant placement, | narrow implants. | W | hen the restorative margins were <1.5mm from the bone, a 2.3x higher risk of peri-implantitis was found compared to those >/=1.5mm (tissue level or implants with transmucosal abutments).] Implant malpositioning has a notable impact on peri-implantitis development. A short distance between the prosthetic margin to the crestal bone may predispose to peri-implantitis, thus a tissue-level implant or transmucosal abutment use is favored.
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Efficacy of Decontamination Methods for Biofilm Removal from Dental Implant Surfaces and Reosseointegration: An AAP/AO Systematic Review on Peri-implant Diseases and Conditions
Authors: Ravidà A, Dias D, Lemke R, Rosen P, Bertolini M
DOI: 10.11607/ jomi.2025suppl4
Purpose: To assess the evidence on the effectiveness of various decontamination methods in promoting reosseointegration, removing biofilm from implant surfaces, and evaluating their potential to cause adverse surface alterations.
Conclusions: [Extracted Metrics/Key Findings: . Several studies demonstrated that reosseointegration (RO) or bone to implant contact (BIC) is possible following surface decontamination. | Air-powder abrasion (APA) and lasers (Er:YAG, CO2, Er,Cr:YSGG) most consistently showed potential to achieve reosseointegration, while soaked cotton pellets and curettes produced inconsistent results. | Electrolytic cleaning showed successful RO with BIC values of | 1.3-5.2mm but was investigated in very few studies] Decontamination of implant surfaces is essential for resolving peri-implantitis and enabling potential reosseointegration, though no method has shown clear clinical superiority in terms of bone gain or reosseointegration when using the same biomaterials and techniques. Combining chemical and mechanical treatments does not significantly improve outcomes over mechanical methods alone. Laboratory studies demonstrate more effective biofilm removal with PEEK, air-powder abrasion (APA), Er:YAG lasers, and electrolytic cleaning, with minimal surface alterations seen using cotton pellets, APA, Er:YAG (<70 mJ/pulse), Er,Cr:YSGG lasers, electrochemical treatment, and cold atmospheric plasma. However, other instruments risk damaging surfaces or leaving remnants. Overall, an ideal protocol should fully eliminate biofilm without altering implant surfaces or releasing titanium particles, with electrolytic cleaning, APA, and Er:YAG laser therapy showing the most promise.
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AO/AAP consensus on prevention and management of peri-implant diseases and conditions: Summary report
Authors: Wang HL et al
DOI: DOI:10.1002/JPER.25-0270
Purpose: The consensus aimed to synthesize current scientific evidence and expert opinion for the prevention and management of peri-implant diseases and provide clinicians with structured tools for risk assessment, treatment decision-making, and long-term maintenance.
Conclusions: [Extracted Metrics/Key Findings: history of periodontitis, smoking, uncontrolled diabetes, obesity, and erratic maintenance compliance were consistently linked to increased incidence of peri-implant mucositis and peri-implantitis. | m | alpositioning, inadequate inter-implant distance, excessive subcrestal placement, unfavorable prosthetic emergence profiles, and thin or insufficient keratinized mucosa. | Prosthetic design factors, such as platform-matched abutments, abutment height <2 mm, convex profiles, and emergence angles >30°, were associated with higher marginal bone loss (MBL), while | platform switching and concave abutments were protective. | in tissues, inadequate keratinized mucosa, and buccal positioning identified as key risks. | Air-polishing, Er:YAG lasers, and electrolytic cleaning showed promise with minimal surface damage whereas brushes and curettes led to surface alterations | utogenous tissue grafts are considered the gold standard for increasing keratinized mucosa, augmenting soft tissue volume, and deepening the vestibule,] The consensus highlighted systemic risk factors for PID, including history of periodontitis, smoking, uncontrolled diabetes, obesity, and excessive alcohol use, along with local factors such as implant malposition, inadequate spacing, and unfavorable soft tissue phenotypes. Prevention requires thorough pretreatment assessment and tailored strategies. For treatment, manual debridement is central for peri-implant mucositis and the first step in peri-implantitis management, with adjuncts applied as needed. Non-reconstructive surgery can effectively reduce probing depth and bleeding, while reconstructive approaches with grafts and membranes are indicated in favorable bone conditions. Long-term success depends on supportive peri-implant therapy, including patient education and maintenance.
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Discrepancy in Crestal Bone Height Level for Adjacent Dental Implants, When is it Significant? A Retrospective Study With a Minimum of 1-Year Follow-Up
Authors: Kasabreh NS, Malaikah S, Khurshid H, Khan MQ, Wang HL
DOI: doi: 10.11607/jomi.11208
Purpose: The purpose of this retrospective study was to assess how crestal height affects marginal bone loss amount in splinted and non-splinted adjacent implants.
Conclusions: When posterior implants are placed at differing crestal bone height levels, splinting them may elicit less progression of marginal bone loss compared to not splinting them. Crestal bone height levels may be a potential factor for marginal bone loss.
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Deep Margin Elevation: Current Evidence and a Critical Approach to Clinical Protocols—A Narrative Review
Authors: Karageorgiou A, Fostiropoulou M, Antoniadou M, Pappa E
DOI: doi.org/10.3390/adhesives1030010
Purpose: This narrative review seeks to summarize existing literature on the techniques and effectiveness of Deep Margin Elevation (DME), a conservative restorative technique used to raise subgingival margins coronally by using composite resin.
Conclusions: [Extracted Metrics/Key Findings: Magne] DME is a technique for conservative management of deep sub-gingival margins and is an alternative to crown lengthening and orthodontic extrusion, so long as >0.5mm of the junctional epithelium is not invaded. Ability to achieve isolation, composite and bonding protocols, assessment of occlusal forces, and patient oral hygiene practices are important considerations for technique success.
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Evidence Supports the Use of Short Implants as a Graftless Solution – A Narrative Review.
Authors: Block, MS.
DOI: 10.11607/jomi.11188
Purpose: The purpose of this narrative review is to prove the success of using short dental implants in patients with minimal bone volume to avoid grafting procedures. This review should guide clinicians on when to use short implants (less than 8.5 mm in length) and when grafting with a longer implant is more advantageous.
Conclusions: Evidence from peer-reviewed studies indicates that splinted short implants demonstrate success rates comparable to those of longer implants. However, single short implants were associated with a higher likelihood of failure secondary to loss of integration over time. Short implants can be used while splinted to other implants to avoid sinus grafting.
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Chairside vs Prefabricated Sealing Socket Abutments for Posterior Immediate Implants: A Randomized Clinical Trial.
Authors: Gnusins, V., Akhondi, S., Zvirblis, T., Pala, K., Gallucci, G.O., & Puisys, A.
DOI: 10.1111/cid.70076
Purpose: This randomized clinical trial evaluated differences in soft tissue height, probing depth, and buccal contour volume reduction after immediate implant placement, comparing chairside composite Sealing Socket Abutments (SSAs) vs. prefabricated zirconia SSAs in posterior sites. Background: Immediate implant placement protocols have become more accepted over the years, for both anterior and posterior extraction sites. Recent literature has confirmed the success in both areas. Research highlights the preservation of peri-implant soft and hard tissue, better outcomes for the pink esthetic score, and favors marginal tissue stability while food impaction incidence is reduced. While both anterior and posterior sites for immediate implant placement have become more popular, the molar region poses greater difficulty in controlling heavy occlusal forces. Finelle et al. in 2017 introduced the Sealing Socket Abutment (SSA) concept to reduce the risk of immediate restoration in the posterior area following extraction, while maintaining the benefits of immediate implant placement. The purpose was to support soft tissue healing by sealing the socket with a custom abutment that creates the proper emergence profile while maintaining the buccal contour. SSAs are typically fabricated chairside with flowable composite resin. However, recently there has been emerging evidence that polished zirconia may offer soft tissue behavior benefits in subgingival applications.
Conclusions: The two treatment approaches produced similar overall results. Zirconia abutments were associated with reduced probing depths, whereas composite abutments demonstrated less tissue volume loss. In both groups, SPTH remained stable. Future studies are needed to determine early differences in PPD influencing long-term peri-implant tissue health.
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Impact of Buccal Bone Arch Contour on Bone Remodeling and Esthetics in Guided Bone Regeneration: A Retrospective Study.
Authors: Zuo M, Zhang H, Xie Z, Zhou Y.
DOI: 10.1111/cid.70086.
Purpose: To evaluate the stability of augmented bone via GBR (at the time of implant placement) in the esthetic zone and to identify correlation between buccal bone arch contours with subsequent bone remodeling and prosthetic outcomes.
Conclusions: Based on the study, implant placement of at least 2mm palatal from the contour and overbulking by at least 1mm from contour is ideal considering augmentation efficiency.
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Correlation of Implant Location to Marginal Bone Level Changes in Single-Unit Restorations: A Retrospective Study.
Authors: Ayyildiz BG, Ayyildiz H, Tözüm TF.
DOI: 10.1111/cid.70092.
Purpose: To analyze the effect of emergence angle (EA) and emergence profiles (EP) to the marginal bone level depending on different locations (molar, premolar, anterior).
Conclusions: Based on the study, different EA cut-off point should be utilized for different locations.
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Partial-Full-Thickness Tunnel Technique with Palatal Vertical Incisions and Supracrestal Sling Sutures for Papilla Reconstruction and Root Coverage in the Esthetic Zone: A Technical Case Report
Authors: Kuo PJ., Chen BJ., Rasperini G., Tsai YW., Wu TH., Do JH.
DOI: 10.11607/prd.7778
Purpose: To present a novel surgical approach for utilizing labial vestibular incisions and palatal marginal vertical incisions to create a partial-full-thickness tunnel for connective tissue graft (CTG) supported root coverage and papilla of recession type 2 (RT2) defects. The technique also utilizes supra-crestal sling (SCS) sutures, optimizes blood supply, maximizes wound stability, resulting in significant papilla augmentation and complete root coverage.
Conclusions: Combining the partial-full-thickness tunnel technique with palatal vertical incisions effectively facilitates passive tissue mobilization without requiring papillary incisions. The CTG, secured by SCS sutures, allows from maintenance of the papilla in a coronally advanced position. The approach shows promise for root coverage a papilla reconstruction in the esthetic zone.
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Papilla Reconstruction via Incision and Submucosal Mobilization (PRISM): A Technique Illustration
Authors: Mourlass J., Cortasse B., Tavelli L.
DOI: 10.11607/prd.7815
Purpose: To introduce a tunnel-like surgical technique for papilla reconstruction via incision and submucosal mobilization (PRISM) in esthetically deficient type C or E papillae.
Conclusions: A tunnel-like surgical approach was used for three-dimensional augmentation of deficient interdental papillae in the esthetic zone. The technique has the potential to improve patient-reported outcomes and may represent a valuable addition to the clinician’s therapeutic options.
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Sinus Floor Elevation With Platelet-Rich Fibrin From Horizontal Centrifugation and Xenograft: Randomized Clinical Trial
Authors: Reis G. G. D., Denardi R. J., de Souza S. L. S., et al.
DOI: 10.1111/cid.70093.
Purpose: The purpose of this article was to examine the effects of using horizontal centrifugation-prepared platelet rich fibrin (H-PRF) in combination with deproteinized bovine bone mineral (DBBM) for sinus augmentation.
Conclusions: The combination of DBBM with H-PRF for maxillary sinus augmentation results in more NFB than DBBM alone.
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Apical horizontal incision with periosteum graft wall technique for periodontal regeneration: A case study.
Authors: Shiraishi K, Chiou LL, Haga T, Hamada Y, Cortellini P.
DOI: 10.1002/cap.10339
Purpose: This case study involved the treatment of a hopeless tooth affected by an endo-periodontal lesion (EPL) via a vestibular access regenerative treatment method with placement of a connective tissue graft (CTG) involving the underlying periosteum. Both radiographic and clinical outcomes, in addition to an improved periodontal prognosis are described in the study.
Conclusions: Interdisciplinary treatment and periodontal regenerative approaches can be utilized in managing teeth with EPL and significant bone loss. Access via a vestibular horizontal incision can provide adequate access to the boney defect, and the utilization of a CTG including the underlying periosteum can aid favorable outcomes in the presence of a non-contained defect.
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Clinical Treatment Endpoints After Active Periodontal Treatment and 10 Years of Supportive Periodontal Care: A Retrospective Cohort Study
Authors: Schroder, et al.
DOI: 10.1111/jcpe.14179.
Purpose: To compare periodontal stability using four predetermined clinical endpoints (CEPs), following active periodontal treatment (APT/T1) and supportive periodontal care (SPC/T2) lasting 120 ±12 months.
Conclusions: Achieving CEP1 is can be done via comprehensive APT but treating a chronic disease more often leads to less ideal CEP2/CEP3. Achieving CEP1, CEP2 or CEP3 after APT made no significant difference regarding PTL to which it can be implied that achieving CEP2 or CEP3 (which are more realistic for most patients than CEP1) may be sufficient for the majority of patients when attempting to predict long-term stability. There was significantly more tooth loss between CEP1-3 at T1/2 with CEP1: 0 teeth, CEP2: 0.22 teeth, CEP3: 0.2 teeth. Thus showing that it is realistic to use CEP3 as the cutoff for predicting PTL.
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Surgical Reconstructive Therapy for the Management of Peri-implantitis: An AAP/AO Systematic Review and Network Meta-analysis
Authors: Barootchi, et al.
DOI: 10.11607/jomi.2025suppl1. PMID: 40476895
Purpose: The purpose of this study was to systematically review the clinical research that has been completed in regard to surgical reconstructive therapy for per-implantitis. This was then used for the joint consensus between the American Academy of Periodontology (AAP) and the Academy of Osseointegration (AO).
Conclusions: When first examining a peri-implantitis lesion the initial severity of the defect and its morphology significantly impact whether reconstructive or resective treatment can be completed. When comparing reconstructive vs. resective treatment for infrabony peri-implantitis defects both can result in reduction of MREC and PPD as well as Rx MBL gain. Reconstructive was found though to be superior to nonreconstructive treatment in all categories except for BoP and SUP where no significant differences were found. The initial KTW has a significant effect providing a benefit for overall clinical outcomes. All clinical outcomes benefited from using both allograft and or xenograft materials, but there was lacking evidence for barrier membranes. Using Ti brushes after completing scaling with ultrasonic or hand instruments showed additional benefits. Using H2O2 or EDTA as a form of chemical decontamination showed no benefit over saline.
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Endpoints of Periodontal Therapy in Elderly Patients With Stage III/IV Periodontitis and Their Oral Health–Related Quality of Life Following 10 Years of Supportive Periodontal Therapy
Authors: Bumm, C et al.
DOI: 10.1111/jcpe.14198
Purpose: To evaluate different periodontal therapy endpoints and their long-term impact on disease stability and OHRQoL, testing the null hypothesis that clinical outcomes are not associated with patient-reported OHRQoL after SPT.
Conclusions: Traditional clinical endpoints of periodontal therapy may not fully capture patient-perceived outcomes. Tooth migration, a key functional and aesthetic concern, significantly impacted OHRQoL, highlighting the need for a holistic, patient-centered approach that combines clinical and patient-reported outcomes to improve long-term satisfaction and quality of life.
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Impact of implant-abutment connection design on biological and mechanical outcomes in posterior single-tooth restorations: A randomized clinical trial
Authors: Rubianes-Porta L et al.
DOI: 10.1016/j.prosdent.2025.06.022.
Purpose: This study aimed to assess whether implant-abutment connection design (external hexagon [EC], internal hexagon [IC], or conical [CC]) influences vertical marginal bone loss in posterior single-unit implant-supported crowns, and secondarily, whether it affects the risk of biological or mechanical complications. The null hypothesis proposed no association between connection design and marginal bone loss.
Conclusions: This randomized clinical trial found no significant differences in short-term survival rates, bone level changes, or complication risks among different implant-abutment connection designs (external, internal and conical) in posterior single-unit implant-supported crowns. However, the results should be interpreted cautiously due to the short follow-up period and the limited clinical experience of the operators.
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Effect of Tooth Splinting on Clinical Outcomes following Periodontal Regenerative Therapy in Teeth with Mobility Degree 1 or 0: A Propensity Score-Matched Analysis
Authors: Mikami, R, et. al.
DOI: 10.1111/jcpe.14190
Purpose: to assess the effects of splinting on 1- and 3-year outcomes of regenerative therapy of intrabony defects with Enamel Matrix Derivative (EMD) on teeth with grade 1 or 0 mobility.
Conclusions: [Extracted Metrics/Key Findings: Splinting might not have adjunct benefits for regenerative therapy of teeth with grade 1 or less mobility,] No statistically significant differences were seen in PD, CAL, and RBD gain in splinted or unsplinted teeth regeneratively treated with EMD, during a 3-year follow-up.
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Cost Effectiveness of Two Short Implants Versus One Short Implant With a Cantilever in the Posterior Region: 7.5-Year Follow-Up of a Randomised Controlled Trial.
Authors: Strauss, F. J., et al.
DOI: 10.1111/jcpe.70039
Purpose: to compare outcomes as well as cost-effectiveness of two non-splinted adjacent short implants with a single short implant that supports a cantilever restoration over 7.5 years.
Conclusions: Both treatments had similar clinical and radiographic outcomes with short implants with a cantilever being more cost effective but having higher early complication and failure rates, potentially due to mechanical overload.
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Pre-Emptive Analgesia for Periodontal and Implant-Related Surgery: A Systematic Review and Meta-Analysis
Authors: Gousias C, Alsuwaiyan Z, Fial A, Han S, Tatakis DN, Kofina V
DOI: 10.1111/jcpe.14157
Purpose: To determine whether pre-emptive analgesic medications, administered before periodontal and implant-related surgeries, effectively reduce post-operative pain compared to placebo. The authors also aimed to rank the effectiveness of different drugs and identify any adverse effects.
Conclusions: [Extracted Metrics/Key Findings: NSAIDs, corticosteroids (dexamethasone), and acetaminophen,] Pre-emptive analgesia can provide clinically meaningful pain reduction for up to 8 hours following periodontal and implant surgeries. The findings support the use of NSAIDs, corticosteroids, or acetaminophen given before surgery to improve patient comfort during the early post-operative period. However, the certainty of evidence was moderate, and further high-quality trials are needed to confirm long-term benefits and safety profiles.
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Prosthetic Outcomes in Stage III/IV Periodontitis Patients With 20–29 Years of Supportive Periodontal Care
Authors: Eger, T., F. Wörner, N. Lingwal, and P. Eickholz
DOI: 10.1111/jcpe.70036
Purpose: To study tooth loss (TL) in treated periodontitis (stage III/IV) patients undergoing supportive periodontal care with and without partial denture (PD) (removable [RPD], fixed PD [FPD], implant supported FPD [iFPD]) and10- year prosthetic outcomes.
Conclusions: [Extracted Metrics/Key Findings: and use of RPDC, RPDD, or FPD were significantly associated with greater tooth loss,] Patients with stage III/IV periodontitis with RPDC, RPDD or FDP experienced higher long-term tooth loss compared to controls, while iFPD showed similar tooth loss rates to untreated controls. Age and heavy smoking were significant risk factors for tooth loss, but despite these factors, over 80% of all prosthetic restorations remained functional for at least 10 years.
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Periosteal Fenestration Procedure in Apically Positioned Flap Increases the Attached Mucosal Width: An In Vivo Experimental Study.
Authors: Hong I, Jeong S, Shin HJ, Thoma DS, Strauss FJ, Lee JS
DOI: 10.1111/jcpe.14188.
Purpose: The purpose of this animal study was to assess the clinical and histological changes between an apically positioned flap (APF) with periosteal fenestration to an APF alone. Background: Shallow vestibules and insufficient masticatory mucosal width (MM) are most often treated with an APF and free gingival graft (FGG). A technique of creating a periosteal fenestration might be beneficial in circumstances where clinicians wish to mitigate post-operative pain and bleeding from the autologous graft. Denuding the alveolus may result in new attached gingiva (scar-like) by inducing granulation tissue formation.
Conclusions: APF with a periosteal fenestration improves attached gingival width via non-keratinized attached mucosa.
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Inverted T-Shape Connective Tissue Graft for Interdental Papilla Reconstruction: A Clinical Case Series
Authors: Alrmali AE, Cury VF, Latimer J, Miller Jr PD, Wang HL.
DOI: 10.1111/jerd.70035
Purpose: This case series assessed the outcomes of inverted T-shape connective tissue graft (CTG) treatment for interdental papillae reconstruction in RT2 and RT3 gingival defects.
Conclusions: The inverted T-CTG technique can be beneficial for treating RT2 and RT3 defects with simultaneous interproximal papilla reconstruction.
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Impact of Collagen Membrane in Vertical Ridge Augmentation Using Ti-Reinforced PTFE Mesh: A Randomised Controlled Trial.
Authors: Urban, I.A., Serroni, M., Dias, D.R., Baráth, Z., Forster, A., Araújo, T.G., Saleh, M.H.A., Cucchi, A., Ravidà, A.
DOI: 10.1111/jcpe.14129
Purpose: The objective of this study was to assess whether PTFE mesh alone is non-inferior to PTFE mesh covered with a collagen membrane (CM) in vertical ridge augmentation (VRA) procedures, with absolute vertical bone gain (VBG) as the primary outcome.
Conclusions: Non-inferiority of PTFE mesh alone compared with PTFE mesh combined with a collagen membrane for VBG was not demonstrated. Nonetheless, both approaches yielded similar results in terms of VBG, complication rates, and bone density. The higher occurrence of type 1 pseudo-periosteum and reduced bone volume observed in the PTFE + CM group indicate that incorporating a collagen membrane may aid in limiting soft tissue ingrowth.
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Stability of Augmented Bone and Its Influencing Factors After Simultaneous Guided Bone Regeneration with Implant Placement in the Posterior Mandible: A Retrospective Study.
Authors: Chen, X., Qi, W., Wang, S., Xu, A., Lu, H., Shen, X., He, F.
DOI: 10.1111/jcpe.14206
Purpose: Given that the posterior mandible poses a higher risk for implant loss due to heavy occlusal forces, thick cortical bone, and high bone density, this study aims to evaluate the stability of augmented bone and the factors influencing it following simultaneous guided bone regeneration (GBR) and implant placement in this region.
Conclusions: [Extracted Metrics/Key Findings: individual phenotypical dimension (IPD)] Simultaneous GBR with implant placement in the posterior mandible demonstrated consistent volumetric stability of the augmented bone. OC grafts resorbed toward each patient’s phenotypical dimensions, whereas a 1–2 mm over-augmentation was beneficial for maintaining a bone arch contour reaching IPD, while increasing the bone augmentation range beyond 2 mm did not provide additional benefits. This finding was consistent with other studies recommending bone grafting of 1-2 mm over-contour range. Bone augmentation range has been identified as the most significant factor affecting ABV%, confirming that IPD serves as the GBR procedure’s limiting boundary. Volumetric stability was reduced in non-contained defects, while the use of 2-mm healing abutments enhanced stability compared with cover screws due to reducing soft-tissue collapse at the coronal aspect and preserving the space for bone regeneration.
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Effect of Dental Implant Design on Stability During Early Healing: A Randomised Controlled Trial.
Authors: Charoenniwassakul R, Aruncharoensuk S, Subbalekha K, Mattheos N, Jiaranuchart S, Pimkhaokham A.
DOI: 10.1111/jcpe.70052
Purpose: To compare the stability of cylindrical and tapered implant during the early healing phase.
Conclusions: Within the limitation of the study, both types of implants exhibited consistent high stability during early healing phase.
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Graftless Sinus Floor Elevation Using the Lateral or Transcrestal Approach. A Randomized Clinical Trial With One Year Follow-Up.
Authors: Fettouh AIA, Ghallab NA, Adel N, Nasser R, Gamal N, Samy M, Shemais N.
DOI: 10.1111/clr.70055.
Purpose: To compare implant stability between a crestal sinus lift and a lateral window approach, both performed without the use of bone grafts.
Conclusions: Both techniques produce a reliable results (in terms of stability) for placing implants with residual bone height of 4-6mm.
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Clinical Performance of Narrow Versus Standard Diameter Dental Implants: A Comparative Retrospective Split-Mouth Study
Authors: Raz P., Kantzuker O., Slutzkey G., Beitlitum I.
DOI: 10.11607/jomi.11490
Purpose: To compare clinical performance of narrow diameter implants (NDIs) versus standard diameter implants (SDIs) in a split-mouth study design over a three-year follow-up period.
Conclusions: NDIs demonstrate similar clinical performance in regard to implant survival and MBL over 3 years. NDIs are a reliable restorative option when space and/or bone is limited in the anterior or posterior jaws. Axial loading schemes in the posterior may be more amendable to NDIs, whereas lateral forces experienced in anterior regions may result in more mechanical complications and necessitate more careful occlusal design.
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Conservative Mucogingival Management of External Cervical Root Resorption Using Bioceramic Repair Materials: A Case Series
Authors: Sforza F., Cerutti F., Stefanini M., Marzadori M., Scarano A., Qorri E., Romano R., Pedulla E., Bugea C.
DOI: 10.11607/prd.7916
Purpose: To present clinical and radiographic outcomes from management of cervical root resorption by bioceramic repair and mucogingival surgery.
Conclusions: Favorable outcomes were found through the surgical approach for the management of external cervical root resorption. Pulp vitality, soft-tissue stability, and satisfactory esthetics were favorable clinical outcomes.
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Reduced prevalence of periodontitis in antidepressant users: Findings from a large-scale US sample.
Authors: Martínez M, Fraguas D, Figuero E, D´Aiuto F.
DOI: 10.1002/jper.70014
Purpose: The purpose of this article was to examine the relationship between periodontitis prevalence and usage of antidepressants.
Conclusions: This evidence from this study proposes that a protective relationship may exist between antidepressant usage and periodontitis, with those taking antidepressants showing a lesser OR of presenting with periodontal disease. Possible mechanisms behind the relationships include anti-inflammatory effects of antidepressants, alternations in bone metabolism (favoring bone formation), or effects to decrease prevalence of systemic risk factors.
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Intentional replantation of periodontally compromised teeth with concentrated growth factors.
Authors: Ayappali Kalluvalappil N, Kumar RS, Hassan TH.
DOI: 10.1002/cap.70017.
Purpose: The purpose of this article is to assess the outcomes relating to the use of concentrated growth factor (CGF) in conjunction with intentional replantation (IR) of anterior teeth that are periodontally compromised.
Conclusions: The use of IR in combination with CGF can results in improvements in clinical and radiographic parameters after a follow-up period of 12 months. Therefore, this procedure can be applied to maintain and save hopeless anterior teeth up to 12 months.
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Pre-Surgical Risk Assessment for Sinus Membrane Perforation: A Retrospective Cohort Study.
Authors: Ninneman, et al.
DOI: 10.1111/clr.70054
Purpose: To evaluate a current risk assessment (RA) tool that aims to predict the chances of having a sinus membrane perforation (SMP) when completing a lateral-window sinus floor elevation (LSFE).
Conclusions: In comparison to the original RA tool, a new cutoff of 3.02mm for RBH and an age of 55.5 years are found to be critical thresholds for increased risk of SMP during LSFE. The current RA tool was found to be good overall, but could not be completely validated due to the small sample size and retrospective study design.
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Volume-Stable Collagen Matrix as a Recombinant Human Bone Morphogenetic Protein-2 Carrier for Maxillary Sinus Augmentation: An Experimental In Vivo Study
Authors: Kim, et al.
DOI: 10.1111/jcpe.70054.
Purpose: To evaluate the effectiveness of using a volume-stable collagen matrix (VCMX) as a carrier for rhBMP-2 during sinus elevation procedures in comparison to absorbable collagen sponge (ACS).
Conclusions: When completing a lateral sinus augmentation using adjunctive rhBMP-2 loaded onto VCMX there is increased bone regeneration (greater total augmented volume, new bone volume). The differences in results between VCMX and ACS are mainly attributed to the better space maintenance property of VCMX.
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The Trouser Technique: A Novel Approach for Peri-Implant Soft Tissue Augmentation
Authors: Pavon P, et al.
DOI: 10.3390/jcm14144974
Purpose: To explain the Trouser Technique, a connective tissue grafting approach designed to enhance peri-implant tissue volume both buccally and interproximally through a single surgical procedure.
Conclusions: The Trouser Technique with CTG is a safe and gentle method to fix the soft tissue volume around implants, especially in the esthetic zone. It thickens the soft tissue on both the buccal and interproximal areas in one procedure using one donor site, which means less discomfort and faster recovery for the patient.
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Treatment of Mandibular Class III/IV Furcation Defects with a Combination Plastic Regenerative Technique: A Case Series
Authors: Suzuki E et al.
DOI: 10.11607/prd.6656.
Purpose: To evaluate how combining fibroblast grow factors (FGF-2), carbonate apatite (CA), and a connective tissue graft (CTG) affect periodontal regeneration in mandibular furcation defects (FD) class III and IV.
Conclusions: It is possible to effectively treat FD class III/IV using a combination of FGF-2, CA, and a CTG
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Impact of Marginal Misfit in Implant-Supported Fixed Dental Prostheses on Peri-Implant Bone Levels: A Retrospective Quantitative Analysis.
Authors: Couso-Queiruga, E., et. al.
DOI: 10.1111/clr.70053
Purpose: to assess the effect of marginal misfit on bone levels in implant-supported prostheses (ISP) and identify a threshold for a misfit gap.
Conclusions: There is a strong association between peri-implant bone levels and the presence of vertical misfit gaps in ISPs. Gaps >/=0.1mm lead to significantly higher DIB compared to those without a gap
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The connective tissue cube for treatment of papillary deficiencies: A case report
Authors: Carvelli, G., et al.
DOI: 10.1002/cap.10371
Purpose: present a surgical technique in managing severely deficient papilla through regenerative and periodontal plastic surgical approaches.
Conclusions: The connective tissue cube technique combines periodontal plastic and regenerative surgery and has the potential to treat severe papillary deficiency.
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Pouch versus non-pouch technique for repairing the maxillary sinus membrane large perforation in rhesus monkey.
Authors: Liao Y, Wu J, Xia L, et al
DOI: 10.1002/JPER.24-0717
Purpose: To evaluate the effectiveness of the pouch vs non-pouch technique in repairing large perforations of the maxillary sinus membrane and their effects on bone regeneration.
Conclusions: Both pouch and non-pouch methods were effective for repairing large sinus membrane perforations and promoting bone formation. However, the pouch technique provided greater graft stability and minimized volume loss.
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Implantoplasty vs. Rotating Titanium Brushes in the Surgical Treatment of Peri-Implantitis: A 1-Year Randomised Controlled Clinical Trial.
Authors: Park SH, Kim DB, Kim DM, Sanz-Martin I, Sanz-Sanchez I, Derks J, Cha JK
DOI: 10.1111/jcpe.70056
Purpose: To compare implantoplasty to the use of titanium brushes in peri-implantitis treatment
Conclusions: Titanium brush surface decontamination showed non-inferiority to implantoplasty in peri-implantitis treatment.
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Aesthetics and patient‐reported outcomes in periodontology and implant dentistry: Consensus report.
Authors: Tonetti M, Sanz M, Cairo F, Nart J, Chapple I, Aimetti M, Aroca S, Avila‐Ortiz G, Blanco J, Bujaldón A et al.
DOI: 10.1111/jcpe.14182.
Purpose: To evaluate current literature regarding soft tissue augmentation techniques for treatment of exposed root and implant surfaces with special reference to clinician and patient reported outcome scores.
Conclusions: Soft tissue augmentation for gingival recession, peri-implant dehiscences, and during implant placement should be performed based not only on expected dimensional changes but also clinician and patient reported esthetic outcomes. Esthetic outcome scores with improved validity in such scenarios are needed.
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Peri- Implant Supracrestal Tissue Characteristics Related to Abutment Materials: A Comparative Histomorphometry Study
Authors: Borie, M., Bosshardt, D., Liegeois, L., Lecloux, G., Haugen, H.J., Hede, D.V., Lambert, F.
DOI: 10.1111/cid.70083
Purpose: This study seeks to evaluate and describe the peri-implant soft tissues (PIST) surrounding experimental abutments fabricated from titanium (Ti), dental resin (Re), and polyetheretherketone (PEEK).
Conclusions: The peri-implant soft tissues surrounding abutments made of Ti, Re, or PEEK appear to develop in a comparable manner. More extensive observation periods are necessary to assess potential long-term effects in using these materials.
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Schneiderian Membrane Elevation up to 8 mm by Transcrestal Technique Using Hollowed Osteotomes: A Human Cadaver Study
Authors: Coutant, J.C., Naveau, A., Lauverjat, Y., Ella, B.
DOI: 10.1111/cid.70096
Purpose: The primary objective of this clinical study was to evaluate the detachment surfaces produced by elevation of the Schneiderian membrane by 4-8 mm in human cadavers with a residual bone height of 4 mm, utilizing the transcrestal technique with the new hollowed osteotomes. The secondary objective was to evaluate the membrane detachment amount in every direction around the site of the implants after both procedures.
Conclusions: Using the new generation osteotome in a transcrestal approach enabled sinus membrane elevations of up to 8 mm in cadaver models, with a low rate of perforations. This innovative, hollowed osteotome allowed for controlled and predictable Schneiderian membrane elevation, demonstrating both safety and reproducibility. The transcrestal protocol may broaden the clinical applicability of the technique, particularly for single-implant cases and medically compromised patients for which the lateral window approach may pose excessive surgical risk.
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Clinical Feasibility of AI-Driven Automated Virtual Dental Implant Placement: A Cross-Sectional Comparative Study.
Authors: Elgarba BM, Fontenele RC, Dawood EA, Lahoud P, Meeus J, Jacobs R.
DOI: 10.1111/cid.70111
Purpose: To compare digital implant planning/placement by AI and human expert (Oral surgeons or periodontists).
Conclusions: AI-planned implant position yields clinically comparable position planned by human experts. AI offers significant (10-fold) time efficiency compared to manual implant planning workflow.
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Impact of a Bioadhesive Oral Wound Dressing Combined With Flowable Resin on Patient-Reported Outcomes After Palatal Graft Harvesting: A Randomized Clinical Trial.
Authors: García-Moreno S, López-Pintor RM, Leco-Berrocal I, Torres J, González-Serrano J.
DOI: 10.1111/clr.70070.
Purpose: To evaluate the effectiveness of oral wound dressing in combination with flowable resin for managing post-op pain after harvesting from the palate for soft tissue grafting.
Conclusions: The method of applying wound dressing in combination with flowable resin is a convenient method that is an effective alternative to protect harvest site on the palate.
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Long-term stability of sinus complication management
Authors: Galindo-Moreno P., Testori T., Padial-Molina M., Olaechea A., O’Valle F., Galindo-Fernandez P.
DOI: 10.1111/prd.70021
Purpose: This article reviews long-term stability and consequences arising from maxillary sinus augmentation in implant dentistry. Introduction: Sinus floor elevation has allowed rehabilitation of patients in the presence of atrophic posterior maxillary sextant. It is a highly successful and predictable procedure with low complication rates. Complications and implant survival are not affected by approach (lateral or crestal), graft type, or graft vs graftless approaches. Patients ASA status, age, and tobacco use status have been shown to influence long-term implant success. Complications such as sinusitis and graft loss may also impact implant survival and overall treatment success. Complications: Complications occur intra- or post-surgical. Intra-surgical complications occur during surgery but do not affect long-term outcomes if successfully managed immediately during the procedure. The most common intra-surgical complication is sinus membrane perforation. Post-operative complications occur after the procedure and are most frequently sinusitis and migration of materials into the sinus cavity. Intra-surgical complications – Hemorrhage: Excessive bleeding may occur when the alveolo-antral artery is lacerated during lateral window elevation. Bleeding is typically self-limiting and rarely leads to long-term issues other than hematomas or bruising. Active bleeding does hinder the surgical field by decreasing visibility and ability to stabilize the graft. Post-operative nasal bleeding and blood clot in the sinus cavity leading to a radiopacity are further possible complications. Intra-surgical complications – Schneiderian Membrane Perforation: Membrane perforation affects approximately 20% of procedures. Risk factors include anatomical challenges (septa, narrow sinus shape), technical factors (types of instruments used – 6% with bone scrapers, 4.7% with piezoelectric devices, 20% with rotary instruments), and patient factors (thin membranes). Complete removal of the lateral bony window increases the risk (up to 9.6% with piezoelectric). Even higher risk is reported when bony window is displaced in, toward into the sinus cavity (with piezoelectric risk up to 17.6%). While many studies suggest perforation does not influence long-term survival, other authors link perforation to increased risk of infection and graft loss. Perforation size has been shown to influence implant survival, with 97% survival for perforations < 5 mm and 74% implant survival for large perforations > 10 mm reported in one case series. Several other articles do not demonstrate a difference in survival based on perforation size. In histomorphometric analysis, less vital bone formation has often been found in perforated sinuses compared to intact membranes. Not all articles highlight a difference in vital bone formation with perforation. Graft material may also migrate more easily in perforated sinuses. This can lead to increased acute sinusitis risk (up to 31% in perforated cases vs 6% in intact cases) – agreement among several articles. Intra-surgical complications – Overfilling of sinus cavity: Overfilling with graft material impairs revascularization and cellular migration resulting in less vital bone formation and more graft resorption. Excessive overfilling can also lead to obliteration of the ostium, compromising sinus patency and resulting in sinus infection. Additional post-op complications: Acute and chronic sinusitis – acute cases must be immediately treated to prevent progression to chronic sinusitis or advanced infections like osteomyelitis. Acute sinusitis subsequent to Schneiderian membrane perforation may pose long-term risk to decrease implant survival and increase risk of secondary infection of the grafted biomaterials. Conversely, loss of any material into the sinus lumen may trigger an inflammatory reaction, reduced permeability of the sinus membrane, and eventually resulting in acute or chronic sinusitis. Chronic sinusitis is rare but may significantly compromise the patient’s quality of life. If not resolved by antibiotics and anti-inflammatories, a surgical approach has a high success rate in resolving chronic sinusitis. Infection of biomaterials – infection of grafted material may occur in 2-5% of cases. It may result from unresolved odontogenic infections (untreated periapical / periodontal pathology), breakdown of the sterile operative field, or from untreated sinus infections that may retrogradely contaminate the grafted material after a perforation. Sinus graft infection rates were higher in perforated vs intact membranes in several studies (6.8% vs 0.3% in one study). Migration of foreign materials – migration of graft biomaterials, dental materials, or implant materials into the maxillary sinus may occur. Diagnosis always requires treatment to prevent complications or avoid potentially dangerous displacements into other cavities or areas. Most displaced implants into the sinus lumen result in chronic sinusitis. Even in absence of symptoms, evidence of pathology, inflammation, and infection have been found on the tissues formed on removed migrated implants. One article interestingly reported the highest incidence of implant migration was in residual ridges 6-7 mm in height. This strongly supports to use of short dental implants to avoid sinus lift procedures. Schneiderian membrane perforation by implants – implant insertion protruding into the sinus up to 5 mm without placement of bone material has been proposed in classic literature. In cases where the implant protrudes < 2 mm, spontaneous healing may occur to cover the exposed implant. When the protrusion is > 2 mm, the Schneiderian membrane is unable to heal over the implant surface. This situation may lead to debris accumulation which may lead to subsequent pathology. Other articles are highlighted which have demonstrated no difference in implant survival over several years in 3 or 4 mm protruded implants. Other authors have found increased sinus opacification which may be related to reaction inflammation from passage of oral bacteria. Explantation of protruding osseointegrated implants should be the last resort after failure of pharmacological and surgical interventions to manage sinusitis. Long-term bone graft resorption – autogenous bone results in the highest vital bone formation but resorbs quickly. Xenograft resorbs significantly more slowly but may still present with residual graft after 10 years (89% vital bone was found after 10 years). Synthetic alloplasts show higher resorption rates, with complete resorption sometimes occurring by 24 months. Sinus augmentation without biomaterials (by mere membrane elevation and clot stabilization) also shows remarkable stability with no volumetric shrinkage after 3 years and implant survival close to 98%. Voice quality alteration – a rare but significant complication which can permanently alter voice modulation. Although sparsely described in the literature, this is a critical complication for professionals such as singers or actors, who’s voice quality is central to their career.
Conclusions: Maxillary sinus floor elevation techniques are highly effective and predictable but not free from complications. Although documented complications that are high-risk and may require complex resolution, most complications are relatively easy to repair. However, this article documents how management of simple acute complications may still result in long-term sequelae leading to eventual graft and/or implant loss. These most common complications are Schneiderian membrane perforation and persistent chronic maxillary sinusitis. Furthermore, persistent alteration in voice quality should be included in the informed consent for lateral maxillary sinus elevation, especially in those individuals reliant on their voice quality for their professional careers.
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Biological Reset Protocol for the Regenerative Treatment of Advanced Peri-implantitis Defects: A Proof of Concept
Authors: Ravidà A., Dias DR., Romano L., Serroni M.
DOI: 10.1160/prd.7923
Purpose: To introduce the Biologic Reset Protocol as an evidence-based approach to achieve bone regeneration of peri-implant intrabony defects in a standardized, predictable manner. Protocol overview: The protocol is organized into three steps: 1) pre-surgical preparation, 2) surgical decontamination and reconstruction, and 3) prosthetic re-establishment. Pre-surgical preparation Prior to preparation for surgery, a baseline assessment consists of evaluating implant maintainability (whether the implant should be removed) and regenerative potential (whether a regenerative or resective approach should be used). Patient- and implant-related contraindications to therapy are provided in the article. Once a regenerative approach is elected, pre-surgical preparation consists of prosthesis removal, non-surgical biofilm control, and soft-tissue closure. Removal of the prosthetic – this is a critical component of this protocol to accurately diagnose pocket depths and extent of disease, design proper surgical flaps which will ideally facilitate primary closure of the wound and allow maximum access to the implant body for decontamination. Non-surgical biofilm control – although non-surgical therapy is inconsistent and limited in peri-implantitis, the use of air powder abrasives (APA) with erythritol powder is recommended in this article to control soft-tissue inflammation and texture prior to engaging in surgical therapy. Soft-tissue closure – placement of a cover screw following non-surgical treatment and waiting 8-weeks until surgery allows for maximal soft tissue migration and maturation in the surgical field, easing the surgical procedure. Before inserting the cover screw, it is recommended to rinse the area with 0.2% CHX. Surgical decontamination and reconstruction Consists of integrating bone graft and guided bone/tissue regeneration principles to re-establish hard- and soft-tissue support. A re-entry surgery is routinely performed to assess degree of bone fill and need for additional regenerative intervention. Soft-tissue augmentation is performed at the time of re-entry, if necessary. Surgery: after 8-weeks, the cover screw will be either completely or partially covered by peri-implant mucosa. In the mandible, a mid-crestal incision is made, and in the maxilla, a buccally biased incision is made. Intrasulcular incisions should extent one or more teeth and vertical releasing “hockey-stick” incisions made 2-3 mm into mucosa can also be made to increase access. Granulation tissue is removed circumferentially with a stainless-steel curette, avoiding contact with the implant body. The periosteal releasing incision for flap advancement may be made now at this earlier time in the procedure to ensure adequate hemostasis prior to closure. APA is recognized as one of the most promising methods for decontamination of the implant surface without altering the implant surface. It also has the capacity to reach otherwise difficult to reach areas. The bony defect can then be filled with xenograft or allograft, covered with a membrane, and stabilized with periosteal sutures. Finally, the flap should be advanced to achieve primary closure without tension. Suturing tips include use of non-plaque retentive sutures, non- or slowly resorbable sutures, and use of mattress and single interrupted suture design. Suture removal should be completed at 2-3 weeks. Standard post-op prescriptions and care is recommended. Second stage surgery: one advantage of the proposed submerged protocol is the necessity of a second-stage surgery to uncover the implant. The defect regeneration may also be assessed and additionally ancillary procedures performed at this time. If partial healing is achieved, additional decontamination and grafting may be indicated, and a non-submerged healing may be used to continue progression of the treatment. Soft-tissue augmentation: an adequate zone of keratinized mucosa > 2 mm should be attained prior to proceeding to the prosthetic phase to ensure optimal long-term peri-implant health. Prosthetic re-establishment A design ensuring long-term cleansability and biologic stability should be achieved. If no additional grafting was performed, a provisional crown may be made after a minimum of 4-6 weeks after healing abutment connection. If re-grafting was performed, a definitive restoration should be postponed for an additional 6 months.
Conclusions: Several key components are highlighted to attain predictable, biologically driven regeneration of the peri-implant tissues. Prosthetic crown removal, air powder abrasion with erythritol, assessment for additional grafting, and prosthetic modification are essential components of this protocol.
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Accuracy of Robotic Computer-Assisted Implant Surgery Combined With Transcrestal Sinus Floor Elevation for Single-Tooth Implants: A Retrospective Case Series.
Authors: Jia J, Du L, He L, Li Z, Li Y, Lv C.
DOI: 10.1111/jcpe.70038.
Purpose: The purpose of this study was to analyze the use of robotic computer-assisted implant surgery (r-CAIS) for transcrestal sinus floor elevation (TSFE) in the placement of single implants.
Conclusions: The outcomes of this study find that the use of r-CAIS for TSFE in single implant sites allows for highly accurate and safe implant placement. Complications- In our study, the mean global coronal, global apical and angular deviations were 0.50 ±0.22mm, 0.54±0.21mm and 1.25° ±0.61°, respectively. One sinus perf.
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Efficacy of Collagen Sponges and Gelatine Sponges as Dressing for Palatal Wounds: A Randomised Controlled Clinical Trial.
Authors: Huang JP, Jiang Y, Cheng XY, Wang J, Huang YH, Dai A, Zhou S, Pan WY, Fu SL, Wang YY, Ding PH.
DOI: 10.1111/jcpe.70028.
Purpose: The purpose of this study was to evaluate healing rates of palatal wounds from graft harvesting, with use of either collagen sponges (CS) or gelatine sponges (GS).
Conclusions: Overall, collagen sponges showed a more rapid wound healing rate and therefore can allow for and improvement over gelatin sponges in terms of decrease post-operative discomfort and early healing.
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Effect of Alveolar Process and Basal Bone Features on Post-Extraction Dimensional Changes
Authors: Emilia Couso-Queiruga, et al.
DOI: 10.1111/jcpe.70069
Purpose: To investigate post-extraction alveolar bone remodeling and the influence that specific phenotypic as well as anatomic variables have.
Conclusions: Initial anatomical and phenotypic features of extraction sites has a significant effect on alveolar ridge remodeling and need to augmentation after extraction. Specifically, there are greater dimensional changes when the facial wall is thin (≤ 1 mm), there is a sagittal root position SRP class IV, and when the tooth is outside the bony housing.
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The Effect of Periodontal Therapy on Renal Function and Diabetes Control in Patients With Chronic Kidney Disease.
Authors: Kouris, et al.
DOI: 10.1111/jcpe.70059
Purpose: Patients with chronic kidney disease were enrolled in the study to investigate the effect of non-surgical periodontal therapy (NSPT) on glycemic control and renal function.
Conclusions: When comparing patients with chronic kidney disease and diabetes mellitus with and without NSPT it can be concluded that there is enhanced renal function via the increase in eGFR and decrease in hsCRP by 84% along with improved glycemic control with a decrease of HbA1c by 0.54%.
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The Esthetic Biological Contour (EBC) Concept 2.0: How to Manage Each Zone of the Implant Restoration Emergence Profile
Authors: Esquivel J. et al.
DOI: 10.1111/jerd.70086
Purpose: to present a practical, zone-by zone guide for designing and managing the prosthetic emergence profile to enhance esthetic outcomes and ensure long-term biological stability
Conclusions: Implant morphology, material choice, and surface treatment affect peri-implant health across all EBC zones, with the C-zone being the most critical for long-term biological stability due to its close interaction with connective tissue and crestal bone. Understanding EBC zones and peri-implant biology is essential for maintaining durable peri-implant health and achieving predictable esthetic outcomes.
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Progression of Furcation Involvement: A Multi-Center Cohort Study of Incidence, Timing, and Risk Factors
Authors: Chatzopoulos, G et al.
DOI: 10.1111/jre.70049
Purpose: To analyze the rate of furcation progression and determine how systemic and tooth-level factors influence the development of new defects and the worsening of existing ones.
Conclusions: [Extracted Metrics/Key Findings: At the tooth level the initial furcation grade proved to be the strongest predictor of future deterioration, increasing the hazard of progression more than threefold (HR: 3.05) for every one-unit increase in baseline severity. | Class I furcations are identified as high-risk sites.] Furcation involvement is a progressive condition for most patients, typically advancing within a median timeframe of 3.6 years. Smoking and diabetes significantly increase the risk of progression. The strongest indicator of future tooth deterioration is the initial furcation grade; every unit increase in baseline severity more than triples the risk of further progression. Long-term tooth preservation requires management of patient-level systemic health paired with intensive, tooth-specific clinical monitoring.
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Buccal Bone Dimensional Changes Following Implant Placement and Guided Bone Regeneration With Submerged or Transmucosal Approach: A Cone Beam Computed Tomography Study
Authors: Alramli, H., et. al.
DOI: 10.1111/clr.70083
Purpose: to assess changes in the buccal bone of implants where simultaneous guided bone regeneration (GBR) had been performed to cover exposed threads in either a submerged or transmucosal approach.
Conclusions: There is NSD in terms of buccal bone dimension changes, when comparing submerged or transmucosal healing in implants placed with simultaneous GBR.
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The influence of flap design on the relevance of biomaterials in regenerative periodontal surgery. Source: Journal of periodontology, 10.1002/jper.70034. Advance online publication.
Authors: Menhadji, P., et al.
DOI: 10.1002/jper.70034
Purpose: to evaluate if flap design has any impact on the results of biomaterial use in regenerative surgeries.
Conclusions: The benefits of biomaterials in regenerative surgery might be affected by the type of flap design. There is a positive effect of biomaterials on clinical outcomes of AFs and PPFs, while no benefit was seen in SFVs.
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Stability of Root Coverage Outcomes After Soft-Tissue Augmentation With a Collagen Matrix With or Without rhPDGF-BB: A 3-Year Triple-Blinded, Randomized, Placebo-Controlled Trial
Authors: Tavelli L, Barootchi S, Rodriguez MV, Mancini L, Sabri H, Nguyen T, Majzoub J, Travan S, Giannobile WV
DOI: 10.1111/jcpe.70030
Purpose: To assess the three-year stability of gingival recession treatment via coronally advanced flap with a novel xenogeneic, porous, cross-linked, volume-stable collagen matrix (VCMX), comparing VCMX and saline to VCMX with rhPDGF. Background: VCMX is a novel collagen matrix (Geistlich Fibro-Gide, Geistlich Pharma AG) used for soft-tissue augmentation. This study is a medium-term (3yr) follow-up from of a previous 6-month analysis.
Conclusions: Soft tissue augmentation using VCMX with or without rhPDGF results in largely non-notable differences in clinical parameters. Untreated contralateral teeth showed an increase in 0.6mm in recession over 3yrs with an increase in patient-reported dentinal hypersensitivity.
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Impact of Peri-Implant Phenotype on Implant Therapy Outcomes: A 5-Year Cohort Analysis on Soft Tissue-Level Implants
Authors: Sabri H, Hazrati P, Tavelli L, Garaicoa-Pazmino C, Calatrava J, Wang HL, Barootchi S
DOI: 10.1111/jcpe.70062
Purpose: To assess the impact of peri-implant phenotype on soft tissue level (STL) implant health via clinical, radiographic, ultrasonographic, and patient-reported outcomes
Conclusions: Emergence angle £35.5°, pre-surgical buccal STT ³1mm, KMW ³2mm, STH ³2.8mm, BBT ³1.5mm were significantly associated with peri-implant tissue stability.
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Bone-Level Versus Tissue-Level Titanium Dental Implants: A Comparative Cross-Sectional Study.
Authors: Couso-Queiruga E, Fonseca M, Chappuis V, Ortiz GA, Salvi GE, Schwarz F, Raabe C
DOI: 10.1111/jcpe.70080
Purpose: To compare long-term outcomes of bone-level and tissue-level titanium dental implants placed in non-molar sites and determine whether implant design affected implant survival and the prevalence of peri-implant health, peri-implant mucositis, and peri-implantitis over time.
Conclusions: Implant survival and peri-implant disease prevalence were similar for bone-level and tissue-level implants. Narrower implants, particularly tissue-level designs, showed lower peri-implantitis rates. Higher plaque levels and smoking increased disease risk, while greater mucosal thickness and parafunctional habits were associated with reduced peri-implant complications.
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Marginal Bone Changes Around Tissue-Level Implants After Prosthesis Delivery: A Multicenter Prospective Study.
Authors: Spinato S, Bernardello F, Stacchi C, et al.
DOI: 10.1111/cid.70071
Purpose: This study evaluated marginal bone remodeling around tissue-level implants after crown delivery and assessed whether patient or prosthetic factors influenced bone changes during early functional loading.
Conclusions: Marginal bone levels remained steady from prosthesis delivery to 18 months post-loading, with no influence from prosthetic design. Bone loss from placement to follow-up was mainly associated with thin mucosa and smoking, with most changes occurring in early healing before prosthesis placement.
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Associations Between Restoration Margins and Adjacent Periodontal Status – Longitudinal Results from SHIP-TREND
Authors: Nafz, P., et al.
DOI: doi.org/10.1111/jcpe.70082
Purpose: To assess the relationship between dental restorations and the condition of the adjacent periodontal tissues over a seven-year period while utilizing data from a population-based cohort study.
Conclusions: Dental restorations may negatively impact periodontal health, highlighting the importance of accurate restorative techniques and diligent post-treatment maintenance.
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Acute-Phase Response Following Different Modalities of Non-Surgical Periodontal Treatment in Subjects Affected by Periodontitis and Co-Morbid Hypertension: A Randomised Clinical Trial
Authors: Petrini, M., et al.
DOI: 10.1111/jcpe.70068
Purpose: To evaluate the acute response and blood pressure changes after full-mouth versus quadrant non-surgical periodontal treatment (FM-SRP vs. Q-SRP) in patients with hypertension and periodontitis.
Conclusions: Q-SRP may be the preferred approach for patients with hypertension and periodontitis because a higher post-operative inflammatory response was linked to smaller improvements in blood pressure control over the medium term.
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Efficacy of Biologics for Surgical Treatment of Periodontal Suprabony Defects: A Systematic Review and Meta-Analysis of Controlled Clinical Trials.
Authors: Baniameri S, Hazrati P, Sabri H, Alrmali AE, Parma-Benfenati L, ElRefaei SA, Wang HL, Saleh MHA.
DOI: 10.1111/jcpe.70078.
Purpose: To compare the effectiveness of OFD combined with different biologics (EMD, PRF, HA) with OFD alone.
Conclusions: Adjunctive use of biologics with OFD for suprabony defect yields better results in terms of PD, CAL and REC compared to OFD alone.
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A Continuous Crossing Mattress Periosteal Suture Technique for Periorestorative Crown Lengthening in Multiple Teeth.
Authors: Alrmali AE, Misch J, Melker D, Al Yousuf H, Chen Z, Wang HL.
DOI: 10.11607/prd.7332. PMID: 39241216.
Purpose: To describe continuous crossing mattress periosteal suture technique (CMPST) for enhanced flap management after esthetic crown lengthening procedure.
Conclusions: CMPST is an alternative suturing technique for functional crown lengthening with enhanced flap stability for enhanced surgical outcomes.
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Laterally Positioned Multiple Papilla Flap with Connective Tissue Graft for the Treatment of Multiple Adjacent Gingival Recessions: A Case Series with 10-Year Follow-up
Authors: Parma-Benfenati S., Parma Benfenati L., Roncati M., Nava P.
DOI: 10.11607/prd.7873
Purpose: To describe the Lateral Positioned Multiple Papilla Flap (LPMPF) with long-term follow-up. The technique was proposed as a strategy to provide full root coverage (RC), increase soft tissue thickness, and augment the band of keratinized tissue (KTW) for multiple adjacent teeth within a single procedure and without use of exposed connective tissue grafts (CTG).
Conclusions: The LPMPF technique is a validated approach in the management of multiple adjacent gingival recession defects to achieve esthetic root coverage while simultaneously augmenting the KTW.
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Long-Term Evaluation of Narrow-Diameter Dental Implants in Posterior Sites in Patients With History of Periodontitis: A Retrospective Study With an 11.5-Year Mean Follow-Up
Authors: Soldini MC., Arroyo I., Peragine R., Roldán E., Valles C., Pons R.
DOI: 10.1111/clr.70028
Purpose: To assess which factors influence the survival and success rates of narrow diameter implants (NDIs) in the posterior sextants.
Conclusions: NDIs offer reliable long-term solutions for rehabilitation of posterior regions of limited bone availability. NDIs eliminate or reduce the need for augmentation while providing stable and predictable outcomes. Survival and success rates are similar to standard diameter implants. Patient selection to avoid prosthetic complications are an essential component of treatment planning.
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Buccal Bone Wall Thickness Dictates the Extent of Vertical Buccal Bone Loss Following Implant Placement: A Preclinical Study
Authors: Jean-Claude Imber, Andrea Roccuzzo, Alberto Monje, Benjamin Pippenger, Dieter D. Bosshardt, Anton Sculean, Daniel Buser
DOI: 10.1111/jcpe.70027.
Purpose: The purpose of this study was to primarily examine pre-clinical data regarding the amount of vertical bone resorption early on in a 2-month healing period after implant placement in healing sites exhibiting various buccal bone thicknesses. Secondarily, the pattern of bone resorption was evaluated during the 2-month period.
Conclusions: Areas with buccal bone (<1mm) following implant placement are subject to more buccal bone loss, thus leading to implant surface exposure. In areas with >1.5mm of buccal bone, vertical buccal bone loss was uncommon.
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Cone beam computed tomography of bone dimensions in periodontally accelerated osteogenic orthodontics: A retrospective study.
Authors: Richmond TD, Dayeh AA, Scarbecz M, Stein S, Fisher J, Abhyankar V.
DOI: 10.1002/cap.10351. Epub ahead of print. PMID: 41105698
Purpose: The purpose of this study was to evaluate changes in dimensions of alveolar bone following periodontally accelerated osteogenic orthodontics (PAOO) at maxillary and mandibular incisor regions in adult patients being treated with orthodontics.
Conclusions: Evidence shows PAOO allows for increasing thickness of the buccal bone accompanied by reduction in crestal bone height, while also reducing the incidence of dehiscence and fenestrations.
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The Use of a Resorbable Membrane as an Adjunct to a Xenogeneic Bone Replacement Graft in the Reconstructive Surgical Therapy of Peri-Implantitis: 3-Year Results of a Randomised Clinical Trial.
Authors: Dionigi C, et al.
DOI: 10.1111/jcpe.70057
Purpose: To evaluate if adding a resorbable collagen membrane when completing surgical reconstructive therapy is beneficial in cases of treating peri-implantitis.
Conclusions: There were no clinical or radiographic benefits found in adding collagen membrane when completing peri-implantitis treatment with bone substitute material.
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Morphological patterns of buccal bone plate in the maxillary esthetic zone: A cross-sectional study
Authors: Domic, et al.
DOI: 10.1002/jper.70071
Purpose: To evaluate buccal bone plate morphology to then categorize them and investigate associations with each category in regard to phenotypical and local anatomic characteristics.
Conclusions: From the CBCT and clinical evaluation four BBP patterns were identified a novel classification system. With each category there are anatomic and phenotypic variables that have association including GT, TS, SRO, and BBT. Using this classification system planning and execution of treatments in the anterior maxilla can be better diagnosed and planned.
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The Supracrestal Tissue Height: A Fundamental Component of the Periodontal Phenotype.
Authors: Avila-Ortiz G et al.
DOI: 10.11607/prd.2026.1.c1.
Purpose: To describe the clinical significance and anatomical role of Supracrestal Tissue Height (STH).
Conclusions: The STH must be formally acknowledged and incorporated as an important element of the periodontal phenotype. Doing so will enhance clinical precision and elevate the standard of dental research and practice.
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Internal Frenectomy-Vestibular Incision Subperiosteal Tunnel Access (IF-VISTA). A technical report.
Authors: Frazão V, et al
DOI: N/A
Purpose: To introduce a novel subperiosteal tunnel technique that combines root coverage and frenectomy in a single procedure, effectively preventing frenum reinsertion and recession recurrence.
Conclusions: This technique improves flap mobility by removing the frenum, which prevents mucosal advancement and recession recurrence. It offers significant advantages over traditional methods, delivering superior esthetics and higher root coverage rates. Current State of Evidence for Implant Placement and Loading in Partially Edentulous Patients: A Systematic Review. Gallucci, G. O., Hamilton, A., Akhondi, S., Pala, K., & Peña-Cardelles, J. F. (2026). Clinical implant dentistry and related research, 28(1), e70120. https://doi.org/10.1111/cid.70120
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Current State of Evidence for Implant Placement and Loading in Partially Edentulous Patients: A Systematic Review.
Authors: Gallucci, G. O, et. al.
DOI: 10.1111/cid.70120
Purpose: To review the success and survival rates of various implant placement and loading protocols.
Conclusions: Among the immediate placement protocols, immediate and conventional loading both showed high survival rates validated by data, while early loading had lower and more variable survival rates. Among the early placement protocols, immediate and conventional loading have been scientifically and clinically validated while early loading still requires further research. All protocols for late implant placement have been validated. Conventional loading has higher survival and long-term stability, but immediate and early loading also report stable survival rates.
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Novel use of amnion-chorion membrane in managing sinus membrane perforations during crestal sinus augmentation: The waffle cone technique
Authors: Alqadoumi, T., et. al.
DOI: 10.1002/cap.70019
Purpose: to present a novel approach in repairing sinus membrane perforations with amnion-chorion membranes during crestal augmentations.
Conclusions: The use of an amnion-chorion membrane via a “waffle cone” technique is a successful approach in the management of small to medium sinus membrane perforations during crestal lifts.
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The Role of Keratinized Mucosa in Peri-implant Tissue Stability After Treatment of Periimplantitis: Clinical and Radiographic Outcomes of a Prospective Cohort Study After 3 Years
Authors: Englezos E, Coucke W, Castro AB, Teughels W, Temmerman A
DOI: 10.11607/prd.7322
Purpose: To assess the impact of keratinized mucosa (KM) on implant stability after surgical peri-implantitis treatment.
Conclusions: In compliant patients undergoing peri-implantitis treatment, the absence of peri-implant keratinized mucosa has no effect on tissue stability.
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Tracing the evolution of root coverage: Clinical milestones leading to a minimally invasive era.
Authors: Tavelli L, Yilmaz B, Back LS, Vigouroux F, Kuo PJ, Tseng E, Barootchi S
DOI: 10.1002/jper.70044
Purpose: To outline the history and biologic rationale for root coverage procedures. Pedicle Flaps: Among the first techniques for root coverage was the laterally sliding flap (Grupe and Warren 1956), a full thickness pedicle flap from adjacent soft tissue with removal of “the inflamed margin,” “the epithelial lining of the soft tissue and the epithelial attachment.” The technique was modified to split thickness to avoid alveolar bone exposure and again by Zucchelli (2004) to become the “laterally moved, coronally advanced flap” that included the preservation of “non-probeable” keratinized tissue around the tooth and mix-thickness flap elevation. More recent modifications include a tunneled approach with a connective tissue graft (CTG) in combination with a lateral sliding flap in the anterior mandible (Agusto). Free Gingival Grafts: Free gingival grafts (FGG) were developed to increase vestibular depth and keratinized tissue (KT) width, prevent periodontal disease progression, and, later and with less predictable results, gingival recession. Attempts to improve predictability included a partially epithelialized gingival graft, but combinations of coronally advanced flaps (CAF) or tunneling (TUN) with CTGs are now more widely used for gingival recession treatment. CAF: After Norberg’s 1926 introduction of the CAF, the technique has been modified extensively. Restrepo (1973) added vertical releasing incisions to improve flap mobility. Bernimoulin et al. (1975) and Maynard (1977) introduced FGG + CTG (2mo later) approaches, with Bernimoulin introducing scaling and root planing of the root surface and sharp dissection of the periosteum at the flap base to enable coronal advancement. To mitigate recession recurrence, Langer and Langer (1985) introduced a partially epithelized CTG beneath a partial thickness flap to relieve muscular tension (bilaminar approach), preserving the blood supply from the underlying periosteum and the overlying flap. Allen and Miller (1989) introduced vertical incisions at line angles adjacent to the exposed root, with the distance between the incision and the papilla tip equal to the recession depth, and the elevation of a split thickness flap. Contrastingly, De Sanctis and Zucchelli’s trapezoidal approach (2007) permits flap placement 1mm coronal to the CEJ via horizontal incisions at the papillae starting at the recession depth +1mm from the anatomical papilla tip, 3mm in length. This modification comes after Pini Prato et al.’s demonstration that some flap contraction occurs during healing. Zucchelli and De Sanctis (2000) introduced treating multiple recession defects in the maxilla via an envelope flap, preserving the interincisal papillae, with oblique incisions anticipating the mesio-coronal (for those surgical papillae mesial to the flap’s midline) or disto-coronal (for those distal) rotation when advancing the flap. To enhance blood supply, improve flap adaptation interproximally, and preserve soft tissue thickness at the midline while achieving tension-free coronal advancement, they also introduced the “split-full-split” flap design corresponding with the interproximal, midfacial, and apical portions, respectively. Their 2007 modification introduced coronal advancement via muscle tension elimination rather than periosteum incisions. Guided tissue regeneration (GTR) was also introduced but has since not been as effective as mucogingival procedures. Tunneling: Raetzke (1985) introduced a partial thickness envelope with CTG insertion without coronal advancement. Allen then introduced the elevation of preserved papillae via lateral dissection and tissue elevation with a small surgical blade. Introduced by Zabalegui et al. (1999), the term “tunneling” involved partial thickness sulcular incisions extending apically to the mucogingival junction and laterally through the preserved papillae. This also included a CTG secured through the tunneled flap. Others introduced coronal advancement of the tunnel and mixed thickness modifications. Zadeh (2011) introduced the vestibular incision subperiosteal tunnel access technique (VISTA) that includes subperiosteal tunnel elevation from the vestibule to the gingival margin. This mitigates restricted access, procedural complexity, and risk of sulcular trauma. Suture stabilization initially included midcoronal flowable composite anchors, but this technique has since been modified and may include interproximal contact point suspension, again with composite. VISTA has been widely modified, including by Kuo et al. (2024), who describe “partial-full-thickness” tunnel elevation from multiple vestibular incisions for treatment of RT2 and RT3 defects. Modifications generally attempt to address limited access, visibility, or graft stability, and each modification may be more applicable than others for different clinical defect presentations. To this end, the tunneled coronally advanced flap (TCAF) is a flexible, site-specific flap design based on defect severity, interproximal attachment and papilla loss, papilla angle and area, local anatomic/phenotypic factors, and esthetic considerations. It integrates both TUN and CAF techniques and generally limits the number of papillary incisions, reducing scarring and preserving papilla integrity.
Conclusions: Pedicle flaps, FGGs, and CTGs, influenced the development of CAF, TUN, and TCAF.
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The Effect of Restorative Emergence Angle on Soft and Hard Tissue Around Splinted Implants: A Preclinical Study
Authors: Seung-Ju Lee, Yuseung Yi, Frank Schwarz, Jungwon Lee, Ki-Tae Koo
DOI: 10.1111/clr.70035
Purpose: To evaluate how the emergence angle influences peri-implant soft and hard tissue as well as the role of splinting.
Conclusions: A wide restorative emergence angle negatively affects peri-implant soft tissue integrity and promotes greater crestal bone remodeling.
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Prosthetically driven implant placement: A simplified method for optimal emergence angle of anterior implants.
Authors: Springer C, Puisys A, Gallucci GO, Akhondi S
DOI: 10.1016/j.prosdent.2025.07.010
Purpose: To present a simplified and prosthetically driven method for determining implant depth and emergence angle in the anterior region to improve esthetic outcomes and peri-implant tissue stability.
Conclusions: This simplified, prosthetically guided method for implant depth calculation can help clinicians achieve controlled emergence angles, support soft tissue stability, and improve long-term outcomes in anterior implants.
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A Retrospective Study of Clinical Risk Factors and Patient-Reported Outcomes of Full-Arch Implant-Supported Prostheses.
Authors: Zhang, X., Wang, Y., Yang, K., Qin, X., Yang, J., Chen, T., Yang, S., Wang, H., Wang, B.
DOI: 10.1111/cid.70119
Purpose: This retrospective study was performed to assess clinical outcomes, patterns of marginal bone loss (MBL), associated risk factors, and patient-reported outcomes following immediate full-arch implant restoration to inform clinical decision-making.
Conclusions: Immediate full-arch implant restoration demonstrates favorable clinical outcomes and enhances oral health related quality of life. Although bone levels generally stabilize after two years, the frequent occurrence of mechanical prosthetic complications emphasizes the necessity for comprehensive long-term maintenance protocols.
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The influence of implant platform apico-coronal position on the bone level of adjacent teeth.
Authors: Yeh, Y.T., Li, V., Chen, C., et al.
DOI: 10.1002/jper.70056
Purpose: This retrospective study investigated the effect of the apico-coronal position of the implant platform on crestal bone levels of adjacent teeth, with particular emphasis on the anterior and premolar regions.
Conclusions: Implants placed more than 2 mm apico-coronally relative to the crestal bone level of adjacent teeth were associated with increased crestal bone loss at those neighboring sites. These findings highlight the importance of careful vertical implant positioning to help minimize bone loss around neighboring teeth.
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Immediate Loading of Four Guided Nonsplinted Implants Supporting a Maxillary Overdenture: A Prospective Clinical Trial
Authors: Salman, A., Choi, D., Chertok, N., Davila, C., Agusto, M., Kordusky, B., & Schincaglia, G. P.
DOI: 10.11607/jomi.11265
Purpose: To evaluate implants placed and immediately loaded for maxillary overdentures.
Conclusions: Within the limitation of the study, immediately loaded non-splinted implants for maxillary overdentures appears to be a predictable treatment options for maxillary arch.
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Abutment-Free Tissue-Level Implants for Personalized Monolithic Zirconia Implant Crowns: A Retrospective Cohort Study.
Authors: Ionescu, A., Marin, M., Bayrich, N., Fennema, P., Nicolescu, M. I., Jung, R. E., & Dodi, A
DOI: 10.11607/jomi.11144.
Purpose: To compare peri-implant bone levels between abutment free tissue level implants and tissue level implants with Ti-base abutment.
Conclusions: Within the limitation of the study, abutment free implant appears to preserve surrounding bone thickness better than conventional Ti-base abutment implants.
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Effect of the Buccal Gap Width on Alveolar Process Reduction Following Immediate Implant Placement: A Retrospective CBCT Study
Authors: Araújo MG., Dias DR., Wang P., Levine RA.
DOI: 10.1111/clr.70106
Purpose: To evaluate the impact of buccal gap width on the preservation of alveolar process dimensions during immediate implant placement (IIP) with socket grafting. The hypothesis was that the wider the gap, the more the space for bone particulate to maintain ridge dimension.
Conclusions: Grafting a buccal gap wider than 2 mm following IIP may promote 90% preservation of ridge dimensions. A greater reduction in the alveolar process area was found with a narrow buccal gap vs wide buccal gap, with reductions of 41.1% vs 8.5%. Linear reductions were also significantly reduced with wide buccal gap, with only 7.4% and 1.2% reduction at 3- and 5-mm versus 52.9% and 42.8% reduction at 3- and 5-mm for the narrow gap group. A wide buccal gap may be crucial in maintaining robust ridge dimensions around dental implants.
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Contour Augmentation Simultaneous to Immediate Implant Placement in Compromised Sockets: A Retrospective Study
Authors: Monje A., Osorio J., Garcia-Torres JA., Lozada J., Kan JY.
DOI: 10.11607/prd.8013
Purpose: To evaluate peri-implant tissue stability, prevalence of peri-implant disease, and patient reported outcome measures (PROMs) in patients receiving immediate implant placement (IIP) with simultaneous guided bone regeneration (GBR), with or without a simultaneous connective tissue graft (CTG).
Conclusions: Contour grafting with or without a connective tissue graft performed simultaneously to IIP was found to result in favorable clinical, radiographic, and PROMs. The approach demonstrated a high level of peri-implant health and stable CBL.
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Reconstructive Peri-Implantitis Surgery Using an Internally Beveled Vestibular Incision for Multilayer Wound Closure.
Authors: Gülnergiz E, Abraha SM, Hürzeler M, Zuhr O.
DOI: 10.1111/jerd.70124.
Purpose: The purpose of this study is to introduce the use of an internally beveled vestibular incision to allow for improved wound stability and primary healing.
Conclusions: N/A
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Muscle Evicted Tunneling Approach (META) with Crossed Belt & Suspenders Sutures (CBS) for Mandibular Incisor Root Coverage: A Proof of Concept.
Authors: Ronco V, Akhondi S, Rendon A.
DOI: 10.11607/prd.8025.
Purpose: The purpose of this article is to introduce the muscle evicted tunneling approach (META) with the crossed belts &suspenders (CBS) approach in suturing. The META involved splitting the combination of splitting the mucosa and a myotomy with blunt instrumentation and apically positioning the muscle. The CBS approach allows for both lateral and coronal movement of the flap over recessions. The combination of approaches can be used to treat a variety of clinical scenarios such as single, wide, deep recession, with high muscle pull, shallow vestibule and minimal keratinized tissue.
Conclusions: The protocol of combining META with CBS allows for treatment of deep recessions in the anterior mandible.
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Comparison of Five Osteotomy Protocols on Implant Stability and Postoperative Anxiety: A Randomized Controlled Trial.
Authors: Konuklu, et al.
DOI: 10.1111/cid.70125
Purpose: To compare five different osteotomy techniques when preparing a site for an implant and how these techniques have an effect on implant stability as measured by insertions torque (IT) and the early implant stability quotient (ISQ).
Conclusions: When comparing the various drilling protocols the 300rpm (moderate-speed) group showed the most consistent stability and highest ISQ over the 3-month follow-up period. The 800rpm (high-speed) group showed the highest IT values.
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Peri-Implant Reconstruction With Autogenous Bone and Electrolytic Therapy: A Randomized Controlled Clinical Trial.
Authors: Puisys, et al.
DOI: 10.1111/cid.70123
Purpose: To assess if using adjunctive electrolytic therapy with autogenous tuberosity bone grafts to treat peri-implant defects via reconstructive therapy.
Conclusions: When completing regenerative peri-implantitis therapy using mechanical debridement and bone graft vs. mechanical debridement, electrolytic therapy, and bone graft showed no significant differences. Both treatment options had a statistically significant radiographic and clinical improvement.
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Comparing Small Buccal Dehiscence Defects Treated With or Without Guided Bone Regeneration: A Subanalysis of an RCT.
Authors: Zuercher A. et al.
DOI: 10.11607/prd.7138
Purpose: To compare outcomes for single posterior implants in intact bone versus small defects (≤5 mm), evaluating the impact of GBR.
Conclusions: After 1 year, implants with a small dehiscence (≤5mm) showed comparable clinical and radiographic results, regardless of whether GBR was performed.
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To Remove or Not Remove Non- Conventional Dental Implants? Eleven- Year Retrospective Study on Implant Outcomes
Authors: Manor Y, et al.
DOI: 10.1111/cid.70112
Purpose: This study examines complex dental implant removals, analyzing techniques, design-specific challenges, and the feasibility of reimplantation through case series. Background: Factors Affecting the Complexity of Dental Implant Removal Removal complexity depends on implant design, location near vital structures, and the extent of osseointegration versus bone loss. Broken subperiosteal or blade implants are particularly difficult to remove and cause significant tissue defects. Techniques for Dental Implant Removal Bone removal via burs or piezosurgery is used when anti-torque fails. Sectional removal divides fractured or integrated implants to minimize bone damage, while guided removal uses surgical guides for precision and reduced trauma. Management Strategies Following Implant Removal Site preservation and tissue regeneration maintain bone and aesthetics for future placement. Comprehensive planning (evaluating bone quality and stability) is essential to minimize removal and complications Stages of Treatment Preoperative Evaluation: Assess medical history, implant stability, and infection signs. Use radiographs and CBCT to map anatomical relationships. Anesthesia: Use local anesthesia, IV sedation, or general anesthesia based on case complexity and patient anxiety. Clinical Procedure: precise execution to protect vital structures and minimize bone trauma. Socket Management: Debride the site and perform bone or soft tissue grafting to support healing and future placement. Postoperative Care: to provide pain management and hygiene protocols, with follow-up to monitor healing and plan future treatment.
Conclusions: Clinicians can optimize care by understanding removal reasons, using proper techniques, and planning thoroughly. Prioritizing smart implant selection and long-term follow-up further reduces the need for complex removals.
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Effect of Early Radiographic Bone Loss Before Loading on Implant-Related Outcomes: A Long-Term Retrospective Study
Authors: Moser, D. E., et. al.
DOI: 10.1111/clr.70112.
Purpose: to evaluate the association between early radiographic bone loss (ERBL) and progressive bone loss, implant survival, and peri-implant disease.
Conclusions: ERBL, male sex, smoking, multiple implants, single crown restoration, and bone level implants are significantly associated with future bone loss around implants. ERBL is considered the strongest predictor and is also associated with greater long-term peri-implantitis and implant failure rates (Higher ERBL, leads to higher risk)
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Peri-implant Buccal and Lingual Keratinized Mucosa Augmentation Following Bone Reconstruction.
Authors: Urban, I. A., et. al.
DOI: 10.11607/prd.7906
Purpose: to present the strip gingival graft (SGG) technique’s four variations for augmenting peri-implant keratinized mucosa (KM) and mucosal thickness (MT) in the mandible.
Conclusions: The four proposed variations of the SGG technique can be used to augment and create a thick 360-degree band of KM around mandibular implants, especially on the lingual aspect.
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Impact of the Buccal Dehiscence Morphotype on the Regenerative Strategy in Immediate Implant Placement
Authors: Cosyn J, De Bruyckere T
DOI: 10.1111/jerd.70115
Purpose: To propose a classification and treatment framework for compromised sockets within the context of immediate implant placement (IIP). The Safe Zone, the Danger Zone, and the Failure Zone The safe zone is delineated vertically by 4mm below the facial soft tissue margin and horizontally by a buccal bone gap greater than 2mm. This zone permits “perfect” prosthetically driven implant placement with the ability to achieve ideal esthetic outcomes. The danger zone is delineated vertically by 2mm coronal to and horizontally by 1mm buccal to the safe zone. Implant placement here may result in absence of bone around the implant shoulder, resulting in an incomplete and thin buccal bone wall, thin soft tissues, and possibly esthetic consequences. The failure zone is delineated coronally by an additional 2mm to the danger zone and by the facial soft tissue margin; it is delineated buccally by the buccal bone wall. Implant placement here will result in facial recession and esthetic failure. The Trimodal Approach in Intact Sockets Flapless surgery, which preserves blood supply of the buccal bone thereby prohibiting buccal bone loss, is strongly recommended. The buccal bone gap is grafted with particulate or moldable bone graft to the level of the bone crest (e.g. deproteinized bovine bone). A 1-1.5mm thick connective tissue graft (CTG), with either 6mm or 3mm (“scarf”) thickness, is also placed. The restoration should be screw-retained with the pontic following the Esthetic Biological Contour (EBC) concept: the Esthetic-zone, Bounded-zone, and Crestal-zone. The E-zone corresponds with the area in contact with the sulcular epithelium which is 0.5mm and convex. The B-zone corresponds with the area in contact with the junctional epithelium and is 1mm and concave. The C-zone corresponds with the abutment of the provisional being at least 2mm with narrow emergence profile. Healing of a Socket with a Buccal Dehiscence: The trimodal approach is insufficient to treat these sockets. The Vertical Extent of a Buccal Dehiscence: Considering Elian and Chu classifications, Type I-a, II-b, and II-c can be treated for IIP with regeneration methods, but Type III sockets should not, which require at least soft tissue augmentation including coronal flap advancement, resulting in poor esthetic outcomes. The Lateral Extent of a Buccal Dehiscence: A new classification is proposed based on the regenerative potential of a buccal dehiscence. Defects with the highest regenerative potential is the defect contained to the facial portion (C). A buccal defect which affects the mesial or distal areas of a tooth are limited in regeneration to the interproximal aspect (PC, partially contained). Defects with reduced regeneration potential on both sides is the non-contained defect (NC), where both mesial and distal areas are affected. Complete interproximal bone loss has no regeneration potential; these defects pose high risks for esthetic failure. They are categorized as extended defects and should not be treated with an IIP. Regeneration of Types II-a-C and II-b-C: Modifications to the Trimodal Approach include having a buccal bone gap of 2.5-3mm, moldable bone graft materials, and 2-2.5mm thick CTG for sealing the regeneration chamber. Regeneration of Types II-b-PC and II-c-C: A four-pillar approach is recommended with the addition of a non-supportive barrier (e.g. collagen membrane) against the facial soft tissues without a lateral or apical pouch. Regeneration of Types II-B-NC, II-c-PC, II-c-NC: A four-pillar approach is recommended with a supportive barrier (e.g. cortico-cancellous shell from the tuberosity or porcine-derived supportive barrier) placed over the bony edges, a composite graft (moldable bone graft material with autogenous bone chips), and soft tissue augmentation.
Conclusions: A buccal dehiscence combined with facial recession and extended defects precludes IIP, and other morphotypes that account for mesial and distal bone loss should be considered in clinical decision-making processes.
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Safety and Feasibility of Extended Platelet-Rich Fibrin as a Solo Barrier Membrane for Ridge Preservation: A Case Series
Authors: Estrin NE, Tran TB, Espinoza AR, Ahmad P, Farshidfar N, Holmes R, Zhang Y, Miron RJ
DOI: 10.1002/cre2.70282
Purpose: To assess the safety and applicability of extended platelet-rich fibrin (e-PRF) in alveolar ridge preservation. Introduction: PRF membranes have not been commonly adopted in ridge preservation due to their associated two-week resorption time. However, by heating the platelet concentrates, i.e. denaturing proteins in the platelet-poor plasma, albumin-rich layer, the resorption time of the PRF membrane is extended to at least four months.
Conclusions: Extended-PRF membranes can be used successfully and safely during ridge preservation as an alternative to collagen and PTFE membranes.
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Prosthetic factors influencing the prevalence of peri-implant diseases and marginal bone loss in static computer-assisted implant sites: A cross-sectional study.
Authors: Sirirattanagool P, Asavanamuang P, Jain S, et al.
DOI: 10.1002/jper.11387
Purpose: To study marginal bone loss and peri-implant disease in static computer-assisted implant surgery and determine whether implant or prosthetic design factors are associated with these outcomes.
Conclusions: [Extracted Metrics/Key Findings: R | emovable prostheses were significantly associated with peri-implantitis, with overdenture-supported implants showing an odds ratio of 2.16 compared with fixed restorations. | short mucosal abutment height and implant surface treatments.] Peri-implant disease and bone loss are influenced by restoration and abutment design, with removable prostheses and unfavorable prosthetic features linked to higher risk, highlighting the importance of careful planning and follow-up.
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When Is a Discrepancy in Crestal Bone Height Level for Adjacent Dental Implants Significant? A Retrospective Study with a Minimum Follow-up of 1 Year.
Authors: Kasabreh NS, Malaikah S, Khurshid H, Khan MQ, Wang HL.
DOI: doi:10.11607/jomi.11208
Purpose: To determine whether vertical differences in crestal bone height between adjacent implants influence marginal bone loss over time and to compare this effect between splinted and non-splinted implant-supported restorations.
Conclusions: Vertical discrepancies in crestal bone height between adjacent implants appear to contribute to marginal bone loss in non-splinted implants. CBHL should be considered during implant planning, although additional studies are needed to confirm the findings.
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Twenty-four month clinical outcomes of modified coronally advanced tunnel technique with leukocyte- and platelet-rich fibrin–functionalized porcine dermal matrix for single/multiple gingival recessions.
Authors: Würflein E, Herrman K, Sculean A, et al.
DOI: 10.1002/jper.70093
Purpose: This study aims to evaluate the 24-month clinical and 3D outcomes of single and multiple RT1 and RT2 gingival recessions managed with the modified coronally advanced tunnel (MCAT) approach combined with an L-PRF–functionalized porcine dermal matrix (PDM), addressing the lack of long-term data on PDM use in root coverage treatments.
Conclusions: The MCAT technique combined with an L-PRF enhanced PDM achieved stable root coverage and modest increases in GT over 24 months for RT1 and RT2 recessions. These results highlight the clinical potential of this approach that avoids connective tissue harvesting and emphasizes the need for randomized controlled trials with patient-reported outcomes to directly evaluate its performance against conventional connective tissue grafting.
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Effect of Connective Tissue Graft as an Adjunct to Guided Bone Regeneration in the Surgical Treatment of Peri-Implantitis: A Dual-Center Randomized Controlled Trial.
Authors: Holtzman, L.P., Milinkovic, I., Vuckovic, M., Malpassi, C., Cuppini, M., Solderer, A., Aleksic, Z., Cordaro, L.
DOI: 10.1111/clr.70093
Purpose: The purpose of this randomized controlled trial was to assess whether the addition of a connective tissue graft (CTG) to guided bone regeneration (GBR) enhances clinical and radiographic outcomes in the surgical treatment of peri-implantitis.
Conclusions: GBR leads to significant improvements in peri-implant clinical outcomes after one year. The addition of a CTG results in greater gains in CAL and KMW and may contribute to improved bone levels. However, its effect on overall disease resolution is still unclear. Further long-term studies are needed to validate these results.
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Comparison of Complications Between Splinted and Nonsplinted Implants Placed in the Posterior Region.
Authors: Kim DY, Pang EK, Choi SH, Lee JB.
DOI: 10.11607/jomi.11251
Purpose: To compare splinted and non-splinted implant supported superstructures’ prognosis and analyze relevant parameters
Conclusions: Based on the findings of this study, consideration regarding FLP, C/I ratio, CHS needs to be made for long term success of splinted implants.
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Complete arch implant surgical guide for accurate implant scanning without photogrammetry device: A workflow based on the calibrated intraoral scan protocol (CISP),
Authors: Li J., Yu J., Joda T., Mohamed F., Yang S., Kan J.
DOI: 10.1016/j.prosdent.2026.01.036.
Purpose: To describe a workflow utilizing calibrated intraoral scan protocol (CISP) for full arch implant surgical guide. Background: ICam photogrammetry accuracy: 5-10micron (cost $30,000-$50,000) 3Shape intraoral scanner accuracy: 20-60micron (cost $12,400-$25,900) LS3 desktop Scanner: accuracy up to 4-15 micron (cost used $2,000, new $15,000) Workflow/Technique: The technique describes fabricating surgical guide for 5 implants with immediate full arch prosthesis. To aid in the accuracy of utilizing intra oral scanner, a calibrator is also fabricated. Implant planning software (BlueSkyPlan) and prosthesis design program (exocad) was utilized. The steps include planning the surgical guide. Once the surgical guide is designed for implant position/tube and anchor pin, the portion including implant position is hidden to create a basic template design for the calibrator. Textures are added to the calibrator template which helps the scanner perform better. The calibrator is scanned using a highly accurate desktop scanner (LS3 scanner). The surgical guide and the calibrator is printed. Once the implant is placed, the scan bodies and the calibrator are scanned together. The scanned file is segmented into sections containing 1 scan body each. Using exocad’s “Align Meshes” function the section are aligned/calibrated to match the calibrator (only) scan. After alignment, segments are put together. Intra orally, another scan is performed without the calibrator. The scan is merged with the calibrated scan to produce soft tissue information.
Conclusions: Using surgical guide with calibrator may achieve accurate scan to fabricate prosthesis for a full arch case.
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Platelet-Rich Fibrin (PRF) Promotes Maxillary Sinus Bone Regeneration: A Randomised Clinical Trial and Proteomic Analysis
Authors: Chen S., Lv H., Ren S., Wang Y., Zhou J., Chen S., Liu X., Zhang J., Guo Y., Chen J., Luo J., Pei Y., He D., Zhai J., Zhou Y.
DOI: 10.1111/jcpe.70103
Purpose: To compare the percentage of new bone formation at 6-months following maxillary sinus floor elevation (MSFE) using platelet-rich fibrin (PRF) combined with deproteinized bovine bone mineral (DBBM) versus DBBM alone. Molecular mechanisms for PRF modulating osteogenesis were also explored.
Conclusions: The combination of PRF with DBBM showed improved quantitative new bone formation during MSFE than DBBM alone. This may be driven by key growth factors and complement-mediated signaling, which could optimize the osteogenic microenvironment.
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Periosteal-guided bone regeneration on severely damaged sockets with simultaneous implant placement: The cortical shield cross-sectional study
Authors: Verdugo F., D’Addona A., Laksmana T., Uribarri A.
DOI: 10.1002/cap.10364
Purpose: To describe clinical outcomes from a technique of socket reconstruction of severely damage sockets with simultaneous immediate or delayed implant placement. The technique utilizes the periosteum and an autogenous cortical bone shield to encase the implant.
Conclusions: Facial bone regeneration was completed within 12-14 weeks during immediate (and delayed) implant placement. Application of autogenous cortical bone and particulate with enhanced blood supply from the periosteum may shorten healing time.
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Bone Regeneration Following Implantoplasty: A Retrospective Cohort Study with Long-Term Radiographic Assessment.
Authors: Khayat P, Aidan D, Calatrava J, Wang HL.
DOI: 10.11607/prd.7422.
Purpose: The purpose of this article is to analyze marginal bone level (MBL) changes around implants after surgical therapy, including implantoplasty following an access flap.
Conclusions: The use of open flap debridement in conjunction with implantoplasty, without graft biomaterials, osseous recontouring, and apical positioning of the flap, is a viable treatment option in addressing peri-implantitis. Rather than bone regeneration, bone repair can be achieved following such treatment.
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Modified nonincised papillae surgical approach: Minimally invasive technique for periodontal regeneration.
Authors: Katayama A, Suzuki E, Rasperini G, Funato A.
DOI: 10.1002/cap.10343.
Purpose: The purpose of this article is to clinically and radiographically investigate the outcomes following the Modified Non-Incised Papillae Surgical Approach (M-NIPSA) in not only treating periodontal disease but also preserving gingival esthetics.
Conclusions: The use of the M-NIPSA technique allows for primary healing, minimal flap reflection, and significant improvements in PD and CAL, while preserving soft tissue contours.
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Mucogingival surgery techniques: Coronally advanced flap versus tunnel approach
Authors: Aroca, et al.
DOI: 10.1002/jper.70116
Purpose: To discuss the historical changes in treatment techniques of the coronally advanced flap (CAF), and tunnel technique and how to the two techniques compare to each other.
Conclusions: Both the tunnel technique and CAF are techniques that provide predictable root coverage. Using a CTG is still the gold standard with substitutes having a reduced morbidity but limited evidence of long-term stability. When deciding to use the tunnel technique or CAF phenotypic characteristics and recession presentation should guide the decision for best outcomes.
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Traumatic Occlusion Exacerbates Bone Resorption by Modifying Gene Expression in the Bone Tissue of Ligature-Induced Periodontitis in Mice.
Authors: Tsuchiya, et al.
DOI: 10.1111/jcpe.70112
Purpose: To investigate the effects of occlusal trauma on the periodontal tissue via transcriptome analysis to identify molecular mechanisms in a mouse model.
Conclusions: Traumatic occlusion does not on its own cause significant bone loss but when combined with ligature induced periodontitis there is accelerated bone resorption. In cases of occlusal trauma + periodontitis there is increased expression of inflammatory genes specifically in the bone.
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The influence of flap design on the relevance of biomaterials in regenerative periodontal surgery.
Authors: Menhadji P, et al.
DOI: 10.1002/jper.70034
Purpose: To Investigate if flap design influences the success of biomaterials in regenerative periodontal procedure.
Conclusions: SFV may reduce the need for biomaterials due to their minimally invasive design. However, it remains unclear whether flap design or biomaterials matter more. Overall, biomaterials improve outcomes with AF and PPF but not SFV. Treatment should be based on defect type and patient factors.
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Long-term stability of conventional non-regenerative periodontal treatment for furcation defects.
Authors: Lin GH, et al.
DOI: 10.1111/prd.70007
Purpose: To analyze non-regenerative outcomes for various furcation involvements (FI).
Conclusions: Both non-regenerative and regenerative furcation treatments provide stable, long-term results. Success depends on customizing therapy to the specific tooth and patient. Teeth are preserved by reducing PD and improving OH access.
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Treatment Outcome of Surgical Protocols for Peri-Implantitis: A Retrospective Cohort Study in a Specialised University Centre
Authors: Zhou, W., et. al.
DOI: 10.1111/jcpe.70115
Purpose: To review the outcomes of various surgical treatments for peri-implantitis, performed by experienced surgeons in one academic setting.
Conclusions: [Extracted Metrics/Key Findings: Implant loss predictors were identified as implant location (molar), Sup at baseline, and the use of pre- and post-op antibiotics.] A 54.7% success rate is seen one year after surgical treatment of peri-implantitis and NSD was found between various techniques. Outcomes were influenced by surgeon-related differences, use of systemic antibiotics, molar sites, baseline suppuration, deeper baseline PDs, and overdentures.
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Influence of Barrier Membrane and Peri-Implantitis-Like Bone Defect Configurations on Graft Stability.
Authors: Suarez, E., et. al.
DOI: 10.1111/cid.70140.
Purpose: to assess how the use of barrier membranes affects early graft displacement in various types of peri-implant bone defects.
Conclusions: Graft stability in regenerative peri-implantitis treatment is directly influenced by defect morphology and vertical levels. As the use of a membrane does not compensate for the lack of graft containment in dehiscence defects, graft collapse was noted with or without a membrane. A limited reduction in graft displacement was seen mainly at the coronal levels of 2-3 wall defects, while high graft stability was seen in circumferential defects regardless of membrane use.
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Complications and treatment errors in root coverage procedures
Authors: Mazzotti C, Mounssif I, Rendon A, Mele M, Sangiogi M, Steganini M, Zuccheli G
DOI: 10.1111/prd.12468
Purpose: To review treatment complications and their prevention associated with root coverage procedures. Presurgical Phase: Complications arising from the presurgical phase include underestimation of risk factors or incomplete medical history review. Medication intake, including with herbal and dietary supplements, and bad habits can impair wound healing and interfere with blood clotting, leading to excessive intra- and post-operative bleeding. The American Academy of Orthopedic Surgeons and the American Society of Anesthesiologists issued a recommendation to discontinue the intake of specific herbal products for up to two weeks prior to surgery, as there is a lack of knowledge on the known effects of dietary and herbal supplements. Altered passive eruption may lead to adjacent teeth appearing elongated, leading to a potential misdiagnosis of gingival recession. Failure to recognize hard tissue discrepancies due to non-carious cervical lesions (NCCL’s) may also result in inadequate root coverage. Identifying smoking habits and aberrant toothbrushing frequency/force/bristle hardness/technique is also essential to pre-op evaluation. Intra-surgical Phase While hemorrhaging during treatment is minimal compared to general surgery, minimizing intra-surgical bleeding can be done by using split-thickness incisions at the beginning of the procedure with a gauze in place to protect the flap. This prevents delayed bleeding after discharge. Hemostasis may be achieved by direct pressure for 3-5min with a gauze, either dry or soaked in hemostatic agents, e.g. tranexamic acid. Flap perforation may occur during the split thickness approach: when the blade is not maintained parallel and in contact with the bone while detaching muscular insertions from the periosteum, or when the blade is not kept parallel to the external flap while separating muscle fibers from the inner aspect of the flap. A full thickness then split thickness approach should be used to overcome the perforation, and sutures should be applied to close the perforation if it is greater than 2mm or on an avascular area (root surfaces). Mental nerve injuries may be mitigated during flap release if the initial release is performed by compressing the flap with gauze in an apical direction, only then performing superficial split-thickness dissection of the flap. Post-surgical Phase Mucogingival surgery is 3.5x more painful than bone surgery. Most patients report pain, swelling, and bruising when the duration of surgery is 60min or longer; the longer the surgery, the greater the reported pain. Discomfort is mainly related to donor sites of connective tissue grafts (CTG’s) and was mostly experienced within the first week after surgery. The apicocoronal, rather than mesiodistal, size of the graft and the graft thickness appear to influence perceived pain. Swelling usually peaks 2-3 days post-operatively, then subsiding within 4-5 days. Anti-inflammatory analgesics (e.g. ibuprofen) and cryotherapy (i.e. ice packing) are used to help control swelling and pain. “Liver clots,” hemoglobin-rich, jelly-like clot characterized by slow, oozing, dark hemorrhaging, can be alarming to patients. They usually appear 24-48hrs after surgery and might be attributed to intrinsic trauma from normal masticatory movements, premature suture loss, inadequate flap stability, or the presence of foreign bodies. The clot should be removed with sterile gauze and saline irrigation, and a gauze should then be placed between the flap and lip/cheek for about 5-10min until hemostasis is achieved. The patient should only be discharged after bleeding is completely controlled. Post-operative bruising typically resolves within a few weeks. Flap dehiscence, when early, may result in flap shrinkage with expected root coverage severely impacted. Management of flap tension and passivity is essential for reducing the incidence of dehiscence and reducing strain on vessel patency and impaired neovascularization. De-epithelialization of anatomical papillae ensures vascular exchange, the survival of the flap margins, and improved blending (color and thickness). Microsurgical scissors should be used to de-epithelize narrow papillae to improve accuracy. Finally, sling sutures, especially with 6-0 and 7-0 sutures, should be used as the main stabilizing sutures. If early flap dehiscence occurs, no intervention is recommended until after soft tissue healing and stabilization occurs (3-6mo). As patient success often regards color and texture of gingiva instead of root coverage, graft exposure may be of consequence. The graft should never be placed coronally to the cemento-enamel junction (CEJ), and using “small” grafts may permit better outcomes. Flap margins, however, should be positioned 1-2mm coronal to the CEJ. Gingivoplasty, removal of the exposed part, and a second root coverage procedure if esthetics are of concern. Of note, porcine-derived matrices resorb and generally do not need further treatment. Scar-like formations are seldom noticed by patients. Nevertheless, they may be formed by excess closing tension and length of vertical releasing incisions. Flap necrosis is correlated with inadequate size of the recipient bed surrounding the avascular area and, when bilaminar techniques are used, the pedicle flap must be sufficiently thick to maintain vascularization of itself and of the underlying graft. Additionally, it is advantageous to start the anesthetic injection to the periphery of the flap at the mucogingival fold level to avoid soft tissue trauma due to needle penetration and to reduce the local ischemia due to the presence of a vasoconstrictor. Complications of flap necrosis should be addressed immediately with antibiotics if swelling, pain, local lymphadenopathy, and pus occur and again after 3-6mo of healing to determine if a second corrective surgery is needed. If an acute infection occurs despite pre-surgical and post-op chlorhexidine rinse and syringe irrigation intra-operatively, antibiotics may be used. External root resorption, exostosis formation, cyst-like formations may occur, albeit infrequently. Residual hypersensitivity may occur, as there is not enough evidence that surgical root coverage procedures predictably reduce dentinal hypersensitivity.
Conclusions: Pre-surgical, intra-surgical, and post-surgical complications and their prevention and treatment should be understood by practitioners performing root overage procedures.
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Neutrophils and periodontitis: From pathological mechanisms to therapeutic opportunities
Authors: Si L, Li N, Yang K
DOI: 10.1016/j.intimp.2025.115912
Purpose: To review the current understanding of how neutrophils, also called polymorphonuclear leukocytes (PMNs), affect periodontitis and pharmacological therapeutic interventions for periodontal diseases. Introduction: Neutrophils use phagocytosis, oxidative burst, degranulation, and neutrophil extracellular traps (NETs) as antimicrobial strategies. NETs, expulsed DNA-protein lattices which immobilize and neutralize bacteria, are abundant in periodontal pockets and excessively released in an environment of persistent microbial and danger signals, leading to accelerated tissue breakdown and chronic inflammation.
Conclusions: Neutrophils are central to periodontal immunity. Their effector mechanisms, especially NETs, intensify local inflammation and serve as targets for therapeutic strategies, a field currently in its infancy.
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Proximal contact loss between implants loaded for more than 10 years and adjacent teeth.
Authors: Kim H, Yoon JU, Lee JY
DOI: 0.5051/jpis.2403300165
Purpose: To evaluate how often proximal contact loss (PCL) develops between long-functioning dental implants and adjacent natural teeth in patients along with factors associated with this complication.
Conclusions: Implants functioning for more than 10 years showed a high incidence of PCL, especially on the mesial side. Posterior implant placement and compromised periodontal condition of adjacent teeth were significantly associated with PCL. Contact loss was influenced more by local site conditions and the periodontal health of neighboring teeth than by broader patient demographics.
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Effect of Suture Diameter and Material on Oral Soft-Tissue Tearing Behaviour: An In Vitro Study Relevant to Periodontal Plastic Surgery
Authors: De Greef, A., Caesbroeck KV, Langers H, Vanrusselt A, Lahoud P, Castro A, Temmerman A
DOI: 10.1111/jcpe.70127
Purpose: To examine how the physical properties of sutures interact with the mechanical characteristics of oral soft tissues to influence tearing behavior and provide an evidence-based framework.
Conclusions: Finer sutures (6-0 and 7-0) act as protective mechanical fuses – failing before causing tissue damage. PA 6-0 offers reliable protection in keratinized gingival tissue, while PGA or PVF in 7-0 are preferable for more delicate mucosal sites. Thicker sutures should be reserved for high-tension applications. Clinical validation studies are still needed to confirm whether these laboratory observations translate to improved surgical outcomes.
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Bleeding on Probing as a Predictor of Peri-Implant Bone Loss During Supportive Care: A Prospective Cohort Study
Authors: de Tapia, B., Torrens, G., di Leone, F., Amerio, E., Valles, C., Nart, K., Monje, A.
DOI: 10.1111/cid.70138
Purpose: This study was conducted to evaluate the diagnostic and predictive significance of bleeding on probing (BOP) and the modified bleeding index (MBI) in detecting progressive peri-implant bone loss over a 24-month period among patients receiving supportive peri-implant care.
Conclusions: The lack of bleeding serves as a dependable sign of peri-implant health in patients receiving supportive peri-implant care. Although bleeding measured at a single time point has limited specificity, repeated patterns of mild bleeding over time provide greater predictive value for disease progression. This underscores the importance of routine monitoring and standardized clinical assessment protocols.
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Survival and Risk Factors of Dental Implants in the Anterior Mandible: A Cohort Study
Authors: Haim, D., Eskander-Hashoul, L., Better, H., et al.
DOI: 10.1111/cid.70142
Purpose: The purpose of this retrospective study was to assess survival rates and identify risk factors associated with dental implants placed in the anterior mandible within a large patient cohort.
Conclusions: Long-term survival of anterior mandibular implants was excellent. Short implant length consistently correlated with elevated failure risk across early, late, and overall time periods. Penicillin allergy was associated with increased risk of early and overall failure, while advanced age and greater implant length provided protective effects. These results underscore the impact of both patient characteristics and implant design on anterior mandibular implant longevity. However, cautious interpretation is warranted given the lack of consistent data on potentially significant confounding variables, including bone grafting materials, surgical techniques, and prosthetic or loading-related parameters.