Externally connected simple taper retention implants in narrow anterior alveolar ridges: 5-7-year follow-up cohort study.

Relevance. Despite sustained research interest, the prevention of regressive changes associated with the absence of mechanical stimuli for bone remodeling and inflammatory alveolar ridge resorption continues to present a clinical challenge. Current alveolar ridge preservation protocols rely predominantly on xenogeneic and alloplastic biomaterials to support new mineralized tissue formation. However, the quality of the regenerated tissue remains suboptimal. High-molecular-weight hyaluronic acid has therefore been proposed as a bioactive adjunct because of its role in cell signaling, extracellular matrix formation, and the regulation of bone growth and mineralization. Objective: To evaluate the additional beneficial effect of exogenous hyaluronic acid combined with osteoconductive biomaterials on alveolar ridge defect repair. Materials and methods. A targeted literature search based on predefined keywords and eligibility criteria was conducted for studies published between 2014 and 2025 in the PubMed/MEDLINE, CyberLeninka, and eLIBRARY databases. Study identification, screening, and selection were performed in accordance with PRISMA guidelines for systematic reviews and meta-analyses. The risk of bias in the four randomized controlled trials included in the review was assessed using the RoB 2.0 tool. Statistical analysis and data visualization were performed using the DeepSeek large language model (LLM), which generated Python code for the meta-analysis. Standardized mean differences (Cohen’s d) were calculated, pooled effect estimates were derived using a DerSimonian–Laird random-effects model, heterogeneity was assessed using I 2 , and forest and funnel plots were generated. All LLM-assisted outputs were verified at each stage of the analysis. Results. The meta-analysis showed that exogenous hyaluronic acid had a statistically significant positive effect on new bone formation and significantly reduced the proportion of residual nonresorbed osteoconductive particles compared with the control group (p = 0.0035, 95% CI [0.275, 1.404] and p = 0.0001, 95% CI [−1.615, −0.547], respectively). In contrast, the percentage area of connective tissue structures/bone marrow spaces within alveolar ridge repair sites showed no significant effect of the bioactive polymer on new tissue modeling (p = 0.1881, 95% CI [−0.248, 1.263]). All assessed bone substitution outcome parameters showed a high degree of heterogeneity (I 2 = 94.9%, 92.6%, and 96.7%, respectively). The main limitations of this meta-analysis include the small number of relevant studies, differences in study design, materials, and treatment protocols, wide variation in follow-up periods, and, more importantly, heterogeneity in the methods used to assess and interpret morphological outcomes, including histological and histomorphometric parameters. Conclusion. High-molecular-weight hyaluronic acid exerts an additional beneficial effect on reparative remodeling of the alveolar ridge. The findings of this meta-analysis emphasize the importance of standardized outcome assessment protocols and the need for further studies to better define the outcomes of reconstructive procedures using more robust and objective evaluation measures.

Determining alveolar bone deficiencies prior to dental implant surgeries is critical for surgical planning. This study aimed to develop a deep learning-based framework that can automatically detect and classify alveolar ridge deficiencies (healthy, horizontal, vertical, and combined defects) using Cone Beam Computed Tomography (CBCT) slices and to evaluate the diagnostic performance of four different Convolutional Neural Network (CNN) architectures. A novel dataset consisting of 1305 anonymous CBCT cross-sectional images, classified and labeled by experts into four categories, was created: Healthy (n=325), horizontal Defect (n=359), vertical Defect (n=310) and combined Defect (n=311). Four different CNN models (RegNetY-008, EfficientNetV2-S, ResNet50, and MobileNetV3-Large) were trained and tested. Model performance was evaluated using accuracy, weighted precision, recall, F1-score, and epoch duration. The RegNetY-008 model demonstrated the highest performance with a 93.87% accuracy rate and a 93.88% weighted F1-score, processing the data with the fastest epoch time (8.04 sec.). This was followed by EfficientNetV2-S with a 93.10% accuracy rate. ResNet50 achieved 90.80% success, while MobileNetV3-Large showed the lowest performance (85.82%). Confusion matrices revealed that RegNetY-008 is particularly effective at distinguishing complex combined defects with minimal misclassification. Deep learning models, particularly the RegNetY architecture, can effectively classify alveolar bone defects from CBCT slices. The proposed automated system provides clinicians with a quick and objective second opinion in preoperative planning. By accurately classifying bone defects, it can assist dentists, particularly those with limited experience, in deciding between standard implant placement and augmentation procedures, thereby potentially reducing surgical complications and planning time.

Abstract Introduction: Augmentation of the alveolar ridge is one of the basic procedures in implant dentistry. It is essentially raising the ridge to accommodate dental implants. Ridge deficiency correction can be achieved using various methods, including guided bone regeneration (GBR), bone block grafting and synthetic/alloplastic grafting. This evaluates the effects of these procedures on the stability of implants, fit of prosthesis and volume of bone. Materials and Methods: A total of 100 individuals were enrolled in this prospective controlled study, and three augmentation techniques (GBR group, bone block group and synthetic graft group) were evaluated. Implant stability was evaluated by means of resonance frequency analysis, and bone volume and quality were radiographically assessed. Fit of the prosthesis was also assessed by clinical inspections and patients’ comments. One week, 1, 3 and 6 months after surgery, follow-ups were performed to monitor clinical and radiographic results. Results: The GBR group’s mean implant stability values surpassed all others. Moreover, they enjoyed the best-prosthesis fit, with 91% of participants indicating that the fit was ‘excellent.’ The GBR group also demonstrated significantly greater volumes and quality of bone, averaging 3.5 mm of bone height and 4.2 mm bone width gain. The bone block grafting and synthetic grafting groups demonstrated some moderate advancement in implant stability and bone volume, yet their outcomes were still below those of GBR. Conclusion: This study showed that GBR offers the highest benefit for alveolar ridge augmentation concerning implant stability, prosthesis adaptation and bone quality. The synthetic graft and bone block gave positive results.

Full-arch rehabilitation in patients with atrophic, edentulous jaws can be challenging due to the need for extensive bone augmentation and achieving primary stability in newly grafted bone. This brief clinical study presents a case of a successful mandibular alveolar ridge augmentation via a subperiosteal tunneling approach, followed by full-arch rehabilitation by using multiple bone-level implants.

Atrophy of the alveolar ridge in the posterior maxilla often requires sinus floor elevation prior to implant placement. Photobiomodulation using low-level laser therapy (LLLT) has been suggested as a supportive approach for bone healing, although data based on histological evaluation are still limited. This study presents histological and radiological secondary outcomes of a randomized clinical trial on bone regeneration after lateral window sinus augmentation. Twenty patients were allocated according to grafting material (allogeneic or xenogeneic) and the use of adjunctive LLLT. After 6 months, bone core biopsies were obtained at the time of implant placement and processed for histological analysis. Radiological bone gain was assessed using CBCT. Bone gain was achieved in all groups, allowing implant placement in every case. Mean bone gain reached 7.53 ± 3.32 mm in LLLT-treated sites and 7.02 ± 2.00 mm in controls, with no statistically significant differences. Histological analysis confirmed trabecular bone formation across all groups. Mild inflammatory cell infiltrates were observed more frequently in LLLT-treated sites (p = 0.029), although this finding was not associated with impaired tissue organization or compromised healing. Both allogeneic and xenogeneic grafts showed good biocompatibility and supported effective bone regeneration after sinus augmentation. The addition of photobiomodulation did not demonstrate statistically significant clinical or radiological benefits within this exploratory cohort, but it may be associated with subtle differences in tissue remodeling.

Alveolar ridge preservation using a bone allograft and collagen membrane significantly limited hard and soft tissue dimensional changes and promoted buccal bone gain compared with spontaneous healing in sockets with buccal dehiscence defects. This approach reduced the need for additional bone grafting, despite higher short-term postoperative morbidity.

Replacement resorption, a pathologic consequence of severe dental trauma, represents a formidable clinical challenge, particularly in the young adult demographic. This sequela, characterized by the progressive substitution of tooth structure with bone, leads to ankylosis and infra-position, compromising long-term periodontal health, alveolar ridge contour, and esthetic outcomes. In young adults, the transition from active skeletal growth to functional maturity creates a complex temporal window where intervention timing is critical. This narrative review synthesizes the contemporary understanding of replacement resorption, beginning with an in-depth exploration of its biological underpinnings, from the critical loss of periodontal ligament (PDL) viability to the subsequent osseous replacement. We critically evaluate the most current guidelines from the International Association of Dental Traumatology (IADT), delineating management paradigms based on a patient's growth potential. Furthermore, we dissect contemporary management strategies, ranging from the biologically-driven "decoronation" procedure for alveolar preservation to advanced restorative "rescue" protocols.

Mandibular third molars are the most frequently impacted teeth. The proximity of impacted third molars to the inferior alveolar canal requires particular consideration during extraction. Hence, we aimed to compare the diagnostic accuracy of CBCT and OPG using radiographic signs of Rood and Shebab's and find out the risk of mandibular nerve injury. A prospective study was conducted in 50 subjects. All patients underwent digital OPG evaluation based on Winter's classification of impacted teeth and Rood and Shehab's classification of seven radiographic signs. Cases with any positive finding were examined using CBCT to assess the positioning of the mandibular canal and alveolar ridge. Horizontal and mesioangular impactions were at higher risk of inferior alveolar nerve damage (p< 0.01 and p < 0.05) along with lingual position of canal (p<0.001), Darkening of roots, interruption of the mandibular canal (p<0.001), and diversion of the mandibular canal (p< 0.04) were associated with a higher risk of damage during extractions. The current study confirmed that horizontal and mesioangular impactions showed a significant association with the absence of cortication between the mandibular canal and third molar roots, indicating a high risk of nerve injury, similar to other studies. Also, CBCT has been proven to be the best imaging modality owing to its high diagnostic accuracy. In the current study, CBCT was considered the gold standard, and diagnostic accuracy was higher than OPG. There was fair agreement about the mesioangular and horizontal impaction and their proximity to the mandibular nerve.

Guided bone regeneration (GBR) is a predictable approach for managing severe alveolar ridge deficiencies prior to implant placement. Resorbable collagen membranes supported by tenting screws are widely used, although space maintenance in non-contained defects may be challenging. Customized CAD/CAM titanium meshes have been introduced to enhance graft stability and surgical workflow, but comparative clinical evidence remains limited. To compare clinical, radiographic, procedural, and peri-implant outcomes of customized CAD/CAM titanium meshes versus resorbable collagen membranes supported by tenting screws for horizontal and/or vertical alveolar ridge augmentation. This retrospective study included 40 patients with severe alveolar ridge defects, allocated to two groups (n = 20 each). Both groups received particulate bone grafts stabilized either with tenting screws and a resorbable collagen membrane or with a patient-specific CAD/CAM titanium mesh. Cone-beam computed tomography (CBCT) scans at baseline and 6 months were used to assess vertical and horizontal bone gain. Intraoperative time, complications, pseudo-periosteum formation, implant survival, and peri-implant marginal bone levels at prosthetic loading and at 5-year follow-up were recorded. At 6 months, mean bone height reached 8.7-8.93 mm in the maxilla and 9.25-9.35 mm in the mandible, while mean ridge width ranged from 4.7 to 5.3 mm, with no significant intergroup differences (p > 0.05). Mean peri-implant marginal bone loss was limited and remained stable from prosthetic loading to the 5-year follow-up in both groups. Mean operative time was significantly shorter in the customized mesh group, 72.7 min (range: 60-85) for the Tent-pole group and 62.4 min (range: 60-65) for the Ti-mesh group. All 60 implants placed in 40 augmented sites survived, with no implant failures and no need for additional grafting procedures. Both GBR techniques provided comparable bone regeneration and long-term peri-implant stability, while customized CAD/CAM titanium meshes were associated with reduced operative time.

Research Trends in Autogenous Dentin Graft: A Bibliometric and Cluster Analysis (2006-2025).

Platelet-rich fibrin versus bone grafts for alveolar ridge preservation: a systematic review and meta-analysis of randomized clinical trials

Impact of alveolar ridge preservation on soft tissue contour changes after extraction of a periodontally compromised molar: A prospective controlled clinical trial.

To evaluate the efficacy of injectable bone fillers for alveolar ridge preservation (ARP). Mandibular premolars (P2, P3, P4) were bilaterally extracted in nine beagle dogs. Each tooth underwent hemisection, with the mesial root devitalized and filled with calcium hydroxide, while the distal roots were extracted. This resulted in six sockets per dog, which were randomly assigned to four injectable test materials (T1-T4), one control (C), and one negative control group (N). Primary wound closure was achieved in all groups except for N. After 12weeks, tissue blocks were analyzed using micro-computed tomography (micro-CT). The primary outcome was bone volume fraction (BV/TV, %). Secondary outcomes included trabecular thickness (Tb.Th, mm), trabecular separation (Tb.Sp, mm), bone surface to bone volume ratio (BS/BV, mm2/mm3), buccal bone defect volume (BBD, mm3), vertical bone height (VBH, mm), buccal wall thickness (BBW, mm) and lingual wall thickness (LBW, mm). Data were analyzed using the Kruskal-Wallis test. After 12weeks of healing, all groups were associated with a similar BC/TV values (64.6%, 68.2%, 69.0%, 66.5%, 76.5% and 79.8% in the T1, T2, T3, T4, C and N groups, respectively; p > 0.05 for all between group comparisons). No statistically significant differences were found among groups for Tb.Th, Tb.Sp, BS/BV, BBD, VBH, BBW and LBW. Within its limitations, the present study showed comparable efficacy of injectable bone fillers in maintaining alveolar ridge dimensions compared with the C and N groups. Injectable bone fillers represent a convenient and potentially effective alternative for alveolar ridge preservation procedures.

Alveolar ridge resorption after tooth extraction may compromise implant placement and frequently necessitates guided bone regeneration (GBR). Platelet-rich fibrin (PRF) is widely used in oral surgery; extended PRF (e-PRF) has been proposed to prolong growth factor availability and membrane stability. This randomized clinical trial compared PRF and e-PRF membranes combined with bovine xenograft for horizontal ridge augmentation with simultaneous implant placement in the posterior mandible. Twenty patients with posterior mandibular ridge deficiencies (residual ridge width 4–6 mm) were randomized (1:1) to receive xenograft + PRF (control, n = 10) or xenograft + e-PRF (study, n = 10) at the time of implant placement. Primary outcome: horizontal bone width gains at 6 months assessed by standardized CBCT measurements 1 mm apical to implant platform. Secondary outcomes: implant stability quotient (ISQ) at baseline and 6 months, postoperative pain (VAS), and edema. Sample size was calculated to detect the expected difference in ISQ change with 80% power and α = 0.05. Statistical tests included paired and independent t-tests, repeated measures analyses, and non-parametric tests where appropriate. Significance threshold was p ≤ 0.05. Twenty patients (30 implants; 8 males, 12 females; mean age 40.2 ± 5.3 years) completed the study. Baseline characteristics and residual ridge widths were similar between groups. Implant stability (ISQ) increased significantly within both groups from baseline to 6 months (p < 0.001) but did not differ between groups at either time point (baseline p = 0.622; 6 months p = 0.263). Postoperative pain and edema followed similar, transient patterns in both groups (no significant between-group differences). At 6 months, horizontal bone gain was significantly greater in the e-PRF group (mean gain 2.28 ± 0.79 mm) than in the PRF group (0.75 ± 0.18 mm), p < 0.001. In this randomized clinical trial, both PRF and e-PRF combined with bovine xenograft and simultaneous implant placement produced favorable clinical outcomes, while e-PRF provided superior horizontal bone gain at 6 months. Further larger and longer-term trials with prospective registration are recommended to confirm these findings. The study protocol approved by the Institutional Review Board of the Faculty of Dentistry, Alexandria University, Egypt (IRB No. 0936-06/2024–00010556). This trial was retrospectively registered at ClinicalTrials.gov (ID: NCT07164417, Date of registration: 04/09/2025; https://clinicaltrials.gov/study/NCT07164417). All participants provided written informed consent before enrollment.

Perigraftitis is a biologic complication associated with dental implants placed in grafted bone, distinct from peri-implant mucositis and peri-implantitis. This report further characterizes its clinical, radiographic, and histopathologic features. Three patients presented with discomfort around a single implant placed following tooth extraction and alveolar ridge preservation. Surgical access was obtained, and the implant fixture and surrounding defect were thoroughly debrided. Tissue fragments were submitted for histology, and sections from two previously reported cases were reexamined. Clinically, perigraftitis presented with signs of inflammation and radiographically as a radiolucent defect centered on the grafted bone rather than the implant fixture, containing radiopacities consistent with grafted bone and graft particulates. Histologically, grafted bone, composed of graft particulates surrounded by mature host bone, demonstrated microbial colonies and inflammatory cells. The hallmark histopathologic feature, irrespectiveof graft type, was microbial aggregates adherent to the surfaces and within the intertrabecular spaces of grafted bone, accompanied by inflammatory infiltrates. Sulfur granules and amoebae were novel observations. Perigraftitis arises from microbial colonization of grafted bone and is not restricted to a specific graft material. Implant recipient site grafting should be performed judiciously. Management requires complete removal of infected grafted bone and associated inflammatory tissue.

Accurate bucco-lingual bone width measurement is essential for implant planning. Manual cone-beam computed tomography (CBCT) assessment is time-intensive and operator-dependent. This study aimed to evaluate the accuracy of an artificial intelligence (AI)–based system for automated bone width measurement compared with manual methods. A retrospective diagnostic accuracy study was conducted using 300 CBCT scans of posterior mandibular edentulous sites. Manual bucco-lingual bone width was measured at 2-mm intervals from the alveolar crest to 2 mm superior to the mandibular canal. A deep learning framework with U-Net + + was trained to segment the alveolar ridge and mandibular canal, followed by automated bone width measurements. Model performance was assessed using Dice score, Intersection over Union (IoU), precision, and recall for segmentation accuracy, and regression metrics (mean squared error [MSE], mean absolute error [MAE], root mean squared error [RMSE], and coefficient of determination [R²]) for comparison with manual measurements. U-Net + + demonstrated high accuracy for alveolar ridge segmentation (Dice score, 0.9798; IoU, 0.9606; precision, 0.9820; recall, 0.9778) and moderate accuracy for mandibular canal segmentation (Dice score, 0.5640). Automated bucco-lingual width measurements showed reasonable correspondence with manual values (MSE, 1.9700 mm²; MAE, 1.1900 mm; RMSE, 1.4000 mm; R², 0.5300). Qualitative analysis confirmed high visual correspondence for ridge segmentation, though variability persisted in canal delineation. The AI-based U-Net + + system reliably segmented the alveolar ridge and provided bone width measurements with moderate agreement to manual methods. Mandibular canal segmentation remained a limitation. Broader validation across jaw regions and imaging systems is recommended to enhance clinical utility.

Natural propolis is widely known to be an antibacterial agent with strong antioxidant and anti-inflammatory properties. In combination with a bovine xenograft, it is expected to promote bone formation in the alveolar ridge, following tooth extraction. The aim of the present study was to evaluate the effect of administering a propolis extract combined with a bovine xenograft on alveolar bone formation. The lower incisor teeth of Cavia cobaya were extracted and the resulting alveolar sockets were filled with different materials based on the group assignment: polyethylene glycol (PEG); a propolis extract (PE); a bovine xenograft (BX); and the propolis extract-bovine xenograft composite (PE-BX). The alveolar sockets were examined after 7 and 30 days by means of immunohistochemical staining for the expression of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-ĸB), tolllike receptor 2 (TLR2), tumor necrosis factor-alpha (TNF-α), and type 1 collagen. The one-way analysis of variance (ANOVA) and post-hoc Tukey's test were used to compare the groups. The PE-BX group demonstrated promising results, with increased type I collagen levels and reduced expression of inflammatory markers (NF-κB, TLR2 and TNF-α) on days 7 and 30 (p < 0.001). Furthermore, in comparison with the BX group, this material demonstrated significantly higher type I collagen expression on days 7 and 30 (p < 0.01). The composite of a natural propolis extract and a bovine xenograft enhances type I collagen expression and reduces the expression of inflammatory markers. Further research is warranted to explore its potential for alveolar bone preservation.

Alveolar ridge resorption (ARP) is a well-recognized consequence of tooth extraction, and multiple adjacent extractions may lead to greater ridge reduction than single-tooth extractions. This multicenter randomized controlled trial aimed to assess ridge remodeling after removing 2 adjacent teeth and whether socket grafting with deproteinized bovine bone mineral with collagen (DBBM-C) plus a collagen membrane could counteract the ridge reduction. Forty-two patients requiring 2 adjacent tooth extractions were randomly assigned to either Test (DBBM-C graft + collagen membrane) or Control (natural healing). Impressions were taken immediately after extraction and at 6 months, and models were analyzed to measure changes in horizontal ridge width (bucco-lingual at 3mm below the crest) and vertical ridge height (buccal and lingual). At 6 months, grafted sites had significantly less ridge reduction than controls. Horizontal ridge width reduction averaged 57.7% in Control versus 23.0% in Test (p<0.001). Vertical height loss was also greater in controls (buccal 3.0mm vs. 1.5mm; lingual 2.2mm vs. 1.3mm; p<0.001). Both mesial and distal sockets benefited similarly from grafting, with comparable preservation at each site. Filling adjacent extraction sockets with DBBM-C and covering with a collagen membrane significantly reduced horizontal and vertical alveolar ridge resorption compared to unassisted healing. This approach effectively preserves bone volume after multiple tooth extractions, which may facilitate later implant placement. When 2 neighboring teeth are removed, the area tends to shrink in width and height as it heals. This bone loss can make it more difficult to place dental implants later. In this study, we tested a method to help maintain the bone after removing 2 adjacent teeth. In the Test group, the empty tooth sockets were filled with a bone graft material (deproteinized bovine bone mineral and collagen) and covered with a collagen membrane. In the Control group, the sites were left to heal physiologically. A total of 42 patients participated, each needing 2 side-by-side teeth removed. After 6 months of healing, we compared models of the patients from right after the extractions to those taken 6 months later. The results showed that the group with the bone graft and membrane had much less bone shrinkage than the group without them. The 2 extraction sites in the graft group maintained their bone height and width similarly. In summary, using a bone substitute material and membrane immediately after multiple tooth extractions helped preserve the jawbone, which could make future treatments like dental implants more successful.

Background: While hydroxyapatite (HA) is considered stable and non-resorbable, other calcium phosphate phases such as Tricalcium Phosphate (TCP), Brushite, and Monetite are characterized by higher solubility and biodegradation rates. This review aims to map the clinical evidence of these resorbable phases. Objective: The aim of this scoping review was to map and synthesize the available clinical evidence on resorbable calcium phosphate phases, focusing on TCP-, brushite-, and monetite-based biomaterials in alveolar bone regeneration. The review evaluates clinical indications, surgical protocols, reported outcomes, and existing knowledge gaps. Methods: This scoping review was conducted in accordance with the PRISMA-ScR guidelines. A comprehensive literature search was performed in PubMed, MEDLINE, Scopus, and SCI Clarivate databases without language or time restrictions (from June 2025 to August 2025) using terms related to brushite, monetite, dicalcium phosphate anhydrous, ridge augmentation, bone regeneration, and dental implants. Clinical studies involving brushite- or monetite-based biomaterials used for alveolar bone regeneration were eligible, including randomized controlled trials, prospective cohort studies, and case series. Data were charted descriptively with respect to study design, patient characteristics, clinical scenario, biomaterials used, surgical approach, healing time, outcome measures, and reported complications. No meta-analysis or formal assessment of comparative clinical effectiveness was undertaken, in line with scoping review methodology. Results: Seven clinical studies were included. The identified evidence encompassed heterogeneous clinical scenarios, including post-extraction alveolar ridge preservation, localized ridge augmentation, and periodontal or intraosseous defects with relevance to future implant placement. Study designs, defect characteristics, biomaterial formulations, and outcome measures varied substantially. Across studies, brushite- and monetite-based materials were associated with new bone formation and progressive graft resorption, as assessed by clinical, radiographic, and histological outcomes. Direct comparisons between studies were not feasible due to methodological and clinical heterogeneity. Conclusions: The available literature on brushite- and monetite-based biomaterials in alveolar bone regeneration is limited and heterogeneous. Current evidence supports their biocompatibility and resorbable nature across different clinical contexts, but does not allow conclusions regarding comparative clinical effectiveness. This scoping review highlights important gaps in the literature, particularly the need for well-designed randomized clinical trials with standardized indications and outcome measures.