Horizontal Bone Research Articles

Evaluation of the Success of Autogenous Block Grafting in Atrophic Maxillary and Mandibular Ridges Prior to and After Implant Placement.

Dental implantology's success relies on adequate bone volume and quality, necessitating bone augmentation for implant placement. Primary lateral bone augmentation, utilizing autogenous block grafts, addresses horizontal bone loss. This study aims to evaluate the efficacy of autogenous block grafting, specifically ramus and fibula blocks, in addressing severe atrophic ridges before and after implant placement. Twenty-one patients underwent block grafting, predominantly using the ramus technique (80/20 ratio). CBCT measurements assessed horizontal grafting outcomes. Implant success and bone volume changes were analyzed. Post-grafting, bone width increased from 1.8-3.1 mm to 4.5-6 mm, exceeding critical thresholds. Implant success reached 95%, indicating the grafting techniques' effectiveness. Autogenous block grafting, especially with ramus and fibula blocks, transforms severe atrophic ridges, enabling successful implant integration. Long-term follow-up is essential for a comprehensive evaluation. This study provides crucial insights into autogenous block grafting's transformative impact on challenging cases, guiding future applications in reconstructive dentistry.

Horizontal ridge augmentation in the maxillary aesthetic region using the autogenous circular cortical-lamina anchoring technique: A case series study.

This case series aimed to evaluate the effectiveness of the autologous circular cortical lamina-anchoring (CCA) technique for horizontal bone augmentation in the maxillary aesthetic region. A total of 25 patients with 28 implants underwent horizontal bone augmentation using CCA followed by implant placement and crown delivery. The primary outcome measures were alveolar ridge width (ARW) and buccal bone thickness (BBT), whereas the secondary outcome measures included marginal bone loss (MBL), mid-facial mucosal margin loss (MML), clinical assessment of peri-implant and aesthetic parameters, patient-reported outcome measures (PROMs), and implant survival rates. All 25 patients with 28 implants completed the treatment, no dropouts occurred. After CCA, the mean ARW at 1, 2, and 4 mm below the alveolar crest significantly increased from 2.38 ± 0.48, 2.85 ± 0.51, and 3.21 ± 0.53 mm to 6.80 ± 0.48, 6.99 ± 0.50, and 8.08 ± 0.52 mm, respectively. At the 3-year follow-up, the mean BBT0, BBT2, and BBT4 slightly decreased from 2.51 ± 0.26, 2.63 ± 0.31, and 2.75 ± 0.29 mm to 2.43 ± 0.27, 2.51 ± 0.30, and 2.64 ± 0.28 mm, respectively. Although the overall MBL was <0.15 mm, the results were statistically significant. The mean MML at the 3-year follow-up was 0.02 mm. All implant sites showed acceptable peri-implant and aesthetic outcomes. Incisions healed without complications, and no significant differences in PROMs observed at any time point. The 3-year follow-up showed a 100% implant survival rate. The autologous CCA technique is a useful method for increasing ARW and maintaining BBT in the maxillary aesthetic region.

3-Year Bone Remodeling in Mandibular Overdenture Wearers: Results from an RCT Comparing Immediate vs Conventional Loading Using Cone Beam Computed Tomography.

To evaluate the circumferential bone level and the morphological changes in posterior mandibular ridge of mandibular overdenture wearers submitted to conventional and immediate loading through cone beam computed tomography (CBCT) at 1 and 3 years. Twenty participants who received 2 NDI (Facility - 2.9x10 mm) were randomly allocated to the conventional loading (CL: n=10) or immediate loading (IL: n=10) groups. CBCT scans were performed in each group to analyze the vertical (VBL) and horizontal (HBL) bone level around the implants, analyzed together with the posterior bone remodeling of the mandible measured at distances of 5, 10, 15, and 20 mm from the mental foramen (L1-L4). Differences between groups were verified using the student t test at a significance level of 5%. The IL group showed a significantly higher HBL in the first year (P=.028) and a significantly higher VBL in the third year (P=.032), with HBL of -0.22 mm and VBL of -0.59 mm, respectively. After the third year, measurements of the percentage of cortical and medullar height indicated that the IL group presented a significantly higher percentage of cortical bone height (40.1 ± 9.3) compared to the CL group (31.8 ± 5.8) at position L1 (P=.05). No difference was found for posterior ridge remodeling (P>.05). IL group showed slightly higher values of HBL and VBL, and locally displayed more replacement of medullary by cortical bone. However, circumferential bone level values in the IL group are still clinically acceptable and the posterior resorption rate remained stable after 3 years of function, irrespective of the loading type.

Detection of periodontal bone loss patterns and furcation defects from panoramic radiographs using deep learning algorithm: a retrospective study

BackgroundThis retrospective study aimed to develop a deep learning algorithm for the interpretation of panoramic radiographs and to examine the performance of this algorithm in the detection of periodontal bone losses and bone loss patterns.MethodsA total of 1121 panoramic radiographs were used in this study. Bone losses in the maxilla and mandibula (total alveolar bone loss) (n = 2251), interdental bone losses (n = 25303), and furcation defects (n = 2815) were labeled using the segmentation method. In addition, interdental bone losses were divided into horizontal (n = 21839) and vertical (n = 3464) bone losses according to the defect patterns. A Convolutional Neural Network (CNN)-based artificial intelligence (AI) system was developed using U-Net architecture. The performance of the deep learning algorithm was statistically evaluated by the confusion matrix and ROC curve analysis.ResultsThe system showed the highest diagnostic performance in the detection of total alveolar bone losses (AUC = 0.951) and the lowest in the detection of vertical bone losses (AUC = 0.733). The sensitivity, precision, F1 score, accuracy, and AUC values were found as 1, 0.995, 0.997, 0.994, 0.951 for total alveolar bone loss; found as 0.947, 0.939, 0.943, 0.892, 0.910 for horizontal bone losses; found as 0.558, 0.846, 0.673, 0.506, 0.733 for vertical bone losses and found as 0.892, 0.933, 0.912, 0.837, 0.868 for furcation defects (respectively).ConclusionsAI systems offer promising results in determining periodontal bone loss patterns and furcation defects from dental radiographs. This suggests that CNN algorithms can also be used to provide more detailed information such as automatic determination of periodontal disease severity and treatment planning in various dental radiographs.

Efficacy of autologous platelet concentrate products for alveolar preservation: A meta-analysis.

The purpose of the study was to systematically evaluate the efficacy of autologous platelet concentrate products in the preservation of the alveolar ridge after tooth extraction through meta-analysis and provide a theoretical basis for the clinical application of autologous platelet concentrates to reduce alveolar bone resorption. This study conducted a meta-analysis of clinical trials between 2013 and 2023, focusing on autologous platelet concentrate products (e.g., PRP, PRF, CGF, and PRCF) used for alveolar ridge preservation after tooth extraction. The analysis included 122 articles and 371 extraction sockets. All statistical analyses were performed using Review Manager version 5.4. Results indicate that these platelet concentrates effectively reduced changes in horizontal width 1 mm below the alveolar crest and vertical socket height. They also promoted a higher percentage of new bone formation in extraction sockets compared with control groups. However, they did not significantly prevent horizontal bone resorption at 3 and 5 mm below the alveolar crest. In conclusion, autologous platelet concentrates are useful for alveolar ridge preservation, but larger clinical studies are needed to confirm these findings due to the relatively small sample size in this study.

Maksillada İki Farklı Ogmentasyon Tekniğinin Karşılaştırılması: Olgu Sunumu

Aim: &#x0D; Dental implant applications are most common treatment methods for rehabilitation of edentulous jaws. The severe bone deficiency could not be allowed implant therapies. Various augmentation methods could be used for reconsruction. In this case report tent-pole and onlay grafting techniques were performed in case at edentulous maxilla with radiological evaluation at 6 months follow-up.&#x0D; Materials and Methods:&#x0D; CBCT (Cone beam computed tomography) were obtained from patient. Extraction of all teeth and explantation of 2 implants were planned because of periodontal problems. The ramus onlay grafting was decided to apply for both anterior side of the maxilla and tent pole technique for right premolar area of maxilla.&#x0D; Results:&#x0D; It was observed 3.5 mm horizontal bone gain at the right maxillary anterior side, 4.8 mm horizontal bone gain at the left maxillary anterior side and 3.4 mm horizontal and 6.8 mm vertical bone gain at right premolar side after 6 months.&#x0D; Conclusion:&#x0D; Tent pole and onlay grafting methods are successful treatment options for alveolar ridge augmentation. Nevertheless, autografts could not be enough in every case. In this situation, xenografts and allografts applications with tent pole technique could be preferred as an effective method for alveolar ridge augmentation both horizontally and vertically.

Does diabetes mellitus affect guided bone regeneration outcomes in individuals undergoing dental implants? A systematic review and meta-analysis

ObjectivesThis systematic review aimed to verify if diabetes affects vertical and horizontal ridge augmentation in individuals undergoing dental implant treatment with guided bone regeneration (GBR).MethodsFive databases were systematically screened up to September 2023, according to predefined eligibility criteria. The methodological risk of bias of included studies was assessed using the ROBINS-I tool, and GRADE was used to evaluate the certainty of evidence. Random-effects pairwise meta-analyses were used to compare changes in vertical (height) and horizontal (width) alveolar bone dimensions between individuals exposed and unexposed to diabetes, through standardized mean differences (SMDs).ResultsThree non-randomized controlled trials met the inclusion criteria, all of which showed a serious risk of bias. The results showed, with overall very low certainty on evidence, that individuals with diabetes did not exhibit a significant difference in horizontal (SMD = −0.41, 95% CI: −0.92–0.10) and vertical (SMD = 0.06, 95% CI: −0.43–0.56) ridge augmentation compared to the those without diabetes.ConclusionsThe available evidence, albeit of very low certainty, suggests that diabetic individuals with moderate or good glycemic control undergoing dental implants and GBR show comparable horizontal and vertical bone gains to their unexposed counterparts. Systematic Review Registrationhttps://osf.io/bpx3t.

Multidimensional 3D-Printed Scaffolds for Ridge Preservation and Dental Implant Placement: A Systematic Review

Background: Regenerative medicine in dentistry involves tissue engineering applications suitable for the unique oral environment. In this regard, advances in computer-aided technology have facilitated the creation of 3D scaffolds using cone beam computed tomography (CBCT). This review aimed to investigate whether 3D-printed scaffolds can be effectively used to achieve ridge preservation and/or predictable vertical and horizontal bone augmentation, ensuring successful outcomes for dental implant placement. Methods: A comprehensive search was conducted across six electronic databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science, Ovid) to identify relevant studies according to specific eligibility criteria, following the PRISMA guidelines. Two independent reviewers screened and selected studies, performed data extraction, and assessed the risk of bias using the Cochrane tool for randomized clinical trials and the Newcastle–Ottawa Scale for non-randomized clinical trials. Results: The initial search yielded 419 articles, which were subsequently screened to remove duplicates. After evaluating 293 articles based on title and abstract, 10 studies remained for full-text assessment. Ultimately, only three studies met all the pre-established eligibility criteria. Conclusions: The studies included in this systematic review showed that the use of multidimensional customized scaffolds appears to promote dental implant placement. Nevertheless, despite the positive reported effects, further well-designed randomized clinical trials are necessary to determine the special characteristics of the optimal 3D-customized scaffold.

A skeleton in a huff: insights in etiologies of osteosclerosis.

A 30-yr-old man developed right lower leg pain and a palpable solid mass. Radiographic imaging revealed a periosteal reaction with an exostotic mass arising from the right distal fibula. Generalized skeletal osteosclerosis with periosteal reaction was discovered on a radiographic skeletal survey. A biopsy of the right fibular mass revealed reactive woven bone. The patient was referred to a metabolic bone disease clinic, where laboratory values were consistent with secondary hyperparathyroidism and increased bone turnover. A DXA bone density scan revealed high bone density, with an L1-4 spine Z-score of +9.3, a left femoral neck Z-score of +8.5, and a total hip Z-score of +6.5. A dental exam revealed generalized gingival inflammation, teeth mobility, generalized horizontal alveolar bone loss and widening of the periodontal ligament space, increased bone density around the teeth, and thickening of the radicular lamina dura. An extensive evaluation was performed, with the result of a single test revealing the diagnosis. The differential diagnoses of osteosclerosis affecting the skeleton, teeth, and oral cavity are discussed.

Comparative analysis of horizontal alveolar ridge augmentation: Guided bone regeneration versus screw-tenting techniques - A systematic review

The aim of this study was to systematically review bone volume changes obtained via the use of the Guided Bone Regeneration Technique (GBR-T) versus the Screw-Tenting Technique (ST-T) in horizontally defective alveolar ridges. In addition to review and compare rates of complications pertaining to post-operative dehiscence with membrane exposure, graft exposure, graft loss or other unforeseen complications and rates of implant placement into grafted sites. PRISMA protocol was used for systematic reviewing, electronic and manual searches of primary and secondary objectives were performed using the National Library of Medicine (MEDLINE via PubMed), EMBASE (Ovid), and EBSCO Host up to and including the 1st May 2023. Three articles qualified under the stipulated inclusion and exclusion criteria. Regarding GBR-T, the mean horizontal ridge bone gain was 2.47±3.16 mm with a mean complication rate of 16.50%, a mean graft loss rate of 11.70% and a mean implant placement rate of 91.30%. Regarding ST-T, the mean horizontal ridge bone gain was 4.76.02±2.57 mm with a mean complication rate of 9.30%, a mean graft loss rate of 2.80% and a mean implant placement rate of 98.10%. Both techniques are predictable in achieving horizontal ridge bone gains with low complication/failure rates leading to high second stage implant placement rates. The adjunctive use of tenting screws appears to be effective, offering additional benefit to the mechanism of space maintenance. Current evidence is however limited and of moderate risk-of-bias with heterogeneity within and between studies. Different interventions were performed by various clinicians with varying surgical skillsets in differing clinical environments using different biomaterials so caution must be used when interpreting these findings.

Guided Customization and Fixation of Allogenic Cortical Lamina in Alveolar Bone Regeneration. A Case Report.

Bone reconstruction surgeries such as the autogenous and allogenic shell techniques where cortical laminates are used to regenerate bone defects, requires time and expertise to adapt and fix the laminated cortical blocks onto the defect area. This case report illustrates the process of customizing and fixing an allogenic cortical laminate (ACL) to reconstruct a horizontal bone defect with guided surgical stents. Two types of surgical stents were designed: one to aid in cutting a prefabricated ACL into the desired shape for the defect to be regenerated, and the other type of stent, was used to assist in the positioning and fixation of the resulting laminates. These stents enabled the clinician to regenerate a horizontal defect with reduced surgical time, increased precision and safety during laminate fixation. After 5 months of healing a dental implant could be placed in the regenerated site. The use of surgical stents in this type of bone regeneration surgeries can be helpful specially in more complex bone defects where precision is key. Further clinical studies are needed to validate this technique.

Evaluation of alveolar bone width alterations around dental implants.

Teeth that are lost can be replaced with dental implants. A sufficient width of bone surrounding the implant is beneficial to its success. Therefore, it is of interest to examine alterations in width of alveolar bone surrounding dental implants at natural and rebuilt bone locations [alveolar ridge preservation (ARP) /Guided Bone Regeneration (GBR)] using CTBT. A CBCT examination of the implant recipient site was performed on sixty patients (both male and female), who had undergone dental implants. All conventional surgical procedures were followed for inserting dental implants. All participants had their horizontal alveolar bone widths around implants assessed at 3 positions: subcrestal width 1 mm (CW1 (crestal level-CW1), subcrestal width 4 mm (CW4), and subcrestal width 7 mm (CW7). There were 32 male patients and 28 female patients out of 60 totals. The mean bone width was 7.02 mm at CW1 prior to surgery and 6.91 mm afterward; it was 8.52 mm at CW4 and 8.13 mm afterward; and it was 10.21 mm at CW7 prior to surgery and 10.08 mm afterward. There was a substantial difference (P<0.05). At CW1, the bone width was 0.38 mm at local bone and -0.02 mm at ARP/GBR; at CW4, the bone width was 0.46 mm at local bone and 0.23 mm at ARP/GBR; and at CW7, the bone width was 0.22 mm at local bone and 0.02 mm at ARP/GBR. There was no discernible difference (P>0.05). Resorption of the alveolar bone width was only noticeable at the middle third of the sites. Long-term alterations in the alveolar bone width surrounding dental implants at local and rebuilt bone sites can be observed using CBCT images.

Effect of Membrane Fixation and the Graft Combinations on Horizontal Bone Regeneration: Radiographic and Histologic Outcomes in a Canine Model.

The aim of this study was to determine the effect of membrane fixation and combinations of bone substitute materials and barrier membranes on horizontal bone regeneration in peri-implant defects. Eight mongrel dogs underwent chronic buccal peri-implant dehiscence defects creation and were randomized into 4 groups: (a) deproteinized bovine bone mineral 1 (DBBM1) with a native collagen membrane (CM) (BB group, positive control group), (b) DBBM1 with native CM and 2 fixation pins (BBP group), (c) DBBM2 with a cross-linked CM (XC group), and (d) DBBM2 with cross-linked CM and 2 fixation pins (XCP group). Following 16 weeks of healing, tissues were radiographically and histomorphometrically analyzed. The total augmented area was significantly larger in the BBP, XC, and XCP groups compared to the BB group (4.27 ± 3.21, 7.17 ± 7.23, and 6.91 ± 5.45 mm2 versus 1.35 ± 1.28 mm2, respectively; P = 0.022). No significant difference for the augmented tissue thickness was observed among the 4 groups. The augmented tissue thickness measured at 3 mm below the implant shoulder was higher in BBP, XC, and XCP than that in BB (2.43 ± 1.53, 2.62 ± 1.80, and 3.18 ± 1.96 mm versus 0.80 ± 0.90 mm, respectively), trending toward significance (P = 0.052). DBBM2 and a cross-linked CM were significantly more favorable for horizontal bone regeneration compared to DBBM1 and a native CM. However, when DBBM1 and a native CM were secured with fixation pins, outcomes were similar. The addition of pins did not lead to more favorable outcomes when a cross-linked CM was used.

Multidisciplinary Approach for Treating Vertical Ridge Defect: Case Report

Background: The outcomes of trauma may have a ridge defect, and it would be hard to replace it with a simple dental implant treatment technique. In some cases, horizontal and vertical bone augmentation therapy is needed for implant placement. Case presentation: The case report described a 24-year-old female diagnosed with a severe bony defect and was managed in collaboration with an orthodontic and periodontic treatment plan. Alveolar bone augmentation was approached using Misch&amp;apos;s fashion, an autogenous block graft harvested from intra-oral (ramus). Moreover, Khoury&amp;apos;s split bone block technique was applied to reconstruct the seat. Conclusion: For complicated abnormalities, autogenous bone is still the best choice. Autogenous bone is the gold standard for bone grafting due to its biocompatibility, absence of antigenicity, and osteoconductive and osteoinductive qualities. Further graft extenders or growth factors may result in better outcomes.

Posterior open wound healing in immediate implant placement using reactive soft tissue versus absorbable collagen sponge: a retrospective cohort study

The soft and hard tissue healing of open wounds in immediate implant placement are yet to be explored. The aim of this study was to compare the clinical outcomes of open wound healing using reactive soft tissue (RST) and absorbable collagen sponge (ACS). Forty implants placed immediately in posterior sockets were included; autologous RST was used in 20 and ACS substitute was used in 20. Soft tissue healing was primarily assessed through a novel scoring system and the evaluation of gingival recession. The horizontal bone width (HBW) and interproximal marginal bone level (MBL) were measured on radiographs to observe the hard tissue healing. No significant difference in total soft tissue healing score was observed at 2 weeks postoperatively. Notably, the ACS group showed better tissue colour (P = 0.016) but worse fibrous repair (P = 0.043) scores than the RST group. Gingival recession levels were comparable in the two groups, both before tooth extraction and after placement of the restoration. Regarding hard tissue, HBW and MBL changes showed no intergroup differences. Within the limitations of this study, both RST and ACS seemed effective for open wound closure, achieving ideal soft and hard tissue healing in immediate implant placement.

Radiographic comparison of atelocollagen versus deproteinized bovine bone minerals covered with a collagen membrane in alveolar ridge preservation: a retrospective study

BackgroundAtelocollagen (AC) is a low-immunogenic collagen derivative with longer degradation time, which can be a suitable material for alveolar ridge preservation (ARP). However, there are few human studies on AC using for ARP. This research aims to radiographically evaluate the efficacy of AC in comparison to deproteinized bovine bone minerals covered with a collagen membrane (DBBM/CM) in ARP.MethodsMedical records in the Implantology Department of the Hospital of Stomatology of Wuhan University were screened for patients who received flapless ARP using either AC or DBBM/CM. A total of 58 patients were included in this retrospective study. 28 patients were treated with AC, while 30 patients were used DBBM/CM. Cone-beam computed tomography (CBCT) scans were taken before extraction and after 6 months of healing. To assess the dimensional change of the extraction sockets, the scanning data were output and transferred to the digital software to measure horizontal bone width change, vertical bone height change and bone volume change in region of interest. To evaluate the bone quality of healed sockets, the bone density of virtual implants was evaluated.ResultsThe horizontal bone width changes at all five different levels showed no significant difference between the two groups. The largest horizontal bone width decrement in both groups occurred at the crest of ridge, which decreased 3.71 ± 1.67 mm in AC group and 3.53 ± 1.51 mm in DBBM/CM group (p = 0.68). At the central buccal aspect, the ridge height reduced 0.10 ± 1.30 mm in AC group, while increased 0.77 ± 2.43 mm in DBBM/CM group (p = 0.10). The vertical bone height differences between two groups showed no statistical significance. The percentages of volume absorption in AC group and DBBM/CM group were 12.37%±6.09% and 14.54%±11.21%, respectively. No significant difference in volume absorption was found (p = 0.36). The average bone density around virtual implants in AC group (649.41 ± 184.71 HU) was significantly lower than that in DBBM/CM group (985.23 ± 207.85 HU) (p < 0.001).ConclusionsARP with AC had a similar effect on limiting the dimensional alteration of alveolar ridge, when radiographically compared with DBBM/CM.

The efficacy of alveolar ridge split on implants: a systematic review and meta-analysis

ObjectivesTo evaluate the effects of the alveolar ridge split (ARS) technique on gained horizontal width of the alveolar ridge and implant survival rate.Materials and methodsElectronic searching was performed in six electronic databases (Pubmed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, and SIGLE) from January 1, 2010, to November 1, 2023. Two authors performed study selection, data extraction, and study qualities (ROBINS-I and RoB 2.0) independently. Meta-analysis was performed by Comprehensive meta-analysis 3.0.Results24 included studies were observational, and 1 study was a randomized controlled trial (RCT). 14 studies investigated the gained width of the horizontal alveolar ridge, and 17 examined the implants’ survival rate. For assessment of risk of bias, nine studies were high risk of bias and 16 studies were moderate risk of bias. Meta-analysis demonstrated that the pooled gained alveolar ridge width was 3.348 mm (95%CI: 4.163 mm, 2.533 mm), and the implant survival rate was 98.1% (95%CI: 98.9%, 96.9%). Seven studies showed seven different complications including exposure, infection, bad split, dehiscence, fracture, paresthesia and soft tissue retraction.ConclusionRecent ARS technique seems to be an effective method of bone augmentation with enough gained width and a high implant survival rate. Further long-term and RCTs research remains needed to enhance the study quality.Clinical relevanceThe ARS technique could generate sufficient bone volume, and implants had a high-level survival rate. Therefore, ARS has been proposed to be a reliable horizontal bone augmentation technique that creates good conditions for the implantation of narrow alveolar crests.

Clinical feasibility evaluation of a digital workflow of prosthetically oriented onlay bone grafting for horizontal alveolar augmentation: a prospective pilot study

BackgroundOnlay bone grafting is considered highly reliable for reconstructing severe horizontal bone defects. A critical problem is how to achieve precise position of the bone block to control alveolar ridge dimensions. This research aims to establish a digital workflow for prosthetically oriented onlay bone grafting and evaluate its accuracy and efficiency.MethodsThis prospective pilot study investigated eight patients who required implant restoration in the esthetic area with horizontal alveolar bone defects. The workflow includes preoperative virtual planning, design and manufacture of patient-specific templates, bone grafting surgery, and implant insertion. Primary outcomes were graft accuracy, defined by root mean square estimate (RMSE) values between preoperatively designed and actual implanted outer contours of bone blocks. Secondary outcomes were bone graft and implant success rates. Besides, the surgeons used the visual analog scale (VAS) to rate the intuitiveness, ease of understanding, and helpfulness of the workflow.ResultsNo bone grafts or implants failed in any of the eight patients, resulting in a 100% success rate. The RMSE values between the preoperative design and the implanted outer contour of bone blocks were 0.41 ± 0.15 mm. The digital approach showed advantages in intuitiveness (9.3 ± 0.5), understanding (9.0 ± 0.5), and helpfulness (8.4 ± 1.1) according to surgeons' VAS scores.ConclusionsA digital workflow provided encouraging results, in terms of accuracy and efficacy, for horizontal bone augmentation.Trial registrationThis study was registered in the National Clinical Trials Registry in 16/02/2023 under the identification number ChiCTR2300068361.

Regenerative potential of a combination of PRF and bioactive glass for the treatment of horizontal bone defects in stage II and stage III periodontitis: a split-mouth randomized controlled trial

Objective: The aim of the study was to evaluate the efficacy of calcium phosphosilicate bioactive glass in combination with Platelet Rich Fibrin (PRF) in the treatment of horizontal bone defects in stages II and III periodontitis. Materials and Methods: The randomized controlled trial included 51 sites of horizontal bone defects from 4 patients with stages II and III periodontitis. The three treatment groups were: Group A - open flap debridement (OFD) + bone graft + PRF gel; Group B - OFD + bone graft + PRF gel covered by PRF membrane; Group C - OFD alone. The clinical and radiographic parameters were recorded at baseline and 9 months post-surgery. Results: All three groups showed statistically significant improvement in clinical and radiographic parameters, except for defect width at 9 months post-surgery. Conclusion: The findings of the present study allow us to conclude that the use of PRF in combination with bone graft can serve as a promising therapeutic approach for the treatment of horizontal bone defects, resulting in improvement of both clinical and radiographic parameters.

Evaluation of Endo Perio Lesions Using Cone Beam Computed Tomography (CBCT) - A Cross Sectional Study.

An accurate assessment of the disease extent and lesion size is needed for appropriate therapy decisions of endodontic-periodontic (endo-perio) lesions. CBCT imaging with less radiation and high spatial resolution can provide a comprehensive evaluation of endo-perio lesions. A total of 71 teeth with endo-perio lesions were assessed using CBCT. Periodontal bone defects were studied for bone loss pattern (horizontal/vertical) along with bone loss levels on mesial and distal sides in association with furcation involvement. The periapical lesions were studied for their prevalence and extent based on CBCT PAI Score. Horizontal and vertical bone loss were detected in 54 teeth (76.1%) and 17 teeth (23.95%), respectively. Mean crestal bone loss levels on mesial and distal aspects were 4.80 ± 3.21 mm and 5.74 ± 3.91 mm, respectively. The mean height, width, and depth of furcation defects were 3.19 ± 2.99 mm, 1.94 ± 0.98 mm, and 4.44 ± 1.92 mm, respectively. Periapical lesions were recorded in 55 teeth (77.5%). A CBCT PAI score of 5 was scored in 35 teeth with a mean lesion diameter of 11.3 ± 2.83 mm, while 16 teeth had healthy periapical tissues (scores of 0 and 1). CBCT is a valuable diagnostic tool that can help assess endo-perio lesions by providing morphometric measurements of periodontal bone defects and the extent of associated periapical lesions.