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.

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.

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: The timing of dental implant placement, whether immediate or delayed following tooth extraction, significantly impacts clinical outcomes, esthetic results, and patient satisfaction. A comprehensive understanding of both protocols is essential for optimizing treatment planning and success rates. Objectives: This review aims to compare immediate and delayed implant placement in terms of clinical outcomes, survival rates, and patient satisfaction. Additionally, it discusses indications, contraindications, and critical factors influencing the choice between these approaches. Methods: Relevant studies, systematic reviews, and clinical trials from peer-reviewed journals were analyzed to assess the outcomes associated with both immediate and delayed implant placements. Key parameters evaluated included implant survival, esthetic results, patient-reported satisfaction, and complications. Results: Both immediate and delayed implant placement protocols demonstrate high survival rates, often exceeding 95%. Immediate placement offers advantages such as reduced treatment time, preservation of alveolar bone, and enhanced patient satisfaction. However, it carries risks related to primary stability and esthetic outcomes, particularly in cases with compromised extraction sites. Delayed placement allows for better healing and bone regeneration but may require additional surgical interventions due to alveolar ridge resorption. Conclusion: Immediate and delayed implant placements are both viable and predictable when appropriate patient selection and surgical techniques are applied. Immediate placement is preferable when conditions are ideal, while delayed placement remains the standard when managing infection, bone defects, or poor soft tissue quality. Careful evaluation of patient-specific factors is critical to achieving optimal clinical and esthetic outcomes. Update Dent. Coll. j: 2025; 15(2): 39-44

Zygomatic implant (ZI) is an effective method for restoring masticatory function and mid-facial appearance in patients with severe alveolar ridge resorption, avoiding complex bone augmentation. Dynamic navigation-assisted surgery has been introduced to improve ZI placement accuracy, with registration being a crucial step. However, the current registration method using fiducial screws is limited by their concentrated placement in the mouth, reducing accuracy around the zygomatic bone. This study aims to evaluate the accuracy and clinical outcomes of a novel minimally invasive registration plate in ZI surgery, guiding its clinical application in dynamic navigation-assisted ZI surgery. This is a prospective, single-center, parallel-group, non-inferiority randomized controlled trial conducted at Shanghai Ninth People's Hospital, Shanghai, China. We plan to recruit 20 patients who need ZI restoration. The inclusion criteria include severe atrophy of the maxillary alveolar ridge or maxillary bone defects. The anterior region must have adequate bone volume to allow placement of two temporary implants or at least four pins for registration plate fixation, or existing implants or residual teeth can provide stable fixation for the registration plate. Participants will be randomly assigned in a 1:1 allocation ratio into two groups: control group: dynamic navigation registration using traditional titanium screws; experimental group: dynamic navigation registration using the novel registration plate. The group assignment will be blinded for accuracy evaluators. Entry and exit point and angular deviations of the ZI, surgical time, registration accuracy, patient satisfaction, implant survival rate, and adverse event incidence will be assessed. A novel minimally invasive registration plate has been designed to extend the coverage of registration points to the zygomatic bone, thereby expanding the registration range for dynamic navigation-assisted zygomatic implant placement. This study aims to compare the new registration approach with the conventional titanium screw-based method to evaluate whether it enhances the accuracy of dynamic navigation-assisted zygomatic implant surgery. Name of the registry: Chinese Clinical Trial Registry (ChiCTR). ChiCTR2500103641 (retrospectively registered). Date of registration: 2025-06-03. First planned enrollment: 2024-11-17. URL of trial registry record: https://www.chictr.org.cn/showproj.html?proj=272887.

Modified Bone Ring Tenting Technique for Alveolar Ridge Augmentation and Simultaneous Implant Placement: A Technical Note.

Complete edentulism significantly affects the oral function, facial aesthetics, phonetics, and psychological well-being of individuals. While conventional complete dentures continue to serve as a widely accepted treatment modality, mandibular dentures often suffer from insufficient retention and stability, especially in cases of moderate to severe alveolar ridge resorption. Implant-supported overdentures provide an effective alternative that improves stability, retention, and overall prosthesis performance. The use of bar attachments in mandibular implant-supported overdentures allows splinting of implants, reduces individual stress on implants, distributes occlusal forces, and enhances long-term success. Customized bars fabricated using CAD/CAM techniques, especially in cobalt-chromium, offer a precise, passive fit and improved biomechanical performance. Incorporating ball attachments at the distal ends of the bar, connected to O-rings within the denture, adds an element of resilient retention, increasing rotational resistance and enhancing comfort and function.Implant-supported overdentures have revolutionized the rehabilitation of edentulous patients by offering superior function and comfort. This clinical case report presents the management of a 59-year-old completely edentulous female patient who received an RP-4 mandibular overdenture supported by a customized cobalt-chromium bar with integrated ball attachments. Two Refirm implants were placed at positions B and D, followed by a stepwise prosthetic protocol including impression making, verification, jaw relation, CAD-CAM bar fabrication, denture reinforcement with metal mesh, and final insertion with torque-controlled screw tightening. O-rings were placed in the intaglio surface of the denture corresponding to the ball attachments. Follow-up demonstrated excellent retention, stability, and patient satisfaction.

This study aimed to quantify the morphology of the retromolar pad (RMP) and its correlation with alveolar ridge resorption, as well as to evaluate its role in edentulous restorations through multidisciplinary research. This multimethod study comprised three components: (1) a cross-sectional analysis of 200 edentulous mandibular models to quantify retromolar pad (RMP) dimensions-including height, area, and others- to classify RMP shapes (pear, triangular, bar) according to Cawood's classification of ridge resorption; (2) finite element analysis (FEA) simulating occlusal loads on three representative RMP morphologies to evaluate stress distribution and displacement; (3) Clinical trial involving 15 edentulous patients (Cawood classes V-VI), each receiving two dentures-one fabricated using a conventional tray (ATD group) and the other using a modified tray designed for the RMP (MTD group)-to compare patient satisfaction and denture fit, assessed via root mean square (RMS) deviation. Model analysis revealed significant dimensional variations among RMP shapes, with a weak negative correlation between RMP morphology and alveolar ridge resorption (Rs = -0.31, P < .001). FEA identified pear-shaped RMP as exhibiting the lowest stress concentration (305.7 kPa) and minimal displacement (236.3 μm). Clinically, dentures from the MTD group demonstrated significantly better fit, indicated by a lower RMS value, and higher patient satisfaction regarding retention and comfort compared to the ATD group. RMP morphology influence restorative outcomes in edentulous jaws, with pear-shaped RMP providing superior effect. RMP can be utilized to enhance complete denture retention, particularly for patients with severe alveolar ridge resorption.

IntroductionSocket preservation is a fundamental procedure in dental implantology aimed at minimizing post-extraction alveolar ridge resorption. Buccal wall integrity plays a crucial role in implant stability and esthetic outcomes. However, limited research has compared the effects of different bone graft materials on buccal wall preservation. The objective of this study is to evaluate and compare the impact of three bone graft materials, namely autografts, allografts, and xenografts, on buccal wall dimensions in socket preservation procedures using cone beam computed tomography (CBCT) and AI-based superimposition techniques.MethodologyA retrospective comparative cohort study was conducted on 23 patients who underwent socket preservation between 2017 and 2024. Patients were categorized into three groups based on graft material: allografts, xenografts, and autografts. High-resolution preoperative (T0) and six months postoperative (T1) CBCT scans were analyzed using 3D Slicer® software. Superimposition techniques enabled precise measurement of buccal wall thickness at three levels (L2, L4, L6). Statistical analyses, including Kruskal-Wallis and Wilcoxon signed-rank tests, were performed to assess differences in buccal wall dimensions and resorption rates.ResultsAt follow-up (T1), xenografts exhibited significantly better preservation of buccal wall thickness at L2 compared to autografts and allografts (P = 0.02 and P = 0.04, respectively). However, no significant differences were observed at deeper levels (L4, L6) (P > 0.05). Buccal wall resorption occurred in all groups, but no statistically significant differences in overall resorption rates were found (P > 0.05). Buccal wall dimensions significantly decreased from T0 to T1 at all levels (L2, L4, and L6) (P < 0.001).The findings suggest that xenografts offer superior preservation at the coronal level, making them a preferred choice in esthetic areas. However, all graft materials showed comparable effects in deeper regions over time. The absence of significant differences in overall resorption rates may be attributed to the study’s small sample size and follow-up duration. These results align with prior literature indicating the prolonged structural support of xenografts but also highlight the ongoing challenge of post-extraction bone loss.ConclusionsThis study underscores the importance of graft material selection in socket preservation, particularly for maintaining coronal ridge dimensions. Despite grafting, significant buccal wall resorption was observed, emphasizing the potential need for additional augmentation techniques. Future research with larger sample sizes and longer follow-up periods is essential to refine clinical protocols and improve long-term implant success.

Post-extraction bone resorption causes a significant reduction in the vertical and horizontal dimensions of the alveolar ridge.Over the years, various socket preservation methods have been adopted to minimize bone loss.However, it has been demonstrated that multiple local and systemic factors influence the resorption process.Tobacco smoking is one of the systemic factors thought to influence the resorption process negatively.This randomized clinical trial aimed to assess the effect of smoking on vertical alveolar bone resorption during the first three months after single tooth extraction, with or without an SP procedure.Materials and methods: The research involved 80 patients who required a single-tooth extraction and underwent either a socket preservation procedure or unassisted socket healing.The heights of the socket plates were measured twice, first after the intervention and then after 3 months, using cone-beam computed tomography.Results: A statistically significant difference was found only in the second experimental group between smokers and non-smokers ( = 7.2, p = 0.007).No statistically significant difference was observed in the vertical resorption of both plates between smokers and non-smokers after 3 months.Discussion: Although the harmful effects of smoking on bone healing and resorption have been welldocumented, the results of this study did not present any evidence that smoking affects the vertical postextraction loss of the alveolar crest for 3 months after the extraction.Conclusion: More long-term preclinical and clinical studies are necessary to assess the enduring effects of smoking (and its intensity) on postextraction resorption, if any.Additionally, its influence on both bone quantity and quality should be examined using suitable radiological, histological, and histomorphometric methods.

This study evaluated the amount of bone regeneration and its microarchitectural integrity in peri-implant gaps in rabbits treated with one of the following approaches: Bovine bone combined with hyaluronic acid (HyA), bovine bone alone, or left untreated as an empty defect. Thirty adult male New Zealand White rabbits were included in this study. In each group (n = 10), a critical bone defect (6 mm diameter × 4 mm depth) was surgically prepared using a trephine bur under copious saline irrigation in the femoral condyle bone. A dental implant was subsequently placed into each defect. The peri-implant defects were left untreated (no biomaterial), filled with bovine bone alone, and filled with bovine bone combined with (HyA) in groups I, II, and III, respectively. All rabbits were randomly selected for euthanasia after 2 months, implant stability, and marginal bone loss (MBL) were evaluated. Then, the bone samples were processed for histological analysis. The highest Implant stability after 2 months was recorded with the group bovine bone combined with HyA (74.69 ± 0.75), followed by the bovine bone alone group (70.25 ± 0.82), and the lowest implant stability in a control group (65.10 ± 0.77), (p < 0.001*), which was supported by a significant difference in MBL between groups (p < 0.001*). The highest MBL was measured in the control group (0.63 ± 0.15). The percentage of newly formed bone in the grafted groups was significantly higher compared to the control group (4.10 ± 0.14) (p < 0.05), as measured by histomorphometry. The combination of HyA with bovine bone exhibits a combined effect promoting bone regeneration and graft replacement. This approach enhances osseointegration of the implant. The use of HyA in conjunction with bovine bone improves both the rate and quality of newly formed bone potentially increase the osseointegration of the implant and reducing alveolar ridge resorption. How to cite this article: Dakhil R, Abdulrahman M, Kandil I, et al. Evaluation of Hyaluronic Acid in Addition to Xenograft Material in Treatment of Peri-implant Bony Defects in Immediate Implant Placement: An Animal Study. J Contemp Dent Pract 2025;26(9):876-882.

ABSTRACTIntroduction:Traditional protocols, which involve delayed implant placement after staged extractions, can lead to progressive alveolar ridge resorption, compromised soft tissue contours, and prolonged edentulous phases, all of which negatively affect patient satisfaction and prosthetic outcomes. Recent advances in immediate implant placement and provisionalization protocols aim to mitigate these drawbacks by preserving hard and soft tissue structures and expediting functional recovery.Materials and Methods:A prospective study was conducted on 45 patients undergoing full-arch rehabilitation. Immediate implants with interim prostheses were placed, and soft tissue and prosthetic parameters were monitored for 6 months.Results:A higher implant distribution number (IDN) was associated with better tissue support and functional outcomes.Conclusion:Immediate implant placement with provisional restoration is a reliable strategy for full-arch cases.

Abstract Orthodontics plays a crucial role in the restoration of oral health in adult patients, particularly when treatment objectives are grounded in accurate diagnoses that respect biological limitations. This case report describes the orthodontic management of a 65-year-old male patient presenting with Angle Class II, division 2 malocclusion. The patient was referred for orthodontic intervention to improve conditions for restoring mandibular incisors. Clinical examination revealed extensive restorations, black triangles between maxillary central incisors, severe incisal wear on mandibular incisors, and gingival recession in maxillary premolars and molars. Radiographic findings included root shortening of maxillary incisors and significant alveolar ridge resorption in the maxillary molars. The complexity of the case was heightened by the patient's age, extensive dental restorations, significant alveolar bone resorption, and gingival recession, requiring meticulous planning to address functional, esthetic, and biological challenges. Treatment was planned with realistic objectives, utilizing partial fixed orthodontics in the maxillary arch, focusing on alignment and leveling while maintaining posterior intercuspation. Interproximal reductions were performed on maxillary incisors to minimize black triangles and improve esthetics. After 10 months, orthodontic objectives were successfully achieved. Retention included a fixed retainer on the maxillary central incisors and an occlusal splint for the maxilla. This case highlights the importance of individualized and multidisciplinary approaches in orthodontic treatment for elderly patients, demonstrating how orthodontics can complement prosthetic rehabilitation to achieve functional and esthetic outcomes.

Despite significant advancements in dental care, edentulism remains the persistent challenge, particularly in cases of severe alveolar ridge resorption. Traditional treatment modalities, such as bone grafting and endosseous implants, are often associated with complications, prolonged rehabilitation periods, and patient dissatisfaction. The aim of this study is to introduce a novel technique for managing patients with severely resorbed ridges. This case report presents a 64-year-old edentulous female with severe jawbone atrophy, successfully treated using custom subperiosteal implants (SPIs) fabricated with advanced additive manufacturing techniques. The SPIs, designed based on the cone-beam computed tomography (CBCT) imaging, provided stable prosthetic support without the need for invasive bone grafting. The patient's treatment plan, included the placement of custom implants, implant-retained overdentures, and a 2-year follow-up, which revealed satisfactory functional and aesthetic outcomes with no complications. Advancements in SPI design, particularly the use of selective laser melting and finite element analysis, have significantly improved clinical outcomes and reduced the incidence of complications. This case highlights custom SPIs as a viable, minimally invasive alternative for the management of severely resorbed jaws, yielding satisfactory clinical results.

socket grafting, and socket augmentation.In cases of severe resorption of the alveolar ridge, an ideal placement of implant may not be possible due to the presence of vital structures like the inferior alveolar nerve, maxillary sinus, etc.The implant placement in these cases becomes difficult, if not impossible, and may require additional surgical procedures like sinus lift in the maxillary posterior, ridge split techniques, or inferior alveolar nerve repositioning in the mandible.Therefore, bone grafting is IntroductIonAn adequate dentition is of importance for the well-being and quality of life of a human being.Despite advances in preventive dentistry, edentulism is described as the "final marker of disease burden for oral health." 1 In order to overcome the problems with conventional prosthesis, implant came into existence and has become increasingly common for management of tooth loss. 1 Dental implants are an ideal option for people in good general oral health who have lost a tooth due to caries, trauma, or advanced periodontal disease.Tooth extraction and subsequent healing of the socket commonly result in osseous deformities of the alveolar ridge, including reduced height and reduced width of the residual ridge. 2 The labial plate of the alveolar bone is frequently lost as a result of tooth extraction and the socket's subsequent healing.The rate of bone loss further increases over a period of time.An average of 40-60% reduction in the buccolingual width of bone has been estimated, in addition to a decrease in bone height at 12 months after extraction, 3 while two-thirds of this reduction has been documented to occur within the first 3 months. 4lveolar ridge preservation (ARP) is "a procedure to arrest or minimize alveolar ridge resorption following tooth extraction for future prosthodontic treatment including placement of dental implants." 5ARP was first described as "bone maintenance" in 1982 6 and is synonymous with socket preservation, ridge preservation, 1,2,

Abstract Background: Denture treatment is crucial for edentulous patients to maintain a long and healthy life, as well as restore their chewing function. After complete dentures are fitted, it is not uncommon for them to become ill-fitting due to ridge resorption over time, requiring adjustments or relining procedures. Residual ridge resorption results from the combined influence of various local and systemic factors. There have been no reported cases of patients who have worn complete dentures for an extended period without experiencing significant alveolar ridge resorption. I report a case of a patient who had not visited a dentist or had any adjustments for 28 years after being fitted with complete dentures. Case presentation: The patient, a 56-year-old woman, visited the general dentistry of the Nippon Dental University Hospital in Tokyo in March 1994. The diagnosis was masticatory dysfunction caused by ill-fitting upper and lower complete dentures. The treatment plan aimed to improve oral hygiene, restore the health of the alveolar ridge, and achieve proper occlusal contact with a final prosthetic device. The upper and lower dentures were fitted in May 1994. In November 2022, her artificial tooth broke, and she visited the clinic requesting denture repair for the first time in 28 years. A medical interview revealed that the patient had never visited another dental clinic since having dentures fitted 28 years ago. Although wear of the artificial teeth was observed, when the fitting condition of the upper and lower dentures was checked using fitting test materials, it was confirmed that there were no problems with the fitting condition and that there was almost no alveolar ridge resorption. Conclusion: I report on a patient who has worn the same dentures for 28 years. Although wear of the artificial teeth was observed due to bilateral balanced occlusion, the occlusal balance was appropriately maintained. It has been found that metal-based dentures, when fabricated using proper methods, do not promote alveolar ridge resorption.

Background: The effectiveness of complete dentures diminishes over time due to alveolar ridge resorption, mucosal changes, and wear of denture materials. These changes lead to loss of retention, stability, and patient comfort, necessitating corrective measures. Denture rebasing serves as conservative alternatives to full denture replacement, aiming to restore fit and function while preserving occlusal relationships and esthetics. Materials and Methods: This literature-based review analyzes landmark studies and clinical techniques from 1936 to 2023, covering direct and indirect rebasing methods, material advancements such as polymethyl methacrylate and tissue conditioners, and criteria for clinical decision-making. Techniques like closed-mouth impression, remounting, and occlusal adjustments are emphasized as essential for success. Contraindications and limitations of procedure are also outlined. Conclusion: Denture rebasing remains clinically valuable procedures when executed with proper case selection and technique. While not substitutes for new dentures in severely compromised cases, they offer functional and economical benefits, particularly for patients in resource-limited settings. Ongoing research into resilient liner materials and antimicrobial properties continues to enhance the durability and success of these treatments.

The alveolar crest is tooth-related, and the tooth extraction causes its horizontal and vertical resorption.This poses numerous challenges regarding the masticatory function, speech, and digestion, as well as deteriorating the patient's esthetics, self-esteem, and psychological health.This article aims to evaluate the amount of vertical bone resorption following tooth extraction in both socket walls for 3 months using cone-beam computed tomography (CBCT).Twenty patients requiring a premolar or molar extraction were enrolled in this study (twelve men and eight women, aged 31-65 years).The surgery included atraumatic tooth extraction (including root separation in multi-rooted teeth) under infiltration anesthesia.The CBCT scans (Planmeca Pro Max 3D) were performed twice, following the extraction and 3 months after.The comparison of the buccal wall height for 3 months presented a significant bone resorption of 3.5 2 mm (t = 8.7, p < 0.0001).For the oral wall, the resorption was 2.1 1 mm (t = 9.3, p<0.0001).The estimated correlation between the vertical bone loss of both walls was weak and statistically insignificant (Pearson's = 0.2, p = 0.3).The mean difference between the resorptions was statistically significant -1.4 mm (t = 3; p = 0.005), suggesting that the resorption in the control group did not proceed evenly, but was more pronounced in the buccal wall.A weak, statistically insignificant correlation was established between the resorption of the buccal and palatal/lingual plates, demonstrating that they did not affect each other.

Background: The rehabilitation of complex bone defects in the anterior maxilla presents significant challenges in restoring both function and esthetics. A multidisciplinary approach integrating guided bone regeneration (GBR) and connective tissue grafting (CTG) has proven effective in addressing such cases. Methods: This report describes the case of a 60-year-old female patient who presented with severe alveolar ridge resorption and peri-implant bone loss, necessitating an advanced regenerative strategy. The treatment protocol involved the use of autologous and xenogeneic bone grafts in combination with hyaluronic acid and polynucleotides to enhance osteogenesis and tissue integration. A six-month healing period was observed before histological and clinical evaluations were conducted. Results: The results demonstrated a significant increase in lamellar bone formation and vascularization in sites treated with biomodulators compared to conventional GBR techniques. Subsequently, CTG was employed to optimize peri-implant soft tissue volume and stability, leading to improved keratinized tissue thickness and enhanced esthetic outcomes. This case underscores the importance of a comprehensive surgical and prosthetic plan that integrates bone regeneration with mucogingival management for optimal results in implant rehabilitation. Additionally, histological analysis revealed that the incorporation of hyaluronic acid and polynucleotides resulted in improved cellular activity, reduced inflammatory responses, and enhanced overall bone quality. Conclusions: These results highlight the potential role of biomodulators in regenerative procedures. While the findings suggest promising clinical applications, further long-term studies are necessary to validate the outcomes and establish standardized protocols for the integration of advanced biomaterials in implantology.

To compare direct and indirect sinus lifting techniques in patients getting implants in the maxillary molar region for parameters such as postoperative pain, swelling, gingival inflammation, implant stability, and patient comfort. Analytical study. Place and Duration of the Study: Department of Oral and Maxillofacial Surgery, The Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from 1st February to 1st November 2023. Sixty patients fulfilling the inclusion criteria were included and divided into two groups, with 30 patients in each group; sinus lifting for implant placement was performed under local anaesthesia. In one group, sinus lifting was performed by the direct method, and in the other group by the indirect method. Postoperatively, patient comfort was recorded immediately after the procedure. Postoperative pain, swelling, and gingival inflammation were recorded on the 3rd and 5th day. Implant stability was recorded after three months. Implant placement via indirect sinus lifting resulted in less postoperative pain, swelling, and gingival inflammation. This technique was more comfortable for the patients and provided more implant stability as compared to direct sinus lifting. For implant placement in compromised ridge height in the maxillary molar region, indirect sinus lifting has better treatment outcomes when compared with direct sinus lifting in terms of postoperative pain, swelling, gingival inflammation, implant stability, and patient comfort. Dental implant, Alveolar ridge resorption, Direct sinus lifting, Indirect sinus lifting, Bone augmentation.