In thirteen different dental clinics in Singapore, Spain, Czech Republic and Italy, 504 patients were selected, and 483 dental implants were placed in maxillary sites after alveolar socket preservation (ASP) procedures with an autologous demineralized tooth extracted as graft material from an innovative Tooth Transformer device was obtained. All procedures used were reported in n°638 Ethical Committee surgical protocol of University of Chieti and approved. After 4 months, at dental implant placing, bone biopsies were performed to evaluate the histologic outcomes, and 12 months after implant loading, global implant survival rate, failure percentage and peri-implant bone loss were detected. After ASP, only 27 post-operative complications were observed and after 4 months, bone biopsy histomorphometric analysis showed a high percentage of bone volume (BV) 43.58 (±12.09), and vital new bone (NB) 32.38 (±17.15) with an absence of inflammation or necrosis areas. Twelve months after loading, only 10 dental implants failed (2.3%), with a 98.2% overall implant survival rate, nine cases showed mucositis (1.8%) and eight showed peri-implantitis (1.6%). At mesial sites, 0.43 mm (±0.83) of bone loss around the implants was detected and 0.23 mm (±0.38) at the distal sites with an average value of 0.37 mm (±0.68) (p > 0.568). Several studies with a longer follow-up will be necessary to confirm the preliminary data observed. However, clinical results seem to suggest that the post-extraction socket preservation procedure using innovative demineralized autologous tooth-derived biomaterial may be a predictable procedure to produce new vital bone able to support dental implant rehabilitation of maxilla edentulous sites.

This systematic literature review set out to investigate the relationship between serum vitamin D levels and dental implants in terms of survival rates, marginal bone loss, and associated complications. The review was conducted according to PRISMA guidelines, performing an electronic search in four databases (Pubmed, Web of Science, Cochrane, and Scopus), complemented by a manual search up to April 2022. Four articles were selected for analysis. The Newcastle-Ottawa Quality Assessment Scale tool was used to assess the quality of evidence of cohort studies, and the Cochrane bias assessment tool was used to assess the quality of evidence of randomized clinical trials. The study included 1089 patients restored with 1984 dental implants, with follow-up periods ranging from 20–240 months. Cases presenting lower serum vitamin D levels obtained slightly worse results in terms of marginal bone loss. Longer follow-up periods are needed in order to determine whether serum vitamin D levels affect implant survival rates and osseointegration over time.

Background/Objectives: Subperiosteal implants (SPIs) were first used in the 1940s, but due to their complications and the rise of dental implants, they were discontinued. Thanks to new technologies and new materials, nowadays they are being used again and studied as a treatment for severe bone defects. This review analyzes the clinical results—survival rates and complications—of SPIs used to support full arch rehabilitations of severely resorbed maxillae and mandibles, comparing the outcomes resulting from implant placement conducted in one or two surgical interventions. Methods: An automated search was conducted in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library), as well as a manual search for relevant clinical articles published before 28 February 2025. The review included human studies with at least four patients, in which SPIs were placed to restore full-arch edentulous maxillae and mandibles. Quality of evidence was evaluated using the Newcastle–Ottawa Quality Assessment Scale and the Joanna Briggs Institute Critical Appraisal tool. Results: A total of 14 studies met the inclusion criteria and were included for analysis, including 958 patients and 973 SPIs. The survival rate was 100% when one surgical intervention was performed and 85% when two interventions were performed after 4–38 months and 3–22 years follow-up, respectively. Conclusions: SPIs would appear to offer a good alternative for patients with severe bone atrophies, especially SPIs fabricated using digital techniques in a single step, presenting promising survival rates and a low complication rate, although more randomized clinical trials with long-term follow-up are needed.

CAD-CAM subperiosteal implants (SPIs) offer a therapeutic solution for edentulous patients with severe bone atrophy. However, scientific evidence of their clinical performance for fixed partial restorations (FPRs) is scarce. The purpose of this review was to evaluate the clinical performance of SPIs supporting FPRs, focusing on survival rates and associated biological and mechanical complications. A scoping review using PRISMA-ScR methodology was conducted, searching the online databases MEDLINE/PubMed, Web of Science, Cochrane Library, and Scopus. Studies that evaluated clinical performance of CAD-CAM SPIs supporting FPRs with at least three patients and follow up of at least one year were included. The search yielded seven articles, which included 96 patients with a total of 121 SPIs. The weighted mean survival rate was 99.17%, with one failure reported in an anterior maxillary restoration. The complication rate was 4.13% for biological complications (wound dehiscence, bone loss, and implant exposure), and 7.44% for mechanical complications (provisional restoration fracture, implant instability, and re-cementing of crowns) over follow-up periods ranging from one to four years. SPIs supporting FPRs may offer a reliable alternative for the restoration of severe bone atrophy, achieving a high survival rate. The complication rate obtained was relatively low. However, the results of this review should be treated with caution, as data were drawn from a small, heterogeneous sample. Studies comparing SPIs supporting FPRs with other techniques are needed to determine their viability in different clinical scenarios.

Background: Extracted tooth material has been seen as a valuable alternative to synthetic biomaterials. Aims: A novel flapless alveolar socket preservation (ASP) procedure with demineralized extracted tooth dentin graft material covered by three reabsorbable membranes was histologically and clinically evaluated 4 months after bone healing. Methods: Ten patients were enrolled and separated into two groups. Five post-extractive sites without buccal and/or palatal bone walls were treated with the flapless ASP procedure with demineralized tooth dentin covered with three reabsorbable membranes (Group A—GA). Five patients were treated with primary wound closure covered only with a reabsorbable membrane (Group B—GB). Bone biopsies were performed for histologic and histomorphometric analyses. Results: In both procedures, all clinical outcomes showed good healing of hard and soft tissue and a good maintenance of maxillary architecture. The histological analysis showed no necrosis or inflammatory areas in either group. The histomorphometric analysis showed higher total bone volume in GA (62.78 ± 7.97%) compared to GB (48.04 ± 9.32%), higher vital new bone in GA (57.53 ± 11.16%) compared to GB (42.41 ± 13.06%) and similar values for residual graft in GA (5.24 ± 5.82%) compared to GB (5.29 ± 4.83%). Conclusions: The data obtained show how this novel technique, mixed with the dentin-derived graft material, seems to promote higher bone regeneration.

Background/Objectives: Perforation of the maxillary sinus floor by dental implants is a complication that can occur during treatment in posterior sectors; however, its clinical and radiological consequences remain controversial. Therefore, this study aimed to use the diagnostic value of CBCT to determine the possible association between sinus floor-perforating implants and their clinical and/or radiological impact. Methods: A retrospective observational study was conducted on CBCT scans from 21 patients with implants protruding into the maxillary sinus. Morphometric analysis was performed to assess sinus membrane thickening (SMT) patterns, height, surface area and density and the presence of sinonasal symptoms. Statistical analysis was used to explore potential associations between SMT and variables such as implant protrusion length, number of perforating implants, age and gender. Results: SMT was observed in all patients, with a mean area of 11.1 ± 6.4 mm² in panoramic sections. Most cases (85.7%) exhibited a circumferential SMT pattern. No statistically significant correlation was found between SMT and implant protrusion length, age or sex. Additionally, none of the patients reported sinonasal symptoms, and no clinical signs of sinusitis were detected during follow-up. Conclusions: Although sinus floor-perforating implants commonly induce SMT detectable on CBCT, this thickening appears largely asymptomatic and may not compromise patient well-being in the short term. Nevertheless, clinicians should monitor these cases radiographically to detect possible long-term complications.