This systematic review evaluated current in vivo research on regenerating critical-sized mandibular defects and discussed methodologies for mandibular bone tissue engineering. Out of the 3650 articles initially retrieved, 88 studies were included, and all studies that used a scaffold reported increased bone formation compared to negative controls. Combining scaffolds with growth factors and mesenchymal stem cells improved bone formation and healing. Bone morphogenic proteins were widely used and promoted significant bone formation compared to controls. However, discrepancies between studies exist due to the various methodologies and outcome measures used. The use of scaffolds with bioactive molecules and/or progenitor cells enhances success in mandibular bone engineering. Scaffold-based mandibular bone tissue engineering could be introduced into clinical practice due to its proven safety, convenience, and cost-effectiveness.

Introduction/Aim: Soft tissue dehiscences such as gingival recessions are a very common problem that we face in modern periodontics. This clinical study aimed to analyze the effectiveness of surgical procedures using a de-epithelialized gingival graft (DGG) combined with a coronally advanced flap and to evaluate the application of plasma-rich fibrin (PRF). Methods: The study included 40 teeth (20 patients) with Miller class I and II gingival recessions. Twenty recessions (20 patients) were treated utilizing the de-epithelialized gingival graft in combination with the coronally advanced flap, and on the opposite side of the jaw, the same number of recessions were treated utilizing plasma-rich fibrin combined with the coronally advanced flap. To evaluate tissue condition and the clinical parameters before and after the surgical procedure, the following parameters were used: the degree of epithelial attachment (DEA), the width of keratinized gingiva (WKG), and the vertical depth of recession (VDR). Results: based on the achieved results and the analysis of clinical parameters, a statistically significant reduction in the vertical depth of recession was proven in both groups, with very similar mean percentages of root coverage, with the difference being that the stability of the soft tissues of the treated region was more visible in the DGG. Conclusion: using modern surgical procedures allows the regeneration of not only the soft tissues but also deeper periodontal tissues.

Background/Aim. A lingual foramen (LF) is a small opening on the lingual surface of the mandible, which is most frequently located in the middle of the anterior part of the mandible and which shows significant variations in its location, size and number. The aim of this study was to assess the location and anatomical characteristics of LF using cone beam computed tomography (CBCT). Methods. The research was designed as a retrospective study in which 99 CBCT scans were analysed. The analysis covered the number of LF, their location in relation to the teeth and the mandibular region itself, diameter, distance from the alveolar ridge crest, distance from the inferior border of the mandible, distance from the tooth apex and position in relation to the tooth apex. Results. The average frequency of LF per patient was 2.4 1.2. The largest number of LF were localised in the region of lower central incisors. Out of the total number of LF, 82.5% of LF belonged to median lingual foramen (MLF), while 17.5% belonged to lateral lingual foramen (LLF). In 63.2% cases, LF had a diameter of ≤1mm, whereas in 98.3% cases it was localised below the tooth apex. There is a statistically significant difference in the distance of LF from the alveolar ridge crest and the LF diameter in relation to gender (p = 0.019; p = 0.008). Conclusion. LF can be reliably localised and visualised by means of CBCT. It is recommended that CBCT scanning of the mandible should be used while planning an oral surgical procedure and implant placement in order to prevent injuries of the neurovascular bundle which passes through LF.

Mucogingival anomalies arise from anatomical and morphological irregularities within the mucogingival complex of periodontal tissues, representing deviations from the normal dimensions and morphology of the gingiva-alveolar mucosa relationship. According to the American Academy of Periodontology glossary, gingival recessions are defined as the exposure of the tooth root surface caused by the apical displacement of the gingiva relative to the CE-mento-enamel junction. In addition to aesthetic concerns, gingival recessions lead to increased sensitivity and ineffective plaque control, which can ultimately result in tooth loss. To address these issues, procedures are performed to cover exposed roots and restore the normal function and appearance of the mucogingival complex. The treatment for gingival recessions is primarily surgical , aiming for complete root coverage with long-term stability. Various methods are available, but the gold standard involves using a connective tissue graft in combination with a coronally advanced flap. This paper compares three treatment methods: the coronally advanced flap (CAF), CAF combined with a connective tissue graft, and CAF with porcine collagen matrix application. The primary objective is to identify which surgical method yields the best clinical outcomes. Nine studies involving 303 patients demonstrated that the highest root coverage is achieved with CAF combined with a connective tissue graft, showing a reduction in recession depth of 2.64 mm, an increase in the keratinized gingival zone of 1.05 mm, and a reduction in pocket depth of 0.36 mm. CAF combined with porcine collagen matrix provided slightly lower results, while CAF alone yielded the lowest outcomes.

Background/Aim. The shortcomings of the orthopantomography (OPG) method and radiographic misinterpretations may lead to poor treatment planning and complications during or after the third molar extraction. The aim of this study was to determine the validity and reliability of OPG findings concerning post-extraction wisdom tooth root morphology, as well as whether the degree of clinical expertise affects assessment accuracy. Methods. The cross-sectional study included 200 patients who were referred for third molar extraction. Preoperative OPGs were evaluated by the examiners, who were classified by their level of experience into three groups: students, residents, and professors. True root morphologies were recorded after the extraction, and the accuracy of the assessment was evaluated using various statistical tests. Results. The majority of assessments were accurate for the lower and upper third molars with a single root. The professor group was the most accurate when compared to the assessments made by the students and residents (p = 0.0015). Weighted Cohen?s kappa (?w) values for intra-respondent accuracy gradually increased from the student to professor group (0.06, 0.28, 0.34, respectively). The highest discrepancy in inter-respondent accuracy was determined between the student and professor groups (poor; ?w = 0.25584). Conclusion. In this study, the results that confirm the reliability of the OPG scan for the detection of accurate third molars root morphology have not been achieved. The level of clinical experience affects diagnostic accuracy, but complex clinical cases should be evaluated using different methods.