Aim: To assess the reliability of ultrasonographic, cone beam computed tomographic (CBCT), probe transparency and transgingival probing (TGP) methods in evaluating gingival thickness (GT), compared with the gold standard histological assessment. Methods: Sixteen fresh cadaver heads with intact gingivae were used. The sequence for GT measurement included CBCT, ultrasonography, probe transparency, TGP and histology. Both stainless steel periodontal probe and colour‐coded probes were used for transparency. TGP involved a calibrated endodontic spreader, and histologic samples served as a comparative standard. Primary outcomes evaluated accuracy in GT measurement, while secondary outcomes assessed agreement among methods and established an optimal threshold for thin versus thick gingiva. Results: One hundred and fifteen teeth were examined, yielding a mean GT of 1.34 mm histologically. US and CBCT underestimated GT (means of 1.25 mm and 1.13 mm, respectively), while TGP overestimated (1.51 mm). Correlations ( r = 0.88–0.98) and ICC values (0.73–0.95) indicated strong inter‐method agreement. Regression models significantly estimated histological GT from US, CBCT and TGP. A new 1.18 mm cut‐off, based on histology, improved diagnostic accuracy over the traditional 1 mm threshold. Conclusions: While histology remains the GT reference standard, US, CBCT and TGP achieved clinically acceptable accuracy. US showed the highest agreement with histology, followed by TGP and CBCT. The study supports US as the most practical non‐invasive tool, although CBCT and TGP remain viable options. Further clinical validation is recommended, acknowledging the limitations of cadaveric models in reflecting in vivo conditions.

Objective: To develop a comprehensive decision‐making tree for evaluating mid‐facial peri‐implant soft tissue dehiscence in the esthetic zone and provide a systematic approach for assessing various clinical case scenarios, determining appropriate treatment strategies, and considering factors such as the need for soft tissue augmentation, prosthetic changes, or implant removal.Clinical Considerations: This clinical decision tree illustrates numerous case scenarios with various esthetic complications around an esthetically compromised, but clinically healthy single implant and provides clinicians with possible solutions as a predictable map for horizontal and vertical soft tissue augmentation in order to manage different clinical circumstances. According to current evidence, the key to treating such esthetic complications is the use of an adequate pre‐surgical prosthetic interdisciplinary approach with proper surgical techniques in order to optimize soft tissue dimensions and create better esthetic results. This may be accomplished through a purely surgical, combination of surgical and prosthetic, or purely prosthetic approaches.Conclusions: The present report describes a series of successfully treated peri‐implant esthetic complication cases in accordance with the decision‐making tree that the authors recommend in order to achieve better long‐term esthetic outcomes.Clinical Significance: The combination of adequate pre‐surgical prosthetic interdisciplinary collaboration and proper surgical technique is critical in the optimization of sufficient soft tissue dimensions and contributes to a more highly esthetic result. This study demonstrates a clinical decision‐making tree to provide comprehensive, effective therapy of an esthetically compromised dental implant by using one of the following approaches: purely prosthetic, purely surgical, or a combination of surgical and prosthetic with or without abutment removal.

Background: Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined “threshold” at which a patient's profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk.Methods: Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc ≥ 5 mm or ≥6 mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model.Results: Over a median follow‐up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5 mm (90.8%) or ≥6 mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5 mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4 mm/grade A. Grading exhibited the best discrimination and model fit.Conclusion: Patients with RPc ≥5 mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5 mm displayed very good predictive capability of TLP.

Objective: Although a standard treatment guideline has not been established to date, various treatment modalities have been described in the literature based on the staging of medication‐related osteonecrosis of the jaw (MRONJ). The aim of this case series was to describe the outcomes of surgical intervention of MRONJ cases with the adjunctive use of platelet‐rich fibrin (PRF).Materials and Methods: Thirteen patients under therapy with zoledronic acid, seven of them underwent surgical removal of necrotic bone with debridement, followed by placement of three to four PRF membranes and achieving primary closure. In six patients, PRF was used preventively to avoid MRONJ.Results: The surgical treatment outcomes were successful in all patients, with a follow‐up range of 12–48 months. In the presented cases, the intraoral evaluation showed excellent soft tissue healing except for one patient secondary wound healing was reported. Additionally, there was no recurrence of bone exposure in all cases. PRF membranes were comparatively effective in postsurgical pain control.Conclusion: The use of PRF could represent a valuable adjunct in the surgical management for advanced stages of MRONJ cases.Clinical Relevance: This clinical case series describes the use of PRF membranes as a valuable adjunct in the surgical management of MRONJ patients, especially when treating advanced MRONJ cases. Moreover, PRF demonstrates usefulness in preventing such difficult complications from occurring.

Autologous dentin grafts derived from extracted teeth have shown promise as bone graft materials for promoting bone regeneration. This retrospective case series aimed to evaluate clinical, radiographic, and histologic outcomes of using autologous dentin matrices in various bone regeneration procedures. This case series included 26 eligible patients and encompassed 4 socket preservation cases, 5 cases of guided tissue regeneration, 5 cases of guided bone regeneration (GBR), 10 cases of sinus augmentation procedures, 2 immediate placement implants, and 2 socket shields. Dentin grafts were prepared from extracted teeth, cleaned, and processed. These grafts were combined with platelet-rich fibrin (PRF) to create adhesive dentin matrices, then covered with collagen membranes for simultaneous guided bone augmentation cases. Cone beam computed tomography (CBCT) scans were conducted before surgery and 4 months postoperatively to assess ridge dimensions. Histologic evaluation was performed through bone core biopsies for socket preservation cases at the 4-month mark. A total of 42 implants were placed in 26 patients, with an average follow-up of 32 months. Notably, two implant failures occurred following lateral maxillary sinus augmentation. CBCT scans at the 4-month interval revealed bone coverage over implant platforms in the majority of cases. Histologic analysis from two cases of socket preservation demonstrated dentin granules enveloped by newly formed bone undergoing continuous remodeling. The quantitative histomorphometric assessment revealed a bone area of 42.8 ± 3.56%, a remaining graft area of 19.05 ± 4.58%, and a viable bone of 38.15 ± 7.84%. The utilization of autologous dentin particles mixed with PRF proved effective as an alternative to conventional bone graft materials in GBR and maxillary sinus augmentation procedures. Larger controlled clinical trials are recommended to further substantiate these findings.

Objectives: This article aims to provide a comprehensive overview of peri‐implant mucositis, covering its etiology, risk factors, clinical features, diagnosis, and available treatment modalities. Methods: A comprehensive electronic and manual search was performed on electronic databases. Studies with focus on peri‐implant mucositis were included and reviewed comprehensively. Based on the latest evidence, decisional workflows and clinical recommendations were proposed. Results: The review highlights the multifactorial etiology of peri‐implant mucositis, primarily driven by bacterial biofilm accumulation. Key risk factors identified include poor oral hygiene, smoking, uncontrolled diabetes, and local factors such as implant surface characteristics and prosthesis design. Diagnostic criteria are based on the presence of clinical signs (inflammation, redness, swelling, and bleeding on probing (BoP)) and the absence of radiographic bone changes. Nonsurgical treatments, including mechanical debridement and photodynamic therapy (PDT), have shown effectiveness in managing the condition. However, the efficacy of adjunctive therapies remains inconclusive. Regular maintenance and optimal oral hygiene are critical in preventing and managing peri‐implant mucositis. Conclusion: Peri‐implant mucositis remains a prevalent condition in implant dentistry, with nonsurgical treatment strategies showing promising outcomes in disease management. Further research is needed to establish the long‐term effectiveness of adjunctive therapies and optimize preventive strategies for maintaining peri‐implant health.