The surgical extraction of the impacted third molar is frequently associated with several complications. The purpose of this study is to assess how two different surgical protocols affect post-operative complications during the extraction of the lower impacted third molars. In order to compare and evaluate two different techniques (triangular flap vs. envelope flap), and the relative post-extraction complications, two groups of 150 patients each underwent to surgical impacted third molar extraction and 60 days of follow-up. The complication rate in the two groups was 14.00% in group A and 17.33% in group B. There was a strong association between smoking (OR: 2.8) and the use of oral contraceptives (OR: 1.75) with complications. The age- and sex-related incidence of complications in hard tissue healing has great variability in the literature; the analysis performed on our data did not show a statistically significant association between them. Even though related to a higher incidence of transient changes in sensitivity, it was found that the envelope flap saw a lower percentage of complications. There is still no clarity on which is the best protocol for the extraction of the lower impacted third molar, and the choice often depends on the surgeon’s experience.

We performed this clinical study in order to evaluate the reliability of the Guided Bone Regeneration (GBR) surgical technique through the use of customized CAD CAM titanium meshes (Yxoss CBR^® Reoss) in order to show an alternative method of bone augmentation. Materials and methods: Nine patients presenting 10 bone defects were referred to solve oral dysfunction due to edentulous atrophic ridges. Guided bone regeneration was performed with titanium meshes combined with autogenous bone grafting and heterologous bovine bone mineral grafting, and exclusively a “poncho technique” soft tissue approach for all the cases. After a mean 9 months of graft healing (range 6–12 months), titanium meshes were removed, and implant surgery was subsequently performed. The results we obtained were positive in terms of volumetric increases in height, length and thickness of the atrophic ridges without biological complications detectable before implant surgery. Results: Out of nine, one site met titanium mesh exposure: however, in all 10 sites a three-dimensional volumetric bone implementation was obtained. The statistical results were estimated by uploading and superimposing cbct scans before and after CBR surgery for each patient, so it was possible evaluate the maximum linear vertical and horizontal bone gain through dedicated Cad Cam software (Exocad GmbH^®). The average horizontal gain was 6.37 ± 2.17 mm (range 2.78–9.12 mm) and vertical gain was 5.95 ± 2.06 mm (range 2.68–9.02 mm). A total of 18 implants were placed into the grafted sites with a 100% survival rate (clearly they are relative percentages to be compared to the short time elapsed). Conclusions: The results we obtained in this study suggest that this CBR procedure (Yxoss^® by Reoss) is reliable and safe for bone regeneration to allow implant-prosthetic restoration in horizontal, vertical and combined bone defects. The soft tissue management is diriment: all the cases were managed with a “poncho” flap approach to decrease exposure complication.

Background. Transparent aligners are recently introduced orthodontic devices considered promising for the improvement of oral health conditions, in terms of faster treatment times and enhanced comfort, especially if compared with traditional fixed orthodontic therapy. This systematic review aimed to evaluate at-home protocols for proper oral hygiene and aligners cleaning during orthodontic treatment. Methods. A search was conducted using the following four databases: PubMed, Cochrane Library, Web of Science, and Scopus. The systematic review (registered as CRD 42024562215) followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and included prospective studies, randomized controlled trials (RCTs), controlled clinical trials, and in vivo and ex vivo studies; they had to assess treatment with invisible orthodontics compared to treatment with fixed orthodontics, home oral hygiene, or aligner disinfection protocols. The evidence in the studies was evaluated for risk of bias using the RoB-2 (for RCTs and randomized crossover studies) and ROBINS-I tools (for observational studies). Results. Eleven studies were included in this systematic review: four RCTs, four crossover studies, and three cross-sectional observational studies. Seven studies considered patients undergoing orthodontic treatment, whereas four examined orthodontic aligners. The cleaning protocols of the aligners were evaluated based on the analysis of residual biofilm on the thermoplastic surfaces. Studies included were characterized by a low level of certainty, thus further evidence is needed. Conclusions. The most effective protocols entailed a combination of mechanical and chemical agents, suggesting that it is fundamental for patients undergoing aligner treatment to focus on individually tailored home oral hygiene protocols.

Background: to evaluate the effectiveness of different topical agents in biofilm disaggregation during non-surgical periodontal therapy. Methods: the search strategy was conducted according to the PRISMA 2020 on Pubmed, Cochrane Library, Scopus, and Web of Science, and it was registered in PROSPERO, ID: CRD42023474232. It included studies comparing non-surgical periodontal therapy (NSPT) with and without the application of topical agents for biofilm disruption. A risk of bias analysis, a qualitative analysis, and a quantitative analysis were performed. Results: out of 1583 records, 11 articles were included: 10 randomized clinical trials and one retrospective analysis. The total number of participants considered in the 11 articles included in the study was 386. The primary outcomes were probing pocket depth (PPD), clinical attachment level (CAL), and bleeding indices. The secondary outcomes were plaque indices, gingival recessions, and microbiological parameters. The meta-analysis revealed the following: [Weighted mean difference (WMD): −0.37; 95% confidence interval (CI) (−0.62, −0.12), heterogeneity I²: 79%, statistical significance p = 0.004]. Conclusions: the meta-analysis of probing pocket depth reduction (PPD) between baseline and follow-up at 3–6 months showed a statistically significant result in favor of sulfonated phenolics gel. The scientific evidence is still limited and heterogeneous; further randomized clinical trials are required.

Recent short-term studies suggested the use of short and ultra-short implants in association with a modified osteotome sinus floor elevation (internal sinus lift) technique for the treatment of edentulous resorbed posterior maxilla. The aim of this retrospective study was to investigate this hypothesis in locking-taper implants with a mid-term follow-up of 5 years. Overall, 155 implants (32, 100, and 23 of, respectively, 5.0 mm, 6.0 mm, and 8.0 mm length) were positioned in the atrophic upper maxilla of 79 patients, and 151 implants were loaded with single crowns. Overall implant survival after 5 years was 94.84%. Implant survival for each length group was 93.75%, 94%, and 100% for 5.0, 6.0, and 8.0 mm length, respectively. Preoperative residual crestal bone height of 4.45 (1.3) mm increased to 9.25 (2.13) mm after implant placement and settled at 6.35 (1.73) mm after loading and at 5.25 (1.68) mm at follow-up. Elevation of the Schneiderian membrane was 4.8 (2.46) mm after implant placement, 3.06 (1.3) mm after loading, and 1.46 (1.06) mm at follow-up. Mean variations of peri-implant crestal bone loss and first bone-to-implant contact point were, respectively, −0.36 (1.3) mm and −0.62 (1.15) mm. It can be confirmed that internal sinus lift procedure revealed stable bone gain and negligible resorption at mid-term follow-up for atrophic upper crests with reduced height.

Background: Additional therapies (e.g., laser, photodynamic therapy, and ozone) have been reported to improve mechanical instrumentation and immune response in non-surgical periodontal therapy (NSPT). With this systematic review we evaluated the effectiveness of ozone therapy in reducing inflammation and progression of periodontal disease. Methods: Three electronic databases (PubMed, Scopus, and Cochrane Library) were searched for randomized and clinical trials on ozone therapy (gas, liquid, gel/oil) combined with NSPT. The study design followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and the risk of bias was assessed using the RoB-2 tool. Results: Eight of the twenty-two studies reviewed reported on gaseous ozone, nine on ozone water, and five on ozonated oil/gel as an adjunct to mechanical periodontal instrumentation, often with scaling and root planing (SRP). Ozone was found to be more effective than SRP alone in treating inflammation, as measured with the gingival index (VMD −0.32; 95% confidence interval (CI) (−0.41; −0.24); p < 0.00001) and compared to chlorhexidine (CHX) (ozone gel; VMD −0.10; 95% CI (−0.20; −0.01); p = 0.03). The study findings were inconsistent, however, with several reporting clinical and microbiological benefit while others observed no marked improvement with the addition of ozone therapy to NSPT. Conclusions: While ozone therapy may represent a useful adjunct to NSPT, further research with larger study groups is warranted to determine its effectiveness.