As an alternative to regenerative therapies, numerous authors have recently proposed bringing back subperiosteal implants. The aim of the study was to present our clinical experience with a subperiosteal jaw implant that needs minimal bone preparation and enables the rapid implantation of prosthetic teeth in edentulous, atrophic alveolar bone. The research included 36 complete or partial edentulous patients (61 subperiostal implants) over a period of 6 years. To create the patient-specific subperiostal implants design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used and fabricated with a Mysint 100 (Sisma S.p.A., Piovene Rocchette, Italy) by titanium alloy powder. The results showed that only 9 of the 36 cases were successful at 6-year follow-up, while 27 cases had complications, including exposure of the metal frame (early or delayed), mobility of the device prior to the first 4–6 months, and late mobility due to recurrent infections and progressive structure exposure; 1 case failed for reasons unrelated to the device. This study indicated that the prudent application of fully customized subperiosteal jaw implants is a dependable alternative for the dental rehabilitation of atrophic edentulous cases that necessitate bone grafts for traditional fixed dental implant solutions.

Background and Objectives: Alveolar ridge augmentation in the complex bone defect is a popular topic in implantology. Guided bone regeneration (GBR) is one of the most commonly applied methods to reconstruct alveolar bone. The application of a membrane is the fundamental principle of GBR. There are many membrane types used in oral surgery, but the advantage of the titanium mesh is the rigidity which provides space maintenance and prevents contour collapse. The smooth surface also reduces bacterial contamination. Using computer-aided design (CAD) and computer-aided manufacturing (CAM) in dentistry allows us to obtain the perfect architecture form of the mesh, which covers and protects the bone reconstruction. Case presentation: We present a surgical case of a 27-year-old female patient with severe aesthetic bone atrophy after a deficient odontectomy. Based on the GBR clinical applications, the technique consists of bone reconstruction and a customized titanium mesh application. Using mesh titanium in this case presentation was a reliable alternative to perform a lateral alveolar bone augmentation and reconstruct ridge deformities before reaching an ideal implant placement. Conclusions: According to our case report, the customized titanium mesh could be a valuable option for guided bone regeneration in aesthetic maxillary defects.

The odontogenic keratocyst (OKC) is among the most aggressive odontogenic cysts because of its high recurrent rate. This study’s objective was to describe a 7-year radiological and clinical follow-up of an OKC with two recurrences and a combination of surgical treatments. The cyst contents were drained at the biopsy to allow decompression, and then marsupialization (Partsch I) was carried out with good results. In the following two years, the endodontic and radiological evaluation of the neighboring teeth indicated endodontic avoidance. The remaining OKC enucleation (Partsch II) with chemical curettage and suture was performed two years after the first presentation, and the multifocal recurrences developed were also treated by enucleation and chemical curettage. At the last radiological follow-up, no recurrence was evident. Based on our experience, we concluded that patients diagnosed with a OKC should be radiologically evaluated at least once a year for at least 7 years, the endodontic diagnosis and treatment of neighboring teeth should be performed as early as possible, and the combination of surgical treatment and the long follow-up period is challenging.

For facial abnormalities, recent developments in virtual surgical planning (VSP) and the virtual design of surgical splints are accessible. Software companies have worked closely with surgical teams for accurate outcomes, but they are only as reliable as the data provided to them. The current case’s aim was to show a fully digitized workflow using a combination of three digital software to correct predicted post–upward sliding genioplasty defects. To reach our goal, we presented a 28-year-old man with long-face syndrome for orthodontic treatment. Before orthognathic surgery, a clinical and paraclinical examination was performed. For a virtual surgical plan, we used the dedicated surgical planning software NemoFab (Nemotec, Madrid, Spain) and Autodesk MeshMixer (Autodesk Inc., San Rafael, CA, USA). To create the design of the digital guides, DentalCAD 3.0 Galway (exocad GmbH, Darmstadt, Germany) and Autodesk MeshMixer (Autodesk Inc., San Rafael, CA, USA) were used. The patient had undergone bilateral sagittal split osteotomy in addition to Le Fort 1 osteotomy and genioplasty, followed by mandible base recontouring ostectomy. Stable fixation was used for each osteotomy. Based on our case, the current orthognathic surgery planning software was not able to perform all the necessary operations autonomously; therefore, future updates are eagerly awaited.

The extraction of deeply impacted lower third molars is a common yet challenging surgical procedure associated with complications such as mandibular fractures, pain, and swelling. This study evaluated the effectiveness of customized 3D-printed titanium plates in reducing the risk of intraoperative iatrogenic mandibular fractures. This innovative approach aims to improve surgical outcomes, enhance patient safety, and boost confidence for both surgeons and patients. Eighteen patients with Pell and Gregory class II/IIIC impacted lower third molars underwent preoperative CBCT scans, which facilitated the design and fabrication of customized plates and drilling guides. The surgical procedure involved incision, flap elevation, precise plate placement, osteotomy, odontotomy, extraction, and the postoperative assessment of pain, swelling, trismus, and anxiety using validated scales and facial scanning. The results show that customized titanium plates successfully prevented mandibular fractures in all cases. Although initial postoperative discomfort, including swelling, trismus, and pain, was observed, significant improvements occurred within one week. This technique provided structural reinforcement during surgery and healing without adverse events or fractures. Customized 3D-printed titanium plates represent a safe and effective solution for minimizing mandibular fractures, offering promising improvements in surgical outcomes.

The purpose of this case report was to present the aesthetic result of the reconstruction of facial residual asymmetry after orthognathic surgery using a patient-specific three-dimensional (3D) mold and a custom-made polymethyl methacrylate implant. Through computer-aided design (CAD), the healthy contralateral side of the mandible was superimposed onto the side with the defect. Exocad Gallway (exocad GmbH, Darmstadt, Germany) was used to design the patient-specific implants (PSIs) of the right mandibular angle. Next, the implant mold was created using the Meshmixer software (Version 3.5, Autodesk Inc., San Rafael, CA, USA) and fabricated using additive manufacturing. During the surgical procedure, the patient-specific implant (PSI) was cast inside the resin mold using Simplex P bone cement (Stryker, Mahwah, NJ, USA). The implant was fixed using three screws. Combining both indirect (involving the dental laboratory) and direct (with surgical intervention) approaches, this innovative hybrid method, which incorporates both computer-aided design and additive manufacturing (AM), not only enhanced facial aesthetics, functional rehabilitation, and patient quality of life but also mitigated the potential risks linked to conventional grafting methods.