Background: Implant-prosthetic therapy requires a detailed assessment of the bone structure before designing a personalized treatment plan. Tooth extraction at the molar level is followed by a series of bone changes dependent on the patient’s general condition and age and the area in which it was performed. The fractal analysis of cone beam computed tomography (CBCT) represents a way to assess the quality of post-extraction bone regeneration. The purpose of this study was to analyze the alveolar bone changes after tooth extraction using fractal analysis on CBCT images. Methods: This retrospective study included pre- and post-extraction CBCTs at 3 months of 60 patients who underwent 100 extractions of first and/or second molars. Fractal analysis on CBCT images was performed using ImageJ, and the data obtained from the measurements were statistically processed. A multiple regression model was used to assess factors influencing bone remodeling. Results: Fractal analysis performed on CBCT images showed that most patients experienced advanced bone remodeling, this being more pronounced in those from rural areas, in the vertical plane at the mandible and at the second molar. The multiple regression model showed that the factors that play an important role in predicting bone resorption are represented by age group (age above 56 years old is associated with less bone resorption), location (bone resorption is more pronounced at the mandible level), and molar (bone resorption for the second molar is higher). Conclusions: Post-extraction bone changes were influenced by the age of the patient and by the location of the extraction, with the maxilla and first molar having better fractal analysis values compared to the mandible and second molar. These results emphasize the importance of training implantologists in CBCT evaluation to improve personalized implant-prosthetic treatment decisions.

Background: Over time, numerous surgical procedures and biomaterials have been proposed for the reconstruction of post-extraction bone defects, each with their advantages and disadvantages. The main objective of this study was to evaluate dimensional changes in the alveolar bone 3 months after tooth extraction, before implant planning, comparing alveolar ridge preservation (ARP) with spontaneous healing. Methods: A total of 84 patients with non-restorable molars were included in the study. Forty-two patients received ARP with advanced platelet-rich fibrin (A-PRF) and spontaneous healing was evaluated in these patients. Cone beam computed tomography (CBCT) analysis performed before and after surgical intervention was used to determine the changes in vertical and horizontal bone dimensions produced after tooth extraction. Results: CBCT measurements showed reduction in both vertical and horizontal alveolar bone size in both groups. For the study group, the alveolar parameters (height, width) were higher compared to the control group. The percentage variations between dimensional differences from the two groups were 38.58% for height, and for width were 36.88% at 0 mm, 35.56% at 3 mm, 36.61% at 5 mm, and 38.73% at 7 mm. The differences were statistically significant (p ˂ 0.0005). Conclusions: The results obtained after ARP with A-PRF showed a reduced loss of bone volume compared to spontaneous healing.

Background/Objectives: Fixed partial dentures (FPD) are intended to restore the impaired functions of the dento-maxillary system (DMS) following the onset of partial edentulism. The objectives of this study were to determine the association of risk factors represented by caries predisposition (DMFT index - decayed (D), missing (M), and filled (F) teeth), oral hygiene, bruxism and smoking with FPD complications. Methods: This retrospective cross-sectional study was conducted on a sample of 428 patients who presented to the Department of Prosthetic Dentistry at the University of Medicine and Pharmacy of Craiova for various complications related to FPD. Biological, technical, and aesthetic complications were identified in terms of their frequency and their association with risk factors, including caries predisposition quantified by the DMFT index, oral hygiene, bruxism, and smoking status. Associations were assessed using Pearson’s chi-square tests and Mann–Whitney U tests (two-sided, α = 0.05), performed in IBM SPSS Statistics, version 26 (IBM Corp., Armonk, NY, USA). Results: The DMFT index showed elevated values, 16.41 ± 4.43 in subjects aged ≤45 years and 18.39 ± 4.89 in subjects aged >45 years. Oral hygiene was satisfactory in a percentage of 75.82%, bruxism was present in 38%, and 40.52% were smokers. Regarding FPD complications, 94.77% were biological, 86.27% were technical, and 85.62% were aesthetic. Conclusions: Caries predisposition, assessed by the DMFT index, and smoking were associated with a higher frequency of biological complications. Bruxism and smoking were associated with technical complications, while unsatisfactory oral hygiene and smoking were associated with aesthetic complications.

Background: Osseointegration is the main factor that ensures the long-term success of implant-prosthetic therapy, but besides this, there are other important factors, such as the quality of the alveolar bone and the time of placement of dental implants. The study aimed to analyze changes in the alveolar bone following tooth extraction, comparing natural healing with immediate implant placement, using fractal analysis on OPG images. Methods: This retrospective study included OPG images obtained before tooth extraction and 3 months after surgery in 91 patients who underwent maxillary and mandibular molar extractions and opted for either natural healing or immediate dental implant placement. Fractal analysis of OPG images was performed using Image J software, and the resulting measurements were subsequently statistically analyzed. Results: Most extractions were performed in the maxilla, and most were at the level of the first molar. The study group showed a faster healing process following immediate placement of dental implants, regardless of location, and a similar distribution of bone resorption and healing, with clear differences in location: the mandible had a faster healing process than the maxilla. Conclusions: Fractal analysis showed a better and quicker bone healing of the alveolar bone in immediate implant placement in molar areas compared with post-extraction natural healing, especially in the lower jaw.

(1) Background: Alveolar bone regeneration in dentistry has become important with the evolution of implantology. Biomaterials used for bone grafting are increasingly used to provide resistant bone support that is favorable for the insertion of dental implants. The aim of the study was to analyze the degree of biocompatibility and bone neoformation of two biomaterials compared to natural healing. (2) Methods: Bone defects of 3 mm diameter were created in the calvaria of 15 adult male Wistar rats. Three groups were created: group A, in which natural healing was achieved; group B, in which porcine xenograft was added; and group C, in which experimental synthetic bone based on hydroxyapatite reinforced with titanium particles was added. Samples were collected at 2 and 4 months postoperatively and analyzed microscopically and histologically. (3) Results: Data were obtained on the healing pattern of the created cavities, as well as the degree of their filling with newly formed bone tissue. Following the results obtained from the stereomicroscope analysis and histological analysis, statistically significant differences were observed between the two biomaterials regarding the time required for the transformation process of the graft particles into bone. Thus, the porcine xenograft was incorporated more quickly into the native bone, while the synthetic bone required a longer period of time. (4) Conclusions: The bone graft materials used acted as scaffolds for the newly formed bone, but each biomaterial required a different amount of time for the particles to be incorporated into the native bone.

Background: Alveolar ridge preservation (ARP) techniques have evolved with implantology development. In clinical practice, biomaterials for ARP are tested in laboratory animals, and rat calvaria is a standard option. The study aimed to evaluate biomaterial osteointegration in defects created in the rat calvaria, comparing an experimental synthetic biomaterial with a bovine xenograft and natural healing. Methods: The study included six groups of animals: two negative control groups with natural healing (2 months (M) and 4 M), two positive control groups with bovine xenograft (2 M and 4 M), and two study groups with nanohydroxyapatite titanium reinforced (2M and 4M). After creating and grafting the defects, healing was expected to take 2 or 4 months, after which bone fragments were harvested, prepared, and then analyzed. OCT, stereomicroscopy, and histology techniques were used for bone fragments analysis, and the obtained images were evaluated using Image J 1.54p software. Results: The results obtained from the three analyses provided information about the healing pattern of bone defects and the degree of new bone formation. Histological analysis of the samples confirmed what the stereomicroscopy and OCT images showed: that the bovine xenograft elicited a better tissue response than the synthetic biomaterial, being incorporated into the bone tissue more than the synthetic biomaterial. Conclusions: Both the bovine xenograft and the synthetic nanocomposite based on hydroxyapatite reinforced with titanium particles favored bone healing, but their integration into the bone was limited for the analyzed period.