Objectives: The objective of this narrative literature review was to highlight all dental procedures attributable to sectoral waste and to consider possible alternatives in line with the concept of sustainable development. Methods: An extensive search of electronic databases, including the Cochrane Oral Health Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, PubMed, EMBASE, and Google Scholar. Search words included ‘Green Dentistry’, ‘Dental Pollution’, ‘Pollutants and Dentistry’, ‘Disinfectants and Dentistry’, and ‘High-tech Dentistry’. All of them allowed an assessment of the impact of dental practice on the external environment, and new frontiers currently applied or possibly applicable for green dentistry were included in the study. Non-full-text papers, animal studies, studies in languages other than English, and studies not related to the topic under consideration were excluded. Results: According to the inclusion criteria, 76 papers were selected for the study. The topics analyzed were the impact of dental practice on the outdoor environment, currently applied and potentially applicable principles of green dentistry, and the ‘Four Rs’ model (Rethink, Reduce, Reuse, and Recycle). Conclusions: With the limitations of the present study, the concept of green dentistry could be applicable provided that the measures already taken to reduce indoor and outdoor risk factors are continued and improved.

(1) Background: Computer-guided surgery is now established as the main technique for implant placement, reducing intraoperative complications and helping the clinician avoid damaging sensitive anatomical structures, such as, for example, the maxillary sinus. (2) Methods: A complex case is discussed to suggest how computer-aided surgery can merge with freehand surgery, as a surgical guide can make a freehand surgical procedure less complicated and more predictable. (3) Results: A surgical procedure was executed following digital planning, except for sites 1.5 and 2.5, where a mixed approach was adopted: they were initially prepared with a milling depth of 1 mm from the base of the maxillary sinus and were then finished using osteotomes, according to the technique described by Summers. Radiography confirmed the correct positioning of the implants and the sinus lift. (4) Conclusions: A mixed digital/analogical approach used in complex cases increases the accuracy of the results and reduces complications and treatment time. The presence of a correctly digitally planned surgical guide helps in the freehand approach and not only in the digital approach.

Objectives: To evaluate the clinical performance of BioHPP^® (Biocompatible High-Performance Polymer) superstructures in full-arch implant-prosthetic rehabilitations following the Toronto-Branemark protocol, focusing on biomechanical and biological outcomes. Methods: A 70-year-old edentulous male patient underwent full-arch implant-prosthetic rehabilitation using BioHPP^® superstructures fabricated through a CAD-CAM workflow. Radiological and clinical evaluations were conducted to plan implant placement and assess outcomes after one-year of follow-up. The primary endpoints included prosthetic stability, peri-implant bone resorption, and patient-reported satisfaction. Results: The BioHPP^® superstructure demonstrated effective stress distribution, leading to minimal peri-implant bone resorption and improved implant stability. Clinical evaluations showed excellent prosthetic fit and functionality, with no complications during the observation period. Radiological analyses confirmed the absence of prosthetic misfits, while patient-reported outcomes indicated high levels of comfort and aesthetic satisfaction. Conclusions: BioHPP^® superstructures offer a promising alternative to traditional materials for full-arch implant-prosthetic rehabilitations, providing significant biomechanical and aesthetic advantages. These findings suggest that BioHPP^® may enhance clinical outcomes, though further research with larger cohorts and longer follow-up periods is required to validate its long-term reliability.

The aim of this clinical study was to investigate and compare implant survival rates, marginal bone loss, and surgical and prosthetic complications of healthy patients and subjects affected by hypertension receiving full-arch implant-prosthetic rehabilitation. From January 2016 to November 2016, patients affected by total edentulism of one or both arches or severe impairment of residual teeth who needed full-arch implant-prosthetic rehabilitation and who had the absence of any systemic diseases or the presence of hypertension as a single pathology were randomly selected. According to the inclusion criteria, 39 patients were enrolled for this study. The sample was divided into two groups: A total of 18 patients were included in Group A (healthy patients), and 21 patients were included in Group B (patients affected by hypertension). No statistically significant difference in implant survival rates, marginal bone loss, and prosthetic complications were observed between Group A and Group B. Except for variable bleeding, the results of the Pearson’s chi-square test and z-test at a 99% confidence level suggest that there is no statistically significant difference in clinical complications between the groups. Within the limitations of this study, full-arch implant-prosthetic rehabilitation could be a feasible option for treating patients with hypertension, provided that hypertension is compensated and controlled.

Background: Drug-induced gingival enlargement is a commonly documented adverse effect in patients administered with calcium antagonist medications. Nifedipine is the medicine most frequently linked to instances of gingival enlargement; nevertheless, amlodipine, likewise a calcium antagonist, can elicit this adverse effect. This case report aims to detail a case of amlodipine-induced gingival hyperplasia, emphasizing the significance of a multidisciplinary approach and outlining its therapy across various surgical phases. Methods: A 48-year-old hypertensive patient using amlodipine therapy presents with aberrant gingival tissue growth in the upper arch. Intraoral examination reveals localized inflammation and tissue enlargement in the papillae areas of the upper arch gingiva, leading to partial covering of the dental crowns. The patient experienced painful sensations and episodes of spontaneous bleeding in the enlarged gingival tissue. Following an initial professional dental hygiene treatment, which included root planning in the upper quadrants, and in consultation with the referring cardiologist, it was determined to discontinue amlodipine and initiate a replacement therapy with olmesartan medoxomil. Fifteen days following the cessation of amlodipine, surgical excision of the thickened interdental gingival tissues in the anterior region was conducted to obtain biopsies for histological confirmation of the observed pathological condition. Results: Histopathological examination validated the diagnosis of drug-induced gingival enlargement, characterized by chorion fibrosis and significant lymphoplasmacytic infiltration. Specifically, parakeratotic and acanthotic characteristics were seen in the gingival epithelium. Adjacent to the inflammatory regions, fibrosis was noted, along with the presence of cytoid bodies, which are typically linked to pathological diseases driven by inflammatory processes. These histological characteristics were consistent with the diagnosis of drug-induced gingival enlargement. Conclusions: A multidisciplinary approach involving the treating physician, dentist, and hygienist, incorporating drug replacement and targeted oral hygiene sessions, is crucial for the management and resolution of calcium channel blocker-induced gingival enlargement.

Background: The rehabilitation of complex bone defects in the anterior maxilla presents significant challenges in restoring both function and esthetics. A multidisciplinary approach integrating guided bone regeneration (GBR) and connective tissue grafting (CTG) has proven effective in addressing such cases. Methods: This report describes the case of a 60-year-old female patient who presented with severe alveolar ridge resorption and peri-implant bone loss, necessitating an advanced regenerative strategy. The treatment protocol involved the use of autologous and xenogeneic bone grafts in combination with hyaluronic acid and polynucleotides to enhance osteogenesis and tissue integration. A six-month healing period was observed before histological and clinical evaluations were conducted. Results: The results demonstrated a significant increase in lamellar bone formation and vascularization in sites treated with biomodulators compared to conventional GBR techniques. Subsequently, CTG was employed to optimize peri-implant soft tissue volume and stability, leading to improved keratinized tissue thickness and enhanced esthetic outcomes. This case underscores the importance of a comprehensive surgical and prosthetic plan that integrates bone regeneration with mucogingival management for optimal results in implant rehabilitation. Additionally, histological analysis revealed that the incorporation of hyaluronic acid and polynucleotides resulted in improved cellular activity, reduced inflammatory responses, and enhanced overall bone quality. Conclusions: These results highlight the potential role of biomodulators in regenerative procedures. While the findings suggest promising clinical applications, further long-term studies are necessary to validate the outcomes and establish standardized protocols for the integration of advanced biomaterials in implantology.