Objective: To identify the different uses and modalities of digital technologies to diagnose, plan and monitor peri‐implant soft tissue conditions and aesthetics.Methods: A comprehensive narrative review of pertinent literature was conducted, critically appraising key digital technologies that may assist peri‐implant soft tissue augmentation and assessment. An electronic search on four databases including studies published prior to 1st July 2023 was performed and supplemented by a manual search.Results: Predominantly, tools such as cone beam computed tomography (CBCT), intraoral scanning (iOS), intraoral ultrasonography and digital spectrophotometry were commonly to assess and monitor peri‐implant soft tissues. The main clinical and research applications included: (i) initial assessment of mucosal thickness, supra‐crestal tissue height and keratinized mucosa width, (ii) evaluation of peri‐implant soft tissue health and inflammation, (iii) monitoring profilometric changes and midfacial mucosal margin stability over time and (iv) aesthetic evaluation through colour assessment. While evidence for some digital tools may be limited, the integration of digital technologies into peri‐implant soft tissue management holds great promise. These technologies offer improved precision, comfort and speed in assessment, benefiting both patients and clinicians.Conclusion: As digital technologies progress, their full potential in peri‐implant soft tissue augmentation and their value will become more evident with ongoing research. Embracing these innovations and their potential benefits is recommended to ensure that during progress in implant dentistry, patient care is not hindered.

Wound healing monitoring for abnormality identification and intervention is crucial to securing a successful surgical outcome. Indices have been used to summarize the degree of healing. Given the increasing frequency of regenerative procedures which preserve dentition and implant stability, and the higher esthetic demands, an appraisal of the available indices is needed to identify the current knowledge gap. This study aimed to systematically review published oral wound healing indices and scores. Materials and Methods: A complete literature electronic search in 5 databases was conducted by two reviewers. A combination of keywords related to oral wound healing was used. Results: A total of 11 articles were included in the evaluation of various procedures (conventional periodontal procedures, guided tissue regeneration, soft tissue reconstruction procedures, and tooth extractions), at different time points (1 day to 12 weeks), with a focus on diverse clinical signs and symptoms. Frequently evaluated parameters included wound dehiscence/epithelialization (91%), tissue color (redness) (73%), suppuration (55%), swelling/edema (55%), and hemostasis (55%). Other less commonly used parameters include esthetics-related and patient-centered outcomes. Conclusion: The available indices evaluate a diverse group of subjective clinical signs and symptoms to estimate the underlying biological healing events and assess the degree of clinical success. The majority of the included indices are not validated. Quantitative and objective subclinical parameters including blood perfusion, biomaterial stability, and completeness of epithelialization, are needed for customized wound healing care and better outcome prediction.

Aim: Technology improvement and a better understanding of sinus anatomy and wound healing in the past decade have allowed the development of minimally invasive surgical techniques. This systematic review focused on identifying and describing these techniques for vertical and lateral sinus augmentation (VSA and LSA).Materials and Methods: Electronic and hand search were conducted to screen the literature published from January 2003 to May 2024. The selected studies had to include detailed techniques for minimally invasive SA. Data extraction included the study types, sample size, technique/instrument details, and outcome measurements.Results: A total of 36 articles (27 VSA, 8 LSA with an additional 1 article included both procedures) with 2732 sinus augmentation met the inclusion criteria. Minimally invasive VSA includes the use of modified rotary instruments with stopper, balloon, hydraulic pressure, digital planning, endoscope, and operating microscope. These techniques aim for conservative flap reflection, precise sinus window preparation, and/or controlled sinus membrane elevation. Most of the selected studies (n = 15) did not report the incidence of sinus membrane perforation.Conclusion: Within the limitations of this review, minimally invasive VSA and LSA achieved sufficient sinus augmentation and implant success with the potential advantages of reduced surgical complications and morbidity. Comparative studies with defined outcomes are encouraged to further validate these useful minimally invasive techniques for SA.

Objectives: The current strategies to reconstruct lost peri‐implant tissues due to the disease have been largely unpredictable. The aim of this conceptual review is to discuss relevant biological and biomechanical challenges of applying reconstructive means to treat peri‐implantitis. Additionally, opportunities to improve treatment predictability are presented.Material and Methods: A narrative review was conducted to fulfill the aim.Results: The four interrelated negative conditions hampering effective reconstruction are: inferior tissue perfusion, unfavorable bone topography, ineffective surface treatment, and unstable wound. First, peri‐implant tissues resemble scars with reduced cellularity and vascularity, coupled with the absence of the periodontal ligament plexuses and the avascular implant and biomaterials, maintaining primary closure is a challenge, which is critical for regeneration. Second, defect morphology and bone topography surrounding implants determine the reconstructive potential. Unfortunately, noncontained defects are frequently encountered, with a combination of suprabony (horizontal bone loss) and infrabony (vertical usually involving circumferential bone loss) defects. Third, current attempts for implant surface decontamination are insufficient due to inaccessible macrostructure and rough surfaces in the micro‐scale. Histologic evaluation has shown bacteria aggregation and calcified deposits around implants. Lastly, wound stability is difficult to achieve due to inherent soft tissue biomechanical quality and quantity deficiencies and mobile bone particulates. Opportunities to tackle the abovementioned challenges include the use of novel imaging technologies, such as high‐frequency dental ultrasound and laser speckle imaging to evaluate tissue perfusion, soft tissue quality/quantity, and bone topography pre‐surgically. The use of the operating microscope could allow better visualization and removal of etiologic factors. Strategies to improve soft tissue quality may include preoperative control of soft tissue inflammation and the potential use of biologics. Methods such as fixation to stabilize the biomaterials could be beneficial.Conclusions: A more nuanced understanding of the current challenges and opportunities can lead to more effective preoperative and postoperative care protocols, ultimately improving the success rate of reconstructive procedures.

The present study was designed to test the hypothesis that there would be a correlation between nasal septum deviation (NSD) and a decreased maxillary sinus volume (MSV) in a Colombian population, using Cone Beam Computed Tomography (CBCT); other sinusal anatomical structures found during the reading were described and analyzed. A retrospective analysis of 537 CBCT scans of adult patients taken between January 2014 and January 2017 included measuring the maxillary sinus diameter in the vertical, horizontal, and sagittal planes. NSD was quantified and related to MSV using the same field of view (FOV). The volume of the right and left maxillary sinuses showed a median and interquartile range (IQR) of 8.18 mm³ (IQR: 6.2–10.33) and 8.3 mm³ (IQR: 6.4–10.36). Statistically significant differences were observed between sex and right and left MSV (p = 0.000), with higher MSV in men. The presence of NSD was observed in 96.81% of the sample and was evaluated in degrees, observing a median of 11° (IQR: 7–16) where 40% of the sample had moderate angles (9–15°). There was no correlation between NSD and a decreased MSV in the population studied. Detailed CBCT analysis with a large FOV is crucial for the analysis of anatomical structures before performing surgical procedures that involve the MS as a preventive diagnostic and therapeutic step for appropriate treatment.