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.

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.

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) represents a severe complication associated with bisphosphonate therapy commonly used in patients with osteoporosis and malignancies. Methods: This retrospective study evaluates the risk factors and clinical outcomes of BRONJ patients treated at the Oral and Maxillofacial Surgery Clinic in Iaşi, Romania, with the goal of optimizing preventive and therapeutic strategies. Data from 72 BRONJ patients treated between January 2013 and December 2023 were analyzed. Results: The majority (83.3%) of patients had underlying malignancies, predominantly breast and prostate cancers. The mandible was most affected, with tooth extraction identified as the primary triggering event. Systemic comorbidities, notably arterial hypertension, diabetes mellitus, and concurrent chemotherapy, were significantly associated with increased BRONJ severity. Surgical intervention was frequently required, with sequestrectomy being the predominant procedure, reflecting advanced disease at the time of diagnosis. Conclusions: The findings underline the critical importance of early identification, preventive dental management, and a collaborative multidisciplinary approach to improve patient prognosis.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) represents a severe complication associated with bisphosphonate therapy commonly used in patients with osteoporosis and malignancies. This retrospective study evaluates the risk factors and clinical outcomes of BRONJ patients treated at the Oral and Maxillofacial Surgery Clinic in Iaşi, Romania, with the goal of optimizing preventive and therapeutic strategies. Data from 72 BRONJ patients treated between January 2013 and December 2023 were analyzed. The majority (83.3%) of patients had underlying malignancies, predominantly breast and prostate cancers. The mandible was most affected, with tooth extraction identified as the primary triggering event. Systemic comorbidities, notably arterial hypertension, diabetes mellitus, and concurrent chemotherapy, were significantly associated with increased BRONJ severity. Surgical intervention was frequently required, with sequestrectomy being the predominant procedure, reflecting advanced disease at the time of diagnosis. The findings underline the critical importance of early identification, preventive dental management, and a collaborative multidisciplinary approach to improve patient prognosis.

Patient-specific Ti–6Al–4V fixation systems are increasingly used to stabilise the maxilla following segmental Le Fort I osteotomy; however, the biomechanical responses of complete locking and non-locking patient-specific fixation configurations remain insufficiently characterised. In this study, two patient-specific plate designs (a standard design and a reduced, minimally invasive design) were analysed by linear-elastic finite element analysis, each with locking and non-locking screws. Because they were developed for different indications and evaluated in distinct patient-specific anatomical models, between-model comparisons were considered descriptive. Vertical forces of 97.6, 206.9, and 257.0 N were applied bilaterally to the incisor and premolar regions, and the equivalent von Mises stress and total displacement were evaluated in the bone, plates, and screws. All results scaled linearly with load. Within the standard model, the locking configuration exhibited slightly greater bone, plate, and screw displacement than the corresponding non-locking configuration. Within the reduced model, it exhibited lower maximum bone, plate, and screw displacement by 16.4%, 19.2%, and 16.3%, respectively. Solver-reported local stress maxima were concentrated at the screw-head/plate-hole transition; because these isolated peaks were contact- and mesh-sensitive, they were not used to quantify relative screw loading or predict yielding. The modelled locking and non-locking fixation configurations therefore exhibited different, model-dependent displacement patterns. Further controlled simulations and experimental validation are required to determine the clinical relevance of these findings.

Advanced cases of unilateral condylar hyperplasia might need combined joint reconstruction and orthognathic surgery. This report illustrates the feasibility of integrating digital planning, patient-specific prosthesis design, and orthognathic correction within a single-stage surgical workflow. A 23-year-old female patient presented with skeletal Class III malocclusion, facial asymmetry, and mandibular midline deviation due to left condylar hyperplasia. After preoperative orthodontic alignment, virtual surgical planning was carried out using specialised software to simulate resection of the hyperplastic condyle, with concurrent total TMJ replacement, contralateral sagittal split ramus osteotomy, and Le Fort I osteotomy. Based on this plan, patient-specific prosthetic components, surgical guides, and fixation plates were designed and manufactured. Surgery was performed according to the digital plan using a combined intraoral and extraoral approach. At 3-month follow-up, clinical and radiological assessments showed stable prosthesis positioning, improved occlusal relationships, restoration of facial symmetry, and high patient-reported satisfaction. However, given the single-case design and short follow-up, these findings should be considered preliminary, and further studies are necessary to evaluate long-term functional outcomes and reproducibility.