Background: The aim of this study was to evaluate the clinical and radiological efficacy of minimally invasive surgical techniques for infraosseous defects by evaluating the effects of Emdogain (EMD) applied alone or with a xenograft, with a follow-up period of one year. Methods: Forty patients with a combined total of forty-eight intraosseous defects participated in the research. Of these, 20 participants were treated with EMD (group 1), and 28 were treated with EMD and a xenograft (group 2). The clinical measurements probing depth (PD), recession (REC), and clinical attachment level (CAL) were assessed at six sites on the tooth. Additionally, the following intraoperative clinical measurements were taken: (1) distance from the cementoenamel junction (CEJ) to the bottom of the defect (CEJ-BD) and (2) distance from the CEJ to the most coronal extension of the interproximal bone crest (CEJ-BC). The infraosseous component of the defect was defined as INTRA = (CEJ-BD) − (CEJ-BC). Results: In comparison with the baseline, both treatment options showed statistically significant improvements in reducing PD and increasing CAL. The reduction in PD was 3.25 ± 0.786 mm for group 1 and 3.29 ± 1.013 mm for group 2. In terms of CAL gain, group 1 recorded a value of 4.65 ± 1.387 mm, compared with 5.07 ± 1.631 mm in group 2. Both groups showed a noticeable increase in radiographic bone filler, with an average of 69.85 ± 17.773%. Conclusions: The two regeneration techniques were both effective for the treatment of deep intraosseous defects, encouraging more substantial filling compared with preoperative levels.

Background: This in vitro study evaluated the influence of macro and microscopic implant design, drilling protocol, and bone density on the primary stability of 4 mm ultrashort dental implants, aiming to provide evidence-based guidance for their use in severely atrophic posterior jaws. Methods: Two implant systems were compared: test group (Klockner Essential Cone^® conical implants with polished neck, diameters 4.0 mm [B1] and 4.5 mm [B2], shot-blasted and acid-passivated surface) and control group (Straumann Standard Plus^® 4.1 mm parallel-walled implants with SLA^® surface). A total of 722 implants (n = 30 per condition) were inserted into natural bone blocks simulating Lekholm and Zarb type II (cortical-dominant) and type III (medullary-dominant) bone qualities. Fifteen experimental conditions were tested, combining three main drilling protocols: (1) manufacturer’s standard preparation, (2) horizontal under drilling (final diameter 3.5 mm), (3) vertical overpreparation (1 mm deeper), and (4) combined vertical + horizontal restriction. Primary stability was assessed by insertion torque (measured with a calibrated Tohnichi^® torque wrench) and Implant Stability Quotient (ISQ) using Penguin^® resonance frequency analysis (RFA) in two perpendicular directions. Subjective insertion ease and complications were also recorded. Conclusions: The conical macrogeometry with progressive, dense V-shaped threads provides significantly better primary mechanical anchorage than parallel-walled designs in ultrashort (4 mm) implants. Within the limitations of this ex vivo animal bone model study, the results indicate that different drilling protocols significantly influence the primary mechanical stability with insertion torque ≥ 25 Ncm and ISQ ≥ 55 of ultra-short implants, as measured by insertion torque and ISQ values. Certain drilling protocols resulted in higher insertion torque and ISQ compared to others, particularly in Type II and Type III bone.