Objectives: This study aims to investigate the underlying causes of dental implant failure, focusing on implant-related complications and associated risk factors. Understanding these factors will help improve treatment planning and enhance implant success rates. Methods: A retrospective case-control study was conducted using clinical, medical, surgical, and radiographic records of patients who underwent dental implant removal due to complications. Key factors analyzed included patient-related variables (age, gender, medical conditions, periodontal disease), implant-related factors (implant site, implant system, restoration status), and procedural aspects (previous surgical interventions and reasons for implant removal). Results: The findings revealed that implant type (p = 0.004) and type of restoration (p = 0.001) significantly influenced implant survival. Gender (p = 0.001), medical conditions, smoking status (p = 0.004), and restoration status (p = 0.005) were significantly associated with specific failure mechanisms. Lack of osseointegration (36.4%) and absence of primary stability (22.4%) were the predominant causes of implant failure. Prior surgical interventions (p = 0.001) and decisions for re-implantation (p = 0.005) significantly affected implant removal frequency. Conclusions: Implant survival is influenced by multiple factors, with implant type, restoration type, and gender playing key roles in failure outcomes. Patient-specific risk assessment, particularly regarding medical conditions and smoking, meticulous surgical technique, and appropriate prosthetic planning, is vital for improving implant longevity and minimizing failure rates.

Peri-implantitis diagnosis typically involves evaluating inflammation, pocket depth, bleeding, and bone loss around dental implants. Although these methods are reliable and convenient, they mainly determine the history of the disease instead of the current activity or disease susceptibility. This meta-analysis evaluates whether the matrix metalloproteinase (MMP)-8 level in the peri-implant crevicular fluids (PICF) can be associated with peri-implantitis. The research was conducted in February 2022, where three electronic databases were searched and complemented with a manual search. The search criteria included original cross-sectional and longitudinal studies that compared MMP-8 biomarkers in crevicular fluids around healthy implants with unhealthy implants (peri-implantitis). To assess the risk of bias, the Newcastle-Ottawa Quality Scale was used. The data was analyzed using the RevMan program, and the standardized mean difference (SMD) with a 95% confidence interval was applied to evaluate the MMP-8 levels, with a significance level of p less than 0.05. Out of 1978 studies, six were eligible. This meta-analysis included 276 patients divided into two groups; 121 patients (124 implants) in the peri-implantitis group and 155 patients (156 implants) in the health implants group. The quality of the included studies was evaluated as high to moderate. The meta-analysis showed a significant increase in MMP-8 levels in individuals with peri-implantitis compared to those with healthy implants (SMD = 1.43, 95% CI [0.19, 2.68], p = 0.02). The current meta-analysis found that the levels of MMP-8 in PICF were significantly elevated in peri-implantitis cases compared to healthy controls, indicating a potential link between MMP-8 and peri-implantitis. However, the meta-analysis does not provide evidence for MMP-8 as a diagnostic test for peri-implantitis. Further research, specifically diagnostic accuracy studies, is needed to establish the value of MMP-8 as a diagnostic tool for peri-implantitis.

Porphyromonas gingivalis (P. gingivalis) is viewed as a keystone microorganism in the pathogenesis of periodontal and peri-implant diseases. Hyaluronic acid (HA) is believed to exert antimicrobial activity. The aim of this study is to assess the in-vitro growth and biofilm formation of P. gingivalis under HA and compare the effect of HA to that of azithromycin (AZM) and chlorhexidine (CHX). In each material, the minimum inhibitory concentration (MIC), 50% MIC, 25% MIC, and 12.5% MIC were tested. The growth of P. gingivalis was evaluated by absorbance spectrophotometry after 48 h. A biofilm inhibition assay was performed on a 72-hour culture by washing planktonic bacterial cells, fixing and staining adherent cells, and measuring the variation in stain concentrations relative to the untreated control using absorbance spectrophotometry. The results show that the overall growth of P. gingivalis after 48 h was 0.048 ± 0.030, 0.008 ± 0.013, and 0.073 ± 0.071 under HA, AZM, and CHX, respectively, while the untreated control reached 0.236 ± 0.039. HA was also able to significantly reduce the biofilm formation of P. gingivalis by 64.30 % ± 22.39, while AZM and CHX reduced biofilm formation by 91.16 %±12.58 and 88.35 %±17.11, respectively. High molecular-weight HA significantly inhibited the growth of P. gingivalis. The overall effect of HA on the growth of P. gingivalis was similar to that of CHX but less than that of AZM. HA was also able to significantly reduce the biofilm formation of P. gingivalis. However, the ability of HA to prevent the biofilm formation of P. gingivalis was generally less than that of both AZM and CHX.

Objectives Implant placement errors remain a persistent challenge, leading to complications such as peri-implant bone loss, neurosensory issues, and, in severe cases, implant failure. This study evaluates the prevalence and characteristics of dental implant positioning errors in patients treated at the Dental University Hospital. Methods: A sample of 500 cone-beam computed tomography (CBCT) scans was used to assess implants for positioning errors, including thread exposure, proximity to anatomical structures, and violations of inter-implant and implant–tooth distances. Results: A total of 56.6% of the implants exhibited positioning errors, with the maxillary posterior region being the most commonly affected area (51.6%). The most frequent errors observed were thread exposure (37.7%) and implant proximity to the maxillary sinus (27.7%). Statistical analysis revealed significant correlations between implant positioning errors and anatomical location, underscoring the need for meticulous preoperative planning and advanced imaging. While factors such as patient age, implant length, and diameter were analyzed, no statistically significant differences were found in error prevalence based on sex or demographic variables. Conclusions: This study highlights the importance of combining clinical expertise with advanced imaging modalities like CBCT to minimize implant positioning errors and improve patient outcomes. Future research should focus on refining surgical techniques and evaluating the impact of the implants’ design and patient-specific factors on the accuracy of placements.

This report presents a two-stage approach for crestal sinus elevation using the osseodensification technique in a case of severe vertical bone deficiency (< 3 mm). Traditional approaches to maxillary sinus elevation with less than 3 mm of residual bone height typically require a lateral window technique. A 55-year-old male patient presented with a missing maxillary right first molar with residual bone height of 2 mm. The treatment involved: Stage 1: Crestal sinus elevation using osseodensification with Versah burs and allograft placement. Stage 2: After 6 months of healing, placement of a Straumann Bone Level Tapered implant (4.1 × 10mm) with 35 Ncm insertion torque and final prosthetic restoration was started 4 months after implant placement. Then, follow-up at 12 months demonstrated stable peri-implant tissues, maintained bone levels, and excellent patient satisfaction. Radiographic evaluation showed uniform bone formation around the implant and maintained sinus floor elevation. The case demonstrates that osseodensification can provide a predictable alternative to lateral window approaches even in cases with severe vertical bone deficiency (< 3 mm), offering reduced invasiveness with enhanced bone density and favorable clinical outcomes.

Background/Objectives: This study aimed to determine the prevalence of aphthous ulcers following periodontal surgery and to identify demographic, behavioral, and clinical predictors of ulcer history before surgery and ulcer development after surgery. Methods: A cross-sectional study was conducted among 227 adult patients undergoing periodontal surgical procedures between November 2024 and May 2025. Demographic, medical, behavioral, and oral health data were collected. Postoperative follow-up at 1 and 2 weeks included a standardized clinical assessment of aphthous ulcers. Statistical analyses included descriptive statistics, chi-square tests, and Chi-squared Automatic Interaction Detection (CHAID) decision tree modeling. Results: Aphthous ulcers developed in 47 patients (20.7%), predominantly within the first postoperative week. CHAID analysis identified age, marital status, and smoking as predictors of preoperative ulcer history (classification accuracy: 73.6%), whereas age and family history predicted postoperative ulcer development (79.4%). Periodontal procedure type was significantly associated with postoperative medication prescription (χ² = 300.45, p < 0.001), suture selection (χ² = 69.19, p = 0.024), and ulcer number (χ² = 48.43, p = 0.031), but not ulcer size or anatomical location. Most ulcers were minor and primarily involved the buccal mucosa. Conclusions: Postoperative aphthous ulceration is a common complication of periodontal surgery, affecting approximately one-fifth of patients. Distinct risk profiles for pre- and post-surgical ulceration highlight the roles of patient-related susceptibility and surgical complexity. These findings support the use of structured risk stratification to guide preoperative counseling and targeted postoperative management.