Background: Dental implants have become the standard for replacing missing teeth. However, patients’ demands for shorter treatment times and the desire for aesthetics in their results can complicate the rehabilitation process, particularly when poor-quality bone is involved. In order to address these challenges, new methods of treating implant surfaces have been introduced. These methods aim to make the implants superhydrophilic and bioactive, enhancing their functionality and interactions with the surrounding tissues. Aim: The aim of the study was to retrospectively examine the efficacy of a superhydrophilic and bioactive implant for treatment of the edentulous maxillary anterior area. The study also aimed to evaluate whether this improved implant surface, by enhancing the osseointegration processes, could serve as a factor in speeding up the loading protocols. Materials and Methods: For this retrospective study, a total of 13 implants were included: 6 delayed restored implants and 7 immediately loaded implants placed in the anterior maxillary area. Clinical, radiographic, and esthetic outcomes were assessed. Baseline measurements of the insertion torque value (ITV) and stability implant quotient (ISQ) were recorded for all implants. In the early-loaded group, these measurements were also taken 30 days (t30) and 45 days (t45) after the placement of the implant to monitor their changes over time. Marginal bone loss (MBL) was calculated according to the changes in marginal bone level on intraoral X-rays taken at two different time points: at baseline and one year after loading. To evaluate the esthetic results, the pink esthetic score (PES) and the white esthetic score (WES) were assessed. For this evaluation, intraoral photographs were taken one year after implant loading. Results: A total of 7 implants were immediately restored, with a mean ITV of 32.29 ± 9.01 Ncm and a mean ISQ of 72.71 ± 2.81. These implants were placed in a bone environment with a mean density of 410.00 ± 194.42 HU. On the other hand, 6 implants with delayed loading had a mean ITV of 28.50 ± 3.27 Ncm, an ISQ of 67.92 ± 8.43, and a mean bone density of 607.50 ± 140.83 HU. The mean PES and WES after 1 year were, respectively, 8.71 ± 1.89 and 8.57 ± 0.79 for immediate and 8.33 ± 1.36 and 9.17 ± 1.33 for delayed-loaded implants. At 12 months after loading, the immediately loaded group had a MBL of 0.29 ± 0.29 mm, while the delayed-loaded group had a MBL of 0.33 ± 0.25. No statistically significant differences between the two treatment groups were found for any of the evaluated outcomes. Conclusions: Despite the limitations of this study, the obtained results may support the use of a superhydrophilic and bioactive implant surface for implant-prosthetic rehabilitation in critical loading protocols with satisfactory esthetic results.

Background: Due to the lack of data on bone-to-graft contact (BGC) over time in the various regions within the subantral space of the augmented sinus floor, the present study aimed to evaluate the osteoconductivity of deproteinized bovine bone mineral (DBBM) with granules of different sizes applied in maxillary sinus floor elevation. Methods: A maxillary sinus augmentation was performed bilaterally in 18 rabbits using DBBM with particle dimensions of either 0.125–1.0 mm or 1–2 mm. The antrostomy was covered using a collagen barrier. The animals were euthanized in groups of six after 2, 4, and 8 weeks of healing. MicroCT and histological analyses were performed. Results: After 2 weeks of healing, BGC was 10.9% and 11.9% for the small and large granule sites, respectively. After 8 weeks of healing, the BGC increased to 65% and 62% at the small and large granule sites, respectively. The highest values were located close to the bony walls and the bony window. New bone content developed between 2 and 8 weeks from 7.0% to 27.6% and from 6.1% to 27.6% at the small and large granule sites, respectively. Conclusions: Similar outcomes in osteoconductivity and bone formation were found at both small and large DBBM granule sites.

Background: The Schneiderian membrane (SM) that is in contact with biomaterial granules may become thinner and eventually perforate. It has been shown that these events are related to the biomaterial used. Hence, the main aim of the present study was to compare the damaging effects of two xenografts with different resorbability rates on SM. The secondary aim was to evaluate the possible protection from damage offered by a collagen membrane placed adjacent to the SM and by inward displacement of the bone window with the SM during elevation. Methods: Thirty-six albino New Zealand rabbits underwent bilateral sinus elevation. One group of 18 animals received deproteinized bovine bone mineral (DBBM group) and the other received swine-collagenated corticocancellous bone (collagenated group). Moreover, in the DBBM group, the bone window was displaced inward during elevation in one sinus together with the SM. In the collagenated group, a collagen membrane was placed adjacent to the SM in one sinus. Six animals were assessed per period after 2, 4, and 8 weeks. Results: The mean pristine mucosa width ranged between 67 µm and 113 µm, and none had a width of <40 µm. In the 2-week group, the elevated mucosa of the DBBM group presented 59 thinned sites and five perforations, while in the collagenated group, 14 thinned sites and one perforation were observed. Damage to SM decreased in number in the 4-week treatment group. In the 8-week group, the number of thinned sites in the DBBM group increased to 124, and the perforations to 8. In the collagenated group, 7 thinned sites and 1 small perforation were observed. Conclusions: More damage to the Schneiderian membrane was observed in the DBBM group than in the collagenated group. The presence of the inward bone window offered protection from damage to the Schneiderian membrane.

(1) Background: Different techniques and tools have been developed for implant site preparation. In this clinical scenario, Hybrid Funnel Technique (HFT), a novel osteotomy procedure, has been proposed. (2) Aim: The aim of this retrospective observational study was to consider the different responses to compression of the histological bony compartments (cancellus and cortical). HFT involves the use of multiple drills for the cortical layer preparation and of an osteotome for the osteocompaction of the cancellous bone. (3) Materials and Methods: Following computer-supported implant planning and guided surgery, 10 osteotomies with HFT were performed and 10 implants with the same length and diameter were placed in seven healthy and no daily smoking patients. Periapical X-ray and intraoral photographs were performed at baseline and after 12 months of follow-up to evaluate marginal bone level (MBL) changes and aesthetic results obtained from implant prosthetic rehabilitation. (4) Results: At 1 year of follow-up, 100% of the implants were successfully integrated, MBL change mean value was 0.17 mm ± 0.21. No differences in terms of MBL were noted between thin and thick biotypes. Pink esthetic score (PES) and white esthetic score (WES), assessed one year after definitive restoration placement, were 7.5 ± 2.3 and 8.5 ± 1.1, respectively. (5) Conclusions: Based on the findings of this preliminary clinical study, HFT has led to stability of peri-implant tissues and could represent a reliable technique for surgical preparation of the implant site.

Background: It has been shown in rabbit models that the sinus mucosa in contact with graft particles might experience a progressive thinning and perforations. The phenomenon depends on the graft used. Hence, the aim of the present study was to compare the damaging effects of a synthetic of a xenogeneic graft. Methods: Forty New Zealand rabbits received a bilateral sinus elevation. Both sinuses of twenty rabbits were grafted with a biphasic 60% hydroxyapatite and 40% β-tricalcium phosphate while the other twenty received a deproteinized bovine bone mineral graft. Thinned sites (<40 µm) and perforations on the mucosa in contact with graft particles were evaluated after 2 and 10 weeks (ten animals each period). The width of the pseudostratified epithelium was also measured as control. Results: After 2 weeks of healing, 61 thinned sites were detected in the Synthetic group and 49 in the Xenogeneic group. After 10 weeks, the number of thinned mucosae increased to 79 sites in the Synthetic group (p = 0.222 between periods), and to 114 sites in the Xenogeneic group (p = 0.030 between groups; p = 0.001 between periods). Perforations were few in the 2-week period, two in two sinuses out of 20 in the Synthetic group, and four in two sinuses out of 20 in the Xenogeneic group (p = 0.721). In the 10-week period, the perforations increased to eight in the Synthetic group, distributed in six sinuses out of 20, and to sixteen in the Xenogeneic group, distributed in 11 sinuses out of 20 (p = 0.082). The pseudostratified epithelium presented a reduced width at the thinned sites. Conclusions: The contact with synthetic or xenogeneic grafts will induce thinning and possible perforations of the sinus mucosa. This effect will increase over time, and it is stronger at the xenogeneic than the synthetic graft.

Background: This study aimed to evaluate the biological behavior of a novel implant design incorporating decompressive cervical blades. Hence, the aim of the present study was to evaluate the healing outcomes in cortical regions where decompressive protocols were implemented using implants equipped with blades and installed applying a bicortical anchorage. Materials and Methods: Blades with varying diameters were integrated into the coronal portion of the implant to prepare the cortical region of rabbit tibiae. The blade diameters differed from the implant collar by the following amounts: control group (0 µm), +50 µm, and +200 µm. Results: No marginal bone loss was detected. Instead, all implants exhibited new bone formation in the coronal region. Complete closure was observed in the CG-0 group, as well as in the TG-50 and TG-200 groups, despite the presence of marginal gaps without primary bone contact at installation. In the apical region, most implants breached the cortical layer. Nevertheless, new bone formation in this region completely closed the osteotomy, effectively isolating the internal environment of the tibia from the external. Conclusions: The use of a blade incorporated into the implant body enabled precise preparation of the cortical layer, allowing for controlled decompression in the targeted area. This technique resulted in optimal osseointegration with no loss of marginal bone, and complete restoration of marginal gaps ranging from 0 µm to 200 µm.