Objectives: The purpose of this clinical study is to compare implant full-arch intraoral scans taken immediately after implant placement with those obtained after tissue healing in patients rehabilitated with implant-supported fixed prostheses. Methods: Between September 2023 and March 2024, a total of 19 patients with compromised residual dentition (6 women; 13 men) were rehabilitated using 4-to-6 immediately loaded post-extraction implants. These implants supported fixed full-arch screw-retained prostheses either in the lower jaw (9 patients) or upper jaw (10 patients). Intraoral scans were taken immediately after implant placement (termed “immediate scan”). After a healing period of four months, the provisional prosthesis was removed, and a second intraoral scan was performed using the same scan bodies and scan pattern as the initial scan (termed “delayed scan”). The two scans were overlaid, and the discrepancies between them were measured. Results: The average discrepancy between the immediate and delayed scans was 0.1905 mm. Our statistical analysis revealed larger discrepancies for implants placed in the posterior areas, with the implant in site 1.6 (Implant 1) showing a discrepancy of 0.2326 mm, and the implant in site 2.6 (Implant 4) showing a discrepancy of 0.2124 mm (p = 0.05). No statistically significant difference was observed when comparing patients treated in the upper and lower jaws. Conclusions: Within the limitations of the study and based on this result, clinicians should be aware that an immediate post-surgical intraoral digital scan for implant-supported full-arch rehabilitations may result in a higher risk of imprecision. Furthermore, according to the results of the study, the accuracy of the digital impression on implant full-arch rehabilitations seems to be influenced by the clinician’s skills. Further studies with larger sample sizes are required to confirm our results.

Objectives: Orthodontic patients are prone to developing gingivitis and require additional tools for maintaining oral hygiene and ensuring plaque control. The present study aimed to evaluate the effects of Bifidobacterium animalis subs. lactis HN019 on plaque accumulation and gingival bleeding in orthodontic patients. Materials and Methods: This study is a randomized, single-blind controlled trial. Orthodontic patients were grouped into two groups: subjects undergoing fixed orthodontic treatment and subjects undergoing treatment with a clear aligner. For each group, patients were divided into a test group (probiotic intake) and a control group (no probiotic intake). Patients took the probiotic for one month following a professional oral hygiene session, suspended its intake for 30 days, and then resumed it for another month. Full Mouth Plaque Score (FMPS) and Full Mouth Bleeding Score (FMBS) were collected at all timesteps. Results: In fixed orthodontics patients, the results show that the average FMPS improved at every timestep in both groups, especially for the test group, decreasing from 56.20 ± 27.7 to 36.47 ± 23.90. The data show a worsening FMBS during the period when patients do not take the probiotic, from 3.13 ± 3.50 to 6.53 ± 7.42. For the clear aligner patients, the comparison between groups suggests that the plaque index particularly improves for the test group during the period when patients are taking the probiotic, from 43.45 ± 19.52 to 25.93 ± 15.67 and from 26.60 ± 15.79 to 18.93 ± 17.99, respectively. For the bleeding index, data analysis shows a progressive improvement in FMBS at all timesteps in the test group, from 6.93 ± 7.00 to 2.60 ± 2.75. Conclusions: The intake of probiotics is useful in decreasing bacterial plaque accumulation and gingival bleeding in orthodontic patients.

Objectives: The study’s objective was to evaluate the accuracy of dynamic computer-assisted surgical implant placement systems during practical training on fresh defrozen cephali. Methods: Three defrozen cephali with terminal dentition received a total of 26 implants (15 4.3 × 13 mm and 11 4.3 × 13 mm, Nobel Biocare Service AG (Zrich-Flughafen Switzerland)) following a standardized protocol: a digital scanning and planning protocol followed by dynamic navigation surgery (X-Guide, X-Nav Technologies, LLC, Lansdale, PA, USA). All surgical interventions were performed by two surgeons: a senior oral surgeon (OE) with more than 5 years of implant dentistry experience and a non-experienced surgeon (NE). Results: Different linear and angular measurements (i.e., deviation shoulder point; deviation tip point; depth deviation shoulder point; depth deviation tip point; B/L and M/D angular deviations) were calculated in duplicate to estimate the discrepancy of the virtual digital planning with respect to the real clinical scenario. The differences between the two operators were also explored. The results of the bivariate analysis detected clinical negligible differences between the operators, without any statistically significant differences for all investigated parameters (p > 0.05). Conclusions: The preliminary positive findings of this pilot study suggest that the investigated dynamic navigation system could be a viable and safe technique for implant surgery and may offer additional safety benefits to non-experienced operators, despite the required learning.

To present a novel digital method to evaluate dynamic computer-assisted implant surgery (dCAIS) accuracy comparing digital implant planning to real implant position. Twenty patients in need of implant supported single unit-crowns (SUC), were consequently treated following a standardized digital protocol encompassing (1) a diagnostic digital intra-oral scan (IOS), (2) a cone beam computed tomography (CBCT), (3) 3D digital implant planning, (4) dynamic navigated implant placement (X-Guide, X-Nav Technologies, LLC, Lansdale, PA, USA) and (5) a post-operative IOS with the scan body in situ. Implant position accuracy was evaluated by superimposing the post-operative IOS with the pre-operative digital planning and calculating the resulting angular deviation (^o), global head deviation (mm) and global tip deviation (mm). From the original 30 installed implants, 29 could be analyzed. All surgical procedures were successfully completed without any complication. The calculated mean angular deviation was 4.50° ± 2.59°, while the mean deviation at the implant head was 1.18 ± 0.52 mm. Finally, the global tip deviation was 1.43 ± 0.78 mm. Flapless implant placement was significantly associated with a reduction in both head and tip linear deviations (p = 0.026; p = 0.007), as well as with a significant reduction in angular deviation (p < 0.001). Implants placed in the anterior region showed a mean statistically significantly higher deviation at the implant head compared to those in posterior sites (difference: 0.39 mm; p = 0.043). Despite its limitations, the proposed digital method does represent a promising and patient friendly approach to evaluate dCAIS accuracy. The proposed digital method represents a promising workflow for the evaluation of dCAIS implant placement avoiding the need of post-operative radiations.

Background/Objectives: The purpose of the study is to determine and compare the accuracy and efficiency of two dynamic navigation systems (DNS)—Navident (ClaroNav, Canada) and X-Guide (Nobel Biocare, Switzerland)—vs. a free-hand (FH) approach in performing endodontic microsurgery (EMS) on human cadavers. Methods: a total of 119 roots of six cadavers were randomly divided into three groups (Navident/X-Guide/FH). The cadavers’ jaws were scanned pre-operatively with computed tomography. The DICOM data were uploaded and digitally managed with software interfaces for registration, calibration, and virtual planning of EMS. Osteotomy was performed under DNS control and using a dental operating microscope (FH control group). Post-operative scans were taken with same settings as preoperative. Accuracy was then determined by comparing pre- and post-scans of coronal and apical linear, angular deviation, angle, length, and depth of apical resection. Efficiency was determined by measuring the procedural time of osteotomy, apicectomy, retro-cavity preparation, the volume of substance, and cortical bone loss, as well as iatrogenic complications. Outcomes were also evaluated in relation to different operators’ skill levels. Descriptive statistics and inferential analyses were conducted using R software (4.2.1). Results: DNS demonstrated better efficiency in osteotomy and apicectomy, second only to FH in substance and cortical bone loss. Both DNS approaches had similar accuracy. Experts were faster and more accurate than non-experts in FH, apart from resection angle, length and depth, and retro-cavity preparation time, for which comparison was not statistically significant. The Navident and X-guide groups had similar trends in increasing efficiency and accuracy of EMS. All complications in the FH group were performed by non-experts. The X-guide group demonstrated fewer complications than the Navident group. Conclusions: Both DNS appear beneficial for EMS in terms of accuracy and efficacy in comparison with FH, also demonstrating the decreasing gap of skill expertise between experts and novice operators. Through convenient use X-guide diminishes the level of iatrogenic complications compared to Navident.

Objectives: The purpose of this clinical study is to compare full-arch intraoral scans taken immediately after implant placement with those obtained after tissue healing in patients rehabilitated with implant-supported fixed prosthesis. Methods: Between September 2023 and March 2024, a total of 19 patients with compromised residual dentition (6 women, 13 men) were rehabilitated using 4 to 6 immediately loaded post-extraction implants. These implants supported fixed full-arch screw-retained prostheses in the lower jaw (9 patients) or upper jaw (10 patients). Intraoral scans were taken immediately after implant placement (termed ‘immediate scan’). After a healing period of four months, the provisional prosthesis was removed and a second intraoral scan was performed using the same scan bodies and scan pattern as the initial scan (termed ‘delayed scan’). The two scans were overlaid and discrepancies between them were measured. Results: The average discrepancy between the immediate and delayed scans was 0.1905 mm. Statistical analysis revealed larger discrepancies for implants placed in the posterior areas, with the implant in site 1.6 ( implant 1 ) showing a discrepancy of 0.2326 mm and the implant in site 2.6 (implant 4) showing 0.2124 mm (P = 0.05). No statistically significant difference was observed when comparing patients treated in the upper and lower jaws. Conclusions: Within the limitations of this study, overlapping digital scans of post-surgical and healed tissues revealed discrepancies that could be attributed to the more difficult conditions present in the post-surgical scenario or operator factors. Further studies are needed to assess the accuracy of post-surgical scans from a clinical point of view.