The purpose of the present study was to evaluate the histological and histomorphometric characteristics of post-extraction sites grafted with decellularized bovine compact bone from bovine femur, mixed and unmixed with leukocyte- and platelet-rich fibrin after four months of healing. This study was designed as a randomized controlled trial of parallel groups. Patients in need of a single, implant-supported restoration to replace a hopeless tooth were recruited for tooth extraction and implant placement four months after socket preservation procedure. After tooth extraction, patients were randomly allocated to receive decellularized bovine compact bone from bovine femur, mixed and unmixed with leukocyte- and platelet-rich fibrin. After four months of healing, tapered implants were inserted with an insertion torque between 35 and 45 Ncm. Two months later, implants were loaded with screw-retained definitive crowns. Outcome measures were implant (ISR) and prosthesis (PSR) survival rates, complications, histological and histomorphometric analyses, radiographic marginal bone-level changes, and patients’ satisfaction. Clinical data were collected up to one year after tooth extraction and socket preservation procedures. Thirty patients were consecutively enrolled in the trial (15 in each group). Unfortunately, due to the COVID-19 pandemic, bone samples were collected only in 19 patients. Two implants failed before definitive prosthesis delivery (ISR 93.3%). No prosthesis failed (PSR 100%). Three complications were experienced in the control group. The mean bone percentage was 40.64 ± 18.76 in the test group and 33.40 ± 22.38 in the control group. The difference was not statistically significant (p = 0.4846). The mean soft tissue percentage was 32.55 ± 19.45 in the test group and 55.23 ± 17.64 in the control group. The difference was statistically significant (p = 0.0235). The mean residual graft was 24.59 ± 18.39 in the test group and 11.37 ± 12.12 in the control group. The difference was not statistically significant (p = 0.0992). Mean marginal bone loss, as well as patient satisfaction, showed no differences between groups. With the limitations of the present study, socket preservation with L-PRF mixed with decellularized bovine compact bone demonstrated favorable results, comparing with decellularized bovine compact bone from bovine femur alone. Further studies with larger sample size and longer follow-up are needed to confirm these preliminary results.

Background/Objectives: Obstructive sleep apnea syndrome (OSAS) is a global condition usually associated with poor health. While common, it appears underdiagnosed due to repeated episodes of upper airway obstruction during the sleep cycle. It is accompanied by other health risks like cardiovascular issues and conditions. Identifying craniofacial characteristics linked to OSAS may enhance diagnostic precision and treatment planning. The aim of our study was to examine the relationship between cephalometric variables and OSAS and determine whether craniofacial features influence the syndrome’s development and severity. Methods: Thirty participants were split into two groups: 15 diagnosed with OSAS and 15 controls. Cephalometric evaluations were performed using standardized lateral imaging, with craniofacial, dental, and hyoid bone parameters assessed. Statistical analysis compared these variables between groups to identify significant differences. Results: OSAS patients exhibited significantly shorter maxillary and mandibular lengths, increased anterior facial height, and reduced posterior facial height compared to controls. Dental analysis revealed reduced interincisal angles and lower mandibular incisor positions in the OSAS group. The hyoid bone was positioned lower and more posteriorly in OSAS patients, with significant differences in its distance to the C3 vertebra and mandibular plane. Although the soft palate dimensions were larger in OSAS patients, the differences were not statistically significant. Conclusions: OSAS is associated with distinct craniofacial features, including shorter maxillary and mandibular lengths, altered facial height proportions, and lower hyoid bone positioning. These findings suggest that craniofacial morphology plays a significant role in OSAS pathophysiology. Future studies hinting at three-dimensional imaging could provide deeper insights into these associations.

Background: Craniofacial clefts represent the most common congenital malformation in the head and neck region. Although most patients undergo primary cleft repair in childhood, many still present midfacial growth deficiencies in adulthood. This study aimed to evaluate and compare the incidence and indications for orthognathic surgery in adult patients with cleft lip (CL), cleft lip and alveolus (CLA), cleft lip and palate (CLP), and isolated cleft palate (CP). Materials and Methods: Sixty adult cleft patients (36 males and 24 females) born with a cleft and with a mean age of 19.51 ± 1.83 years were retrospectively enrolled in this study. All patients had undergone primary lip and palate repair during childhood at the Oral and Maxillofacial Surgery Service of “Mother Teresa” University Hospital Centre in Tirana. Clinical records, orthodontic documentation, and cephalometric data were reviewed to determine the indication for orthognathic surgery. Results: The statistical analysis showed that orthognathic surgery was deemed necessary in 30% patients, including ten males (56%) and eight females (44%). The most prevalent type of cleft was CLP, accounting for 35% of all patients, and it showed the highest surgical indication rate (83.3%). Cleft patients and the need for orthognathic surgery were evaluated according to the skeletal malocclusion in three planes. The need for surgery was more prevalent in patients with skeletal class III malocclusion with maxillary hypoplasia (83.3% of surgical cases), those with anterior and posterior crossbite (21.7% of all patients), and in deep bite patients (16.7% of all patients). Additionally, all patients with facial asymmetry (15%) required orthognathic surgery, highlighting the strong association between asymmetry and surgical indication. Conclusions: Patients with craniofacial cleft, especially those with CLP and combined maxillary deficiencies, demonstrate a significantly higher need for orthognathic surgery. Quantitative assessment supports the necessity of a multidisciplinary treatment approach to address persistent skeletal discrepancies and optimize functional and aesthetic outcomes in adult cleft patients.

Background/Objectives: Multilayer zirconia restorations can feature a shade gradient or a strength gradient, with layers differing in color or phase composition within the same material. The aim of this in vitro study was to evaluate the color stability in all layers of multilayer zirconia after exposure to staining solutions and artificial aging. Methods: Square-shaped specimens (N = 120) of color A2 were fabricated from 4Y-PSZ and 3Y/4Y-PSZ multilayer zirconia—Katana STML, DD Cube One ML, and Katana YML—and their baseline color values (T0) were measured with a clinical spectrophotometer (VITA Easyshade V). The specimens were randomly divided into four groups (n = 10/gp) and immersed in physiologic solution, 0.2% chlorhexidine gluconate (CHX) mouth rinse, and staining coffee solution. Then, they were measured continuously for 7 (T1), 14 (T2), and 21 days (T3). The last group of specimens underwent accelerated aging in a steam autoclave at 134 °C and 2 bar pressure and measured after 1 (T1), 3 (T2), and 5 h (T3). After the immersion process and artificial aging, discoloration values (ΔE) were calculated using the formula ΔE = [(ΔL*)² + (Δa*)² + (Δb*)²]^1/2 and analyzed with the SPSS v 23.0 software with a p value < 0.05. Results: All specimens showed significant color differences in the T3 measurements after exposure to coffee and CHX, with the highest ΔE values in the enamel layers. Katana YML showed the most significant differences in ΔE in the cervical layers after exposure to artificial aging. Conclusions: Multilayer zirconia exhibited dependent optical changes, with the enamel layers being the most affected after exposure to staining solutions. Gradient pigmentation and differences in phase composition caused differences in color to the multilayer zirconia layers after exposure to staining solutions and artificial aging.

Background: Congenital tooth agenesis is a common dental anomaly in individuals with orofacial clefts and may be related not only to cleft type but also to skeletal growth characteristics. This study aimed to investigate whether the number of congenitally missing permanent teeth is associated with cleft type, sex, and sagittal and vertical skeletal patterns in non-syndromic cleft patients. Materials and Methods: A retrospective cross-sectional analysis was conducted on 60 patients aged ≥17 years (36 males, 24 females; mean age 19.5 ± 1.8 years) with surgically repaired cleft lip and/or palate, based on clinical records collected over a long-term follow-up period. Sagittal (Class I, II, III) and vertical (normal, deep bite, open bite) skeletal patterns were extracted from available orthodontic records based on routine cephalometric assessment. The number of congenitally missing permanent teeth, excluding third molars, was recorded. Statistical analysis included non-parametric tests and Poisson regression. Results: The distribution of missing teeth deviated significantly from normality according to the Shapiro–Wilk test (p < 0.001). In the Poisson regression model, sex (p = 0.011) and cleft type (p < 0.001) were significantly associated with the number of congenitally missing teeth, whereas sagittal skeletal pattern (p = 0.338) and vertical skeletal pattern (p = 0.281) were not significant predictors. Conclusions: In this retrospective record-based analysis, the number of congenitally missing teeth appeared most consistently associated with cleft type, while sex showed a model-dependent association in the adjusted regression analysis.

Background: Sleep apnea is a breathing affliction that affects sleep quality, with significant implications for overall physical and oral health, as well as mental health. Aim: The aim of this study was to evaluate the validity of the STOP-Bang and Epworth questionnaires as preoperative screening tools for obstructive sleep apnea (OSA) in the adult population from the NE region of Romania. Materials and Methods: A total of 222 participants were selected. The questionnaire method was used, with the subjects completing the STOP-Bang and Epworth questionnaires. A chi-squared test, an ANOVA, and Student’s t-tests were used for the statistical analysis. Results: the STOP-Bang questionnaire revealed an increased risk of OSA among those with a high BMI, an age over 50 years, or a large neck circumference. Regarding the Epworth questionnaire, daytime sleepiness was more frequent among obese individuals and those with associated pathologies. Significant correlations were found between OSA and obesity, age, and associated pathologies, with limited observations on the influence of gender on the risk of OSA. Conclusions: The studied questionnaires are effective and easy-to-use tools for the preoperative screening of OSA, demonstrating a significant correlation between the identified risk factors and the disease severity.