Background: Implant-prosthetic therapy requires a detailed assessment of the bone structure before designing a personalized treatment plan. Tooth extraction at the molar level is followed by a series of bone changes dependent on the patient’s general condition and age and the area in which it was performed. The fractal analysis of cone beam computed tomography (CBCT) represents a way to assess the quality of post-extraction bone regeneration. The purpose of this study was to analyze the alveolar bone changes after tooth extraction using fractal analysis on CBCT images. Methods: This retrospective study included pre- and post-extraction CBCTs at 3 months of 60 patients who underwent 100 extractions of first and/or second molars. Fractal analysis on CBCT images was performed using ImageJ, and the data obtained from the measurements were statistically processed. A multiple regression model was used to assess factors influencing bone remodeling. Results: Fractal analysis performed on CBCT images showed that most patients experienced advanced bone remodeling, this being more pronounced in those from rural areas, in the vertical plane at the mandible and at the second molar. The multiple regression model showed that the factors that play an important role in predicting bone resorption are represented by age group (age above 56 years old is associated with less bone resorption), location (bone resorption is more pronounced at the mandible level), and molar (bone resorption for the second molar is higher). Conclusions: Post-extraction bone changes were influenced by the age of the patient and by the location of the extraction, with the maxilla and first molar having better fractal analysis values compared to the mandible and second molar. These results emphasize the importance of training implantologists in CBCT evaluation to improve personalized implant-prosthetic treatment decisions.

Background: Over time, numerous surgical procedures and biomaterials have been proposed for the reconstruction of post-extraction bone defects, each with their advantages and disadvantages. The main objective of this study was to evaluate dimensional changes in the alveolar bone 3 months after tooth extraction, before implant planning, comparing alveolar ridge preservation (ARP) with spontaneous healing. Methods: A total of 84 patients with non-restorable molars were included in the study. Forty-two patients received ARP with advanced platelet-rich fibrin (A-PRF) and spontaneous healing was evaluated in these patients. Cone beam computed tomography (CBCT) analysis performed before and after surgical intervention was used to determine the changes in vertical and horizontal bone dimensions produced after tooth extraction. Results: CBCT measurements showed reduction in both vertical and horizontal alveolar bone size in both groups. For the study group, the alveolar parameters (height, width) were higher compared to the control group. The percentage variations between dimensional differences from the two groups were 38.58% for height, and for width were 36.88% at 0 mm, 35.56% at 3 mm, 36.61% at 5 mm, and 38.73% at 7 mm. The differences were statistically significant (p ˂ 0.0005). Conclusions: The results obtained after ARP with A-PRF showed a reduced loss of bone volume compared to spontaneous healing.

(1) Background: Alveolar bone regeneration in dentistry has become important with the evolution of implantology. Biomaterials used for bone grafting are increasingly used to provide resistant bone support that is favorable for the insertion of dental implants. The aim of the study was to analyze the degree of biocompatibility and bone neoformation of two biomaterials compared to natural healing. (2) Methods: Bone defects of 3 mm diameter were created in the calvaria of 15 adult male Wistar rats. Three groups were created: group A, in which natural healing was achieved; group B, in which porcine xenograft was added; and group C, in which experimental synthetic bone based on hydroxyapatite reinforced with titanium particles was added. Samples were collected at 2 and 4 months postoperatively and analyzed microscopically and histologically. (3) Results: Data were obtained on the healing pattern of the created cavities, as well as the degree of their filling with newly formed bone tissue. Following the results obtained from the stereomicroscope analysis and histological analysis, statistically significant differences were observed between the two biomaterials regarding the time required for the transformation process of the graft particles into bone. Thus, the porcine xenograft was incorporated more quickly into the native bone, while the synthetic bone required a longer period of time. (4) Conclusions: The bone graft materials used acted as scaffolds for the newly formed bone, but each biomaterial required a different amount of time for the particles to be incorporated into the native bone.

Background/Objectives: The aim of the study was to determine the prevalence of molar absence and the need for limited preprosthetic orthodontic treatment in the situation of lateral molar edentulism in adult patients. Methods: The need for orthodontic treatment was studied retrospectively in a cohort of adult patients of both genders who presented for dental treatment at the Oral Rehabilitation Clinic of the University of Medicine and Pharmacy of Craiova. After applying the inclusion/exclusion criteria, the final study group consisted of 478 patients. The collected data were centralized in Microsoft Excel and statistical analyses were performed using SPSS software version 26. Results: The results of the study showed that more than 50% of adult patients need orthodontic treatment. The patients with the greatest need for orthodontic treatment also had a higher DMFT (p < 0.0005), indicating a higher need for dental caries treatment, as well as prosthetics of edentulous areas. The prevalence of molar edentulism was 57.31%. The acceptance of the treatment plan was inversely proportional to the need for orthodontic treatment. Tooth wear (p < 0.0005) and maxillary edentulism (p = 0.002) significantly contributed to a higher DAI. Conclusions: The need for orthodontic treatment increases with age, but the acceptance of oral rehabilitation plans that include orthodontic treatment is low. Better interdisciplinary collaboration is needed to ensure that adult patients benefit from the best treatment options.