Objectives: This study aimed to assess the systemic and local inflammatory responses in patients with periimplantitis, focusing on key immune markers and clinical parameters. The study further explores the relationship between inflammatory markers, clinical indices, and immune dysregulation, particularly regarding T-cell exhaustion and systemic inflammation. Methods: A cohort of patients with periimplantitis, classified into moderate and advanced stages, was compared to a control group of healthy individuals with dental implants. Clinical parameters, including plaque index (API), bleeding on probing (BoP), probing pocket depth (PPD), and peri-implant sulcus depth (PSI), were recorded. Hematological, immunological, and biochemical analyses were performed, with a focus on immune cell populations (NK cells, T-cells, and their exhaustion markers PD-1 and PD-L1). Results: Patients with periimplantitis exhibited significantly higher clinical indices (API, BoP, PSI, and PPD) than the control group, with the most pronounced differences in the advanced periimplantitis group. Hematological analysis revealed increased leukocyte and neutrophil counts, whereas NK cell levels were significantly reduced. Immunological profiling indicated elevated PD-1 and PD-L1 expression on T-cells, suggesting T-cell exhaustion and immune dysregulation. Furthermore, strong correlations were found between increased PPD values and elevated inflammatory marker levels, highlighting the relationship between peri-implant pocket depth and systemic inflammation. Conclusions: The findings confirm that immune dysregulation plays a central role in periimplantitis progression. The association between increased inflammatory markers, immune alterations, and clinical indices emphasizes the need for a multifactorial diagnostic and treatment approach. Integrating immune modulation strategies, clinical assessments, and lifestyle modifications, such as improved oral hygiene and smoking cessation, could improve disease management and reduce recurrence.

Objectives: Cone-beam computed tomography (CBCT) is central to three-dimensional assessment in oral surgery and implant dentistry; however, CBCT-derived gray values expressed as HU-like units are not equivalent to true CT-derived Hounsfield Units (HU). This brief methodological secondary analysis evaluated the reliability and practical limitations of such values in assessing radiographic changes after peri-implantitis surgery. Methods: The analysis used the imaging protocol and group-level radiological data from a previously published prospective clinical cohort, conducted under the same protocol and ethical approval of the Institutional Ethics Committee of the Medical University of Lublin (KE-0254/248/11/2023; 23 November 2023). The source cohort included 57 patients treated after implant removal for severe peri-implantitis with small-particle dentin (n = 22), Bio-Oss (n = 15), or spontaneous healing without grafting (n = 20). CBCT scans were analyzed in OnDemand3D (version 1.0.11.1007) using manually selected square regions of interest (ROI; 30 × 30 pixels). No external phantom calibration, cross-device normalization, or formal intra-/inter-observer reproducibility assessment was available in the secondary dataset. Results: The previously reported mean study-site values were 779.62 ± 325.92 gray-value units for small-particle dentin, 910.51 ± 155.03 gray-value units for Bio-Oss, and 206.04 ± 174.21 gray-value units for controls. These findings are presented as protocol-dependent attenuation patterns, not as direct material rankings, bone-density thresholds, or proof of regeneration. Variability remained substantial, with study-site coefficients of variation of 41.8%, 17.0%, and 84.6%, respectively, and high adjacent-site variability. Interpretation was constrained by manual ROI placement, lack of calibration, absence of observer-agreement metrics, unequal follow-up timing, and CBCT sensitivity to scatter, beam hardening, field of view, reconstruction settings, and metal-related artifacts. Conclusions: CBCT-derived gray values may be useful as relative indicators of local radiographic attenuation change within a standardized protocol, but they should not be interpreted as absolute measures of bone density. Future regenerative oral surgery studies should combine standardized acquisition, explicit ROI methodology, repeated measurements, observer-agreement analysis, and complementary clinical, radiographic, or histological outcomes.

Primary implant stability arises from mechanical engagement at placement, and insertion torque is not a direct measure of osseointegration. This retrospective single-centre study included 101 MultiNeO titanium implant placements in 55 adults treated between April 2023 and January 2026. Four experienced operators placed implants subcrestally using a W&H Implantmed SI-1023, a bone-resistance-adapted drilling protocol, and a programmed target of 35 N·cm. Associations with recorded torque were assessed using a patient-clustered Gaussian generalized estimating equation adjusted for sex, age, anatomical sector, implant length and diameter, hard-tissue augmentation, and placement timing. The mean torque was 31.63 ± 5.57 N·cm; the median was 35 N·cm (Q1–Q3, 30–35). Recorded torque was 3.25 N·cm higher for implants placed in women than for those placed in men (95% CI 1.20–5.31; p = 0.002). Relative to maxillary anterior/premolar sites, mandibular molar sites showed higher torque (β = 4.02; p = 0.001), whereas mandibular anterior/premolar sites showed lower torque (β = −5.41; p = 0.013). Implant length had a modest adjusted association (β = 0.93 N·cm/mm; p = 0.022); age, diameter, augmentation, and placement timing did not. The concentration of recorded values at 35 N·cm reflects a clinical target rather than the device limit. These exploratory associations do not establish an intrinsic sex effect or predict osseointegration, and residual confounding due to unmeasured bone characteristics remains possible.