Background/Objectives: The management of edentulism and severe alveolar bone loss in older adults remains a significant challenge in implant dentistry. Given the potential biological and therapeutic burden associated with extensive regenerative procedures, increasing interest has been directed toward treatment strategies that utilize available anatomy and reduce surgical complexity. This narrative review examined contemporary augmentation-avoidance approaches for implant rehabilitation in geriatric patients. Methods: A structured narrative literature search was performed in PubMed/MEDLINE, Scopus, and Web of Science, including studies published up to 30 May 2026. Clinical studies, systematic, umbrella and narrative reviews, meta-analyses that evaluate augmentation-avoidance approaches in implant dentistry were considered. The review examined evidence relevant to older adults, including clinical, prosthetic, functional, and patient-centered outcomes. Results: The available literature describes multiple strategies for managing reduced bone availability, including short and ultra-short implants, narrow-diameter implants, tilted implant concepts, pterygoid and trans-sinus implants, zygomatic implants, immediate loading protocols, flapless and computer-guided surgery, and implant-retained overdentures. These approaches have broadened the range of treatment options available for patients with reduced bone availability and may reduce the need for extensive regenerative procedures in selected clinical situations. In addition to implant and prosthetic outcomes, increasing attention has been directed toward oral health-related quality of life, masticatory function, treatment satisfaction, and maintenance requirements. However, evidence specifically focused on geriatric populations remains limited. Conclusions: Contemporary implant dentistry offers several alternatives to extensive bone regeneration in carefully selected geriatric patients, although current evidence is largely extrapolated from mixed adult populations. Treatment planning should integrate anatomical conditions with systemic health, functional status, frailty-related factors, and long-term maintenance considerations. Further geriatric-focused research is needed to support patient-centered decision-making and optimize long-term rehabilitation outcomes in aging populations.

Background/Objectives: Antibiotic prescribing remains common in oral surgery and implant dentistry, although indications, regimens, and supporting evidence vary across procedures and patient populations. This comprehensive narrative review evaluated prophylactic and therapeutic antibiotic use within an antimicrobial stewardship framework and examined the transition from procedure-based prescribing toward risk-adapted decision-making. Methods: PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to 15 September 2026 using a structured modular strategy, complemented by reference-list screening and targeted searches. Evidence addressing clinical indications, antimicrobial regimens, patient-related factors, antibiotic-related harms, resistance, microbiome and resistome alterations, antibiotic-sparing approaches, and stewardship was qualitatively synthesized. Study selection was independently performed by two reviewers, and extracted information was cross-checked. Results: Antibiotic benefit varied across clinical indications. Prophylaxis reduced selected postoperative outcomes in third-molar surgery and conventional implant placement, whereas evidence was less certain for reconstructive procedures and medically complex patients. Routine postoperative continuation did not provide a consistent additional benefit across several surgical settings. Patient vulnerability alone did not establish greater prophylactic benefit, while preventive indications differed according to the complication addressed. Adverse drug reactions, resistance selection, and microbiome and resistome alterations broadened the consequences relevant to antimicrobial exposure. Stewardship interventions improved prescribing outcomes, although evidence concerning appropriateness and longer-term outcomes remained limited. Conclusions: Antibiotic prescribing should be guided by indication and expected clinical benefit rather than by procedural complexity or patient vulnerability alone. Risk-adapted decision-making can support proportionate antimicrobial exposure while remaining anchored to indication-specific evidence and established clinical guidance.