Objective: A peri-implant gap or a “jumping gap” between an implant surface and the buccal bone can often complicate the successful integration of dental implants, impairing osseointegration and long-term implant stability. Although various techniques and materials are available for managing this gap, there is no consensus on the most effective approach. The current literature lacks standardized, evidence-based guidelines for selecting the optimal technique or material for managing peri-implant gaps, especially following immediate implant placement. This systematic review aims to evaluate the efficacy of various techniques and materials to manage the peri-implant gap to improve the implant stability, bone preservation, and esthetic outcomes using the PROSPERO registration number CRD42024508852. Methods: A comprehensive search of the MEDLINE, Embase, and Cochrane databases was conducted, and various studies were selected, including 11 randomized clinical trials that investigated different grafting materials and techniques for managing the gap between the implant and the buccal plate. The selected studies were assessed for the risk of bias, and the data were extracted based on primary outcomes such as implant stability, bone density, and esthetic parameters. Results: The findings indicate that xenografts and alloplastic grafts were superior in preserving bone volume compared to platelet-rich fibrin. Techniques like the socket shield and immediate provisional prothesis methods showed promise in maintaining soft tissue and bone integrity. However, heterogeneity across the studies limits definitive conclusions. Conclusions: Further high-quality research is needed to establish standardized guidelines for peri-implant gap management. The selection of techniques and materials should be tailored to individual patient needs.

OBJECTIVE: To study the prevalence of different gingival biotypes in a sample of patients and the association between gingival biotype and different dental malocclusions. METHODS: Two hundred adult patients (100 males and 100 females) who presented for treatment at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia were recruited from February 2011 to February 2012. Gingival thickness was assessed for the maxillary central incisors using the transparency of periodontal probe technique. Angle9s classification of malocclusion and smoking habit were also recorded. RESULTS: The mean age was 32.1 (±11.0) years. Thin gingival biotype was observed in 44.5% of the sample, of which 64% were females and 25% were males (p=0.001). Only 31.4% of current smokers had thin gingival biotype compared to 51.9% of subjects who never smoked (p=0.011). No significant association between dental malocclusions and the presence of thin gingival biotype was found (Class I = 42.9%, Class II = 44.1%, and Class III 53.9%, p=0.6). CONCLUSION: A high prevalence of thin gingival biotype especially among females was observed. Smokers had thicker gingival biotype. No relationship was found between gingival biotypes and Angle9s classification of malocclusion.

Objectives: To examine ridge dimensional changes and histologic parameters of healing when ridge preservation (RP) was performed at molar sites using dense polytetrafluoroethylene (dPTFE) membrane alone, without a bone graft.Material and Methods: Eighteen patients had molar extraction and RP using dPTFE membrane alone. Ridge dimensions were measured using two standardized cone beam computerized tomography (CBCT) scans taken within 72 h and 3 months following extraction. Following a 3‐month healing period, an implant osteotomy was prepared using a trephine drill and bone cores were collected for histological analysis. Four‐arm analyses were performed using data from three previously published study arms of the same research group.Results: There was a significant change in the buccal ridge height between the four groups at all aspects of the socket. Alveolar ridge width reduction at 3 mm from crest for all aspects (mesial, midpoint, distal) of the socket showed statistically significant difference for dPTFE alone group compared to the other three groups. Percentage of vital bone formation (62.10%) was significantly greater in dPTFE alone group compared to the other groups.Conclusions: RP using dPTFE membrane alone in molar sites with intact socket walls showed successful outcomes in maintaining ridge dimensions and in histologic wound healing.

Shaimaa M. Al Harthi, BDS, MS/Thomas J. Prihoda, PhD/Brian L. Mealey, DDS, MS/David J. Lasho, DDS, MSD/Marcel Noujeim, DDS, MS/Guy Huynh-Ba, DDS, MS: Purpose: Ridge preservation limits dimensional changes after tooth extraction. However, it is still unclear if using a membrane may be advantageous over a collagen wound dressing. Therefore, the goal of this report was to evaluate the outcomes of ridge preservation using freeze-dried bone allograft with a collagen wound dressing. Materials and Methods: This study included 21 patients who had one molar extracted, and the site received ridge preservation using freeze-dried bone allograft and a collagen wound dressing (test 2 group). Patients had two standardized cone beam computed tomography (CBCT) scans, taken within 72 hours and 3 months after extraction, to measure changes in ridge height and width, and buccal and lingual plate thicknesses. Changes in keratinized tissue width were recorded. Three-arm analyses were performed using historic data from a previous randomized controlled trial by the same study group, in which 20 molar sites received a collagen wound dressing alone (control) and 20 received ridge preservation with freeze-dried bone allograft and a dense polytetrafluoroethylene membrane (test 1) using the same methodology. Results: There was a statistically significant difference in mean buccal ridge height changes between the control group (2.6 ? 2.06 mm) and test 2 group (1.55 ? 0.93 mm) but no difference in ridge and keratinized tissue width changes between groups. No correlation was found between buccal plate thickness and ridge width change. Conclusion: Freeze-dried bone allograft with collagen wound dressing as a barrier was used successfully for ridge preservation in intact molar extraction sites (< 50% bone loss) and can be considered as a treatment alternative to freeze-dried bone allograft with a dense polytetrafluoroethylene membrane.