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In recent scientific literature, oral infections and systemic manifestations, or correlations between oral health and systemic diseases are a topic of discussion. Porphyromonas gingivalis is one of the bacteria implicated in the biofilm formation of bacterial plaque, and plays an important role in the progression of periodontal disease. In this systematic review authors have evaluated the literature of the last 10 years on P. gingivalis and all the systemic implications proven. This study therefore evaluates all the districts of the organism in which this bacterium may have implications. From the results it emerges that P. gingivalis has implications in the onset of different systemic pathologies, including rheumatoid arthritis, cardiovascular pathologies, and neurodegenerative pathologies. Surely, understanding the mechanisms of diffusion of this bacterium, it would be possible to prevent a series of pathologies. Thus, putting the dentist clinician at the center of prevention for these diseases.

Objective Implantology represents the gold standard for oral rehabilitation, unfortunately, often, despite there are no local contraindications to this type of rehabilitation, there are uncertainties regarding the general health of our patients. Many patients nowadays take bisphosphonate drugs, often without first seeking advice from an oral surgeon or a dentist. The purpose of this review is precisely to highlight any contraindications to this type of treatment reported in the literature, in patients who take or have taken bisphosphonate drugs. Methods For this study the scientific information sources were consulted using as search terms “(“bisphosphonate AND “dental implant”)”, obtaining 312 results, these were subsequently skimmed according to the inclusion and exclusion criteria, and further evaluated their relevance to the study and the presence of requested outcomes. Results Only 9 manuscripts (RCTs, Multicentric studies and Clinical Trials) were included in this review, as they respected the parameters of this review, they were analyzed and it was possible to draw important results from them. Surely from this study it is understood that the use of bisphosphonate drugs does not represent an absolute contraindication to implant therapy, it is evident how adequate pharmacological prophylaxis, and an adequate protocol reduce the risks regarding implant failures. Furthermore, the values of marginal bone loss over time seem, even if not statistically significant, to be better in implant rehabilitation with bisphosphonate drugs association. Only a few molecules like risedronate, or corticosteroids, or some conditions like smoking or diabetes have shown a high risk of surgical failure. Conclusion Although this study considered different studies for a total of 378 patients and at least 1687 different dental implants, showing better results in some cases for dental implant therapy in cases of bisphosphonate intake, further clinical, randomized and multicentric studies are needed, with longer follow-ups, to fully clarify this situation which often negatively affects the quality of life of our patients and places clinicians in the face of doubts.

Objective For severely atrophic alveolar ridges, block grafting procedures are usually decided to use for reliable results. Various intraoral donor sites for autogenous block graft are presented in the literature. However, vital anatomic structures can limit intraoral bone block graft surgeries, and they must be evaluated in detail. The aim of this study is to evaluate the dimensions and volume of the maximum potential symphysis block graft donor site and their relations to the anterior loop of mental foramen. Materials and methods According to inclusion criteria, 408 cone beam computed tomography (CBCT) images were evaluated. Mental foramen diameter, anterior loop length, the maximum potential symphysis graft dimensions (height, width, and length) and volume were measured. Results Prevalence of anterior loop of mental foramen was calculated 30.15% (123 patients) for right and 29.66% (121 patients) for left sides. The length of anterior loop of mental foramen was measured for right and left side 4.470 ± 1.355 and 5.223 ± 1.599, respectively. The maximum potential symphysis graft height, width, length, and volume were 13.253 ± 3.261 mm, 12.694 ± 1.711 mm, 34.353 ± 2.944 mm, and 3.102 ± 1.013 cm 3, respectively. Presenting anterior loop has no significant effect on the maximum potential symphysis graft height ( P  = 0.560) and width ( P  = 0.242). However, the maximum potential symphysis block graft length ( P  = 0.017) and volume ( P  = 0.026) were decreased by increasing number of anterior loops of mental foramen. Conclusion The mandibular symphysis bone block graft can be reliably selected as the donor site for a number of different augmentation procedures. However, there are restrictions owing to surrounding anatomical structures such as mental foramen and anterior loop. These vital structures should be considered using accurate CBCT evaluation. Presenting anterior loop of mental foramen is limiting symphysis bone block graft length and volume.

Objectives: Sinus floor elevation and augmentation surgery is widely used as a reliable procedure to increase insufficient bone height in the posterior maxillary area. The purpose of the present clinical study was to determine the associations between periodontal bone loss (PBL), maxillary sinus lateral bone wall thickness, age, and gender using cone-beam computerized tomography (CBCT). Materials and Methods: The current retrospective study consists of 716 maxillary sinus CBCT images of 358 patients. The CBCT scans were assessed to detect the relationship between lateral wall thickness and PBL. ANOVA and Student t test analysis were used to determine the influence of PBL on sinus lateral wall thickness. Results: Sinus lateral wall thickness was significantly associated with PBL (p < 0.05) at 3, 13, and 15 mm height. There was no significant association between lateral wall thickness and gender (p > 0.05). However, there was a significant association between lateral wall thickness at 3 and 13 mm and age (p < 0.05). There were significant associations between PBL and age (p < 0.001), and PBL and gender (p < 0.05). Conclusions: PBL might have an association with maxillary sinus lateral bone wall thickness. Further studies are needed to confirm this possible relationship.

The present study was designed to test the hypothesis that there would be a correlation between nasal septum deviation (NSD) and a decreased maxillary sinus volume (MSV) in a Colombian population, using Cone Beam Computed Tomography (CBCT); other sinusal anatomical structures found during the reading were described and analyzed. A retrospective analysis of 537 CBCT scans of adult patients taken between January 2014 and January 2017 included measuring the maxillary sinus diameter in the vertical, horizontal, and sagittal planes. NSD was quantified and related to MSV using the same field of view (FOV). The volume of the right and left maxillary sinuses showed a median and interquartile range (IQR) of 8.18 mm3 (IQR: 6.2–10.33) and 8.3 mm3 (IQR: 6.4–10.36). Statistically significant differences were observed between sex and right and left MSV (p = 0.000), with higher MSV in men. The presence of NSD was observed in 96.81% of the sample and was evaluated in degrees, observing a median of 11° (IQR: 7–16) where 40% of the sample had moderate angles (9–15°). There was no correlation between NSD and a decreased MSV in the population studied. Detailed CBCT analysis with a large FOV is crucial for the analysis of anatomical structures before performing surgical procedures that involve the MS as a preventive diagnostic and therapeutic step for appropriate treatment.

PurposeTo determine the shape, position, vertical height, surrounding bone characteristics, and opening angle of mental foramen (MF) using dental cone beam computed tomography (CBCT).MethodsA retrospective study was performed on 663 patients. CBCT records analyzed for the shape, position, and surrounding bone measurements of the MF using Simplant 3D software (Hasselt, Belgium). Opening angle of MF was also assessed. Kruskal–Wallis and Mann–Whitney U tests were employed to test significant differences between parameters, genders and ages.ResultsAll mental foramina were visualized. Regarding location, 49.2% of the MFs were located between first and second premolars, 7.7 distal and 39.7% coincident to the apex of the mandibular second premolar. The mean MF opening angle was 45.4° on the right side, and 45.9° on the left. There were no statistically differences between gender groups with regard to the opening angle degrees.ConclusionsThis study may provide useful information about variations in the position, shape and size, angle of mental foramen, which may help the practitioners to perform safer mental nerve blocks and surgical procedures.

Sufficient bone volume is necessary for placing a dental implant in an ideal position. To restore severely insufficient bone volume, autogenous block graft procedures with various intraoral donor sites are presented in the literature. The aims of this retrospective study are to present the dimensions and volume of the potential ramus block graft site, and to evaluate possible effect of mandibular canal diameter and its position in relation to mandibular ramus block graft volume. Two-hundred cone-beam computed tomography (CBCT) images were evaluated. The maximum length, width, height, and volume of the potential ramus block graft site, mandibular canal diameter, mandibular canal–mandibular basis distance, and mandibular canal–crest distance were measured. Mandibular canal diameter, mandibular canal–crest distance, and mandibular canal–mandibular basis distance were 3.139 ± 0.446 mm, 15.376 ± 2.562, and 7.834 ± 1.285 mm, respectively. In addition, the dimensions of the potential ramus block graft sites were measured 11.156 ± 2.297 mm × 10.390 ± 3.420 mm × 8.816 ± 1.720 mm (height × length × width). Moreover, the potential ramus bone block volume was calculated as 1.076 ± 0.398 cm 3 . While a positive correlation was detected between mandibular canal–crest distance and the potential ramus block graft volume ( r = .160, P = .025), a negative correlation was found between mandibular canal–mandibular basis distance and the potential ramus block graft volume ( r = −.020, P = .001). Mandibular ramus is one of the predictable intraoral donor sites for bone augmentation procedures. However, ramus has some volumetric limitations related to its neighboring anatomic structures. It seems to be important to evaluate lower jaw in a 3-dimensional manner to prevent surgical complications.

In recent years, implantology has made significant progress, as it has now become a safe and predictable practice. The development of new geometries, primary and secondary, of new surfaces and alloys, has made this possible. The purpose of this review is to analyze the different alloys present on the market, such as that in zirconia, and evaluate their clinical differences with those most commonly used, such as those in grade IV titanium. The review, conducted on major scientific databases such as Scopus, PubMed, Web of Science and MDPI yielded a startling number of 305 results. After the application of the filters and the evaluation of the results in the review, only 10 Randomized Clinical Trials (RCTs) were included. Multiple outcomes were considered, such as Marginal Bone Level (MBL), Bleeding on Probing (BoP), Survival Rate, Success Rate and parameters related to aesthetic and prosthetic factors. There are currently no statistically significant differences between the use of zirconia implants and titanium implants, neither for fixed prosthetic restorations nor for overdenture restorations. Only the cases reported complain about the rigidity and, therefore, the possibility of fracture of the zirconium. Certainly the continuous improvement in these materials will ensure that they could be used safely while maintaining their high aesthetic performance.

Background/Objectives: Accurate scientific methods are essential for monitoring the osseointegration of dental implants postoperatively. This study aims to evaluate peri-implant bone changes using the fractal analysis (FA) method during follow-up. Methods: Periapical radiographs were obtained from 77 patients with dental implants, and 33 permanent teeth serving as a control group, retrieved from the radiology archive. Radiographs were taken using the parallel technique at 3, 6, and 12 months post-surgery. All images were digitized and saved in TIFF. Each image was aligned using the TurboReg plugin in ImageJ software. Regions of interest (ROIs) were selected from the mesial and distal aspects of the implants, then prepared for fractal analysis. FA was performed to assess changes in bone structure over time. Results: In the study group, radiographs of 24 patients for 0, 3 and 6 month, radiographs of 34 patients for 0, 6 and 12 month, radiographs of 8 patients for 0 and 12 month, radiographs of 5 patients for 0 and 3 month, radiographs of 5 patients for 0 and 6 month, and 1 patient of 0, 3, 6 and 12 month of radiographs were used in the study. There were no statistically significant differences in FA values over time when analyzed by gender and age in both the study and control groups. However, a statistically significant difference was observed in FA value changes over time and jaws. Conclusions: The study indicates a positive correlation between bone remodeling over time and FA results, likely due to the restoration of masticatory forces in the implant area. Image analysis on two-dimensional dental radiographs can be a useful tool for detecting changes in bone density. Fractal analysis is a cost-effective and practical diagnostic method for monitoring bone changes over time.

INTRODUCTION Dental implants have become a highly successful and routine treatment for the loss of teeth, with implant survival rates reported as greater than 89% at 10-15 years of follow-up.1 Although the success rates of dental implants are high, several reports have demonstrated implant failures.2 The etiology and mechanism of implant failures are multifactorial and categorized as failures due to infection (ie, peri-implantitis or retrograde peri-implantitis), or failures due to trauma (ie, excessive overloading or implant fracture).3 Peri-implantitis is defined as ''an inflammatory process affecting the soft and hard tissues surrounding an osseointegrated implant resulting in rapid loss of supporting bone and associated with bleeding and suppuration. The underlying causes may include bacterial contamination during insertion, vascular impairment, overheating of bone during drilling, and vascular ischemia, all of which can result in bone loss around the apex of the implant.10 Other etiologic factors may include overdrilling of the site, implant surface contamination, preexisting bone pathology (bacteria, inflammatory cells, and/or remaining cells from a cyst, granuloma), the presence of root remainings, and implant placement close to an infected maxillary sinus.11 Sussman et al12 classified implant periapical lesions (IPLs) into 2 case types according to the main infection pathway: (1) implant to tooth, which occurs during osteotomy preparation either by direct trauma or indirect damage, causing the adjacent pulp to undergo devitalization; and (2) tooth to implant, which occurs shortly after implant placement when an adjacent tooth develops periapical pathology, either because of operative damage to the pulp or the reactivation of a prior apical lesion.