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Background/Objectives: Buffered local anesthetics are suggested to enhance patient comfort and anesthetic efficacy during dental procedures. However, their advantages over non-buffered solutions in maxillary third molar extractions remain under-investigated. This prospective, randomized, double-blind, split-mouth study aimed to compare the efficacy of buffered versus non-buffered 4% articaine in terms of pain, anesthetic onset, and the duration of anesthesia during maxillary third molar extractions. Methods: Each participant randomly received two buccal infiltrations on two single appointments to extract maxillary third molars: one with 4% articaine buffered with sodium bicarbonate and the other with non-buffered 4% articaine. Pain during injection, post-extraction pain, onset time, and the duration of anesthesia were assessed using a visual analog scale (VAS; 0–10). Results: Fifty adult participants (23 males and 27 females) with a mean age of 21.6 years were included in the study. Buffered 4% articaine significantly reduced injection pain (mean VAS: 3.12 ± 1.36 vs. 4.2 ± 0.3, p = 0.0001) and post-extraction pain (mean VAS: 4.4 ± 1.75 vs. 5.76 ± 1.78, p = 0.0002) compared to non-buffered articaine. Additionally, buffered articaine demonstrated a faster onset of anesthesia (mean time (seconds): 85.92 ± 27.37 vs. 126.86 ± 33.15, p < 0.0001) and a longer duration of anesthesia (mean duration (minutes): 70.4 ± 13.64 vs. 51.4 ± 7.2, p < 0.0001). Regarding gender's factor, the comparisons revealed no statistically significant differences (p < 0.05) in pain perception between males and females for either injection pain or post-extraction pain. Conclusions: Buffered 4% articaine provides superior anesthetic efficacy compared to non-buffered 4% articaine, enhancing patient comfort by reducing pain, accelerating onset, and prolonging the duration of anesthesia during maxillary third molar extractions. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions This retrospective study aimed to evaluate the clinical outcomes associated with zygomatic implant (ZI) rehabilitation in partially atrophic edentulous maxillae over a mean follow‐up period of more than 10.3 years.All consecutive patients underwent ZI rehabilitation between 1999 and 2020, with a minimum follow‐up period of 3 years. The primary outcome was the implant survaival rate. Secondary outcomes included the prosthesis success rate, complications, and Oral Health‐Related Quality of Life.Of the 21 patients, treated with 27 ZIs and 48 conventional implants (CIs), 9 (42.9%) were females. The mean follow‐up was 10.3 ± 5.7 years (range 3.2–23.4). ZI and CI survival rates were 100% and 97.9%, respectively, with one CI that failed. Eleven patients received 12 CIs placed in the pterygoid and tuberosity region. Most of the implants (81.33%) were immediately loaded, with 17 patients (80.9%) receiving 21 acrylic bridges. Of the total of 26 definitive prosthesis, the success rate was 96.1%. Local inflammation (n = 2) and soft tissue recession (n = 1) were reported as complications, occurring at a mean follow‐up of 4.5 and 3.2 years, respectively. The mean score of the OHIP‐14 questionnaire was 1.19 ± 1.99.Unilateral ZI rehabilitation was a predictable option for patients with partially atrophic edentulous maxilla who have experienced previous graft or implant failures, or who require immediate loading. Splinting the ZI with CI for restoration appeared to be essential in unilateral ZI treatment. Complications were infrequent and could be managed effectively, with patient‐reported outcomes indicating normalization in quality of life. [ABSTRACT FROM AUTHOR]

Purpose: Zygomatic implants (ZIs) have been considered a reliable alternative treatment for patients with maxillary atrophy and/or maxillary defects. The use of a navigation system for assisting ZI placement could be a reliable approach for enhancing accuracy and safety. The purpose of this in vitro study was to evaluate the accuracy of a new dynamic surgical navigation system with its minimally invasive registration guide for quad zygomatic implant placement in comparison with a gold standard navigation approach. Materials and Methods: A total of 40 zygomatic implants were placed in 10 3D-printed models based on the CBCT scans of edentulous patients. For registration, a surgical registration guide with a quick response plate was used for the test group, and five hemispheric cavities as registered miniscrews in the intraoral area were used for the control group. In each model, a split-mouth approach was employed (two ZIs in bilateral zygomata) to test both systems. After ZI placement, a CBCT scan was performed and merged with pre-interventional planning. The deviations between planned and placed implants were calculated as offset basis, offset apical, and angular deviation and compared between the systems. Results: The offset basis, offset apical, and angular deviation were 1.43 ± 0.55 mm, 1.81 ± 0.68 mm, and 2.32 ± 1.59 degrees in the test group, respectively. For the control group, values of 1.48 ± 0.57 mm, 1.76 ± 0.62 mm, and 2.57 ± 1.51 degrees were measured without significant differences between groups (all P < .05). The accuracy of ZI positions (anterior and posterior) were measured without significant differences between groups. Conclusion: Two navigation systems with different registration techniques seem to achieve comparable acceptable accuracy for dynamic navigation of zygomatic implant placement. With the test group system, additional preinterventional radiologic imaging and invasive fiducial marker insertion could be avoided. [ABSTRACT FROM AUTHOR]

Introduction: The objective of the study was to provide long‐term clinical outcomes and complications in the severely atrophic edentulous maxillae treated by means of the quad zygoma protocol (QZP) using the Anatomy‐Guided Approach (AGA). Methods: This was a retrospective cohort study of all consecutive patients with severely atrophic edentulous maxilla and insufficient bone height and width in the anterior and posterior regions bilaterally, who underwent rehabilitation with the QZP between May 2006 and December 2021. All patients were followed for at least 1 year. All zygomatic implants (ZIs) were placed by the same surgeon. The primary endpoint of the study was the implant survival rate. Secondary endpoints were implant success rate, prosthesis success rate, complications, and Oral Health‐Related Quality of Life using the OHIP‐14 questionnaire. Results: A total of 56 patients (men 16, women 40) with 224 ZIs (Nobel Biocare, n = 204; Straumann, n = 16; Southern Implant, n = 4) placement were included with a mean follow‐up period 8.8 ± 3.9 years (range, 1.2–17.0). The survival (success) rate was 97.7%. Five ZIs in four patients failed. The mean time between implant placement and failure was 8.6 years (range, 0.5–13.3). All patients received immediate loading with acrylic prosthesis. The successful rates for the definitive prosthesis were 98.2%. Forty‐two patients received posterior cantilever for rehabilitation of fixed definitive prosthesis. Local orofacial inflammation (35.7%) and Sinusitis (12.5%) were the most common complications, occurring at a mean follow‐up of 10.0 (range, 4.2–14.9) and 10.3 (range, 4.3–16.2) years, respectively. In 48 patients, the mean score of the OHIP‐14 questionnaire was 1.7 ± 2.6 with the follow‐up period of 9.0 ± 4.1 years. Conclusions: The rehabilitation of severely atrophic edentulous maxilla using the QZP has shown a predictable and high survival rate in the long term. The implementation of an immediate loading protocol offers potential benefits in stabilizing ZIs with cross‐arch stabilization. Moreover, the use of a posterior cantilever in reconstruction can effectively establish functional occlusion through well‐distributed ZIs, eliminating the need for additional implant placement. [ABSTRACT FROM AUTHOR]

Background: Screening ultrasonography was proposed for monitoring periodontal soft tissues in the early 1960s, owing to its nonionizing, real‐time, and cost‐effective properties. Studies have provided convincing preliminary evidence for the use of ultrasound (US) in implant dentistry. Purpose: To assess the feasibility of ultrasonography (US) for measuring the buccal thickness of periodontal and peri‐implant tissues. The secondary objective was to evaluate the reliability of US measurements compared to classic techniques, such as CBCT and directly measurements. Materials and Methods: An electronic literature search was conducted by three independent reviewers through February 2023. The inclusion criteria were articles investigating at least five patients/cadavers with US measurements in periodontal or peri‐implant buccal tissues. Compliance with methodological reporting standards and risk of bias was assessed using EULAR and QUADAS‐C tools, respectively. Random‐effects meta‐analysis was conducted, using Bland–Altman analysis. Certainty of the evidence was assessed using GRADE. Results: The final selection included 12 studies examining 458 patients and 13 cadavers, with a total of 226 implants, 1958 teeth and 60 edentulous sites. The body of evidence was assessed as partially compliant with methodological reporting standards for US studies and had an unclear to high risk of bias. Meta‐analysis of five comparative studies showed no evidence of clinically significant bias between US and direct measurements (very low certainty), and between US and CBCT (very low certainty) for soft‐tissue thickness. Likewise, for bone thickness, there is no evidence of clinically significant bias between US and CBCT (low certainty). Conclusions: Compared to the CBCT and direct measurements, ultrasonography might be a reliable approach for monitoring on periodontal and peri‐implant phenotype. However, there is uncertainty about estimates of the actual effect, so further standardized and larger sample size of clinical research is needed. [ABSTRACT FROM AUTHOR]

Aim: To assess the correlation between the periodontal phenotype (PP) and sinus membrane thickness (SMT) in humans. Methods: This review was conducted according to the PRISMA guidelines. Two reviewers independently carried out electronic and manual literature searches of studies published in English, German, and Spanish, from 1970 to September 2022 in four electronic databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, in addition to gray literature. Studies that assessed the correlation between PP and SMT in adults (aged 18 years) were included. Methodological quality was evaluated using the Appraisal Tool for Cross‐Sectional Studies (AXIS) for articles that met the eligibility criteria. Results: Six studies, including 510 patients, were considered for qualitative analysis. All included studies were cross‐sectional, and the correlation between the PP and SMT was evaluated, finding a positive and high correlation in 83.3% of them, based on a value of ≥0.7. All the included studies were assessed with a high overall risk of bias. Conclusions: Periodontal phenotype and sinus membrane thickness are likely correlated. Nevertheless, further standardized studies are required to draw definitive conclusions. [ABSTRACT FROM AUTHOR]

The cover image is based on the Original Article Long‐term survival and complications of Quad Zygoma Protocol with Anatomy‐Guided Approach in severely atrophic maxilla: A retrospective follow‐up analysis of up to 17 years by Rubén Davó MD et al., https://doi.org/10.1111/cid.13296. [ABSTRACT FROM AUTHOR]

Zygomatic implant (ZI) is considered a predictable alternative for patients with atrophic maxilla. However, regarding the case of patients with cleft lip and palate (CLP), the evidence of ZI rehabilitation remains unclear. This study aimed to evaluate the indications and clinical outcomes of rehabilitation using ZI in CLP patients. The focus question was: "What are the indications and clinical outcomes of ZI rehabilitation in patients with CLP?" Electronic and manual literature searches were performed from January 2000 to May 2024 in five databases. Clinical studies and case reports were selected. The primary outcome was the ZI survival rates. The secondary outcomes were indications, loading protocols, and complications. The extracted data were subjected to descriptive analysis. In total, 16 studies were included, 24 patients with CLP received 48 ZIs, with an average of 4.2 years of follow-up. The survival rate of ZIs was 97.9% and was mainly indicated for those with Cawood and Howell classification V and VI, with insufficient bone in the maxilla with bilateral CLP. The immediate loading was performed in 33.3% of the cases, and the prosthesis was designed according to case complexity and necessity. ZI rehabilitation appears to be a reliable and predictable solution for the patient with CLP. The immediate loading solution can be beneficial to CLP patients as it helps avoid additional treatments. However, with the inconsistently limited data, the indications cannot be only based on the existing CLP classification., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: This experimental study compared the accuracy of implant insertion using the free-hand (FH) technique, static computer-aided surgery (S-CAIS), or dynamic computer-assisted surgery (D-CAIS) and to evaluate the correlation of learning curves between surgeons' experience and surgical time., Materials and Methods: Thirty-six models were randomly assigned to three groups (FH, n = 12; S-CAIS, n = 12; D-CAIS, n = 12). Each model was planned to receive four implants in the maxillary anterior and posterior regions. Twelve participants, six experienced surgeons, and six dental students were included in this study. The primary outcome was the deviation between the planned and final implant placement from each group. Secondary outcomes were each technique's learning curve regarding surgical time., Results: The average deviation at implant platform, apex and gradual deviation with FH technique were 1.31 ± 0.88 mm, 1.75 ± 0.9 mm and 6.67° ± 3.70°, respectively. The average deviation of implant platform, apex and angular in S-CAIS were 0.67 ± 0.32 mm, 1.00 ± 0.39 and 2.66° ± 1.77°, respectively. The average deviation of implant platform, apex and angular in D-CAIS were 1.14 ± 0.70 mm, 1.23 ± 0.58 and 3.20° ± 2.16°, respectively. Significant discrepancies at the implant platform, implant apex, and angular deviation were found between all surgical methods (p < 0.016). Learning curves were evident after multiple implant insertions using both freehand and S-CAIS., Conclusion: The findings indicate that computer-assisted implant insertion leads to a more precise implant alignment than implants inserted freehand in an experimental set-up., (© 2025 The Author(s). Clinical Oral Implants Research published by John Wiley & Sons Ltd.)

Purpose: Real-time surgical navigation has been increasingly applied in implant placement. The initial registration procedures were found to substantially affect the overall accuracy of the system for zygomatic implant placement, but the exact number and distribution of fiducial markers was yet undetermined. This study aimed to determine the minimal numbers and optimal distributions of fiducial markers to achieve clinically acceptable accuracy in surgical navigation, through systematically analyzing the effects of different setups of fiducial markers on target registration errors (TRE)., Materials and Methods: A maxillary phantom with bone-anchored fiducial markers was scanned using cone beam computed tomography, followed by data processing on Brainlab, a commercially available navigation system. A total of 10 mini-screws were inserted in the edentulous maxilla for configuration of fiducial markers, with another two mini-screws as implant targets to assess TRE in zygomatic bone. Data were then collected in nine configurations with distinct fiducial numbers and positions. Statistical analyses were performed with SPSS., Results: Accuracy of the surgical navigation system was found to depend on both the numbers and positions of fiducial markers. No significant difference was observed in accuracy among groups with eight fiducials and with polygon span distribution (P > .05). When the fiducial numbers decreased to less than six, the markers inserted in a regular triangle area were more precise than in an inverse triangle configuration. When the number of fiducials was five with a polygonal distribution, a low TRE value of 0.59 mm was detected, which was comparable to the accuracy with more than eight fiducials in the study., Conclusion: A scattered distribution with a polygon span with at least five fiducial markers in the edentulous maxilla for registration seems to achieve an acceptable TRE value with a high accuracy for navigation in zygomatic implant placement.