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Purpose: To establish consensus-driven guidelines that could support the clinical decision-making process for implant-supported rehabilitation of the posterior atrophic maxilla and ultimately improve long-term treatment outcomes and patient satisfaction. Materials and methods: A total of 33 participants were enrolled (18 active members of the Italian Academy of Osseointegration and 15 international experts). Based on the available evidence, the development group discussed and proposed an initial list of 20 statements, which were later evaluated by all participants. After the forms were completed, the responses were sent for blinded analysis. In most cases, when a consensus was not reached, the statements were rephrased and sent to the participants for another round of evaluation. Three rounds were planned. Results: After the first round of voting, participants came close to reaching a consensus on six statements, but no consensus was achieved for the other fourteen. Following this, nineteen statements were rephrased and sent to participants again for the second round of voting, after which a consensus was reached for six statements and almost reached for three statements, but no consensus was achieved for the other ten. All 13 statements upon which no consensus was reached were rephrased and included in the third round. After this round, a consensus was achieved for an additional nine statements and almost achieved for three statements, but no consensus was reached for the remaining statement. Conclusion: This Delphi consensus highlights the importance of accurate preoperative planning, taking into consideration the maxillomandibular relationship to meet the functional and aesthetic requirements of the final restoration. Emphasis is placed on the role played by the sinus bony walls and floor in providing essential elements for bone formation, and on evaluation of buccopalatal sinus width for choosing between lateral and transcrestal sinus floor elevation. Tilted and trans-sinus implants are considered viable options, whereas caution is advised when placing pterygoid implants. Zygomatic implants are seen as a potential option in specific cases, such as for completely edentulous elderly or oncological patients, for whom conventional alternatives are unsuitable. [ABSTRACT FROM AUTHOR]

The aim of this study was to retrospectively evaluate 75 implants inserted in vertically augmented bone at the time of or prior to implant placement after 1 to 6 years of prosthetic loading. The study included 21 patients (29 surgical sites). The vertical procedure was performed combining a titanium-reinforced expanded polytetrafluoroethylene membrane with autograft (7 sites), allograft (5 sites), or auto-xenograft (17 sites). Healing was uneventful in 24 surgical sites. Three sites showed premature exposure, and two sites presented an abscess. Two implants were lost, for a cumulative survival rate of 93.6%. Mean bone remodeling at 1, 2, 3, 4, 5, and 6 years was 0.34, 0.72, 1.04, 0.84, 0.56, and 0.61 mm, respectively. The implant success rate was higher with a simultaneous approach (82.5%) compared with a staged approach (66.8%). Implants surrounded by keratinized mucosa revealed a higher success rate (82.1%) than those without it (58.4%). [ABSTRACT FROM AUTHOR]

The core of the research project CittAumentata is the development of a software tool that fully uses the potential of AR as a way of understanding and improving ancient landscapes. The app links a model of collecting and processing archaeological and topographical datasets to an experience that increases users' interaction thanks to the ease-to-use and compatibility with most of the devices (smartphones and tablets). The scalability and the certification of a data protocol allows to systematize an innovative tool that manages 3D data and offers to citizenship a new way to understand cultural heritage and historical stratification in landscapes. [ABSTRACT FROM AUTHOR]

Soft tissue augmentation around dental implants in the esthetic region remains a challenging and unpredictable procedure. The ideal surgical technique would include of an off-the-shelf product to minimize morbidity after autogenous grafting procedures. The aim of this study was to use a resorbable collagen matrix (Mucograft) to serve as a scaffold to recombinant human platelet-derived growth factor BB (rhPDGF-BB) to increase peri-implant soft tissue volume in anterior maxillary sites. A total of six patients who had previously undergone a bone regeneration procedure were included in this study. The collagen matrix was applied during stage-two surgery (expanded polytetrafluoroethylene membrane removal and implant placement). Measurements were performed through customized stents by means of endodontic files, and at abutment connection, a soft tissue biopsy specimen was harvested for histologic examination. The healing period was uneventful in all six patients. Measurements were taken apically, centrally, and occlusally for each site. The mean gains in volume from baseline to the 4-month measurement at the apical, central, and occlusal aspects were 0.87 ± 2.13 mm, 2.14 ± 3.27 mm, and 0.35 ± 3.20 mm, respectively. The results showed a moderate increase in the soft tissue volume in esthetic peri-implant sites when applying a collagen matrix infused with rhPDGF-BB. However, the measuring techniques available need to be further improved to record exact changes in the soft tissue volume. [ABSTRACT FROM AUTHOR]

The goal of classifying complications in guided bone regeneration procedures with nonresorbable membranes is to provide the clinician with an instrument for easier identification of both the problem and treatment modality. A standardized terminology represents a key point for proper communication among clinicians and provides guidelines for managing these drawbacks. [ABSTRACT FROM AUTHOR]

This preclinical study evaluated the efficacy of purified recombinant human platelet-derived growth factor (rhPDGF-BB), combined with a novel equine hydroxyapatite and collagen (eHAC) bone block, in providing vertical bone regeneration in critical-size defects simulating localized mandibular alveolar bone atrophy. In addition, the impact of barrier membrane placement in growth factor-mediated bone regeneration was also studied. Bilateral posterior mandibular defects simulating severe localized bony atrophy were created in 12 adult foxhounds following removal of all four mandibular premolars. Three months later, the defects were grafted as follows: group A: eHAC block alone; group B: eHAC block + collagen membrane; group C: eHAC block + rhPDGF-BB; group D: eHAC block + rhPDGF-BB + membrane. The animals were sacrificed after 5 months and the grafted areas were examined histologically, radiographically, and clinically. Groups A and B (controls) exhibited little to no vertical bone regeneration. Group C demonstrated significant vertical bone regeneration, with dense, well-vascularized bone, high bone-to-implant contact, and accelerated replacement of graft particles with newly formed bone. In group D, with the imposition of a barrier membrane, robust bone regeneration was less evident when compared to group C. As in the first study in this series, the importance of the periosteum as a source of osteoprogenitor cells in growth factor-mediated regenerative procedures is examined. [ABSTRACT FROM AUTHOR]

The present investigation was performed to compare the biocompatibility, safety, and manageability of a newly developed bone block and a deproteinized bovine bone block (Bio-Oss) for the treatment of localized bone defects in a dog model. Two male beagle dogs were used for this study. The mandibular premolars were extracted and two saddle-type defects were created bilaterally in the edentulous area. The defects were filled according to a randomized design with Bio-Oss bone block or with an equine hydroxyapatite plus collagen bone block (eHAC). Most control and test sites developed dehiscences during healing. After 4 weeks, the animals were euthanized and each hemimandible was prepared for histologic examination. No significant difference in terms of local tolerance was observed between test and control sites, and test and control sites showed similar histologic findings. However, a significant difference was noticed between the Bio-Oss block and the new bone block in terms of manageability. [ABSTRACT FROM AUTHOR]

Purpose: To compare clinically and histologically an allogeneic bone matrix to autogenous bone chips in the vertical ridge augmentation technique using titanium-reinforced e-PTFE membranes. Materials and Methods: The study protocol was designed to include patients with bilateral posterior mandibular partial edentulism. Patients were treated with a split-mouth design approach: each side was randomly assigned to the test group (titanium-reinforced e-PTFE membrane and allogeneic bone matrix) or to the control group (titanium-reinforced e-PTFE membrane and autogenous bone chips). Different clinical parameters including the amount of vertically regenerated bone (DSB) and biologic complications were recorded. Histomorphometric analysis and the bone-implant contact percentage were performed. Results: Five female patients were enrolled in the study. Ten edentulous sites were vertically augmented and 25 implants were inserted (13 test group, 12 control group) with a staged approach. In the test group no membrane was exposed. The mean bone regeneration was 4.70 mm (SD 0.48 mm). All 13 implants appeared clinically stable. In the control group, 1 membrane was exposed after 2 months. The mean crestal bone regeneration was 4.10 mm (SD 0.88 mm). All 12 implants were stable at the abutment connection. Nine biopsy specimens from the regenerated areas were evaluated. Vertical bone regeneration was evident in both groups since all the samples demonstrated trabecular bone with different degrees of maturation and mineralization in the regenerated area. Conclusion: Within the limits of this study based on 5 patients, it appears that the behavior of the allogeneic bone matrix is similar to that of autogenous bone chips when used for vertical ridge augmentation by means of guided bone regeneration techniques. Both grafts demonstrated analogous histologic characteristics. Nevertheless, long-term clinical studies are needed to confirm these preliminary results. [ABSTRACT FROM AUTHOR]

This clinical study retrospectively evaluated, after 1 to 7 years of prosthetic loading, 38 implants consecutively placed in 16 surgical sites, where severe atrophy of the posterior maxilla was treated by combining sinus elevation with the vertical ridge regenerative procedure. Two different surgical techniques were adopted. In seven patients (16 implants), implants were placed at the same stage as the regenerative procedures. In the other seven patients (22 implants), implant placement was performed at second-stage surgery, after 6 to 13 months of submerged membrane healing. Each implant was classified as a success, survival, or failure. The distance between the top of the implant shoulder and the first visible bone-implant contact was assessed radiographically for every implant at the mesial and distal sides. Two membranes became exposed during the healing process (12.5%). In the remaining 14 sites (87.5%), the membrane remained covered for a 6- to 13-month healing period. The survival rate of the implants was 92.1%, whereas the success rate was 76.3%. Three implants (7.9%) failed. A comparison of the implant shoulder--bone implant contact distances between abutment connection and the last examination showed a mean crestal loss of 1.65 mm at the mesial side and 1.68 mm at the distal side. The bone regenerated vertically by means of sinus floor elevation and vertical ridge augmentation showed the same biologic behavior as native, nonregenerated bone; however, in a few cases, its remodeling pattern seemed to determine slightly higher bone crest resorption. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of the Nd:YAG laser therapy in the management of oral mucosal lesions. This retrospective study concerns several clinical cases. Materials and Methods: 130 patients with a variety of benign oral soft tissue lesions were treated with laser excision and ablation. Surgery was performed on all patients with a pulsed, fiberoptically delivered Nd:YAG contact laser (Smarty-10). The most frequent lesions excised or vaporized and biopsied were fibroma (27), epulis (16), leukoplakia (13), lichen planus (13), hemangioma (5), mucocele (13), fiber-mucosa hyperplasia (13), and squamous papilloma (10). All patients were included in a postoperative follow-up program for up to 24 months (range 6 to 24 months). Results: In most cases, Nd:YAG laser therapy led to complete resolution of the lesion. No negative effects were reported during or after this type of laser surgery. Especially for oral mucosal white lesions, this treatment obtained resolution or real control regarding their symptoms and growth. Conclusion: Based on our results and the international literature, Nd:YAG laser therapy can be considered as effective as traditional surgical techniques in the treatment of benign oral mucosal lesions. Moreover, in addition to its therapeutic excellence, this laser method possesses the great advantage of being much more comfortable (no postoperative problems or pain, no need of sutures, often no need for local anesthesia). [ABSTRACT FROM AUTHOR]

Aim and Objective: The aim of the present split-mouth prospective study was to evaluate clinically and histologically the bone regeneration obtained following preprosthetic vertical bone augmentation performed with titanium-reinforced dense polytetrafluoroethylene membrane (d-PM) compared to titanium mesh (TM)., Materials and Methods: Healthy adult patients presenting with bilateral partial edentulism in the posterior mandible requiring vertical ridge augmentation for implant placement purposes were consecutively included. One side of the mandible was randomly assigned to the use of d-PM, the other to TM. The graft consisted in a mixture of autogenous bone harvested nearby the surgical site and deproteinized bovine bone mineral particles in a 1:1 ratio. On each side during bone augmentation surgery, a 2-mm diameter mini-implant was inserted for clinical and histological analyses. After a healing period of 8 months, the second surgical phase was carried out to remove the nonresorbable barriers, to evaluate clinically the vertical bone gain, and to collect a bone biopsy that included the mini-implant. During the same surgical session, dental implants were inserted in a prosthetically guided position., Results: A total of five patients were enrolled. Eight out of 10 sites healed uneventfully. In the remaining two sites, premature exposure of the TM was observed. Mean vertical bone gain of 4.2 and 1.5 mm was achieved in d-PM and TM groups, respectively ( p = 0.06). A mean mineralized tissue of 48.28 and 35.54% was observed in d-PM and TM groups, respectively ( p = 0.51)., Conclusion: The vertical bone gain, although not significantly, was higher in the d-PM group. Similar histological outcomes were noticed if exposure did not occur. In case of wound dehiscence, major resorption was observed., Clinical Significance: Both d-PM and TM can be used to augment atrophic localized ridges vertically. The outcome of bone regeneration seems to be impaired by exposure of the device. How to cite this article: Maiorana C, Fontana F, Rasia dal Polo M, et al . Dense Polytetrafluoroethylene Membrane versus Titanium Mesh in Vertical Ridge Augmentation: Clinical and Histological Results of a Split-mouth Prospective Study. J Contemp Dent Pract 2021;22(5):465-472.