Vílchez B, Caneiro L, Lima C, Sanz-Sánchez I, Montero E, Figuero E, Blanco J, Sanz M Clinical and radiographic performance of two distinct sandblasted, large-grit, acid-etched implant surfaces: A split-mouth randomized clinical trial. Clin Oral Implants Res. 2026;37:141-54. https://doi.org/10.1111/clr.70071 . Among adults requiring bilateral implant-supported restorations in healed posterior sites, does a chemically modified hydrophilic sandblasted, large-grit, acid-etched (SLActive) implant surface provide superior peri-implant tissue outcomes compared with a conventional SLA surface after one year of functional loading? Multicentre, split-mouth, randomized controlled clinical trial with blinded outcome assessment and 1-year follow-up after prosthetic loading. Adults (≥18 years) requiring at least two implants in healed posterior ridges located in different quadrants were recruited from two university referral centers in Spain. Eligible sites had healed for at least 3 months after extraction and required neither simultaneous hard- nor soft-tissue augmentation. Exclusion criteria included uncontrolled systemic conditions affecting healing, poor oral hygiene (full-mouth plaque score ≥20%), heavy smoking (>10 cigarettes/day), pregnancy, untreated periodontal disease, severe parafunctional habits, insufficient keratinized mucosa (<2 mm), recent grafting procedures, or other local or systemic factors that could compromise osseointegration. Seventy patients were screened; 68 were randomized, each receiving one SLActive implant and one conventional SLA implant according to a split-mouth allocation (136 implants total). Owing primarily to early implant failures and protocol-related exclusions inherent to the paired design, 61 participants completed follow-up, while 56 contributed complete radiographic data for analysis of the primary outcome. The primary endpoint was radiographic marginal bone level (MBL) change from prosthetic loading to 12 months. Secondary outcomes comprised MBL changes from implant placement, implant stability quotient (ISQ), wound healing, peri-implant clinical parameters, implant and prosthesis survival, adverse events, and oral health-related quality of life (OHIP-14). The patient served as the unit of analysis. Quantitative variables were analysed using paired Student’s t tests and repeated-measures mixed ANOVA with Bonferroni adjustment, whereas categorical outcomes were compared using Wilcoxon or chi-square methods, with statistical significance set at p ≤ 0.05. Sixty-eight patients (136 implants) entered the trial and 61 completed clinical follow-up. Early implant survival before loading was 95.5% for SLActive and 97.0% for SLA implants; no additional implant losses occurred after loading (100% post-loading survival). For the primary outcome, mean MBL change from loading to 12 months was −0.04 ± 0.39 mm for SLActive implants and −0.07 ± 0.22 mm for SLA implants (mean difference 0.03 mm; 95% CI − 0.09 to 0.14; p = 0.658). A statistically significant but small difference was detected for bone remodeling from implant placement to 12 months (0.20 ± 0.39 mm vs 0.06 ± 0.20 mm; mean difference 0.15 mm; 95% CI 0.02–0.27; p = 0.024). Implant stability (baseline ISQ approximately 73; 8-week ISQ approximately 76), wound healing, probing depth (2.61 vs 2.58 mm), bleeding on probing, peri-implant mucositis prevalence, adverse events, and patient-reported outcomes were comparable between groups. No cases of peri-implantitis were observed during follow-up. Both implant surfaces achieved excellent short-term clinical performance. Although a small statistical difference in overall bone remodeling from implant placement to 12 months favored the conventional SLA surface, no clinically meaningful superiority of the hydrophilic surface was demonstrated for the prespecified primary outcome or for clinically relevant secondary outcomes after one year of functional loading.
To assess and compare the effectiveness of various prosthetic impression techniques in enhancing retention, stability, and patient satisfaction in the rehabilitation of severely resorbed mandibular ridges. A comprehensive literature search was conducted across multiple databases including PubMed, ScienceDirect, Google Scholar, and the Cochrane Database to identify studies meeting the Population, Intervention, Comparator, Outcome, and Study Design (PICOS) framework. Randomized controlled trials (RCTs) evaluating prosthetic impression techniques for severely resorbed mandibular ridges were included in the review. Methodological quality was assessed using the Cochrane Risk of Bias (RoB) tool for RCTs. Data extraction was carried out independently by two authors, with disagreements resolved by third authors. The study adhered to PRISMA guidelines for systematic reviews. A total of 6 studies were included in the final analysis. The results indicated that prosthetic impression techniques such as the neutral zone, functional impressions, two-step impressions, and admixed methods showed improvements in denture stability and retention. No single impression technique consistently outperformed others across all outcomes. Techniques such as the neutral zone impression and single-step methods showed favourable results in certain scenarios, highlighting the importance of individualized clinical decision-making. The currently available evidence on prosthetic impression techniques for severely resorbed mandibular ridges is limited and heterogeneous, making it difficult to draw firm conclusions regarding the most effective approach. Some studies report improvements in outcomes such as retention, stability, and patient comfort with techniques including the neutral zone and functional impressions. However, no single technique has proven universally superior, and patient-specific factors should guide clinical decision-making. Future large-scale RCTs are required to refine clinical guidelines and assess the durability of prosthetic outcomes over time. CRD420251008136
Meyns J, Meewis J, Dons F, Schreurs A, Aerts J, Shujaat S, Politis C, Jacobs R. Long-term comparison of maxillary protraction with hybrid hyrax-facemask vs. hybrid hyrax-mentoplate protocols using Alt-RAMEC: a 5-year randomised controlled trial. Eur J Orthod. 2025;47(2):cjaf011. https://doi.org/10.1093/ejo/cjaf011 . Single-centre two-arm parallel randomised controlled trial with 1:1 allocation and 5-year follow-up. Twenty-eight children in the mixed dentition with skeletal Class III malocclusion were recruited. Eligible patients had an anterior crossbite or edge-to-edge incisor relationship and a Class III molar relationship. Children with craniofacial syndromes, previous orthodontic or surgical treatment, marked skeletal asymmetry or functional Class III malocclusion were excluded. Participants were allocated to hybrid Hyrax plus facemask therapy or hybrid Hyrax plus mandibular mentoplate therapy. Both groups received Alt-RAMEC. Low-dose computed tomography was performed at baseline, 1 year and 5 years. Virtual lateral cephalograms were used to assess Wits appraisal as the primary outcome with skeletal and dentoalveolar variables as secondary outcomes. Between-group comparisons used unpaired two-sided t tests. Outcome assessment and statistical analysis were blinded. Measurement reliability was assessed using intraclass correlation coefficients. Twenty-four of 28 randomised participants contributed data at 5 years. Wits appraisal improved by 4.42 mm with facemask treatment and 2.86 mm with mentoplate treatment at 1 year. At 5 years the corresponding improvements from baseline were 3.33 mm and 1.50 mm. Between-group differences were not statistically significant. Long-term vertical skeletal measures and incisor inclination were also comparable. Minor hook fracture and mucosal irritation occurred without treatment discontinuation. Adding a mandibular mentoplate did not demonstrate superior long-term skeletal correction over hybrid Hyrax plus facemask treatment in this small trial. The findings support selective rather than routine use of the more invasive approach. They do not establish equivalence between the protocols.
Asavalertpalakorn C, Jirarattanasopha V, Nakornchai S, Horsophonphong S. Plaque and salivary fluoride levels in preschoolers following applications of silver diamine fluoride, sodium fluoride varnish, and their combination: a randomized clinical trial. Int J Paediatr Dent. 2026;36:81–9. https://doi.org/10.1111/ipd.70030 . A three-arm randomised controlled trial compared the salivary and plaque fluoride levels for young children, following application of different fluoride prevention and treatment procedures (silver diamine fluoride, sodium fluoride varnish and silver diamine fluoride and sodium fluoride varnish together), in child development centres in Thailand. Children aged 3–6 were selected who had at least one carious tooth reaching dentine in the primary dentition. Included children were considered healthy and co-operative. Children who had received professional fluoride application within the last three months were excluded, or those with a known allergy to any component. Twenty children were randomised to each group. Group 1 received silver diamine fluoride application (1 drop) to dentinal carious lesions; group 2 received sodium fluoride varnish application (0.25 ml) to all erupted primary teeth; group 3 received both the silver diamine fluoride and sodium fluoride varnish interventions. Fluoride applications were not applied to pulpally involved teeth. Plaque and saliva samples were collected at baseline (prior to fluoride application), at 5, 30 and 60 minutes, and at 24 and 48 hours. Kruskal-Wallis and Friedman tests were used to compare the 3 groups at the various time points. A Bonferroni correction was applied to account for the multiple comparisons. In total, 60 children were randomised, data were analysed for 50 children’s salivary samples and 49 children’s plaque samples. The mean age was 3.7 months, with children having a mean of 7.6 decayed, missing or filled teeth. At the shorter-term (5, 30 and 60 minute) time points, the salivary fluoride levels were significantly higher in the sodium fluoride varnish alone and silver diamine fluoride with sodium fluoride varnish groups than in the silver diamine fluoride alone group. There was no difference in the silver diamine fluoride with sodium fluoride varnish and sodium fluoride varnish alone groups for both salivary and plaque fluoride levels. Considering fluoride levels in plaque, the sodium fluoride varnish group had significantly higher levels at 5 and 60 minutes than the silver diamine fluoride group and the silver diamine fluoride with sodium fluoride varnish group was significantly higher at 30 and 60 minutes in comparison to silver diamine fluoride alone. At 60 minutes, the silver diamine fluoride and sodium fluoride varnish groups had returned to baseline; this was at 24 hours for the silver diamine fluoride with sodium fluoride varnish group for salivary fluoride. For plaque levels, the return to baseline was at 60 minutes for the silver diamine fluoride group, and 24 hours for the sodium fluoride varnish and silver diamine fluoride with sodium fluoride varnish groups. Children receiving sodium fluoride varnish and silver diamine fluoride had higher plaque and salivary fluoride levels than those treated with silver diamine fluoride alone in the short term. Plaque and salivary fluoride levels returned to baseline at 24 hours for all groups.
Chaple Gil AM, Pereda Vázquez L, Santiesteban Velázquez M, Menéndez JJ. Minimally invasive treatments for dental fluorosis: a network meta-analysis of aesthetic masking efficacy. J Esthet Restor Dent. 2026;38(7):1323–1337. A systematic review and network meta-analysis evaluated the comparative aesthetic masking efficacy of minimally invasive treatments for dental fluorosis, including microabrasion, bleaching, resin infiltration, and remineralization strategies. The authors searched PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Library. It is stated that the review was conducted according to PRISMA-NMA guidelines. Randomized clinical trials with at least two parallel-group or split-mouth treatment arms were included. Eligible studies enroled patients with dental fluorosis diagnosed clinically using Dean’s Index, the Thylstrup–Fejerskov Index (TFI), or the Tooth Surface Index of Fluorosis (TSIF), and reported aesthetic outcomes using continuous colorimetric measures, such as ΔE or CIE Lab* values, at short- or mid-term follow-up. Studies were excluded if they reported only subjective or ordinal aesthetic outcomes (e.g., TSIF categories, shade-guide scores, or visual analogue scale ratings) or evaluated restorative or prosthodontic treatments. Mean differences (MDs) in change scores with corresponding standard errors were pooled using a random-effects model. Network geometry, consistency, heterogeneity, and influence diagnostics were assessed to evaluate model fit and robustness. Results were presented using network forest plots, league tables, and treatment ranking plots (SUCRA/P-scores). Separate network meta-analyses were conducted for immediate post-treatment, 3-month, and 6-month follow-up periods. Risk of bias and certainty of evidence were assessed using the RoB 2 tool and CINeMA. Across the seven included trials, the greatest improvement in aesthetic outcomes was observed with the combination of microabrasion and in-office bleaching. Among the standalone interventions, resin infiltration demonstrated the most consistent and clinically meaningful benefit. The overall risk of bias assessment indicated that most studies were judged as having some concerns. Assessment of incoherence using the CINeMA framework indicated a generally coherent evidence network. The highest aesthetic masking efficacy was observed with sequential multimodal approaches that combined surface modification, bleaching, and resin-based refractive adjustment in fluorosis lesions after 3- and 6-month follow-up.
