ABSTRACT This scoping review aimed to map and assess the available evidence on human exposure to potentially toxic elements released from metallic dental and orthopedic implants, describing their levels in biological samples and the potential impacts on human health. Searches were performed in PubMed, Medline, Embase, Web of Science, and Scopus. Seven prospective studies were included and analyzed by two reviewers. The following elements were detected in the volunteers: titanium (Ti), chromium (Cr), cobalt (Co), molybdenum, and aluminum. Three studies reported a significant increase in Ti, Cr, and Co concentrations after implant placement. Despite PTE contamination being detected, no systemic effects were observed. In conclusion, individuals with metal implants are contaminated by PTEs; however, evidence of clinical impact remains insufficient due to methodological limitations. Larger longitudinal cohorts, tissue-based assessments, and standardized analytical methods are required to understand the clinical implications of chronic exposure to PTEs in implanted patients.
ABSTRACT Oligodontia, the congenital absence of multiple teeth, is often linked to genetic mutations influencing craniofacial and dental development. This case describes a 27-year-old female with nonsyndromic oligodontia, where clinical exome sequencing identified a heterozygous variant of uncertain significance in the AXIN2 gene, confirming a molecular basis for her condition. Guided by this genetic insight, a biologically risk-modified personalized rehabilitation plan incorporating digital diagnostics and guided bone regeneration (GBR) was executed using deproteinized bovine bone mineral and a resorbable collagen membrane. Histological evaluation – considered the gold standard for assessing GBR success – confirmed vital new bone formation, ensuring a stable foundation for implant placement. Implant-supported prostheses restored aesthetics and function. Two-year follow-up demonstrated excellent osseointegration, healthy peri-implant bone, and durable prosthesis stability. This case highlights the pivotal role of clinical exome sequencing and histological validation in achieving predictable regenerative and prosthodontic outcomes.
ABSTRACT The elderly patients are the ones who receive majority of the implant based treatment and interventions. These elderly patients pose a challenge not because of local bone and the tissue conditions but also due to systemic co-morbidities. The implant systems with surface modifications aim to aid in early osseo-integration and offer larger surface are for osseous integration thus enhancing the longevity of the survival of the implants. The review concludes that bioctive surfaces offer better outcomes but further long term studies are needed.
ABSTRACT Immediate implant placement with immediate loading offers reduced treatment time and improved esthetic outcomes, but becomes challenging in sites with severe buccal bone deficiency. This report describes the management of a 45-year-old male who presented 3 weeks after the extraction of the maxillary second premolar. Clinical evaluation showed complete soft-tissue closure, while cone-beam computed tomography demonstrated extensive buccal plate loss reaching the root apex. A digitally guided surgical protocol was used to place a 4.5 mm × 13 mm implant with 50 Ncm torque by engaging the palatal and proximal bone. The buccal defect was reconstructed with particulate bone graft mixed with 0.2% hyaluronic acid gel and covered with a resorbable collagen membrane. A definitive screw-retained zirconia crown was delivered within 24 h. One-year clinical and radiographic follow-up revealed stable crestal bone and healthy peri-implant tissues, indicating that immediate definitive restoration is feasible even in compromised early extraction sockets when supported by precise digital planning and enhanced regeneration.
