Wettability of dental implants surface might be an additional key variable in the regeneration process and osseointegration. The aim of the study was to evaluate the effect of a new nanoscale roughness, combined with super-hydrophilic surface on bone volume change after trans-crestal sinus floor lift procedure for implant positioning. The study was reported according to SPIRIT guidelines. A 12-month, single-center, parallel group clinical trial was conducted to compare changes in bone regeneration and crestal bone level as shown on x-ray, following trans-crestal sinus floor lift using a collagenated hydroxyapatite graft and insertion of single dental implants with two different surfaces: moderately rough surface implants (Control Group – CG) and nanoscale super-hydrophilic surface implants (Test Group – TG). Radiographic bone volume and maximum height of regenerated bone as well as peri-implant crestal bone level were evaluated immediately following implant insertion and after 12 months. A multivariate regression model was built to address the impact of surface characteristics and clinical variables on the outcome. The study was completed by 25 participants (12 in the TG and 13 in the CG). CG achieved a volume change of 94.54mm3 (SD 70.24), while the TG increased by 207.41mm3 (SD 168.10) Focusing on bone height gain, CG presented 6.25 mm (SD 1.88), compared to 5.02 mm (SD 1.71) in the TG. For both outcomes, no statistically significant differences were found between the two groups (p = 0.087 for bone volume change; p = 0.123 for bone height gain). Multivariate linear regression models only partially explained observed variance (respectively 8.6 and 35.4
Traditional surgical techniques are based on the manual application of force using mallets and osteotomes, which often result in uncontrolled impact forces, procedural inconsistencies, and patient discomfort. Magnetic mallets (MMs), magnetodynamic devices, provide a controlled application of force using electromagnetism, aiming to achieve greater precision, reduced operating time, and improved surgical outcomes. The aim of the present systematic review was to evaluate the effectiveness of MMs compared to conventional surgical techniques in oral and implant surgery. The focused question was as follows: “Do magnetic mallets improve clinical outcomes in oral and implant surgery compared to traditional instruments?” Only clinical studies comparing the use of MMs with traditional techniques in oral surgery were included. The following databases were searched up to 27 November 2025: Pubmed, Scopus, Web of Science. For quality assessment, the Cochrane Risk of Bias 2 (RoB 2) tool was applied for randomized controlled trials (RCTs), while the Newcastle–Ottawa Scale (NOS) was used for non-randomized studies. Data were screened and synthesized by two reviewers. The systematic review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. In total, 347 studies were initially found and 6 matched the inclusion criteria and were included in the review, for a total of 282 patients. Five RCTs were included, as well as one retrospective study. The studies investigated were as follows: implant site preparation (two studies with a total of 86 patients), sinus lift and contextual implant insertion (three studies, total: 102 patients), dental extraction (two studies, total: 70 patients), and split-crest (one study with 46 patients). The outcomes suggest that MMs may serve as a potential alternative to traditional techniques, exhibiting promising although preliminary outcomes. The studies included reported a lower incidence of benign paroxysmal positional vertigo with the use of MMs compared to hand osteotomes. Regarding quality assessment, RCTs raised some concerns, while the retrospective study had a moderate risk of bias. Despite the promising results, the paucity of high-quality controlled trials limits definitive conclusions on the superiority of MM over conventional techniques. Further well-designed comparative trials are needed to confirm the clinical benefits, optimize protocols across different indications, and evaluate MMs’ potential role in the management of critical bone conditions and complex surgery.
This study evaluated the efficiency and potential risks associated with three clinical tools for removing cement-retained implant-supported prostheses: Magnetic Mallet, sliding hammer, and Coronaflex. The tests consisted of: cementation of three-unit bridge models onto titanium abutments with different geometries using Zinc Oxide non-eugenol or Zinc Phosphate cement. Seven different geometries of three-unit bridges were tested; therefore, a total of 7 bridges × 2 luting agents × 3 tools were combined in a full factorial analysis. Five test replicates were performed for each combination, resulting in a total of 5 × 7 × 2 × 3 = 210 retrieval tests. The 70 tests regarding the Coronaflex were taken from a previously conducted experiment on the topic, using the same dental bridge models and the same experimental conditions. Efficiency was assessed by the percentage of successful removals and the maximum force recorded with a piezoelectric load cell. For temporary cementations, the sliding hammer achieved the highest retrieval rate, while the Magnetic Mallet demonstrated comparable efficiency with lower forces. Coronaflex showed lower success rates and higher forces than Magnetic Mallet. For permanent cementations, most bridges were not removable, and attempts with the sliding hammer occasionally resulted in abutment screw damage. Within the limitations of this study, the Magnetic Mallet appears to be an effective option for removing bridges cemented with temporary cement, potentially in combination with a sliding hammer for highly retentive geometries. Zinc phosphate cement should be avoided when retrievability is desired, except for abutments with very low retention capability.
Objectives To evaluate the three-dimensional bone regeneration achieved with digitally customized titanium meshes in patients presenting Cawood and Howell Class V defects, 8 months after surgery. Methods This retrospective clinical case series included 9 patients with severe alveolar ridge atrophy (Cawood and Howell Class V), who underwent guided bone regeneration using customized titanium meshes at 10 surgical sites (8 mandibular and 2 maxillary). Meshes were designed through a fully digital workflow based on cone-beam computed tomography (CBCT) data and manufactured using Direct Metal Laser Sintering (DMLS). This approach allowed accurate preoperative planning, optimal adaptation of the mesh, smooth and rounded margins, intrinsic stability, and reduced intraoperative time. Surgical procedures were performed with careful flap management to achieve tension-free primary closure. Clinical and histological outcomes were assessed at 8 months postoperatively. Results No cases of mesh exposure, infection, or graft failure were observed. The mean vertical bone gain was 5.18 ± 1.82 mm, while the mean horizontal bone gain was 7.27 ± 1.74 mm. The mean regenerated bone volume was 1.25 ± 0.67 cm³. Histological analysis revealed vital, well-vascularized bone in direct contact with residual graft material. Conclusions Within the limitations of this retrospective case series, customized titanium meshes were associated with measurable three-dimensional bone gain in Cawood and Howell Class V defects. These preliminary findings support the feasibility of this patient-specific digital approach and warrant further investigation in larger prospective studies with appropriate control groups.
INTRODUCTION:The aim of the present study was to evaluate the opinion of Italian dental hygienists about the use of domiciliary water flosser for the oral hygiene of implant-supported fixed prostheses. EVIDENCE ACQUISITION:A narrative review of the literature is presented, and a digital questionnaire was shared on Facebook professional groups to be anonymously filled by Italian dental hygienists. A descriptive analysis of the answers was conducted. EVIDENCE SYNTHESIS:Three hundred thirty-three dental hygienists participated of which 34% have worked for 0-5 years, 27.4% for 6-10 years, 26.81 27% for 10-20 years, and 11.14% for more than 20 years. Water flosser was recommended by the 49,7%. A small proportion of respondents, the 7.83%, thought that this intervention could cause emphysema/abscesses, while the 43.98% and the 36.75% believed respectively that it was either ineffective in the plaque removal or even it could push the biofilm under the gums. The 12.35% believed that the water flosser could cause gum recession, was difficult to use (20.48%) and it could damage the prosthodontic and implant components (1.2%). These information were acquired from textbooks (31.63%), web (25%), universities courses (57.23%), companies (25.6%), other courses (38.25%) and personal experience (6.33%). The 48.2% of the hygienists reported that they were often asked from their patients about water flosser, 47.3% rarely, 1.25% always and 3.3% never. CONCLUSIONS:Although the scientific literature supports the use of water flosser in terms of efficacy and safety, Italian dental hygienists rarely recommend it for home oral hygiene of implant-supported prostheses mainly because they consider it ineffective or even dangerous.
Introduction: This study highlights the importance of maintaining dental implants, particularly in the context of peri-implantitis. It emphasizes the need for dental hygienists to choose appropriate instruments that will not damage implant surfaces while effectively cleaning them. Materials and Methods: The research involved in vitro tests using 4 ultrasonic inserts for peri-implant mechanical instrumentation on one machined and one etched healing abutment, with a focus on how these instruments affect surface roughness. For each insert, four surface roughness measurements were recorded on each abutment. The data were then analyzed in two separate designs, one for the machined abutments and one for the etched abutments. The significance of the factors was determined by analyzing them using an ANOVA test. Results: The study found significant effects of surface treatment and instrument type on surface roughness parameters. Instrumentation tended to alter the roughness of machined surfaces more than etched ones, with notable differences in performance among the various inserts. Discussion: The results suggest that surface treatment has a more substantial impact on roughness than the choice of instrument. Future studies are encouraged to explore other parameters related to bacterial biofilm retention and the potential release of material from non-metallic inserts. Conclusions: Key findings include that surface treatment significantly influences surface roughness and that specific instruments can either increase or decrease roughness based on the type of surface.
Background: In modern dentistry, alveolar socket preservation after tooth extraction plays a critical role in maintaining the alveolar ridge for future dental implants. This retrospective clinical study evaluated bone-level changes 15 years after immediate implant placement, coupled with alveolar ridge preservation. Methods: Fifty non-smoking patients aged 25 to 75 (30 males and 20 females) who underwent single-implant rehabilitation in both anterior and posterior regions of the upper and lower jaws were included. The study examined bone levels and implant survival over time, using standardized intraoral radiographs at 1, 5, and 15 years post-loading. Implants were placed immediately after atraumatic extraction, and the residual gap was grafted with bovine hydroxyapatite and covered with a collagen membrane. The primary outcome was bone-level stability, while secondary outcomes included implant failure. No temporary crowns or removable dentures were provided during healing. Radiographs were digitized for detailed analysis. Results: The results for 50 patients with immediate implant placement showed that bone-resorption levels were significantly higher in the upper jaw than in the lower jaw. Conclusions: Posterior implants exhibited greater bone loss than anterior implants, particularly at 1 year and 15 years, while no implant failures occurred.
PURPOSE:Few studies have explored the bone response in dental implant sites prepared using a piezoelectric device, indicating moderate effectiveness in enhancing secondary stability and osteogenesis. This study seeks to expand our understanding of the changes in biological, clinical, and radiographic parameters, during the initial phases of osseointegration in sites prepared with piezoelectric surgery. MATERIALS AND METHODS:Two implant sites were prepared in the tibia of four minipigs. At the time of implant placement (T0), bone cortex thickness and Implant Stability Quotient (ISQ) were assessed. A bone specimen was collected from the tibia and used as the baseline for biomolecular analyses. X-ray was taken after implant insertion. After 14 days (T14), a computed tomography (CT) scan of the tibias was conducted, and ISQ values were reassessed. Histological and biomolecular analyses were performed on bone sections containing the implant. RESULTS:ISQ significantly increased from T0 to T14, in the absence of any correlation between the cortical thickness and ISQ. In two animals, CT showed a slight trabecular bone thickening adjacent to the implants and disorganized radiodense spots; in the other two, no trabecular osseodensification was evident. Newly formed bone was about 48% of the tissue around implants. At T14, an increase in osteogenic factors and a decrease in inflammatory molecules were observed. CONCLUSION:This study enhances understanding of the biological and clinical responses at bone implant sites following piezoelectric surgery. It highlights the relationship between the rise in certain osteogenic factors and new bone formation, as well as a potential association with increased ISQ.
Background: Resorbable biopolymers are increasingly explored for use in regenerative procedures within dental surgery. Their ability to degrade naturally, minimize surgical reinterventions, and potentially reduce immunogenicity makes them appealing in guided bone and tissue regeneration applications. However, despite these advantages, uncertainties persist regarding their comparative effectiveness and associated risks. For example, polyethylene glycol (PEG)-based membranes have shown comparable outcomes to porcine-derived collagen membranes in bone regeneration procedures, yet studies have reported a higher incidence of soft tissue healing complications associated with PEG-based materials. Similarly, while polycaprolactone (PCL) and dextrin-based hydrogels have demonstrated promising clinical handling and bone fill capabilities, their long-term performance and consistency across different anatomical sites remain under investigation. These findings highlight the need for further well-powered clinical trials to establish standardized guidelines for their safe and effective use. Methods: A systematic review protocol was registered with the PROSPERO database and developed in alignment with PRISMA guidelines. Database searches were conducted in PubMed, Medline, Scopus, and Cochrane from June to December 2024. Only randomized controlled trials (RCTs) focusing on synthetic resorbable biopolymers in bone augmentation procedures were considered. Bias was evaluated using the Cochrane Risk of Bias tool. Results: Eleven RCTs were included, totaling 188 patients. The findings suggest that materials such as polylactic acid (PLA), polycaprolactone (PCL), and polyethylene glycol (PEG) contributed effectively to new bone formation. PEG-based membranes were found to perform on par with or occasionally better than traditional collagen membranes derived from porcine sources. Additionally, the application of 3D-printable polymers demonstrated promise in site-specific healing. Conclusions: Resorbable biopolymers are effective and safe for GBR procedures, with clinical outcomes comparable to traditional materials. Advances in 3D-printing technology and bioactive coatings may further enhance their regenerative potential. However, the incidence of soft tissue healing complications suggests the need for further long-term studies to optimize material properties and clinical application.
Successful implant therapy must also ensure the integration of the soft tissues around the crown/abutment emergence profile. The existing literature does not consistently agree on the necessity of a minimal amount of keratinized tissue (KT), though it appears advantageous for the long-term stability and aesthetics of implants. The purpose of this clinical retrospective study is to compare the effectiveness of amnion/chorion membrane and autogenous subepithelial connective tissue in increasing the keratinized mucosa and maintaining it over a 5-year follow-up. Twenty patients who had previously undergone implant surgery were included in the study. Ten patients had received the allograft (Group 1) and ten had received autogenous connective tissue (Group 2).An independent examiner retrospectively analyzed the patient records at 7, 15, and 60 days, and five years post-procedure. Data from these observations were collected and analyzed using SPSS Statistics, version 25. Descriptive statistical analysis was conducted. All patients exhibited an increase in KT. For Group 1, the mean KT width measurements were 1.27 ± 0.46 mm at the initial evaluation, increasing to 2.00 ± 0.38 mm, 2.80 ± 0.78 mm, 3.27 ± 0.80 mm, and 3.01 ± 0.68 mm at 7, 15, and 60 days post-surgery (with prosthesis delivery on day 60), and five years after prosthetic rehabilitation, respectively. Within the limitations of this retrospective clinical study, both amnion/chorion and connective tissue show significant potential for KT expansion when used in conjunction with implant surgery. The use of allografts, due their low morbidity, and acceptable results should be considered as a viable option for soft tissues augmentations.
Background: Third-molar extractions are common procedures often complicated by infections and alveolitis. The use of antibiotics as prophylaxis to prevent these complications is debated due to potential risks and side effects. Therefore, the aim of the present systematic review was to determine the efficacy of antibiotic prescription for the prevention of these complications. Methods: A comprehensive literature search was conducted in MEDLINE/PubMed, Cochrane, and SCOPUS databases up until June 2024. The focused question was “Does the antibiotic prescription influence the incidence of postoperative complications following third-molar extractions in healthy patients?” Systematic reviews assessing complications after third-molar extractions were included. Results: A total of 16 studies were included, revealing that antibiotic use significantly reduces infection risk and dry socket incidence compared to no prescription. Amoxicillin–clavulanic acid was particularly effective. Conclusions: Antibiotics, especially amoxicillin–clavulanic acid, are effective in preventing postoperative infections and alveolitis after third-molar extraction. However, their administration should be carefully considered to balance benefits against potential risks. Evidence supports the judicious use of antibiotics in dental surgery to optimize patient outcomes, minimizing possible adverse effects and the risk of developing antibiotic resistance.
BACKGROUND:The purpose of the study is to evaluate the use of a magnetodynamic instrument (Magnetic Mallet®, Metaergonomica, Turbigo, Milan, Italy) to perform a horizontal bone expansion in edentulous sites that need to be rehabilitated with a dental implant. METHODS:A sample of 15 patients, 11 men and 4 women, age between 39 and 78 years, was analyzed. A total of 18 conical-shaped implants with a diameter of 3.80 mm and a length between 10 and 11.5 mm were inserted in the maxillary region in the area between the lateral incisor and the first upper molar. The patients were treated by two different surgeons. Bone thickness was measured through CBCT before treatment and at 3 months post-surgery. RESULTS:No implant failed and all of them achieved a correct osseointegration. The average pre-surgery bone thickness was 4.36±0.70 mm, it changed to 5.58±1.11 mm after using the Magnetic Mallet®, finally stabilized at 6.72±1.24 mm with the insertion of the implant. CBCT examination revealed a statistically significant difference in mean bone thickness before treatment and at 3 months post-surgery with a mean bone thickness of respectively 4.39±0.60 mm and 6.97±1.25 mm. Significantly different outcomes were obtained by operators with a different learning curve. CONCLUSIONS:At 3 months of follow-up, the Magnetic Mallet® proved to be a useful tool in the horizontal expansion of the atrophic upper jaw bone crest, along with the preparation of the implant site. A learning curve is necessary to optimize the clinical outcomes. Further studies are needed with a larger patient cohort and a longer follow-up to confirm the present results.
BACKGROUND:Alveolar bone resorption remains a major challenge in implant and prosthetic rehabilitation. While autologous bone grafts are still considered the gold standard, their biological and surgical limitations have promoted the use of synthetic biomaterials such as biphasic calcium phosphate (BCP), β-tricalcium phosphate (β-TCP), nanocrystalline hydroxyapatite, and bioactive glass. METHODS:This systematic review, conducted in accordance with PRISMA guidelines, was based on a comprehensive search performed in March 2025 across PubMed, MEDLINE, Embase, and Google Scholar. A total of 11 clinical studies-including both randomized and non-randomized comparative trials-were identified. Due to the marked heterogeneity of study designs and outcome measures, meta-analysis was not feasible. Reported outcomes focused on bone volume preservation, residual biomaterial, implant stability, histological integration, and postoperative complications. RESULTS:Overall, synthetic biomaterials achieved satisfactory bone regeneration and implant stability, with mean bone preservation ranging between 85% and 95%, often comparable to xenografts and other grafting materials. Among the materials analyzed, β-TCP and BCP generally demonstrated superior resorption control and dimensional stability, while bioactive glass showed favorable integration and remodeling rates. The addition of bioactive agents such as rhBMP-2, rhPDGF-BB, or platelet-rich plasma further enhanced new bone formation. CONCLUSIONS:Within the limits of current evidence, synthetic biomaterials show clinical performance comparable to xenografts, particularly in socket preservation and ridge augmentation procedures. Their predictable handling, absence of donor-site morbidity, and potential for bioactive enhancement make them valuable tools for routine clinical use. Larger, standardized trials with long-term follow-up are needed to validate these findings and refine material selection in alveolar bone regeneration.
Background: Wettability of dental implant surfaces is a key factor in the osteointegration process. This study aimed to evaluate the effect of a new hydrophilic surface on implant stability in posterior maxilla rehabilitations. Materials and Methods: A 6-month, single-center, parallel-group clinical trial following STROBE guidelines was reported. Implant Stability Quotient (ISQ) changes were compared between implants with a moderately rough surface (MultiNeO CS, Alpha-Bio Tec, Israel, Control Group–CG) and those with the same surface and, in addition, nano-scale roughness and hydrophilic properties (MultiNeO NH CS, Alpha-Bio Tec, Israel, Test Group–TG) placed using a crestal sinus lift technique. ISQ values at bucco-lingual (ISQBL) and mesio-distal (ISQMD) sides were measured at insertion (t0), 4 months (t4), and 6 months (t6). Repeated measures ANOVA (RMA) was performed for statistical evaluation. Results: The study included 35 participants (18 TG, 17 CG). Mean ISQBL0 was 69.45 (SD = 12.62), increasing to 71.72 (SD = 6.74) at t4 and 75.21 (SD = 4) at t6. ISQMD0 mean was 67.54 (SD = 12.54), rising to 72.32 (SD = 6.90) at t4 and 75.67 (SD = 4.60) at t6. No statistically significant differences were found between groups, though TG showed a significant increase in ISQBL at t6 vs. t4 and ISQMD at t6 vs. t0. One-way ANOVA revealed no significant variations between mean ISQ differences over time. Conclusion: Both groups exhibited an increasing ISQ trend, but no significant differences were observed between t4–t0 and t6–t4 periods. Further research is required to assess the impact of hydrophilia on early loading, osteointegration, and long-term outcomes.
Background: Coaxial implants with an inclined neck might overcome some problems related to angulation of the implant axis when using tilted implants. Therefore, the aim of the present work was to conduct a narrative review of the current literature and to present a case series comparing traditional and coaxial external hex implants in full-arch immediate loading rehabilitations of the maxilla. Methods: A total of 13 external hex tapered implants (Southern Implants) was inserted in the upper jaw of 3 patients. Each patient received two tilted implants in distal sites. In one randomly selected quadrant, the tilted implant was a standard implant, while a Co-Axis® implant with a 24° inclination of the implant shoulder was inserted on the other hemi-arch. Straight conical abutments were screwed on coaxial implants while multiunit abutments of appropriate inclination were screwed as needed on the other implants to correct their axes. Peri-implant bone level was recorded radiographically at T0 (delivery of the immediate loading prosthesis), and at 3, 6, 12, and 24 months of healing and then annually. Plaque index, probing depth, and bleeding on probing were also evaluated. Cumulative implant survival rate (CSR) was calculated, and biological or technical complications were recorded as well as the operator satisfaction towards the use of coaxial implants. Results: The preliminary data collected did not show significant differences in peri-implant tissues health and maintenance over time between the two implant types. No implants failed, and both implant types proved to be favorable for full-arch rehabilitation using tilted implants. Coaxial implants facilitated the prosthodontic procedures. However, a learning curve is required in order to optimize their insertion. Conclusions: Both implants proved to be reliable and suitable for achieving clinical success in full-arch immediate loading rehabilitations, but further research with longer follow-up and larger sample size is needed to confirm these preliminary outcomes.
Socket preservation post-tooth extraction is crucial for optimal conditions for subsequent dental implant placement. This review explores the efficacy, impact on tissue volumes, and economic considerations of socket preservation techniques. Socket preservation involves grafting the alveolar cavity with a bone substitute and sealing it with a membrane. Various graft and membrane types offer different outcomes. Xenograft materials are favored for optimal clinical outcomes. Membranes range from autogenous grafts to synthetic options like collagen matrixes, with resorption time being a key differentiator. Recent systematic reviews highlight the effectiveness of socket preservation in maintaining alveolar ridge dimensions and soft tissue integrity, with favorable outcomes across various studies. This review examines the efficacy, impact on tissue volumes, and economic considerations of socket preservation techniques. Favorable outcomes in maintaining alveolar ridge dimensions and preserving soft tissue integrity are highlighted. However, further research is needed to assess long-term stability and efficacy.
Aim: Magnetodynamic surgery has assumed increasing importance in recent years. The purpose of the present study was to compare in vitro, using dry porcine ribs, two methods of dental implant site preparation (conventional drill and magnetic mallet) on three aspects of the site. These were the difference between the diameter of the site and the diameter of the last drill used (an index of the accuracy of the preparation), the weight loss of the specimen on which the site was prepared (index of the bone loss in the site), and the change of temperature at the site (an index of the change to the material at the site). Methods: Eight preformed pork ribs were chosen for the study. Four implant preparations were made on each rib, two with Magnetic Mallet (Meta Ergonomica, Turbigo, Italy) and two with traditional drills. Each bone sample was weighed before and after implant site preparation in order to calculate the amount of bone lost during preparation. The diameter of preparations was analyzed with the aid of an optical microscope (MZ6, Leica, Wetzlar, Germany) connected to a dedicated measurement software. For the evaluation of the temperature, eight preparation sites were marked. In correspondence of each preparation site, on the opposite side of the rib, a hole was made for the thermocouple (HI 91530K, Hanna Instruments, Padova, Italy). During the preparations, the thermocouple was kept inserted inside the control hole to record the temperature variation. The results were analyzed using appropriate statistical methods, such as the Kolmogorov-Smirnoff test and the Wilcoxon test. Results: It was found that mallet drill provided significantly higher accuracy of preparation, lower amount of damage at the site, and less change to the porcine rib test material at the preparation site. Conclusions: A possible clinical implication of this finding is discussed.
Background: Tooth extraction techniques have been refined over the years in order to be less traumatic and to better preserve alveolar bone. A recently introduced extraction method involves the use of the Magnetic Mallet®, which allows clinicians to be more precise and perform extractions faster. Moreover, the instrument enables the procedure to be less traumatic for patients. The aim of the present study was to clinically evaluate whether extractions performed using the Magnetic Mallet® can lead to less buccolingual bone resorption. Methods: Between February 2023 and June 2023, nine patients with an average age of 62 years underwent 29 extractions using the Magnetic Mallet®. Sectorial CBCTs were performed in order to measure buccolingual bone thickness at time 0 (T0, before extraction) and 3 months after extraction (T3M). All the extractions were performed by two different expert operators exclusively using the Magnetic Mallet®. For statistical analysis, a two-sample t-test was performed to determine the difference between the measurements taken at T0 and those taken at T3M in the 29 dental elements and the difference in bone loss between the surgeries conducted by the two clinicians. Results: A total of 22 teeth were extracted in the upper jaw and 7 in the lower jaw. The average degree of mobility was 1. The average degree of force impressed by the instrument to extract the teeth was 2, while the average frequency of blows administered was 7. The average time taken for the extractions was 3½ min. After 3 months, the mean buccolingual bone resorption was 1.54 mm (SD: ±). The difference in buccolingual bone thickness between T0 and T3 was significant at an alpha significance level of 0.01. No difference in bone resorption was found between the surgeries conducted by the two clinicians. Conclusions: The use of the Magnetic Mallet® results in bone loss in the buccolingual direction comparable with existing data in the literature on healing the post-extraction socket. This tool seems to be predictable in producing the same results between different operators.
Objectives: The aim of this study was to systematically revise the state of art of the accuracy of digital and conventional impressions in clinical full-arch scenarios. Methods: Electronic and manual searches were conducted up to December 2024. Only trials comparing the accuracy of digital versus conventional impressions were selected by two independent reviewers. Accuracy was evaluated by analysing the fit of the prostheses obtained through conventional workflows and those obtained from digital workflows using intraoral scanners. Alternatively, accuracy was assessed by comparing the standard tessellation language data acquired from intraoral scanning with those obtained from scanning the physical model. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Meta-analysis was conducted to pool the mean differences from the included studies, with heterogeneity tested by Cochran’s Q test and quantified by the I2 index. Results: We included 9 relevant studies from a total of 2535 identified studies. The risk of bias was evaluated as low, and the main results of all the included articles reported similar accuracy between digital and conventional impressions. Random effects meta-analysis resulted in a pooled mean difference of 152.46 (95% C.I. = 76.46–228.46, p-value < 0.001, I2 = 93.48%). Conclusions: In conclusion, the results of the present systematic review reveal contradictory findings regarding the accuracy of digital impressions. However, most studies analysing the clinical performance of prostheses obtained through digital impressions suggest that their accuracy falls within clinically acceptable thresholds. Future research should report comparable outcomes and focus attention on linear deviations, comparing differences between conventional and digital impressions not in absolute terms, but relative to the distance measured.
Tooth extraction techniques have been refined over the years in order to be less traumatic and better preserve alveolar bone. A recently introduced extraction method involves the use of the Magnetic Mallet®, which allows the clinician to be more precise, faster and less traumatic. The aim of the present study was to clinically evaluate whether extractions performed by means of the Magnetic Mallet® can lead to less bucco-lingual bone resorption. Between February 2023 and June 2023, 9 patients with an average age of 62 years underwent 29 extractions using the Magnetic Mallet®. Sectoral CBCTs were performed in order to measure bucco-lingual bone thickness at time 0 (T0, before extraction) and 3 months after extraction (T3M). All the extractions were performed by 2 different expert operators using exclusively the magnetic mallet. For statistical analysis, a two-sample t-test was performed between the measurements taken at T0 and those taken at T3M in the 29 dental elements and between the difference in bone loss among the 2 different clinicians. 22 teeth were extracted in the upper jaw and 7 in the lower jaw. The average degree of mobility was 1. The average degree of force impressed by the instrument to extract the teeth was 2, while the average frequency of blows administered was 7. The average time taken for the extractions was 3½ minutes. After 4 months, the mean bucco-lingual bone resorption was 1.54 mm (SD: +-). The difference of bucco-lingual bone thickness between T0 and T3 was significant at an alpha significance level of 0.01. No difference were found in bone resorption based on the clinician. The use of the Magnetic Mallet® during tooth extraction led to less bucco-lingual bone resorption in the 3 months following dental extraction, compared to the traditional use of manual hammers, chisels and levers.