Aims To evaluate bone regeneration and osseointegration using low-dosage Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2) incorporated with calcium phosphate cement (CPC) via a biomimetic coating method during simultaneous lateral ridge augmentation with implant placement. Materials and methods Chronic horizontal alveolar bone defects were created in the mandibles of 5 dogs. Before implant placement, defects were randomly assigned to different grafting groups: autologous bone, CPC, high-dosage ErhBMP-2 (1088 µg/g) adsorbed to CPC (ErhBMP-2 Ads. CPC), and low-dosage ErhBMP-2 (239 µg/g) incorporated with CPC (ErhBMP-2 Inc. CPC). Lateral ridge augmentation was performed at the buccal aspect of each defect during implant surgery. Bone regeneration and contour maintenance were assessed using micro-CT and histology 3 months postoperatively. Results Micro-CT showed that the ErhBMP-2 Inc. CPC group developed substantial mineralised tissue covering the implant surface, with no exposed threads at the implant neck. Trabecular thickness in this group was significantly greater than in the CPC and autologous bone groups. Histology confirmed greater bone marrow formation and horizontal augmentation below the implant shoulder in the ErhBMP-2 Inc. CPC group compared with CPC alone. Collectively, the histological and radiographic findings were consistent with enhanced peri-implant bone regeneration in the ErhBMP-2 Inc. CPC group. Conclusions ErhBMP-2 Inc. CPC enhanced peri-implant bone regeneration than CPC alone. Clinical relevance Low-dosage ErhBMP-2 incorporated into CPC may offer a more predictable and effective approach for simultaneous lateral ridge augmentation and implant placement by enhancing bone regeneration and maintaining ridge contours.

INTRODUCTION AND AIMS:Compromised bone quality and quantity in the posterior maxilla are widely recognised as significant risk factors for implant failures. This study aimed to (1) assess the bone quality of the resorbed posterior maxilla both radiographically and histologically and (2) evaluate the impact of native alveolar bone quality on osteogenesis following maxillary sinus floor augmentation (MSFA). METHODS:Patients presenting advanced posterior maxillary atrophy (residual bone height ≤ 4 mm) underwent MSFA via a lateral window approach using deproteinised bovine bone matrix (DBBM). Bone core biopsies were collected during second-stage implant placement for histological analyses. Preoperative cone-beam computer tomography (CBCT) images were used to classify bone quality based on cortical bone configuration. Multiple linear regression was employed to identify factors influencing osteogenesis. RESULTS:A total of 190 sinuses from 176 patients (96 males/80 females, mean age: 45.77 ± 4.13 years) underwent MSFA and biopsy. Radiographic analysis revealed the presence of bicortical bone in 42.21% of the maxillary ridges, unicortical bone in 25.97%, no cortical bone in 19.48% and sinus floor-crestal bone fusion in 12.34%. Histologically, native bone comprised 40.01% ± 14.85% of mineralised trabeculae while newly formed bone accounted for 18.77% ± 5.69% in the DBBM grafted areas. A significant positive correlation was observed between native bone trabecula percentage and new bone formation (r = 0.23, P = .04). No significant associations were found with age, sex, healing time or radiographic alveolar type (P > .05). CONCLUSION:Greater density of native trabecular bone may contribute to enhanced osteogenesis following MSFA. CLINICAL RELEVANCE:This study enhances our understanding of the bone characteristics of the resorbed posterior maxilla. It emphasises the need to consider the bone quality of the recipient site before conducting a MSFA for determining the surgical procedure and predicting the prognosis.

AIM:To evaluate the prevalence and risk indicators of peri-implant diseases in a randomly selected Chinese population. MATERIALS AND METHODS:A total of 819 patients with 1412 implants from eight university hospital databases were clinically and radiographically evaluated along with medical records to assess the prevalence of peri-implant diseases. Potential risk/protective indicators were explored using multilevel mixed-effects logistic regression analysis. RESULTS:According to the 2017 EFP/AAP World Workshop case definitions, the prevalence of peri-implant mucositis at the subject and implant level was 36.4% and 31.3%, respectively. The prevalence of peri-implantitis at the subject and implant level was 4% and 3.3%, respectively. History of periodontitis and heavy smoking were identified as risk indicators for peri-implantitis in the final model. CONCLUSION:In this randomly selected diverse patient sample within China, the prevalence of peri-implant diseases was moderately high (40.4%) after a mean follow-up duration of 6.65 ± 1.18 years post loading.

Zygomatic implant-(ZI) supported prostheses are reliable and effective treatment options for patients with a severely atrophic maxilla or maxillary defects. This article described a novel custom registration plate for dynamic computer-assisted ZI placement in a patient with a narrowed zygoma. By distributing registration points around the zygoma, this registration plate enhanced the accuracy and safety of ZI placement.

PurposeThis study aimed to assess whether zygomatic implant-supported fixed restorations (ZIFRs) provide comparable chewing efficiency and patient-centered outcomes to conventional implant-supported fixed restorations (CIFRs) in edentulous maxilla cases.Material and methodsA total of 29 patients were enrolled in this study. These patients with maxillary edentulism received ZIFR (16) or CIFR (13) treatment between October 2018 and April 2022. Chewing efficiency was evaluated by the subjective assessments of the scales of chewed gums and the variance of the Hue in a two-color chewing gum mixing ability test. In addition, the Oral Health Impact Profile-14 (OHIP-14) was employed to compare the oral health-related quality of life of patients between these two groups.ResultsThere were no significant differences in chewing efficiency between the ZIFR and CIFR groups according to the results of the subjective assessments (P = 0.59 and P = 0.19 in the first and second stroke of the chewing test, respectively) and the variance of the Hue (P = 0.55 in the first stroke and P = 0.28 in the second stroke). Based on OHIP-14 results, the ZIFR group reported less psychological pain, physical disability, and psychological discomfort. In addition, the success rate of implants in the ZIFR and CIFR groups was 100% and 98.1% at the implant level and 100% and 93.75% at the patient level, respectively.ConclusionsWith the limitations of the study, the chewing efficiency of ZIFRs was comparable to CIFRs in the rehabilitation of maxillary edentulism. However, under such conditions, ZIFRs can offer better postoperative quality of life compared to CIFRs.

Objective·To combine the Cre/loxP recombinase system with a tooth extraction model to explore the spatiotemporal distribution of Col1+ cells secreting type Ⅰ collagen (collagen type Ⅰ, COL1) during alveolar socket healing and their potential to differentiate into osteoblasts.Methods·Col1-CreERT2 mice were mated with Rosa26-LoxP-Stop-LoxP-tdTomato mice to obtain Col1-CreERT2;tdTomato double transgenic offspring mice. Fifteen offspring mice were selected and tamoxifen (TA) was intraperitoneally injected to label the Col1+ cell lineage. One week later, the right maxillary first molars of the offspring mice were completely extracted under general anesthesia to establish a double transgenic mouse tooth extraction model. The offspring mice were divided into 5 groups, with 3 mice in each group. Maxillary bone samples were collected at 0, 3, 7, 14, and 28 days after tooth extraction, respectively. Paraffin sections were used to observe the dynamic distribution of the Col1+ cell lineage during alveolar socket healing. Immunofluorescence techniques were employed to label the osteoblast-specific transcription factor osterix (OSX), vascular marker endomucin (EMCN), and neuronal marker β3-tubulin to investigate the osteogenic potential of Col1+ cells and their spatial localization relationship with blood vessels and nerves.Results·The tooth extraction model of Col1-CreERT2;tdTomato double transgenic mice was successfully established. Paraffin section observations revealed that Col1+ cells appeared in the alveolar socket on the third day after the model was established; on the seventh day, the number of Col1+ cells increased and alveolar socket osteogenesis gradually occurred; on the 28th day, the proportion of Col1+ cells further increased and they were distributed around the bone trabeculae. The results of statistical analysis showed that the number of Col1+ cells increased over time during alveolar socket healing (all P<0.001, compared with day 0). The results of Immunofluorescence assay indicated that the number of Col1+ OSX+ double-positive cells in the alveolar socket gradually increased from the 7th to the 28th day after the model was established, and Col1+ cells were spatially adjacent to EMCN and β3-tubulin.Conclusion·During alveolar socket healing, Col1+ cells have the potential to differentiate into osteoblasts, and may also be involved in the formation of blood vessels and nerves.

OBJECTIVES:The 1st Global Consensus for Clinical Guidelines (GCCG) in Implant Dentistry introduced an evidence-based, patient-centered framework for rehabilitating the edentulous maxilla. Working Group 3 aimed to develop clinical recommendations on advanced diagnostic imaging, soft and hard tissue augmentation, and management of complications. MATERIALS AND METHODS:Recommendations were developed following the S2k-level guideline framework of the AWMF and a structured nominal group technique. The evidence base included two systematic reviews on clinician-reported outcomes (ClinROs) and patient-reported outcomes (PROs), supplemented by single-round international surveys of expert clinicians, patients, and cross-disciplinary experts. Survey content addressed diagnostics, treatment planning, clinical procedures, and maintenance care. Draft recommendations were discussed at the in-person consensus meeting in Boston (June 16-18, 2025) and finalized through anonymous plenary voting. Consensus thresholds were predefined as ≥ 75% but ≤ 95% agreement for consensus and > 95% agreement for strong consensus. RESULTS:Working Group 3 formulated four clinical recommendations spanning advanced diagnostic imaging, augmentation techniques, and complication management. All four recommendations reached consensus. Voting participation per recommendation ranged from 68 to 88 (mean 79) out of a possible 105 participants. CONCLUSIONS:The Working Group 3 consensus statements offer practical guidance on surgical procedures and complication management in the rehabilitation of the edentulous maxilla. These recommendations are grounded in current evidence, interdisciplinary clinical practice, and patient perspectives. Furthermore, important evidence gaps, particularly in standardized patient-reported outcome measures (PROMs), long-term outcomes, and maintenance protocols, highlight key priorities for future clinical research.

Objective: Accurate preoperative planning for dental implants, especially in edentulous or partially edentulous patients, relies on precise localization of radiographic templates that guide implant positioning. By wearing a patientspecific radiographic template, clinicians can better assess anatomical constraints and plan optimal implant paths. However, due to the low radiopacity of such templates, their spatial position is difficult to determine directly from cone-beam computed tomography (CBCT) scans. Methods: To overcome this limitation, high-resolution optical scans of the templates are acquired, providing detailed geometric information for accurate spatial registration. This paper proposes a geometric-driven cross-modal registration framework that aligns the optical scan model of the radiographic template with patient CBCT data, enhancing registration accuracy through geometric feature extraction such as curvature and occlusal contours. Results: A hybrid deep learning workflow further improves robustness, achieving a root mean square error (RMSE) of 1.68mm and mean absolute error (MAE) of 1.25mm. The system also incorporates augmented reality (AR) for real-time surgical navigation. Conclusion: Clinical and phantom experiments validate its effectiveness in supporting precise implant path planning and execution. Significance: Our proposed system enhances the efficiency and safety of dental implant surgery by integrating geometric feature extraction, deep learning-based registration, and AR-assisted navigation

Introduction and aims The clinical efficacy of alveolar ridge preservation (ARP) is well-documented in the literature. However, there is a lack of evidence regarding ARP in the posterior area and in periodontally compromised sites. There is no clinical decision-making guideline on the choice of bone substitute particle size for ARP in periodontally compromised molar sockets. This study aimed to compare the radiographic outcomes and implant feasibility of two deproteinized bovine bone mineral (DBBM) particle sizes for alveolar ridge preservation (ARP) in periodontally compromised molar extraction sockets. Methods A total of 96 patients (96 sites) with stage III/IV periodontitis requiring molar extraction were divided according to DBBM particle size (small particle [SP]: 0.25-1 or large particle [LP]: 1-2 mm). Dimensional and volumetric changes of the alveolar ridge and level of implant placement difficulty (LIPD) were evaluated. Multivariable linear regression was used to adjust for potential confounders. Results LP-DBBM showed a non-significant trend toward increased vertical central socket height (VC; 8.54 ± 2.34 vs 7.76 ± 1.93 mm; P = .077). No significant differences between SP and LP groups were observed for the remaining alveolar dimensional and volumetric changes. However, multivariable linear regression found that socket integrity (number of socket walls with height ≥5 mm; P < .001), jaw (P = .007), and particle size (P = .041) showed significant effects on VC. Conclusion A trend of higher VC using LP after ARP in periodontally compromised molar extraction sockets was observed. The choice of DBBM particle size should be considered alongside site-specific factors, especially socket integrity. Clinical Relevance Understanding the impact of graft particle size on ridge dimensional changes and implant placement feasibility can provide clinical decision-making guidance for ARP in periodontally compromised molar sockets. Larger particle size facilitates superior VC and increases the predictability of subsequent implant treatment.

OBJECTIVE:To validate the performance of a novel automated zygomatic implant (ZI) planning tool (Zygoplanner) in an international multicenter cohort. METHODS:Preoperative computed tomography (CT) scans from 69 patients (276 ZIs) who underwent quad zygomatic implant surgery were retrospectively analyzed using Zygoplanner. Automated ZI plans generated by Zygoplanner were compared with the corresponding clinically placed implants. The comparison metrics included three-dimensional bone-to-implant contact (3D-BIC), Zygoma Anatomy-Guided Approach (ZAGA) classification, safety distances to the orbital rim and the inferior border of the zygoma, inter-implant spacing, surgeon subjective assessments, and a blinded Turing test. RESULTS:Compared with clinically-proved manual plans, Zygoplanner-based automated ZI plans achieved significantly higher 3D-BIC values (p < 0.001). In the internal dataset, automated plans showed slightly shorter orbital rim distances (4.51 vs 5.71 mm, p = 0.022) but significantly greater distances to the inferior zygomatic border (8.21 vs 7.20 mm, p = 0.015). In the external dataset, Zygoplanner demonstrated significantly larger inter-implant spacing (3.01 vs 1.18 mm, p < 0.001). Despite these differences, ZAGA classifications remained consistent between both groups. Subjective evaluations by experienced surgeons yielded high scores for stability (4.63/5), feasibility (4.51/5), and safety (4.25/5). In the blinded Turing test, Zygoplanner-generated plans were identified as human expert in 65.2 % of cases, significantly exceeds the 50 % random guessing threshold (p = 0.0075). CONCLUSION:Zygoplanner automatically generates clinically acceptable quad ZI plans with improved 3D-BIC, which effectively reduces the planning complexity and facilitates better preoperative ZI planning. CLINICAL SIGNIFICANCE:Zygoplanner shows strong potential to automate and standardize quad zygomatic implant planning, thereby improving surgical predictability and safety while simplifying the planning workflow. Its automated workflow supports more consistent outcomes and may broaden access to advanced zygomatic implant rehabilitation for patients with edentulous maxillae.

BackgroundZygomatic implant (ZI) is an effective method for restoring masticatory function and mid-facial appearance in patients with severe alveolar ridge resorption, avoiding complex bone augmentation. Dynamic navigation-assisted surgery has been introduced to improve ZI placement accuracy, with registration being a crucial step. However, the current registration method using fiducial screws is limited by their concentrated placement in the mouth, reducing accuracy around the zygomatic bone. This study aims to evaluate the accuracy and clinical outcomes of a novel minimally invasive registration plate in ZI surgery, guiding its clinical application in dynamic navigation-assisted ZI surgery.MethodsThis is a prospective, single-center, parallel-group, non-inferiority randomized controlled trial conducted at Shanghai Ninth People's Hospital, Shanghai, China. We plan to recruit 20 patients who need ZI restoration. The inclusion criteria include severe atrophy of the maxillary alveolar ridge or maxillary bone defects. The anterior region must have adequate bone volume to allow placement of two temporary implants or at least four pins for registration plate fixation, or existing implants or residual teeth can provide stable fixation for the registration plate. Participants will be randomly assigned in a 1:1 allocation ratio into two groups: control group: dynamic navigation registration using traditional titanium screws; experimental group: dynamic navigation registration using the novel registration plate. The group assignment will be blinded for accuracy evaluators. Entry and exit point and angular deviations of the ZI, surgical time, registration accuracy, patient satisfaction, implant survival rate, and adverse event incidence will be assessed.DiscussionA novel minimally invasive registration plate has been designed to extend the coverage of registration points to the zygomatic bone, thereby expanding the registration range for dynamic navigation-assisted zygomatic implant placement. This study aims to compare the new registration approach with the conventional titanium screw-based method to evaluate whether it enhances the accuracy of dynamic navigation-assisted zygomatic implant surgery.Trial registrationName of the registry: Chinese Clinical Trial Registry (ChiCTR). Trial registration number: ChiCTR2500103641 (retrospectively registered). Date of registration: 2025-06-03. First planned enrollment: 2024-11-17. URL of trial registry record: https://www.chictr.org.cn/showproj.html?proj=272887

Periodontitis and dental caries are common oral diseases affecting billions globally. While observational studies suggest links between these conditions and lung cancer, causality remains uncertain. This study used two sample Mendelian randomization (MR) to explore causal relationships between dental traits (periodontitis, dental caries) and lung cancer subtypes, and to assess mediation by pulmonary function. Genetic instruments were derived from the largest available genome wide association studies, including data from 487,823 dental caries and 506,594 periodontitis cases, as well as lung cancer data from the Transdisciplinary Research of Cancer in Lung consortium. Inverse variance weighting was the main analytical method; lung function mediation was assessed using the delta method. The results showed a significant positive causal effect of dental caries on overall lung cancer and its subtypes. Specifically, a one standard deviation increase in dental caries incidence was associated with a 188.0

The rapid development of computer-assisted implant surgery (CAIS) and the respective research and clinical applications have necessitated a standardization of the terminology related not only to different devices, but also the different steps involved, surgical and presurgical procedures. The present glossary was introduced at the 1st International Team for Implantology Symposium on Computer-assisted Implant Surgery, based on the collective work of clinicians and researchers with deep understanding and experience in these technologies. The glossary was further refined and revised through the structured input of a large group of global experts within clinical application, research, and education of CAIS. The glossary includes 98 terms organized in 5 domains, aiming to clarify ambiguity and propose some standard nomenclature in the service of clinical practice, research but also development of new devices, protocols, and approaches.

Maxillary Sinus Lifting is a crucial surgical procedure for addressing insufficient alveolar bone mass andsevere resorption in dental implant therapy. To accurately analyze the geometry changesof the bone graft (BG) in the maxillary sinus (MS), it is essential to perform quantitative analysis. However, automated BG segmentation remains a major challenge due to the complex local appearance, including blurred boundaries, lesion interference, implant and artifact interference, and BG exceeding the MS. Currently, there are few tools available that can efficiently and accurately segment BG from cone beam computed tomography (CBCT) image. In this paper, we propose a distance-constrained attention network guided by prior anatomical knowledge for the automatic segmentation of BG. First, a guidance strategy of preoperative prior anatomical knowledge is added to a deep neural network (DNN), which improves its ability to identify the dividing line between the MS and BG. Next, a coordinate attention gate is proposed, which utilizes the synergy of channel and position attention to highlight salient features from the skip connections. Additionally, the geodesic distance constraint is introduced into the DNN to form multi-task predictions, which reduces the deviation of the segmentation result. In the test experiment, the proposed DNN achieved a Dice similarity coefficient of 85.48 6.38%, an average surface distance error is 0.57 0.34mm, and a 95% Hausdorff distance of 2.64 2.09mm, which is superior to the comparison networks. It markedly improves the segmentation accuracy and efficiency of BG and has potential applications in analyzing its volume change and absorption rate in the future.

PURPOSE:To integrate the medium-term outcomes of four-implant-supported overdentures (IODs) and full-arch fixed restorations (IFRs) in the maxilla. MATERIALS AND METHODS:The search was performed in PubMed, Embase, and Cochrane databases, complemented by manual search. The inclusion criteria were at least 10 maxillary edentulous patients restored by IOD or IFR with at least 5 years of follow-up. Risk of bias (RoB) 2 and Newcastle-Ottawa Scale (NOS) tools were used to assess RoB. The implant survival rate (ISR) was calculated as the primary outcome. Prothesis survival rate, marginal bone loss (MBL), and complications were the secondary outcomes. RESULTS:A total of 16 studies with 5,568 implants met the criteria (9 implants on IODs, 7 implants on IFRs). The weighted ISR of IODs was 94.5% (95% CI [92.1%, 96.9%]; I2 = 84.22%), and subgroup analysis was performed on the attachment system and study type. The weighted ISR of IFRs was 98.5% (95% CI [97.4%, 99.5%]; I2 = 77.88%). For prosthesis survival, the rate of 85.0% in IODs was lower than that of 99.9% in IFRs. MBL after 5 years was -0.27 ± 1.31 mm in IODs and -1.20 ± 0.76 mm in IFRs. Retention loss (0.34 per patient) and dislodgment/fracture of the acrylic teeth (0.09 per patient) were the most common complications in IODs and IFRs, respectively. CONCLUSIONS:Despite the variance of baseline, IFRs had a relatively higher implant and prothesis survival rate than IODs, whereas IODs had less MBL at the 5th year and a higher incidence of complications. Both maxillary IODs and IFRs have predictable medium-term clinical results.

OBJECTIVES:This study aimed to compare the trueness and precision of mandibular molar immediate implant placement (IIP) between dynamic computer-assisted implant surgery (dCAIS) and robotic computer-assisted implant surgery (rCAIS). METHODS:Ten mandibular models with 40 implant sites, consisting of two types of molar extraction sockets (type B: multiple roots with septal bone; type C: single root without septal bone), were divided into the dCAIS group and the rCAIS group for IIP. The pre- and post-operative CBCT were compared, and the trueness of the implants was measured and statistically analyzed. Precision was evaluated using the Levene test (α = 0.05). RESULTS:No significant differences were found between dCAIS and rCAIS in 3D or angular deviations. For trueness, the two groups were comparable (p > 0.05) except that rCAIS performed better in the buccolingual dimension (p = 0.003 at the crest and apex) in type C sockets. For precision, Levene's tests (α = 0.05) showed that dCAIS had significantly better precision across all sockets in the apicocoronal direction (p = 0.009 at the crest, p = 0.022 at the apex) and in the mesiodistal direction at the apex (p = 0.021). CONCLUSIONS:Both dCAIS and rCAIS achieved high trueness and precision for molar IIP. rCAIS achieved higher buccolingual trueness in type C sockets, whereas dCAIS provided greater precision. CLINICAL SIGNIFICANCE:Both dynamic navigation and robotic-assisted systems achieve high accuracy in mandibular molar immediate implant placement. While rCAIS has an advantage in challenging type C sockets, dCAIS requires intentional adjustment in directions with uneven resistance to achieve optimal outcomes.

OBJECTIVES:WNT10A mutations are associated with tooth agenesis. This study aimed to assess the clinical outcomes of dental implants in patients carrying WNT10A mutations with different molecular statuses and phenotypes over a long-term follow-up period. MATERIALS AND METHODS:Patients with tooth agenesis were screened by whole-exome sequencing (WES) from January 2010 to September 2023. Carriers of pathogenic WNT10A mutations who underwent subsequent dental implant therapy were evaluated. RESULTS:WES identified 66 patients with tooth agenesis carrying WNT10A mutations. Of these, 27 patients (11 males/16 females; mean age 19.6 years) met the inclusion criteria. Homozygotes had significantly more missing teeth (24.4 ± 3.8) than heterozygotes (10.9 ± 5.1, p < 0.0001) and compound heterozygotes (13.8 ± 3.5, p = 0.001). A total of 160 conventional implants were placed. Seven implants were lost in four patients before final prosthesis placement, resulting in overall failure rates of 14.8% at the subject level and 4.4% at the implant level. The 5-year cumulative survival rate (range: 0.23-12.74 years) was 85.2% and 95.6% at the subject and implant levels, respectively. The mean marginal bone loss (MBL) was 0.80 mm (95% CI: 0.59-1.02). Subgroup analysis revealed higher MBL in homozygotes (p = 0.002), sites requiring extensive bone augmentation (p = 0.016), anterior regions (p = 0.031), and full-arch bridge cases (p < 0.0001). Patient satisfaction and OHIP-C49 scores were favorable. CONCLUSIONS:Implant rehabilitation is predictable for patients with WNT10A mutations. However, increased MBL observed in homozygotes with severe tooth agenesis and in cases requiring extensive alveolar bone augmentation highlights the importance of genetic diagnosis prior to implant therapy in patients with severe tooth agenesis.

OBJECTIVES:To assess how artificial intelligence (AI) models perform in evaluating bone quality and quantity in the preoperative planning process for dental implants. DATA:This review included studies that utilized AI-based assessments of bone quality and/or quantity based on radiographic images in the preoperative phase. SOURCES:Studies published in English before April 2025 were used in this review, which were obtained from searches in PubMed/MEDLINE, Embase, Web of Science, Scopus, and the Cochrane Library, as well as from manual searches. STUDY SELECTION:Eleven studies met the inclusion criteria. Five studies focused on bone quality evaluation and six studies included volumetric assessments using AI models. The performance measures included accuracy, sensitivity, specificity, precision, F1 score, and Dice coefficient, and were compared with human expert evaluations. AI models demonstrated high accuracy (76.2 %-99.84 %), high sensitivity (78.9 %-100 %), and high specificity (66.2 %-99 %). CONCLUSIONS:AI models have potential for the evaluation of bone quality and quantity, although standardization and external validation studies are lacking. Future studies should propose multicenter datasets, integration into clinical workflows, and the development of refined models to better reflect real-life conditions. CLINICAL SIGNIFICANCE:AI has the potential to offer clinicians with reliable automated evaluations of bone quality and quantity, with the promise of a fully automated system of implant planning. It may also support preoperative workflows for clinical decision-making based on evidence more efficiently.

Supported by the Clinical Research Plan of SHDC [SHDC2020CR3049B]; the CAMS Innovation Fund for Medical Sciences (CIFMS) [project 2019-I2M-5-037]; and by the Research Discipline fund from the Ninth People's Hospital [KQYJXK2020], College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University (Shanghai), PR China.

PURPOSE:To retrospectively evaluate the clinical outcomes of implant-supported prosthesis in alveolar cleft patients.METHODS:A total of 14 patients with alveolar cleft underwent implant restoration in Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2015 to January 2023 were collected.Among them,9 were male and 5 were female.The age ranged from 18 to 52 years,with a mean of(26.1±10.6)years.The se-quence treatment history of patients with cleft lip and palate and the effect of implant repair were retrospectively analyzed.RESULTS:Bone grafting in the fissured area failed repeatedly in 1 patient and no implant was implanted.A total of 21 implants were implanted in the remaining 13 patients with alveolar cleft,all of which achieved good osseointegration.In 10 cases,one implant was implanted in each fissure area for single crown or single end bridge repair.In 3 cases,11 implants were implanted in the non-fissure area for fixed bridge repair.Seven patients with single implant were followed up for 6 to 96 months,with an average of(39.4±29.2)months.During their visits,patients underwent various examinations,including pink aesthetic score(PES)averaging 10.16±0.98,white aesthetic score(WES)averaging 8.50±1.23,and probing depth(PD)with a mean of(2.68±0.61)mm.Additionally,gingival index(GI)was recorded with a mean of 1.33±1.10,and marginal bone loss(MBL)was measured with a mean of(0.17±0.35)mm.The width of the mid-labial keratinized mucosa was ob-served to be(5.14±2.10)mm.CONCLUSIONS:Implant-supported prosthesis in the alveolar cleft area after well-estab-lished multidisciplinary sequential treatments have predictable middle-term success rate,satisfactory aesthetic outcomes and stable peri-implant soft and hard tissue conditions.