BACKGROUND: The biological effects of dental implants on peri-implant tissues have been widely investigated. Recent reports of oral squamous cell carcinoma (OSCC) cases adjacent to dental implants have raised concerns regarding the potential impact of implant materials on cellular aging and oncogenic transformation. Telomeres, which protect chromosome ends, undergo progressive shortening and play a critical role in cellular senescence and tumorigenesis. However, the impact of dental implants on telomere length in peri-implant mucosa remains unclear.

OBJECTIVE: This study aimed to compare telomere length in mucosa adjacent to dental implants with that of gingival tissue associated with healthy teeth.

METHODS: A paired cross-sectional study was conducted with 16 patients who had dental implants for at least 1 year. Swabs were collected from the peri-implant mucosa and healthy gingival mucosa of the same patient. Telomere length was assessed using quantitative PCR, with the relative telomere-to-single-copy-gene ratio (T/C) calculated using the 2-∆∆Cq method.

RESULTS: Telomere length in the peri-implant mucosa was not significantly different from that in the healthy gingival mucosa (p = 0.117).

CONCLUSION: These findings suggest that dental implants do not alter telomere length in adjacent mucosal cells.

OBJECTIVE: To assess the clinical and radiographic outcomes of overdentures and their retaining dental mini-implants, based on a single-arm systematic literature review.

METHODS: Electronic search was undertaken in three databases, last updated in October 2023, plus manual search of journals. Cumulative implant survival rate (CSR) and the estimated marginal bone loss (MBL) under different follow-up times were calculated.

RESULTS: Thirty-nine studies were included, with 3,787 mini-implants supporting 1,026 overdentures (109 maxilla, 896 mandible) in 1,005 patients, with a mean follow-up of 28.1 ± 19.8 months (min-max 0.3-84.0). 202 mini-implants failed, after a mean of 9.4 ± 11.8 months (7-year CSR 91.4%). The implant survival was lower in the maxilla in comparison to the mandible (p < 0.001), lower for early/delayed-loaded in comparison to immediately-loaded implants (p = 0.005) and lower for 2-mini-implant in comparison to 4-mini-implant-retained mandibular overdenture (p < 0.001; Log-rank test). A high rate of transversal fracture of the prosthesis and wear of the attachment parts was observed. The estimated mean MBL gradually increased from 0.518 (≤ 6 months) to 1.260 mm (58.8-90 months). There was an estimated MBL increase of 0.011 mm per additional month of follow-up.

CONCLUSION: Although presenting a high 7-year CSR, mini-implant-retained overdentures may require frequent maintenance follow-ups, due to the high rate of technical complications. The estimated MBL of mini-implants over 80 months is low.

CLINICAL RELEVANCE: The ability to anticipate outcomes is an essential part of risk management in clinical practice. The findings reported herein set some recommendations and potential strategies for minimizing failures and complications commonly associated with this mini-implant-retained overdentures.

PURPOSE: This research aimed to investigate potential factors associated with the risk of perforation of the labial bone plate, nasal floor, or maxillary sinus floor during immediate implant placement (IIP) in the maxillary premolar area, utilizing a cone-beam computed tomography (CBCT) virtual study.

METHODS: CBCT exams from 179 eligible participants, encompassing 716 teeth, were included. Implants were virtually positioned in 2 orientations: along the long axis of the tooth (the prosthetically-driven position) and in an optimal position relative to adjacent anatomical structures (the bone-driven position). Binary logistic regression analysis was employed to assess potential associations between perforation or invasion and various covariates, including sex, age, tooth region, the distance from the tooth apex to the nasal floor or maxillary sinus floor, the angle between the prosthetically- and bone-driven positions (implant-line A angle [ILAA]), and the labial concavity angle (LCA).

RESULTS: The mean ILAA was 18.3°±8.0°, and the angle was significantly larger for the second premolar compared to the first premolar. The mean minimum implant length was 13.0±2.1 mm, with a bone anchorage of 4 mm. The incidence of perforation was 84.1% for the prosthetically-driven position and 40.5% for the bone-driven position. Factors associated with a higher risk of cortical bone wall perforation or invasion of the 2-mm safety margin from surrounding anatomical structures (in the bone-driven position) included female sex, older age, shorter distance from the tooth apex to the nasal cavity/maxillary sinus, and smaller LCA.

CONCLUSIONS: A high prevalence of cortical bone wall perforation or invasion of the 2-mm safety margin is anticipated when performing IIP in the maxillary premolar region.

Occlusal tactile acuity (OTA) and bite force are essential components of the sensorimotor control of oral behaviors. While these variables have been studied independently, it has not yet been revealed whethercompressive force impacts the occlusal perception mediated by the mechanoreceptive afferents in the periodontal ligament. The present study examined the effect of repetition and maximum bite force on OTA by testingnine aluminum foils of different thicknesses together with a sham test with no foil, three times each, in randomized order in 36 healthy individuals. In addition, the 40 μm foil was tested three more times at the start ofeach session to evaluate possible short-term effects. This test session was repeated with and without an interspersed maximum bite force task in between. The results demonstrated that repeated measurements increasedOTA significantly (p = 0.033); a change mainly driven by the 40 μm thickness, whereas maximum bite force testsdid not affect OTA (p = 0.097). Collectively, the results suggest that the enhanced OTA may be attributed torepetition-mediated learning and neuroplasticity within the pathways related to OTA. Furthermore, thecompressive bite force may have induced a short-term change that lasted seconds and was not detected by thesubsequent OTA measurements or may have altogether inhibited the facilitatory effect of repeated OTA. Thisunderscores the potential for future research to explore the implications of compressive force and pain on OTA inpatient populations, which could provide valuable insights into the adaptive mechanisms of the sensorimotorsystem in pathological conditions.

The aim of this long-term follow-up study was to investigate the relationship between bite force, bruxism, and fractures of teeth and veneer porcelain of fixed dental prostheses. Patients previously assessed as probable bruxers (n = 30) and non-bruxers (n = 21), all rehabilitated with dental implant-supported restorations, underwent a clinical examination and measurement of maximum bite force. A univariate general linear model was used to compare regression lines showing the relationship between fractures and bite force. Bruxers had significantly higher maximum bite force (p = 0.023) and higher proportion of tooth/veneer porcelain fractures per total number of tooth/prosthetic units (p = 0.045). There was no significant difference in the relationship between frequency of tooth/veneer porcelain fractures and maximum bite force between probable bruxers and non-bruxers (p = 0.054). However, there was a significant difference between probable bruxers and non-bruxers when the percentage of fractures in relation to the total number of units was considered instead of the frequency of fractures (p = 0.035). Higher maximum bite force in probable bruxers was related to higher prevalence of fractures of teeth and veneer porcelain, emphasizing the potential benefits of pre-treatment assessment of bruxism as well as bite force. Easy-to-use reliable clinical methods for bite force measurement should be tested and implemented in dental practice.

60 Years of Innovation, Research, and Clinical Excellence

From the pioneering days of Per-Ingvar Brånemark’s visionary work to the global impact of modern dental implantology, this landmark volume traces the remarkable journey of osseointegration. Edited by Tomas Albrektsson and Bruno Chrcanovic—two of the most respected minds in the field—the book brings together a unique blend of historical insight, clinical milestones, and future-facing perspectives.

Featuring personal recollections, untold stories, and expert contributions from international leaders such as George Zarb, Paulo Malo, Matts Andersson, Oded Bahat, and many more, this book captures the scientific and human spirit behind one of medicine’s most transformative discoveries.

Published to commemorate the 60th anniversary of the first fully edentulous patient treated with osseointegrated implants, this volume is more than a celebration of the past—it is a guiding compass for the next generation of clinicians, scientists, and innovators.

Background: Oral and plunging ranulas require effective treatment strategies to minimize recurrence; yet no consensus exists on the most effective approach.

Objectives: This systematic review evaluated several treatments for the recurrence of oral and plunging ranulas.

Methodology: A comprehensive search was conducted in five bibliographic databases and gray literature. Randomized and non‐randomized studies were included if they investigated treatment approaches for oral or plunging ranulas. Two independent reviewers screened studies, extracted data, and assessed the risk of bias. The primary outcome was recurrence of (1) oral and (2) plunging ranula. For each type of ranula, a random‐model frequentist network meta‐analysis (NMA) was established for seven treatment strategies: enucleation, micromarsupialization, marsupialization, marsupialization with packing, partial sublingual gland excision, sublingual gland excision, and sublingual gland excision plus submandibular gland excision. A minimal important difference (MID) and the GRADE approach for NMA were used for interpretation of data.

Results: Eighteen studies were included (all non‐randomized—14 for oral ranula and six for plunging ranula). No treatment demonstrated clear superiority in preventing recurrence. Certainty of evidence was low to very low for oral ranulas and very low for plunging ranulas, primarily due to the risk of bias, imprecision, and intransitivity.

Conclusions: Given the low certainty of evidence, no single treatment can be considered superior to others. Future research should prioritize longer follow‐up randomized controlled trials.

Background: Two-piece zirconia implants offer a metal-free alternative to titanium implants, but only limited long-term data are available. The aim of this retrospective study was to evaluate the clinical outcomes of two different, identically designed two-piece zirconia implants (NobelPearl™ and Zeramex XT) in a private dental practice.

Material and methods: Between 2017 and 2024, 167 implants were placed in 106 patients and followed up to 88 months (Ø 39.1 months). In addition to the implant survival rate, marginal bone loss (MBL), clinical parameters and surface properties were examined using 3D profilometry. The statistical analysis included descriptive evaluations and a survival analysis using the life table method.

Results: Three implants were lost (two fractures, one failed osseointegration), corresponding to an effective survival rate of 98.2%. The mean marginal bone loss varied between -0.14 mm and -0.58 mm. The surface roughness was minimal (Sa ~0.5 µm). No risk factor showed a significant association with implant loss in the univariate analysis.

Conclusion: Two-piece, screw-retained zirconia implants showed a high survival rate and stable peri-implant tissue conditions over a period of up to seven years. They represent a promising metal-free alternative to titanium implants. Further prospective long-term studies are needed to validate these results and to better understand potential risk factors.

PURPOSE: To present a survival analysis of 133 consecutively placed moderately rough implants, all with a total follow-up of 20 years.

MATERIALS AND METHODS: A total of 133 implants of the same brand placed in 46 patients at the same county clinic in Sweden were followed up prospectively over 20 years and analyzed for survival and bone height, the latter evaluated in periapical radiographs.

RESULTS: A total of 7 implants failed, 4 of which were in the same patient. Implant failure was associated with a combination of smoking and bruxism in 5 of the 7 failed cases. A 20-year survival rate of 94.7% was observed. Average marginal bone loss (MBL) at 20 years of follow-up was 0.543 ± 1.193 mm, with 9 implants having more than 2 mm of MBL. A total of 20 patients with 25 implants dropped out of the study; however, if death of the patient is excluded as a dropout reason, only 3 implants in 3 patients were unaccounted for.

CONCLUSIONS: Good clinical results in the 95% survival range were observed with moderately rough implants over a 20-year follow-up period.

Background: Overload from bruxism may affect survival of dental implants.

Objectives: To evaluate implant failure and marginal bone loss (MBL) in patients presenting with probable bruxism compared to non-bruxers. The study was registered in PROSPERO (CRD42021238397).

Methods: An electronic search September 2022 in PubMed/Medline, Web of Science and Science Direct was combined with a hand search. Two independent reviewers carried out abstract screening, full-text assessment, quality assessment (National Institutes of Health tool) and data extraction. Only studies that provided information on self-report and clinical examination needed for the diagnosis of at least 'probable' bruxism were included. A pairwise random-effect meta-analysis was carried out.

Results: In total 1338 studies were identified, and after screening and full-text assessment 27 studies that presented data on 2105 implants in probable bruxers and 10 264 implants in non-bruxers were included, with 138 and 352 implant failures in respective groups. the meta-analysis showed that implants placed in probable bruxers had a higher risk of failure than in non-bruxers (OR 2.189; 95% CI 1.337, 3.583, p = .002). A meta-regression showed that follow-up time did not affect this OR. Eighteen studies provided general data on MBL but did not report results separated between bruxers and non-bruxers. Therefore, an analysis of MBL was not possible.

Conclusion: The results of the present systematic review show that implants placed in probable bruxers present a significantly higher risk of failure than implants placed in non-bruxers. This should be considered in treatment planning and management of implant patients.