Medication-related osteonecrosis of the jaw (MRONJ) has emerged as a serious complication associated with antiresorptive therapy and anti-angiogenic therapy, and has received increasing attention in recent years.In implant patients, severe MRONJ can lead to devastating consequences for the jawbone, with few effective preventive strategies currently available.Although a substantial body of literature on MRONJ exists, it often lacks systematic organization.Therefore, this review discusses the definition, incidence, etiology and pathogenesis, staging, diagnostic criteria, histopathological manifestations, risk factors, prevention, and treatment strategies for MRONJ. Special emphasis is placed on the risks and management of peri-implant MRONJ (PI-MRONJ). Despite the lack of consensus on many aspects of MRONJ, the objective discussion in this article presents current research progress to clinicians and provide references for the prevention and treatment of MRONJ and PI-MRONJ.

Objective To evaluate the possibility of GO/ZnO/nHAp composite microspheres as bone regeneration materials, a critical bone defect model of the rabbit femoral condyle was established to access bone regeneration in vivo. Methods Composite microspheres were prepared by the ionic gel-drip method, and the prepared GO/ZnO microspheres, nHAp microspheres, and GO/ZnO/nHAp microspheres were implanted into three groups of experimental rabbit femoral condyle standard critical bone defect models, with a blank control group. The animals were killed in batches at 4 weeks, 8 weeks, and 12 weeks after the operation, and the samples were taken completely for evaluation. Gross observation, X-ray film, CBCT detection, qPCR, Western blot, hard histological section, and HE staining of liver and kidney pathology were carried out to explore the osteogenesis and osseointegration of implanted materials. Results At 4 weeks, 8 weeks and 12 weeks after operation, the results of X-ray, CBCT, qPCR and Western blot in the GO/ZnO/nHAp composite microsphere group were significantly better than those in GO/ZnO and nHAp microspheres group at the same time point. The comparison of the experimental results of the qPCR, Western blot and hard tissue section showed that there were statistically significant differences among the three microspheres in promoting bone formation (P<0.05). Conclusion GO/ZnO, nHAp, and GO/ZnO/nHAp all have good biocompatibility and osteogenic activity. GO/ZnO/nHAp composite microspheres can effectively repair the bone defect of rabbit femoral condyle, and their in vivo bone conduction and bone induction properties are superior to GO/ZnO microspheres and nHAp microspheres, which have potential application value in bone defect repair materials.

Objective To investigate the differences in precision among various techniques in implant surgery by comparing the accuracy of freehand, dynamic navigation-assisted, and robot-assisted implant placement. Methods Patients who underwent implant surgery at Zhejiang Provincial People's Hospital between January 2022 and December 2023 were retrospectively analyzed and divided into freehand, dynamic navigation, and robotic groups. Implant accuracy was assessed by comparing preoperative CBCT-designed implant positions with actual postoperative CBCT implant positions. Results A total of 87 cases (96 implants) were included in this study, including 30 cases (31 implants) in the freehand group, 28 cases (36 implants) in the dynamic navigation group, and 29 cases (29 implants) in the robot group. In the robot group, the total deviation at the starting point (0.91±0.46) mm, endpoint (1.05±0.61) mm, and angular deviation (3.07°±1.69°) were significantly lower than those in the freehand group [(1.42±0.86) mm, (2.00±1.18) mm, and 7.78°±3.58°] and the dynamic navigation group [(1.32±0.57) mm, (1.64±0.77) mm, and 4.59°±2.65°]. Conclusion Robot-assisted implantation demonstrates significant advantages in terms of precision when compared to dynamic navigation and freehand implantation.

Objective To use a retrospective clinical approach to analyze the clinical treatment effects of screw tenting technology in implant restoration of consecutively missing teeth in the anterior esthetic zone. Methods A total of 86 patients with consecutive anterior teeth esthetic area defects who were treated at the Implant Center of the West City Branch of Hangzhou Stomatology Hospital from December 2019 to December 2023 were included. They were divided into the experimental group (tenting screw technique + delayed implantation) and the control group (conventional guided bone regeneration technique + immediate implantation), with 43 cases in each group. Cone beam computed tomography (CBCT) imaging data of patients were collected at the following time points: before bone augmentation, 6 months, and 12 months after bone augmentation, after implant placement, and 1 to 12 months after final restoration. The implant survival rate of the two groups was compared. Based on CBCT digital imaging data, the alveolar bone width at the alveolar ridge crest of the two groups of patients 6 months and 12 months after bone augmentation was measured respectively. Meanwhile, the esthetic status of the implant restorations immediately after restoration, 6 months after restoration, and 12 months after restoration was evaluated using the pink esthetic score, and the differences between the two groups were compared. Results The implant survival rate was 98.21% in the control group and 100.00% in the experimental group. The alveolar bone width at the alveolar ridge crest in the experimental group was higher than that in the control group at 6 months and 12 months after bone augmentation, with values of (7.69±0.42) mm and (7.22±0.40) mm in the experimental group, and (6.53±0.39) mm and (6.20±0.43) mm in the control group (P=0.001). The pink esthetic score (PES) of the experimental group was higher than that of the control group at 6 months and 12 months after the final restoration, with scores of (10.72±1.42) and (9.95±1.34) in the experimental group, and (7.52±1.20) and (7.01±1.15) in the control group (P=0.001). Conclusion The tenting screw technique can effectively ensure the survival rate of implants in the implant restoration of consecutive anterior teeth esthetic area defects. Its implantation effect is comparable to that of the guided bone regeneration (GBR) technique. In the implant restoration cases of consecutive anterior teeth esthetic area defects, the tenting screw technique can achieve better bone augmentation and restoration effects.

Objective With the widespread application of digital technology and advancements in implant materials, our team utilized concentrated growth factors (CGF) combined with the osteotome condensing and hydraulic pressure elevation technique to modify the surgical protocol for simultaneous implant placement during maxillary sinus floor elevation. This approach significantly increased the success rate of sinus augmentation, achieving greater elevation heights while reducing the risk of Schneiderian membrane perforation. Methods This retrospective study analyzed clinical data from 30 patients with single-tooth loss in the posterior maxilla treated at Shenzhen Stomatological Hospital between May 2023 and August 2024. All patients underwent sinus floor elevation with simultaneous implant placement using osteotome condensing combined with hydraulic pressure elevation. The Schneiderian membrane thickness and the achieved elevation height at the implant sites were compared preoperatively and postoperatively. Results Data showed no significant difference in Schneiderian membrane thickness before and after the procedure, while the mean elevation height was 7.6 mm (P<0.001). Conclusion With the aid of a digital surgical guide, the combined use of osteotome condensing and hydraulic pressure elevation transforms a procedure previously performed blindly into a precisely controlled surgical technique. This method enables effective and safe separation and elevation of the Schneiderian membrane without damage while allowing for simultaneous placement of bone substitute material and dental implants. The modified protocol demonstrates a high success rate and significant clinical effectiveness and can be standardized to facilitate broader clinical application.

Objective To explore the effect of topical minocycline combined with conventional antibiotics on modified plaque index and soluble intercellular adhesion molecule-1 (sICMA-1) and interleukin-1β (1L-1β) after localized periodontitis. Methods A prospective study was conducted on 60 patients with localized periodontal disease who underwent dental implant surgery from May 2022 to September 2024. These patients were randomly divided into a control group and an observation group using a random number table method. The control group received routine antibiotics and conventional treatment for localized periodontal disease and dental implant surgery, while the observation group received minocycline hydrochloride ointment in addition to these treatments. The study compared the treatment outcomes, clinical indicators of periodontal soft tissue before and after intervention, and the levels of sICAM-1, IL-1β, matrix metalloproteinase-8 (MMP-8), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px). Results The total clinical effective rate in the observation group was 93.33%, which was higher than 70.00% in the control group (P<0.05). After intervention, the peri-implant pocket depth, plaque index, peri-implant mucosa index, and clinical attachment loss in both groups decreased (P<0.05), and those in the observation group were lower (P< 0.001). At 3 days, 7 days, and 1 month after intervention, the levels of sICAM-1, IL-1β, and MMP-8 in the peri-implant sulcular fluid of the observation group were lower than those of the control group (P<0.05), while the levels of SOD and GSH-Px in the peri-implant sulcular fluid were higher than those of the control group (P<0.05). Conclusion Minocycline hydrochloride ointment can reduce the oxidative stress response after dental implant surgery in localized periodontitis and improve the inflammatory state of peri-implantation.

Objective To compare the release kinetics of key osteogenic growth factors and inflammatory cytokines in advanced platelet-rich fibrin (A-PRF) between patients with diabetes mellitus (DM) and healthy populations. Methods Participants meeting the inclusion and exclusion criteria were assigned to either the DM group (n=8) or the healthy control group (n=8). Venous blood was centrifuged to prepare A-PRF membranes, and eluates were collected at 15 min, 60 min, 8 h, 1 d, 3 d, 10 d, 14 d, and 21 d post-incubation. The concentrations of platelet-derived growth factor-BB (PDGF-BB), vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), epidermal growth factor (EGF), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) were quantified using enzyme-linked immunosorbent assay (ELISA) and analyzed comparatively. Results (1) Cumulative PDGF-BB release from A-PRF in the DM group was consistently lower than that in healthy controls, with statistically significant differences observed from 15 min onward (P<0.01). (2) VEGF release from A-PRF was significantly reduced in the DM group from day 1 to day 21 compared to controls (P<0.01). (3) No statistically significant difference in cumulative EGF release was observed between the two groups (P>0.05). (4) Cumulative TGF-β release from A-PRF was significantly lower in the DM group from day 1 onward (P<0.05). (5) TNF-α release from A-PRF was significantly higher in the DM group than in healthy controls from 8 h onward (P<0.05). (6) No statistically significant difference in cumulative IL-6 release was observed between the two groups (P>0.05). Conclusion Compared to healthy individuals, DM patients exhibited significantly lower cumulative release of osteogenic growth factors (PDGF-BB, VEGF, TGF-β) from A-PRF and elevated levels of the inflammatory cytokine TNF-α. No significant differences were observed in EGF and IL-6 release.

This case report evaluates the clinical outcomes of the dual-zone therapeutic technique in flapless immediate implant placement and immediate restoration in the maxillary anterior aesthetic zone. A 47-year-old female patient presented with an irreparable crown-root fracture of the upper right central incisor caused by trauma. Following minimally invasive tooth extraction, flapless immediate implant placement and immediate restoration were performed using the dual-zone therapeutic technique. A personalized impression was taken 7 months postoperatively, and a screw-retained zirconia crown was delivered. Over a 7-year follow-up, the aesthetic outcome remained stable, and the patient reported high satisfaction. CBCT and standardized periapical radiographs taken with the paralleling technique showed a stable marginal bone level and sufficient labial bone thickness. Digital intraoral scans confirmed well-maintained labial contour without significant collapse or resorption. This case suggests that, with strict case selection and standardized protocols, the dual-zone therapeutic technique can achieve long-term stability and favorable aesthetic outcomes in cases of flapless immediate implant placement and immediate restoration.

This paper reports a case of a peri-implant cyst associated with periapical periodontitis of the adjacent tooth. The patient presented with swelling and pain around the implant at site 47 in the right mandible, and the diagnosis was confirmed by cone beam computed tomography and other examinations. Treatment included removal of the loosened implant at site 47 and curettage of the cystic lesion. Additionally, a partial root resection and lesion curettage were performed on tooth 46. Histopathological examination confirmed an odontogenic cyst with secondary infection. Follow-up showed satisfactory wound healing without complications. Based on an in-depth analysis of this case and a review of the relevant literature, we comprehensively discuss the etiology, clinical features, diagnostic approaches, and prevention and treatment strategies for peri-implant cysts. This report aims to provide valuable insights for oral implant clinicians to enhance understanding, diagnosis, and management of this condition.

This paper report a case of delayed implantation using staged ridge split combined with guided bone regeneration (GBR) in a patient with a knife-edge alveolar ridge due to free-end edentulism in the posterior mandible. For a patient with insufficient alveolar ridge crest width in the mandible who met the indications for ridge splitting, a two-stage ridge split was performed. The first surgery involved splitting the cortical bone to promote bone remodeling. One month later, a second ridge split was carried out with simultaneous implant placement, combined with GBR to achieve horizontal ridge augmentation. The horizontal alveolar bone width increased by 4~5 mm, meeting clinical requirements for implantation while reducing the risk of buccolingual implant exposure, minimizing surgical trauma, and shortening the treatment period. However, a two-year follow-up revealed buccal bone plate resorption in the surgical area at a rate of 0.1~0.3 mm/year. The staged ridge split technique provides a treatment option for patients with severe horizontal alveolar ridge deficiency (width≤3 mm) in the posterior mandible, but attention should be paid to the issue of long-term bone resorption.

Maintaining the stability of marginal bone levels and soft tissue around dental implants is essential for the long-term success of implant therapy. The relative position of the implant platform to the crest of the alveolar ridge plays an important role in marginal bone resorption and soft tissue attachment. Currently, the optimal implant placement depth is still controversial. This article intends to review the effects of different implant placement depths on crestal bone levels and soft tissue height.

Dental implant restoration is one of the primary methods for repairing dentition defects and edentulism, and its occlusal design is a critical factor influencing the restoration outcome and the implant success rate. Due to the differences in biomechanical properties between dental implants and natural teeth, the rational distribution of occlusal forces becomes a key issue in implant restoration design. This review begins with the differences between implant prostheses and natural teeth, analyzes the association between occlusal forces and peri-implant bone resorption, as well as mechanical complications, and summarizes the occlusal design principles for different types of implant restorations, aiming to provide references for clinical decision-making.

Osseointegration of implants is defined as the direct structural and functional connection between a loaded implant and the surrounding ordered bone tissue. This process is complex, involving the interactions among multiple cell types. Osteoblasts adhere to, proliferate on, and differentiate at the implant surface, and through a sequence of biological processes, they facilitate the integration of the implant with the adjacent bone tissue—an event pivotal to osseointegration. Robust osseointegration enhances implant stability, reduces the risk of infection, and thereby increases the success rate of restoration and improving patients’ quality of life. However, studies indicate that diabetes can impede the osseointegration process and lower the implant success rate. To enhance osseointegration in diabetic patients, researchers have developed a variety of novel materials and techniques, including continuous antibacterial materials, biological factor sustained-release materials and surface modification techniques. Among these, implant surface treatment has attracted significant attention due to its ability to improve osseointegration performance while enhancing biocompatibility and antibacterial properties. This article reviews the principles and efficacy of various implant surface treatment methods, such as mechanical treatments, coating technologies, and biomaterial scaffolds.

With the development of bone tissue engineering technologies, novel biomaterials have gradually become a major research focus in the field of modern bone tissue repair. Injectable hydrogels, due to their excellent biocompatibility, high tunability, and drug-loading capacity, have increasingly emerged as important materials in bone tissue regeneration. This review summarizes the research progress on injectable hydrogels in bone tissue repair, with a particular focus on their application strategies in the field of bone tissue regeneration.