Reconstruction of craniomaxillofacial bone defects using 3D-printed hydroxyapatite (HA) bioceramic patient-specific implants (PSIs) is a new technique with great potential. This study aimed to investigate the advantages, disadvantages, and clinical outcomes of these implants in craniomaxillofacial surgeries. The PubMed and Embase databases were searched for patients with craniomaxillofacial bone defects treated with bioceramic PSIs. Clinical outcomes such as biocompatibility, biomechanical properties, and aesthetics were evaluated and compared to those of commonly used titanium or poly-ether-ether-ketone (PEEK) implants and autologous bone grafts. Two clinical cases are presented to illustrate the surgical procedure and clinical outcomes of HA bioceramic PSIs. Literature review showed better a biocompatibility of HA PSIs than titanium and PEEK. The initial biomechanical properties were inferior to those of autologous bone grafts, PEEK, and titanium but improved when integrated. Satisfactory aesthetic results were found in our two clinical cases with good stability and absence of bone resorption or infection. Radiological signs of osteogenesis were observed in the two clinical cases six months postoperatively. HA bioceramic PSIs have excellent biocompatible properties and imitate natural bone biomechanically and radiologically. They are a well-suited alternative for conventional biomaterials in the reconstruction of load-sharing bone defects in the craniomaxillofacial region.

BACKGROUND: Although various surgical techniques have been utilized in the reconstruction of severely resorbed alveolar bone, its regeneration is still regarded as a major challenge. Most of the surgical techniques used in advanced ridge augmentation have the disadvantages of prolonging the patient\'s edentulous healing and increasing the need for surgical revisits because simultaneous implant placement is not allowed. This report presents a new and simplified method for advanced ridge augmentation, which utilizes a vertical tenting device.
METHODS: The first case presented the reconstruction of the mandibular posterior region with severely resorbed alveolar bone due to peri-implantitis using tenting pole abutment for ridge augmentation. The second and third cases presented three-dimensional ridge augmentations in severely resorbed ridges due to periodontitis. The last case presented horizontal ridge augmentation using a vertical tenting device. All cases were performed under local anesthesia. Implants were simultaneously placed in the bone defect area. A vertical tensioning device was then connected to the implant platform to minimize the collapse of the bone graft during the bone regeneration period due to the contraction of the soft tissue matrix. A sticky bone graft was transplanted onto the exposed surface of the implant and on top of the vertical tensioning device. After covering with an absorbable barrier membrane, the soft tissues were sutured without tension.
CONCLUSIONS: In all cases, prosthetic restorations were provided to patients after a bone grafting period of 5-6 months, leading to a rapid restoration of masticatory function. Results tracked for up to 6 years revealed observed stable reconstruction of the alveolar bone. The use of a vertical tenting device can prevent the collapse of biomaterials in the augmented ridge during the healing period, leading to predictable outcomes when achieving three-dimensional ridge augmentation.

BACKGROUND: Patients with dysplastic bone diseases, including fibrous dysplasia (FD), represent a particular challenge for placement of dental implants. This is due to structural bony changes that may compromise the bone blood supply and plasticity, thus potentially affecting the process of osseointegration. This case report describes a novel approach for dental-implant-based rehabilitation of the posterior maxilla affected by craniofacial fibrous dysplasia (CFD), with 7 years of treatment follow-up.
METHODS: A 35-year-old female patient was referred due to a suspected unidentified bone lesion affecting the left side of the maxilla. A clinical and radiographic diagnosis of fibrous dysplasia was confirmed through a wedge bone biopsy. Particulate bone substitute was packed into a box-shaped ostectomy area of the lesion in the affected maxillary alveolar ridge. This was followed by the placement of four implants 6 months post operation. The implants were successfully integrated, as confirmed by clinical examination over 7 years of follow up.
CONCLUSIONS: this treatment approach may be considered as a predictable and efficient treatment modality for dental implant rehabilitation in patients with a variety of fibro-osseous lesions, including fibrous dysplasia, which affect the alveolar bone.

BACKGROUND: With the entire papilla preservation (EPP) technique, it is possible to perform regenerative therapy without incisions in the interdental papilla and to reduce the risk of papillary rupture. However, one limitation of the EPP is the sole access from the buccal side. Here, we present a case of periodontitis treated by the combination regenerative therapy employing the Double-sided (buccal-palatal) EPP (DEPP) technique, which adds a palatal vertical incision to the EPP.
METHODS: A patient with 1-2 wall intrabony defects received the regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 and carbonate apatite (CO3Ap). Using the DEPP technique, vertical incisions at buccal and palatal aspects were placed to gain adequate access to the 1-2 wall intrabony defects between #11 and #12 without incision in the interdental papilla. After debridement, rhFGF-2 and CO3Ap were applied to the defect. Periodontal clinical parameters and radiographic images were evaluated at the first visit, following initial periodontal therapy (baseline), 6, 9, and 12 months postoperatively.
RESULTS: Wound healing was uneventful. Scarring of the incision lines was minimal. At 12 months postoperatively, probing depth reduction was 4 mm, clinical attachment gain was 4 mm, and gingival recession was not observed. An improvement in radiopacity in the previous bone defect was observed.
CONCLUSIONS: The DEPP is an innovative technique that allows approaching from both the buccal and palatal sides while ensuring flap extensibility without compromising the interdental papilla. This report suggests that the combination of regenerative therapy with the DEPP may be promising in the treatment of intrabony defects.
CONCLUSIONS: Why is this case new information? The DEPP allows a direct visual approach to a 1-2 wall intrabony defect extending from the buccal to palatal sides, and increases flap extensibility, without compromising the papilla. What are the keys to the successful management of this case? Assessment of three-dimensional bone defect morphology is required. Computed tomography images are very useful. The flap elevation just under the interdental papilla should be carefully performed with a small excavator to avoid damage to the interdental papilla. What are the primary limitations to success in this case? Despite the addition of a palatal incision, it was not possible to obtain complete flexibility of the palatal gingiva. Caution must be taken in a case in which the distance between the interdental papilla is narrow. Even if the interdental papilla is ruptured during the operation, recovery is possible by continuing the operation and suturing the rupture at the end.

Paediatric distal tibial and fibular fractures are seen quite regularly in orthopaedic trauma practice. Most patients are managed conservatively with closed reduction or casting while only a selected few required surgical treatment. Surgical options include plating, percutaneous Kirschner wires, rigid intramedullary nails, and flexible intramedullary nailing. This is dependent upon the patient\'s age, fracture site, comminution, and concomitant injuries. Here, we present an interesting case of a patient with an unusual lesion seen at the fracture site. This lesion was curetted out during surgery and filled with an injectable synthetic Cerament bone void filler (Bone Support AB, Lund, Sweden), which later formed into bone and allowed the bone to remodel.

BACKGROUND: Numerous techniques have been reported in the literature for the reconstruction of gingival recession defects. The purpose of this case series was to evaluate clinically and radiographically the efficacy of sticky bone with i-PRF-coated collagen membrane in the treatment of gingival recession.
METHODS: Sixteen patients exhibiting isolated Miller\'s Class I or II recession in the maxillary esthetic zone were treated using sticky bone (i-PRF + freeze-dried bone allograft) with i-PRF-coated collagen membrane using the coronally advanced flap. Clinical parameters including probing depth (PD), width of keratinized gingiva (WKG), gingival thickness (GT), and recession depth (RD) were recorded at baseline and 6 months post-surgery. The radiographic (ST-CBCT) measurements computed were labial plate thickness (OT1, OT3, and OT5) and GT (GT1, GT3, and GT5) at baseline and 6 months post-treatment. Twelve out of sixteen treated cases achieved complete root coverage. An increase in GT was observed in all the cases.
CONCLUSIONS: Within the limitations of this case series, sticky bone with i-PRF-coated collagen membrane showed promising results in the treatment of isolated maxillary Miller\'s Class I or II gingival recession and serves as an altered approach for root coverage procedure. However, histological analysis and larger sample size are needed to establish definitive proof of soft and hard tissue regeneration.

Periodontitis has a multifactorial etiology as a result of interactions between periodontal pathogens and the host response. Due to the complex etiology and esthetic complications, the management of such patients is a challenging task. Vast arrays of treatment modalities are employed in the treatment of generalized periodontitis with varying success rates. Placental-derived tissues as allografts have recently been introduced for guided tissue regeneration in dentistry with favorable results. In this case report, successful periodontal treatment of a 25-year-old male patient with generalized periodontitis; Stage IV, Grade C, is presented with a 3-year follow-up. An interdisciplinary approach using regenerative periodontal surgery and a modified Andrew\'s bridge was used to successfully rehabilitate the patient. In a compliant patient with a well-structured interdisciplinary approach, questionable and hopeless teeth too can be retained over an extended period of time with no detrimental effect on the adjacent teeth.

The objective of this study was to clinically evaluate an autogenous tooth graft (ATG) as a novel bone graft material in the treatment of Class II furcation defects. ATG is prepared at chairside from a freshly extracted tooth to be used immediately for bone regeneration. It has an advantage over the autogenous and other bone graft materials as it is non-immunogenic, inexpensive, easily available, and lacks donor-site morbidity.
This study was conducted on three middle-aged (35 to 55 years) male patients, who had at least one mandibular molar with Class II furcation involvement (a total of 5 sites) and one tooth that required extraction because of poor prognosis and was not endodontically treated. At 9 and 12 months, the mean reductions in horizontal probing depth were (1.40 ± 0.57 mm) and (1.52 ± 0.59 mm), respectively, and the mean gains in linear bone-fill were (3.90 ± 0.15 mm) and (5.33 ± 0.10 mm), respectively.
Within the limitation of this study, ATG exhibited ideal properties for alveolar bone regeneration. In addition, this study outlines the chairside method to prepare a graft and highlights the improvement in clinical and radiographic parameters at 9 and 12 months.

BACKGROUND: The aim of the study was to evaluate whether the use of preventive osteosynthesis after curettage in benign and primitive low-grade malignant bone tumor localized in the distal femur in adult patients provides sufficient mechanical stability to the system as to allow weight-bearing and reduce the risk of postoperative fracture. Additionally, lower limb function after curettage and preventive osteosynthesis was evaluated.
METHODS: We analyzed twelve cases of benign and low-grade malignant bone lesions of the distal femur in adult patients treated in our orthopedic department between 2008 and 2011 with curettage, bone filling and preventive osteosynthesis. All patients were treated with curettage with the use of high-speed cutters, plus liquid nitrogen as local adjuvant in low-grade malignant lesions, and filling of the lesion with bone graft or allograft or acrylic cement, followed by osteosynthesis.
RESULTS: No fractures or major complications were observed; good function of the knee was observed.
CONCLUSIONS: We recommend preventive osteosynthesis after curettage in patients with very large lesions (>5 cm, >60 cm3) or high functional requirements, in obese patients, and when local adjuvants are used.
METHODS: Level IV retrospective case-series study.