Progression of inflammatory osteolytic diseases, including rheumatoid arthritis and periodontitis, is characterized by increased production of proinflammatory mediators and matrix-degrading enzymes by macrophages and increased osteoclastic activity. Phenotypic changes in macrophages are central to the healing process in virtually all tissues. Using a murine model of periodontitis, we assessed the timing of macrophage phenotypic changes and the impact of proresolving activation during inflammatory osteolysis and healing. Proinflammatory macrophage activation and TNF-α overproduction within 3 wk after induction of periodontitis was associated with progressing bone loss. Proresolving activation within 1 wk of stimulus removal and markers of resolving macrophages (IL-10, TGF-β, and CD206) correlated strongly with bone levels. In vivo macrophage depletion with clodronate liposomes prevented bone resorption but impaired regeneration. Induction of resolving macrophages with rosiglitazone, a PPAR-γ agonist, led to reduced bone resorption during inflammatory stimulation and increased bone formation during healing. In vitro assessment of primary bone marrow-derived macrophages activated with either IFN-γ and LPS (proinflammatory activation) or IL-4 (proresolving activation) showed that IL-4-activated cells have enhanced resolving functions (production of anti-inflammatory cytokines; migration and phagocytosis of aged neutrophils) and exert direct anabolic actions on bone cells. Cystatin C secreted by resolving but not inflammatory macrophages explained, in part, the macrophage actions on osteoblasts and osteoclasts. This study supports the concept that therapeutic induction of proresolving functions in macrophages can recouple bone resorption and formation in inflammatory osteolytic diseases.

A virtual articulator is a computer software tool that is capable of reproducing the relationship between the jaws and simulating jaw movement. It has gradually gained research interest in dentistry over the past decade. In prosthodontics, the virtual articulator should be considered as an additional diagnostic and treatment planning tool to the mechanical articulator, especially in complex cases involving alterations to the vertical dimension of occlusion. Numerous authors have reported on the available digital methodologies used for the assembly of virtual arch models in a virtual articulator, focusing their attention on topics such as the virtual facebow and digital occlusal registration. To correctly simulate jaw movement, the jaw models have to be digitalized and properly mounted on the virtual articulator. The aim of this review was to discuss the current knowledge surrounding the various techniques and methodologies related to virtual mounting in dentistry, and whether virtual articulators will become commonplace in clinical practice in the future. This review also traces the history of the virtual articulator up to its current state and discusses recently developed approaches and workflows for virtual mounting based on current knowledge and technological devices.

Objectives The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes. Materials and methods Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available. Results Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS. Conclusions Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes. Clinical relevance Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04157-3.

Aim: Tooth-level prognostic systems can be used for treatment planning and risk assessment. This retrospective longitudinal study aimed to evaluate the prognostic performance of 10 different tooth-level risk assessment systems in terms of their ability to predict periodontal-related tooth loss (TLP).Materials and methods: Data were retrieved retrospectively from patients who received surgical and non-surgical periodontal treatment. Data on medical history and smoking status at baseline and the last maintenance visit were collected. Ten tooth-level prognostic systems were compared using both univariate and multivariate Cox proportional hazard regression models to analyse the prognostic capability of each system for predicting TLP risk.Results: One-hundred and forty-eight patients with 3787 teeth, followed-up for a mean period of 26.5 ± 7.4 years, were evaluated according to 10 different toothlevel prognostic systems, making up a total of 37,870 individual measurements. All compared prognostic systems were able to stratify the risk of TLP at baseline when different classes of association were compared. After controlling for maintenance, age, and gender, all systems exhibited excellent predictive capacity for TLP with no system scoring a Harrell's C-index less than 0.925. Conclusions: All tooth-level prognostic systems displayed excellent predictive capability for TLP. Overall, the Miller and McEntire system may have shown the best discrimination and model fit, followed by the Nunn et al. system.

Periodontal tissue engineering involves a multi-disciplinary approach towards the regeneration of periodontal ligament, cementum and alveolar bone surrounding teeth, whereas bone regeneration specifically applies to ridge reconstruction in preparation for future implant placement, sinus floor augmentation and regeneration of peri-implant osseous defects. Successful periodontal regeneration is based on verifiable cementogenesis on the root surface, oblique insertion of periodontal ligament fibers and formation of new and vital supporting bone. Ultimately, regenerated periodontal and peri-implant support must be able to interface with surrounding host tissues in an integrated manner, withstand biomechanical forces resulting from mastication, and restore normal function and structure. Current regenerative approaches utilized in everyday clinical practice are mainly guided tissue/bone regeneration-based. Although these approaches have shown positive outcomes for small and medium-sized defects, predictability of clinical outcomes is heavily dependent on the defect morphology and clinical case selection. In many cases, it is still challenging to achieve predictable regenerative outcomes utilizing current approaches. Periodontal tissue engineering and bone regeneration (PTEBR) aims to improve the state of patient care by promoting reconstitution of damaged and lost tissues through the use of growth factors and signaling molecules, scaffolds, cells and gene therapy. The present narrative review discusses key advancements in PTEBR including current and future trends in preclinical and clinical research, as well as the potential for clinical translatability.

Background: The 2017 World Workshop classified peri-implant diseases into health, peri-implant mucositis, and peri-implantitis. The aim of this article is to build upon this recent classification and propose a framework for the diagnosis of peri-implant status after surgical treatment for peri-implantitis. Methods: A literature review was conducted to discuss the relevant diagnostic, clinical, and radiographic parameters, including probing depth, bleeding on probing, visual inspection, and radiographic bone loss. Case definitions of possible treatment outcomes were discussed, and a flowchart was constructed to guide post-treatment diagnosis according to the possible clinical scenarios which can be encountered in daily practice. Results: Three possible treatment outcomes were identified after resective treatment of peri-implantitis: 1) peri-implant health with a reduced support, 2) periimplant mucositis with a reduced support, and 3) recurrent/refractory periimplantitis. After regenerative treatment for peri-implantitis, the peri-implant condition was classified according to the same diagnoses with the addition of peri-implant health or peri-implant mucositis after complete regeneration for cases where complete regeneration was attained. Criteria for successful treatment of peri-implantitis were proposed. After resective therapy, a successful treatment outcome was defined as peri-implant health with a reduced support, whereas, after regenerative therapy, a successful outcome was described as either peri-implant health after complete regeneration or peri-implant health with a reduced support. Conclusions: The proposed classification system of peri-implant status after surgical treatment for peri-implantitis provides a framework for diagnosing the various forms of peri-implant stability or disease to guide clinical decisionmaking post-treatment.

Mounting dental casts in an articulator is an important prerequisite for prosthodontic rehabilitation cases where the design of an accurate static and dynamic occlusion is needed. Virtual mounting can be achieved through the superimposition of various 3D images acquired from the hard and soft tissues of the patient. The purpose of this technical report is to describe a digital cross‐mounting technique for patients undergoing implant‐supported fixed prosthetic treatment. Through the use of face scanning, intraoral scanning, and cone beam computed tomography, this technique enables creation of a 3D virtual patient with occlusal registration in centric relation. Ultimately, the described methodology allows for the fabrication of definitive full‐mouth implant‐supported fixed prostheses.

Background: Accurate implant placement is essential in reducing post-treatment complications and in ensuring a successful treatment outcome. Purpose: To compare the accuracy of fully-guided static computer-assisted implant surgery (s-CAIS) using partially-and fully-digital workflows. Materials and methods: Electronic and manual literature searches were performed to collect evidence concerning the accuracy of fully-guided s-CAIS procedures utilizing tooth-supported guides. Quantitative analysis was conducted to evaluate the accuracy of partially-and fully-digital workflows, and survival rates and complications were qualitatively analyzed. Results: Thirteen studies, including 6 randomized controlled trials and 7 prospective clinical studies, were selected for quantitative and qualitative synthesis. A total of 669 implants in 325 patients using s-CAIS were available for review. Meta-analysis of the accuracy revealed a total mean angular deviation of 2.68 (95% CI: 2.32-3.03); mean global coronal deviation of 1.03 mm (95% CI: 0.88-1.18 mm); mean global apical deviation of 1.33 mm (95% CI: 1.17-1.50 mm); and mean depth deviation of 0.59 mm (95% CI: 0.46-0.70 mm). Minimal differences were found between the two different workflows. Few complications were reported, and survival rates were between 97.8% to 100% (range of follow-up: 12 to 24 months) in the available studies. Conclusion: Similar accuracy is obtained when implants are placed in partially edentulous patients using fully-guided s-CAIS, independently of the workflow utilized.