Background Conventional wisdom states that reactive soft tissue consisting of granulation tissue and long junctional epithelium in compromised sites should be curetted completely, while others approve of its preservation in implant surgeries. Purpose To evaluate the presence of reactive soft tissue as wound closure for immediate implantation in posterior compromised sockets. Materials and Methods Thirty‐three implants were included in this study: (a) experimental group (EG), the reactive soft tissue was raised as the primary wound closure for the implant; (b) control group (CG), the reactive soft tissue was also elevated but failed to cover the site. Implants were inserted immediately after the tooth extraction. The bone dimensional changes were observed instantly after surgery (T1) and 6 months later (T2) by cone beam computed tomography. Soft tissue alterations were evaluated before tooth extraction (T0), at prosthesis delivery and at 1‐year follow‐up (T3). Measurements of marginal bone level (MBL) was obtained at the time of prosthesis placement and at T3. Results In all, 100% implant survival was reported during the study period. The buccal bone height and width of keratinized mucosa decreased less in the EG compared to the CG. At the 1‐year follow‐up, MBL and soft tissue changes were not significantly different between the two groups. Conclusions Within the limitations of this study, the presence of reactive soft tissue as primary closure may contribute to hard‐soft tissue augmentation during immediate implants into posterior compromised sockets.

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AimTo evaluate the effectiveness and complications of the cushioned grind‐out technique. The primary outcome was endo‐sinus bone gain (ESBG), while secondary outcomes included the Schneiderian membrane perforation rate and mid‐ to long‐term implant survival.Materials and MethodsIn this retrospective study, we compared the cushioned grind‐out technique with the classic osteotome technique, establishing statistical models to assess ESBG, membrane perforation rate and implant survival rate.ResultsA total of 259 patients and 340 implants were included. The mean ESBG was 5.31 mm for the cushioned grind‐out group and 4.64 mm for the osteotome group. Multivariable regression analysis revealed that the cushioned grind‐out technique significantly facilitated ESBG (p = .028). Nineteen preparation sites experienced membrane perforation, with rates of 5.5% and 6.4% for the cushioned grind‐out and osteotome groups, respectively. However, the difference was not statistically significant (p = .920). Additionally, the cumulative survival rate of the implants for 7 years was 95.2% and 91.4%, respectively, with the surgical technique not significantly influencing the results.ConclusionsWith 6 months to 7 years of post‐prosthetic restoration review data, our findings show that the cushioned grind‐out technique facilitates a higher ESBG, with no significant difference in membrane perforation or implant failure rate.

Periosteum, which covers the surface of most bones, mediates bone regeneration through endochondral ossification during fracture repair and intramembranous ossification under steady state. Periosteal cells (PCs) of jaw bones are different from those of long bones in phenotypic characteristics and functions. So far, the role of periosteum in jaw bones during bone grafting remain unclarified. Here we propose a subperiosteal bone grafting model based on the clinical procedures. By integrating single-cell RNA sequencing (scRNA-seq) and spatial transcriptomic (ST), we found a functional Ctsk+Fmod+ subset of PCs in jaw bones. The Ctsk+Fmod+ PCs had the potential of multi-directional differentiation. Furthermore, Spp1 secreted by macrophages could impair the osteogenic capacity of Ctsk+Fmod+ PCs, which could be partly rescued by blocking Spp1. The identification of this Ctsk+Fmod+ subclusters, which shows osteoprogenitor characteristics and close interaction with macrophages, reveals the heterogeneity of periosteal cells in jaw bones, and may provide target of intervention to improve osteogenesis during bone augmentation surgery.

Objectives This study aimed to evaluate the effects of the cushioned grind‐out technique transcrestal sinus floor elevation for simultaneous implant placement with ≤4 mm of residual bone height (RBH). Materials and Methods This was a retrospective propensity score matching (PSM) study. Five PSM analyses included the confounding variables of Schneiderian membrane perforation, early and late implant failure, and peri‐implant apical and marginal bone resorption. After PSM, we compared the difference in five aspects between the RBH ≤ 4 and >4 mm groups. Results A total of 214 patients with 306 implants were included in this study. After PSM, the generalized linear mixed model (GLMM) indicated that RBH ≤ 4 mm had no significantly higher risk of Schneiderian membrane perforation and early and late implant failure (p = .897, p = .140, p = .991, respectively). The implant cumulative 7‐year survival rate of the RBH ≤ 4 and >4 mm groups was 95.5% and 93.9%, respectively (log‐rank test: p = .900). Within at least 40 cases per group after PSM, two multivariate GLMMs indicated that RBH ≤ 4 mm could not be identified as the promotive factor of bone resorption of either endo‐sinus bone gain or crest bone level (RBH × time interaction p = .850, p = .698, respectively). Conclusions Within the limitations, 3 months to 7 years of post‐prosthetic restoration review data indicated an acceptable mid‐term survival and success rate of applying the cushioned grind‐out technique in RBH ≤ 4 mm cases.