Yong-Gun Kim

Background: Lateral sinus augmentation is a widely used procedure for implant placement in the posterior maxilla with insufficient residual bone height. This study retrospectively described the clinical and radiographic outcomes of lateral sinus augmentation performed using a controlled osteotomy strategy, referred to as the Wedge and Feather (WF) technique, and explored factors potentially associated with vertical bone gain. Methods: This descriptive retrospective case series included consecutive patients who underwent lateral sinus augmentation using the WF technique. Clinical and radiographic data were collected from routine records. Vertical bone gain and complication rates were summarized descriptively. Because of the small sample size and absence of a control group, inferential analyses were considered exploratory and hypothesis-generating. Results: A total of 38 patients (43 sinus augmentation sites, 55 implants) was included. The mean vertical bone gain measured on postoperative panoramic radiographs was 8.5 ± 2.3 mm (range: 3.8–13.3 mm). Schneiderian membrane perforation occurred in 2 sites (4.7%), intraoperative bleeding in 1 site (2.3%), and postoperative sinusitis in 3 sites (7.0%). No implant failure was observed during the available follow-up period; however, no formal survival analysis was performed. Conclusion: Because this retrospective case series lacked a control group and postoperative bone gain was measured using panoramic radiographs rather than CBCT, the findings should be interpreted as descriptive and hypothesis-generating. The WF technique was associated with clinically manageable surgical complications and radiographic bone gain in this single-surgeon cohort, but no conclusions regarding superiority or non-inferiority relative to conventional rotary or piezoelectric techniques can be drawn.

The purpose of this study was to evaluate the clinical and radiographic outcomes of combined surgical therapy for the management of peri-implantitis associated with complex bone defects. We hypothesized that this combined approach may be associated with improvements in clinical parameters and radiographic defect fill. This study was designed as a single-arm exploratory retrospective study. Twenty-one patients with thirty-eight implants diagnosed with peri-implantitis were enrolled. All patients initially received non-surgical mechanical debridement and local antimicrobial therapy, followed four weeks later by combined surgical therapy. The surgical protocol consisted of full-thickness flap elevation, debridement of granulation tissue, implantoplasty of the supra-bone defect portion, chemical surface decontamination, and regenerative treatment with xenogeneic bone grafts and resorbable collagen membranes using the Poncho technique. Clinical parameters, including probing pocket depth (PPD), probing attachment level (PAL), and bleeding on probing (BOP), as well as standardized radiographic assessments, were recorded at baseline and at one, three, six, and twelve months postoperatively. Mean probing pocket depth decreased from 6.15 ± 1.08mm and 5.68 ± 1.23 mm at buccal and lingual sites at baseline to 3.79 ± 0.67 mm and 3.45 ± 0.49 mm at 1 month, respectively, and remained stable through 12 months. Probing attachment level showed a similar pattern, decreasing from 5.80 ± 0.89 mm and 5.46 ± 1.11mm to 3.78 ± 0.61 mm and 3.54 ± 0.46 mm at buccal and lingual sites, respectively. Bleeding on probing and suppuration decreased from 80.9% at baseline to 0% at 1 month and remained low throughout follow-up. Mean bone defect depth decreased from 3.40 ± 1.73mm at surgery to 055 ± 0.79 mm at 6months and 0.77 ± 0.94 mm at 12 months (p < 0.001). Within the limitations of this study, including the small sample size, short follow-up period, and heterogeneity in implant-related factors such as prosthetic design, peri-implant soft tissue, implant systems, and surface characteristics, combined surgical therapy was associated with improvements in clinical and radiographic parameters in implants affected by peri-implantitis with complex bone defects. Combined surgical therapy may represent a potential treatment option for peri-implantitis when careful case selection, thorough surface decontamination, and supportive periodontal maintenance are provided.

A compromised extraction socket in the maxillary esthetic zone presents challenges for achieving predictable ridge preservation and soft-tissue stability. This case describes the management of a maxillary left central incisor with a history of endodontic and apical surgery, including alveolar ridge preservation, delayed implant placement, and soft-tissue augmentation, and evaluates dimensional changes using superimposition of intraoral scanner images. Following extraction, ridge preservation was performed with deproteinized bovine bone mineral and a collagen membrane. After 3 months of healing, the implant was placed with additional grafting, followed by the application of a volume-stable collagen matrix at second-stage surgery to enhance buccal contour and soft-tissue thickness. Intraoral scans were obtained at baseline and at 1, 3, 6, 12, and 18 months, and surface-distance changes at predefined regions of interest were assessed by digital superimposition. The greatest dimensional reduction occurred during the early healing period (baseline to 3 months). Yet ridge preservation effectively limited buccal contour loss despite compromised socket morphology—the collagen matrix produced localized buccal augmentation that remained stable for 18 months. Within the limitations of a single case, this combined approach supported ridge-contour maintenance and soft-tissue stability in a compromised socket. Intraoral scanner superimposition proved to be an effective, noninvasive method for monitoring dimensional changes over time.

Prosthetic factors, including abutment angulation and the crown–implant ratio (CIR), have been suggested to influence peri-implant marginal bone loss; however, their long-term effects remain unclear. This study aimed to evaluate the pattern of peri-implant bone loss over 2 years and to analyze the clinical relevance of abutment angulation and CIR. A total of 200 posterior internal-connection implants placed between 2017 and 2021 were retrospectively evaluated using standardized periapical radiographs taken at baseline, 6 months, 1 year, and 2 years after loading. Bone level changes were measured mesially and distally and average per implant. Patients were categorized according to abutment angulation (p < 0.05), whereas CIR showed no significant association at any time point (p > 0.05). No interaction effect was found between the two variables. Most peri-implant bone remodeling occurred within the first year after loading, followed by a stable phase. Abutment angulation of ≥30° was associated with increased bone loss, while CIR alone did not demonstrate clinical significance. When possible, minimizing abutment angulation may help improve long-term peri-implant bone stability.

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Su-young Choi, Youngkyun Lee, Myoung Ok Kim, Sung-Min Hwang, Jae-Mok Lee, and Yong-Gun Kim. Oral Biol Res 2025;49:. https://doi.org/10.21851/obr.25.024