Michele Miranda

Background: The long-term success of implant-supported mandibular overdentures depends largely on the type of attachment system used. This review compares the clinical performance, complication rates, maintenance requirements, and patient satisfaction between ball and Locator attachments. Methods: A literature search was conducted across PubMed, Scopus, and Web of Science. Studies evaluating clinical outcomes, prosthetic complications, patient-reported satisfaction, and frequency of maintenance in ball and Locator attachments were included. Results: Locator attachments showed higher patient satisfaction scores (mean VAS 8.1–9.0) compared to ball attachments (VAS 6.7–7.9). Complication rates, including matrix wear and attachment loosening, were lower in Locator systems (14–20%) than in ball systems (24–35%). Maintenance needs were more frequent in ball attachments, particularly for the replacement of retentive components (1.8 interventions/year vs. 0.9 in Locator). Peri-implant bone loss was comparable in both systems (<1.5 mm/year), with no statistically significant difference in survival rates over 3–5 years. Conclusions: Locator attachments demonstrate superior clinical performance in terms of patient satisfaction and lower complication rates, with reduced maintenance interventions compared to ball attachments. However, both systems remain viable options depending on anatomical and financial considerations.

Cyanoacrylate-based adhesives have gained increasing attention in dentistry for their rapid polymerization, biocompatibility, and antimicrobial activity. This review analyzes the clinical use of cyanoacrylate adhesives—particularly the Glubran II formulation—in dental procedures, including wound closure, tissue management, and bleeding control. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science databases for studies published between 2000 and 2024, using specific inclusion criteria (clinical and in vitro studies focusing on dental applications of cyanoacrylates) and exclusion criteria (non-dental uses, insufficient data). The findings indicate that compared to traditional sutures, cyanoacrylates, especially n-butyl and octyl derivatives, significantly reduce operative time, postoperative pain, and infection rates. However, differences among formulations—such as degradation rate and cytotoxicity—require further exploration. Glubran II, in particular, shows promising results in hemostasis and wound stability. This review highlights the potential of cyanoacrylate adhesives as effective, minimally invasive alternatives in dental surgery and underlines the need for standardized protocols and long-term comparative studies.

Objectives: This retrospective study aimed to evaluate the increase in vertical bone height following sinus lift procedures using the CAS (Crestal Approach Sinus) kit technique in combination with tissue-level implants. Additionally, the quantity of bone between the implant apex and the Schneiderian membrane was assessed to determine the effectiveness and safety of this minimally invasive approach. Methods: The study included 15 patients (20 implants) who underwent sinus lift procedures with the CAS kit technique and tissue-level implants in the posterior maxilla between September 2021 and October 2024. Inclusion criteria required a minimum residual bone height (RBH) of 2 mm. Cone-beam computed tomography (CBCT) scans were used for initial screening, and panoramic radiography evaluated outcomes at implant placement and nine months postoperatively. Primary outcomes included implant and prosthetic survival rates, as well as biological and technical complications. Secondary outcomes were vertical bone height and the amount of bone above the implant tip. Statistical analyses were conducted using the Wilcoxon signed-rank test with a significance level of 0.05. Results: All implants achieved successful osseointegration, with no implant or prosthetic failures and no biological or technical complications reported. The mean RBH at implant placement was 4.2 ± 1.4 mm, which increased to an overall membrane elevation of 13.8 ± 1.8 mm. At the 9-month follow-up, the overall membrane elevation was slightly reduced to 13.0 ± 1.6 mm (p = 0.000), with a mean bone gain of 9.6 ± 2.4 mm. The amount of bone above the implant tip was 3.4 ± 1.7 mm at placement, decreasing to 3.0 ± 1.2 mm at follow-up (p = 0.007). Conclusions: The CAS kit technique combined with tissue-level implants demonstrated significant vertical bone gain and high implant survival rates without complications. This minimally invasive approach proved effective and safe for sinus augmentation in patients with limited residual bone height. The findings support the CAS kit’s potential as a preferred technique for maxillary sinus elevation. Further research with larger cohorts and long-term follow-up is needed to validate these results.

Graft-versus-host disease (GVHD) is a complication of hematopoietic stem cell transplantation (HSCT). GVHD may also develop following solid transplants or blood transfusions if white blood cells are transferred. GVHD affects multiple organs, including the oral tissues. This pictorial review provides a background of GVHD to dental practitioners, describes the most common oral manifestations of GVHD, and highlights the main treatment modifications needed to deliver dental care to patients with GVHD. A narrative review enriched with clinical data was performed by searching the scientific literature for all articles regarding GVHD and oral manifestations/therapies. All articles without exclusion criteria, except animal tests, were included in the above review. Acute GVHD may manifest in the oral mucosa; however, it often develops immediately following HSCT when routine dental treatment is postponed. Chronic GVHD may manifest in the oral mucosa, the salivary glands, and the musculoskeletal compartment. It may indirectly affect the teeth and the oral flora, putting the patient at risk for infections. Importantly, GVHD poses an increased risk for oral cancer. GVHD has a wide range of oral manifestations, some of which may affect dental treatment.

This work aims to assess the risks both thromboembolic that bleeding of a management protocol "non-conservative" in patients on oral anticoagulant therapy (OAT) to be undergoing implant surgery. We decided to take a surgical "non-conservative" protocol, to insert four implants in the aesthetic zone, without using flapless surgery and the surgical template. In accordance with the hematologist, the value of INR is lowered and warfarin was replaced with heparin low molecular weight, to have a better coagulation's control. The modern guidelines impose a protocol of conservative management in patients with OAT, with minimally invasive surgery, flapless, and use of surgical template to reduce the risk of uncontrolled bleeding. This, thanks to the team-work between dentist and hematologist, thanks to careful adjustment of INR and the use of local haemostatic agents, were not encountered any problems with bleeding or intra or postoperative. Surgical treatment of patients with OAT is a real problem for the oral surgeon, to treat every time in association with the hematologist. Applying this type of surgical procedure, different from today's guidelines, in our experience there were no post-operative complications (bleeding or bleeding); osseointegration has not been compromised and the prosthetic rehabilitation was completed successfully.