Denisa Alexandra Al Share

Background/Objectives: Peri-implant marginal bone stability is a relevant indicator of the medium-term outcomes of implants placed simultaneously with maxillary sinus floor elevation. This study aimed to describe peri-implant marginal bone levels after at least 60 months and to assess their association with three implant-site preparation and condensation techniques: osteotomes, Densah/Versah burs, and DASK Simple, used in conjunction with transcrestal or lateral sinus floor elevation. Methods: This retrospective cohort study included 248 patients and 528 Dentium SuperLine bone-level implants placed in the posterior maxilla. Immediate restoration without occlusal contacts was used for single-unit or splinted prostheses, whereas immediate loading was applied exclusively to All-on-X rehabilitations. Marginal bone levels were assessed by cone-beam computed tomography (CBCT) at delivery of the definitive restoration, 3–6 months after implant placement, and at the final follow-up, 63–66 months after implant placement. The primary analysis used a linear mixed-effects model to account for dependence among implants within the same patient. Results: Six documented implant losses occurred before the final assessment, representing 1.1% of the implants in the selected cohort. Paired radiographic measurements were available for 522 implants. The mean marginal bone level at the final assessment was 0.11 ± 0.18 mm, and the mean change from baseline was 0.03 ± 0.06 mm. Inter-examiner reproducibility was excellent (ICC = 0.994, 95% CI, 0.992–0.996), with a standard error of measurement (SEM) of 0.0085 mm and a 95% minimum detectable change (MDC95) of 0.0235 mm. Repeated intra-examiner measurements showed no numerical differences at the recorded measurement precision. The mean longitudinal change remained substantially below the nominal 0.125-mm CBCT voxel size and should therefore be interpreted cautiously with respect to measurement precision and clinical relevance. After adjustment for the available covariates and clustering of implants within patients, the implant-site preparation and condensation technique was not independently associated with the 5-year marginal bone level. Conclusions: No adjusted association was detected between implant-site preparation technique and the 5-year marginal bone level in this retrospective cohort. The very small observed longitudinal changes should be interpreted cautiously in view of measurement uncertainty, potential selection bias, and residual confounding, and the findings should not be interpreted as evidence of equivalence among the three techniques.

Background/Objectives: This retrospective observational study assessed 36-month final apical status after primary endodontic treatment and nonsurgical retreatment performed using different nickel–titanium (NiTi) instrumentation systems and explored its association with available clinical and morphological variables. Methods: The study included 89 permanent teeth from 69 patients treated between January 2022 and January 2023. Teeth with periapical lesions and complete baseline and 36-month clinical and radiographic records were evaluated using a stringent binary endpoint in which complete healing required the absence of clinical signs or symptoms and residual apical radiolucency. Associations were examined primarily using univariable logistic generalized estimating equation (GEE) models accounting for clustering of teeth within patients, while Pearson’s chi-square tests and Cohen’s w were retained as supplementary unadjusted analyses. Because CBCT/Diagnocat information could contribute to final outcome classification when available, Diagnocat-based CBCT availability was not analyzed as an explanatory variable. Results: Complete clinico-radiographic healing at 36 months was observed in 61 teeth (68.54%). When reported separately by treatment modality, complete healing was observed in 12 of 29 primary-treatment cases (41.38%) and in 49 of 60 nonsurgical retreatment cases (81.67%). Because treatment allocation was non-random and the groups differed in case characteristics, this contrast was considered exploratory rather than an estimate of comparative treatment effectiveness. Exploratory analyses showed no evidence of an association with the NiTi instrumentation system or type of NiTi motion. Conclusions: Subgroup comparisons were exploratory, unadjusted for multiple testing, and should not be interpreted as evidence of independent prognostic effects. Final apical status should therefore be interpreted within the broader context of treatment indication, tooth morphology, the method of outcome ascertainment, and the overall therapeutic protocol rather than attributed to a specific NiTi system.

Background/Objectives: Morphological signs of non-carious tooth surface loss are clinically heterogeneous, and their prevalence depends strongly on the diagnostic framework and threshold used. This exploratory secondary analysis evaluated a study-specific combined morphological outcome restricted to second permanent molars and its association with cumulative caries experience in a regional clinical sample of adolescents. Methods: The analysis included 231 adolescents aged 13–19 years from Dolj, Gorj, and Olt counties, selected from a parent clinical database of 638 participants. The study-specific outcome was coded when a clearly discernible non-carious hard-tissue change compatible with an abrasive, erosive, or abfraction-related morphology was identified on any clinically accessible surface of tooth 17, 27, 37, or 47. This study did not use BEWE, the Smith and Knight Tooth Wear Index, or another validated severity-based tooth wear index; subtype, surface, and severity were not retained separately in the analytical dataset. Dental caries experience was measured using DMF-T. Group comparisons, correlations, and multivariable logistic regression were performed in JASP version 0.96.0. Sensitivity analyses included a participant-level coding audit and a logistic model using DMF-T recalculated after excluding the contribution of teeth 17, 27, 37, and 47. Results: The study-specific morphological outcome was present in 50/231 participants (21.6%). A coding audit confirmed that 181 participants had no positive second molar and 50 had exactly one positive second molar; tooth-specific counts were 14, 15, 12, and 9 for teeth 17, 27, 37, and 47, respectively. In the primary model, male sex (adjusted OR = 3.34, 95% CI 1.67–6.71) and DMF-T (adjusted OR = 1.15 per point, 95% CI 1.01–1.31) were associated with the outcome. After excluding the four evaluated second molars from DMF-T, the caries experience association remained positive but borderline (OR = 1.198, 95% CI 1.000–1.435, p = 0.049), while male sex remained associated (OR = 3.310, 95% CI 1.647–6.652, p < 0.001). Conclusions: A modest exploratory association was observed between the study-specific morphological outcome and cumulative caries experience in this clinical sample. The result should not be interpreted as a standardized NCDL prevalence estimate, a causal relationship, or a prediction model. Confirmation using validated whole-mouth tooth wear measures, outcome-specific reliability assessment, and population-based longitudinal data is required.