In my opinion, the ITI is one of the rare organizations in our field that consistently grows and develops, covering all the disciplines involved, both scientific and clinical, emphasizing individual and institutional improvement, and providing important practitioner guidelines.

Objective: The rehabilitation of edentulous mandibles with implant-supported overdentures is a state-of-the-art contemporary implant treatment. Computer-assisted flapless surgery is associated with decreased chairside treatment time, as well as significant reduction in patient postoperative morbidity and discomfort. The aim of this study was to evaluate the protocol of computer-guided surgery in the treatment of edentulous mandibles with overdentures supported by four intraforaminal implants and retained by Locator® attachments in elderly patients, both from a clinician's and a patient's perspective, as well as to assess the stability of the results in a 2-year period. Method and Materials: 15 patients presenting edentulous mandibles and discomfort while wearing conventional overdentures were enrolled in the study. Careful presurgical and computer-assisted 3D treatment planning was performed. Patients were treated with four intraforaminal implants using a computer-assisted flapless approach. All patients were prosthetically rehabilitated with overdentures. Clinical parameters such as peri-implant probing depth (PPD), Plaque Index (PI), and bleeding on probing (BOP) were evaluated. Patients' perceptions regarding the outcome were assessed on visual analog scales (VAS). Results: Out of 15 patients consecutively included in the study, only 10 patients could be treated with the designed protocol. A total of 40 Camlog implants were placed. No implant was lost over a 2-year period. BOP was negative in 82% of sites; mean PPD was 2.34 mm; 8 of the 40 implants showed the absence of keratinized tissue on the lingual or the vestibular aspect. The VAS score of 9.9 demonstrated the satisfaction of the patients. Conclusions: Within the limitations of this study, the data demonstrate that in a significant number of cases this protocol could not be used for anatomical or technical reasons. In the cases where it could be used, the computer-assisted protocol appeared suitable for treating elderly patients with mandibular edentulism and restoring them with an overdenture in a minimally invasive way. The possibility of placing implants outside the borders of the keratinized tissue is relevant. Schlagwörter: flapless surgery, guided surgery, overdenture

Objective: The main objective of this study was to evaluate the clinical effectiveness of platelet-rich fibrin membrane used in combination with a coronally advanced flap (CAF) and to compare it with the use of an enamel matrix derivative (EMD) in combination with a coronally advanced flap in gingival recession treatment. Materials and methods: 20 split-mouth cases of maxillary anterior teeth or bicuspids presenting with Miller Class I or II gingival recession were treated with a CAF combined with a platelet-rich fibrin membrane (PRF group) or with EMD (EMD group) placed under a CAF. The following parameters were measured at baseline and at 12 months post treatment: gingival recession (GR), apicocoronal width of the keratinized tissue (WKT), and probing depth (PD). Results: Complete root coverage in the PRF group was 65% (13 out of 20 recessions) and 60% in the EMD group (12 out of 20 recessions). GR was 4.10 ± 1.05 mm in the PRF group and 3.90 ± 1.00 mm in the EMD group at baseline, and 1.05 ± 0.45 mm in the PRF group and 1.15 ± 0.65 mm in the EMD group at 12 months. The difference observed between the two groups at 12 months was statistically significant. Average root coverage was 70.5% in the EMD group and 72.1% in the PRF group. WKT was 1.30 ± 0.56 mm in the EMD group and 1.45 ± 0.86 mm in the PRF group at baseline, and 1.90 ± 0.81 mm in the EMD group and 1.62 ± 0.28 mm in the PRF group at 12 months. The difference observed between the two groups at 12 months was not statistically significant. Twelve-month changes in PD were not significantly different between the two groups. The pain intensity was statistically different between groups for the first 5 days, favoring the PRF group. Conclusions: The present study did not succeed in demonstrating any clinical advantage of the use of PRF compared to EMD in the coverage of gingival recession with the CAF procedure. The EMD group showed a higher success rate in increasing WKT than did the PRF group.

Ziel: Ziel der vorliegenden Studie war es, die klinische Wirksamkeit einer plättchenreichen Fibrinmembran (PRF) in Kombination mit einem koronalen Verschiebelappen (CAF) zu untersuchen und diese mit der Verwendung eines Schmelzmatrix-Derivats (EMD) in Kombination mit einem koronalen Verschiebelappen für die Behandlung von gingivalen Rezessionen zu vergleichen. Material und Methode: 20 Split-Mouth- Untersuchungen von oberen Frontzähnen oder Prämolaren mit einer gingivalen Rezession der Miller-Klasse I oder II wurden entweder mit einem koronalen Verschiebelappen in Kombination mit einer plättchenreichen Fibrinmembran (PRF-Gruppe) oder mit EMD (EMDGruppe) behandelt, das mit einem koronalen Verschiebelappen abgedeckt wurde. In der Ausgangssituation und 12 Monate nach der Behandlung wurden folgende Parameter gemessen: gingivale Rezession (GR), apikokoronale Breite des keratinisierten Gewebes (WKT) und Sondierungstiefe (PD). Ergebnisse: Eine vollständige Wurzeldeckung wurde in der PRF-Gruppe zu 65 % erreicht (13 von 20 Rezessionen). In der EMD-Gruppe waren es 60 % (12 von 20 Rezessionen). In der PRFGruppe betrug die GR zu Beginn 4,10 ± 1,05 mm, in der EMD-Gruppe 3,90 ± 1,00 mm. Nach 12 Monaten waren es in der PRF-Gruppe 1,05 ± 0,45 mm und in der EMD-Gruppe 1,15 ± 0,65 mm. Der Unterschied, der nach 12 Monaten zwischen den beiden Gruppen festgestellt wurde, war statistisch signifikant. Die durchschnittliche Wurzeldeckung betrug in der EMD-Gruppe 70,5 % und in der PRF-Gruppe 72,1 %. In der EMDGruppe betrug die WKT zu Beginn 1,30 ± 0,56 mm, in der PRF-Gruppe 1,45 ± 0,86 mm. Nach 12 Monaten waren es in der EMD-Gruppe 1,90 ± 0,81 mm und in der PRF-Gruppe 1,62 ± 0,28 mm. Der Unterschied, der nach 12 Monaten zwischen den beiden Gruppen festgestellt wurde, war nicht statistisch signifikant. Bei der veränderten Sondierungstiefe wurden nach 12 Monaten keine signifikanten Unterschiede zwischen den beiden Gruppen festgestellt. Bei der Schmerzintensität gab es in den ersten fünf Tagen statistisch signifikante Unterschiede zwischen den beiden Gruppen, wobei die PRF-Gruppe günstigere Werte aufwies. Schlussfolgerungen: In der vorliegenden Studie konnten keine klinischen Vorteile für die Verwendung des PRF im Vergleich zu EMD für die Deckung von gingivalen Rezessionen mit einem koronalen Verschiebelappen festgestellt werden. Für die EMD-Gruppe wurde bei der Verbesserung der WKT eine höhere Erfolgsrate verzeichnet als für die PRFGruppe.