Objectives: Reconstruction of mandibular integrity following a block resection is complicated by the loss of function and integrity of the graft. We report on rehabilitation of a patient who underwent mandibular resection and fibular reconstruction. Methods: A 16-year-old girl was referred to the Oral Implantology Department Clinic at the Istanbul University Faculty of Dentistry, 2 years after mandibular construction via a fibular graft. The geometry and topography of the graft was inconsistent and challenging for a removable prosthesis. To avoid the risk of fracture and necrosis, computer-assisted planning and flapless implant surgery was chosen as the best course of action. After obtaining a cone beam computerised tomography (CBCT) scan of the mandible with a radiographic template, the images were transferred into dedicated software and three implants were planned for shortened fixed composite–hybrid prostheses. Following surgery, one implant was found to be mispositioned and removed the following day. Results: The mandible was successfully restored by two implant-supported hybrid prostheses, fabricated with the use of nano-filled composite following the osseointegration period. Conclusions: Rehabilitation of a pathologically reconstructed edentulous jaw may be successfully completed using computer-assisted planning and guided implant surgery. Clinicians should be cautious regarding deviations related to the use of sterolithographic guides.

Objectives: Extraction socket grafting has been validated for preservation of alveolar ridge dimensions following tooth loss. For making a scientific comparison of different materials requires extraction of at least two teeth. This pilot study aimed to explore the viability of using a single mandibular molar extraction to compare two different materials. The results were evaluated and compared clinically, radiographically and histologically. Methods: Five consecutive patients received an atraumatic tooth extraction of the mandibular first molar with subsequent placement of bone allograft (PurosTM/®) in one socket and xenograft (Bio-OssTM/®) in the other. All sites were covered with a single layer of an absorbable collagen membrane (Ossix PlusTM/®), which was intentionally left exposed. After 20 weeks, the surgical sites were accessed for placement of dental implants. Prior to placement, two trephine core samples were taken for histologic analysis. Dental implants were successfully placed between all previously grafted surgical sites in a single-stage manner. Results: Complete healing of both grafted sites was observed at 20 weeks. The clinical and radiographic aspects of the sites grafted with either allograft or xenograft were significantly different. Xenograft-grafted sites were significantly more radiopaque and residual graft particles were seen at the alveolar crest; allograft-grafted sites demonstrated radiopacity similar to non-grafted adjacent areas, and no visible residual graft particles were seen at the osseous crest, suggesting a higher degree of material turnover. Significant differences were also observed histologically, with more residual graft particles and less vital bone where xenograft was placed, confirming that the two materials behave in significantly different ways when placed in extraction sites for alveolar ridge preservation. Conclusions: This pilot study demonstrated that a single mandibular molar socket can be used to make both clinical and histological comparisons between two different types of bone grafting materials. Future studies should consider using this less traumatic and more convenient research protocol.

Unlike bone, which undergoes remodeling by resorption followed by bone apposition, teeth are not subject to physiological remodeling. They are remarkably resistant to physiological remodeling processes. The reason for this is found in the periodontium and cementum. The mechanisms that take effect in this area and the effectiveness of the periodontal system - consisting of gingiva, alveolar bone, periodontium and cementum - after injuries will be visualized in the new scientific 3D film, "Periodontal Regeneration".The visualization of these complex processes is of great interest for academic teaching as well as for the clinician and general practitioner as the cellular interactions are presented in the context of four phases. For the first time scanning electron microscopic images of real cells will be visualized allowing the comparison of their characteristics with computer animated simulations. DVD 1: Expert Version approx. 14 minutes DVD 2: Public Version approx. 13 minutes Outline: - Cementum formation - Orthodontic tooth movement - Trauma and periodontitis - Periodontal regeneration