Objectives: Effective root canal disinfection remains challenging due to the complex anatomy of the root canal system and the ability of microorganisms to form resistant biofilms. The 445 nm blue diode laser has recently gained attention as a potential adjunctive disinfection method. This systematic review aimed to evaluate the antibacterial effectiveness of the 445 nm diode laser within the root canal system.

Material and Methods: A literature search was conducted in PubMed, ScienceDirect, and SpringerLink for studies published between 2018 and 2026. A total of 40 papers were identified. Studies meeting predefined inclusion criteria were selected for analysis. Methodological quality and risk of bias were assessed using the Cochrane RoB 2.0 tool for clinical studies and the Joanna Briggs Institute critical appraisal tools for in vitro studies.

Results: Five studies met the inclusion criteria: four in vitro and one in vivo clinical study. All studies demonstrated that the 445 nm diode laser exhibited antibacterial activity against Enterococcus faecalis and other endodontic pathogens, although the magnitude of the effect varied depending on laser parameters, dentine thickness, and evaluation methods. In vitro studies reported bacterial reductions ranging from 6.9% to 97.6%, and one study demonstrated a 1.0 to 2.5 log₁₀ CFU/mL reduction. In the clinical study, the 445 nm laser alone reduced bacterial load by 58.2%, while its combination with 3% sodium hypochlorite achieved a 92.7% reduction. All included studies demonstrated a low risk of methodological bias.

Conclusions: The 445 nm diode laser shows measurable antibacterial activity within the root canal system. However, its effectiveness depends on irradiation parameters and dentine thickness. As a standalone method, it is less effective than conventional irrigants, but when combined with 2.5 to 3% sodium hypochlorite, a significantly greater antibacterial effect is achieved. More clinical studies are needed to determine its long term clinical relevance.

Objectives: The aim of this systematic review was to compare the positional accuracy of dental implant placement using free-hand to different computer-assisted implant surgery techniques.

Material and Methods: The literature search was conducted by using PubMed, ScienceDirect, and Cochrane Library databases. Studies comparing implant placement accuracy among free-hand and three computer-assisted implant surgery (CAIS) techniques - robotic (rCAIS), static (sCAIS), and dynamic (dCAIS) - were analysed. Inclusion and exclusion criteria, as well as PRISMA guidelines, were applied. Data were collected from human published studies in English between January 2016 and April 2026.

Results: Twelve articles were included, with a total of 586 implants placed, from which 296 were done by free-hand, 77 by rCAIS, 117 by sCAIS, and 85 by dCAIS. Across all studies, CAIS consistently yielded lower angular, apical, and platform deviations than free-hand placement, with angular deviation showing the largest statistically significant differences. Among the CAIS techniques, rCAIS demonstrated the lowest deviations, in all three parameters, along with the smallest inter-study variability. Although to a lesser extent, sCAIS and dCAIS also demonstrated deviation reduction, compared to free-hand, but with greater variability. Free-hand placement consistently reported the highest deviation values in all comparisons to CAIS techniques.

Conclusions: Computer-assisted techniques demonstrated higher accuracy when compared to free-hand placement in terms of angular, apical, and platform deviations, with the greatest improvement observed in the angular deviation. The largest deviation reductions were observed in the robotic computer-assisted implant surgery groups.

Objectives: This retrospective multicentre chart review assessed single-tooth rehabilitation following osteotome-mediated sinus floor elevation across six European departments between January 1, 2018, until December 31, 2023.

Material and Methods: The study was performed according to Strengthening the Reporting of Observational Studies in Epidemiology. Intraoperative, early- and late postoperative data were registered in a standardized excel sheet and analysed using a standardized computer-assisted database. Parametric data was presented as mean and standard deviation. Level of significance was P < 0.05.

Results: Ninety-five patients with a mean age of 48.9 (SD 11.3) years were included. Mean preoperative alveolar ridge height was 6.4 (SD 1.2) mm. Mean implant length and diameter were 10.8 (SD 2.1) mm and 4.3 (SD 0.4) mm, respectively. Xenograft was the most used grafting material followed by coagulum. High implant survival (93.7%), limited peri-implant marginal bone loss at the mesial (0.5 [SD 0.9] mm and distal implant surface (0.7 [SD 1.0] mm), and low incidence of complications were observed after 38 (SD 27.2) months. Schneiderian membrane perforation occurred in 6.3%. Peri-implant marginal bone loss was statistically significantly correlated with omission of preoperative antibiotics (P = 0.001, P = 0.00002), preoperative alveolar ridge height (≤ 6 mm) (P = 0.049), and utilization of calibrated osteotomes alone (P = 0.02).

Conclusions: Osteotome-mediated sinus floor elevation is a highly predictable method for single-tooth rehabilitation of the atrophic posterior maxilla. However, meticulous preoperative assessment of patient-related parameters, anatomical factors, or surgical risk factors is mandatory to improve the long-term implant outcome.

Objectives: This in vitro study investigated whether combining peak and accumulated drilling torque value improves assessment of bone density distribution at implant sites using simulated bone models with predefined density patterns.

Material and Methods: Three-layer polyurethane bone models composed of D1- and D4-equivalent materials were fabricated with identical overall compositions but different density distributions (D1-4-4, D4-1-4, and D4-4-1). After initial osteotomy with a 2.0-mm twist drill, drilling was performed using a 2.7-mm torque-measurement drill. Torque was recorded continuously at 0.05-second intervals. Peak and accumulated drilling torque values were calculated and compared among the three density distribution models (n = 5).

Results: Representative torque profiles showed that the timing of peak drilling torque value varied with the position of the D1 layer, occurring earlier when the high-density layer was located in the upper layer. Peak drilling torque did not differ significantly among models. In contrast, accumulated drilling torque decreased significantly as the D1 layer was positioned deeper (D1-4-4: 187.6 (SD 22.7), D4-1-4: 125.7 (SD 28.1), and D4-4-1: 78.4 (SD 13.8) Ncm; P < 0.05).

Conclusions: Peak drilling torque reflected maximum local mechanical resistance but could not distinguish internal bone density distributions. Accumulated drilling torque provided additional information on density distribution throughout the osteotomy. Combined evaluation of both torque values may therefore provide a more comprehensive assessment of bone conditions at implant sites than peak drilling torque alone.

Objectives: The purpose of this retrospective cohort study was to identify clinical and treatment-related predictors of relapse following surgical intervention in patients with medication-related osteonecrosis of the jaw.

Material and Methods: This retrospective single-centre cohort study conducted at Odense University Hospital, Denmark, included all consecutive patients diagnosed with medication-related osteonecrosis of the jaw (MRONJ) between 2009 and 2022. Patient demographics, medical indications, antiresorptive (AR) therapy, anatomical site, staging, and treatment modalities were recorded. Multi-model selection via exhaustive binary logistic regression was applied across 8,192 model combinations to identify key predictors of relapse, followed by multivariable logistic regression analysis.

Results: The study evaluated 124 patients (median age 70 years, interquartile range 62 to 77; 54% female). Indications for AR therapy were osteoporosis (36%), multiple myeloma (27%), adjuvant cancer therapy (27%), and bone metastases (10%). Surgical management was performed in 91 patients (73%), achieving complete mucosal healing in 71% (n = 65). Multivariable analysis identified four independent risk factors for MRONJ relapse: intraoperative tooth extraction in the MRONJ site (OR = 6.74), bilateral MRONJ presentation (OR = 6.56), smoking (OR = 3.88), and underlying disease diagnosis (osteoporosis vs. cancer; OR = 2.87 to 6.13). Concurrent tooth removal during MRONJ surgery significantly increased relapse rates compared to non-extraction procedures (48% vs. 17%; P = 0.002).

Conclusions: Surgical intervention provided acceptable mucosal healing rates. However, intraoperative tooth removal within the affected area, bilateral involvement, smoking, and underlying diagnosis significantly increase the risk of postsurgical relapse. Adequate resection margins around adjacent compromised teeth are essential to minimize postsurgical recurrence.