ChatGPT, an artificial intelligence (AI) chatbot can generate text prompts based on user input. This study investigated the possibility of generating adequate and relevant patient education and management documents in the context of dental implant surgery utilizing this tool. Methods: Twenty-seven (n=27) periodontists were surveyed on the accuracy and usefulness of AI-generated documents comprising patient information handouts on surgical risks and post-operative instructions sheets for dental implant placement either in smokers or patients with diabetes. They were also asked in a blinded fashion about their preferences between the generic dental implant placement consent form currently used at Boston University and two AI-generated consent forms: one generic and one tailored to patients with diabetes. Results: A vast majority of participants found that the information in the AI-generated forms was accurate, useful and would feel comfortable using them with their own patients. The AI-generated generic consent performed as least as well as the human-written one, while the personalized informed consent for patient with diabetes performed significantly better (p<0.001). Conclusions: Within the limitations of this study, ChatGPT was able to independently generate accurate and useful patient information and management documents.

Numerous surgical techniques have been developed as effective means to facilitate orthodontic treatment, but they may cause significant postoperative discomfort. Piezocision was established as a flapless and minimally invasive technique to accelerate orthodontic tooth movement by com- bining small vertical incisions and piezoelectric corticotomies. Computed tomography is combined with the Piezocision technique to fabricate CAD/CAM surgical guides to prevent iatrogenic damage. A method to combine computer-assisted dynamic navigation with Piezocision is introduced here. CBCT was combined with motion-tracking technology to allow real-time tracing of the piezoelectric instruments during the surgical procedure. This technique delivers the location of the piezoelectric knife in regard to roots and important anatomical structures to increase the safety and accuracy during corticotimies. Keywords: dynamic guidance, navigation, periodontal surgery, piezocision, surgically accelerated orthodontics

Purpose: To quantify the clinical accuracy of a robotically assisted implant guidance system in partially edentulous patients without the use of postoperative CBCT. Materials and Methods: A total of 10 implants (7 patients) were placed in partially edentulous patients utilizing a robotically assisted implant guidance system. Following the implant placement, an intraoral scan was performed to register the implant position after attaching a scan body. The virtual plan and the postoperative intraoral scan with the scan bodies were exported as STL files and superimposed, and discrepancies were analyzed using Geomagic Control X software. Positional deviations were measured between the midpoint of the platform and apex of the planned and achieved implant positions. Results: Seven of the 10 implants in this study were defined as fully robotically guided, while 3 were partially robotically guided. For the fully robotic dynamically guided group, the mean deviation at the midpoint of the restorative platform of the implant, the apex of the implant, the top of the scan body, and the mean angular deviation were 1.31 ± 0.46 mm, 1.58 ± 0.61 mm, 1.11 ± 0.57 mm, and 2.34 ± 1.71 degrees, respectively. For the partially robotic dynamically guided cases, these values were 1.31 ± 0.49 mm, 1.45 ± 0.3 mm, 1.74 ± 0.47 mm, and 3.75 ± 2.53 degrees, respectively. Eight of the 10 implants (irrespective of full or partial guidance) showed a buccal displacement. Conclusions: Robotic surgery offers a level of accuracy similar to fully guided implant placement, without the need for a physical template, and allows for changes in the surgical plan at any time. The analytical method described in this study is an effective and radiation-free quality-control tool that can be used in implant dentistry as well as in other areas of dental research. 

The correction of transverse malocclusions due to maxillary width deficiency in adults is challenging. Multiple surgical and nonsurgical procedures have been used in conjunction with orthodontics to address this situation, and most common is the surgically assisted rapid maxillary expansion (SA-RME). Although successful, it is quite aggressive. The present investigation assesses the usefulness of Piezocision-assisted orthodontics as a less-invasive option for treatment of transverse maxillary deficiencies in adults. Dental casts were taken before and after Piezocision-assisted palatal expansion in four patients. They were digitized into STL files and superimposed. Differences on cross-arch tooth torque, angulation/tipping, and movement distances between time points were quantified using a digital static and a novel digital 3D-movement evaluation method. For the buccolingual movement per tooth, first premolars averaged 3.33 ± 1.3 mm, second premolars averaged 3.63 ± 0.6 mm, and first and second molars averaged 1.56 ± 1.2 mm and 0.36 ± 1.2 mm, respectively. Bodily movement of the teeth was observed with minimal tipping and no development of gingival recessions. Piezocision-assisted palatal expansion is a safe and reliable procedure that can help patients with maxillary width deficiency. It is a new tool in the orthodontist's armamentarium that can be used as an accelerator of treatment and as a new way to solve orthodontic challenges in selected adult patients.

Piezoelectric surgery utilizes ultrasonic vibrations to cut bone more precisely and less traumatically than conventional methods. The regional acceleratory phenomenon following bone injury has a demineralization phase followed by a remineralization phase. Part I of this study on rats assessed the biologic modifications following bone injuries with the piezoelectric knife at 10-Hz and 30-Hz modulation frequencies. Part II focuses on piezoelectric surgery–regulated osteoblast activity and changes occurring in the bone during the regeneration phase. The results indicate that at 30 Hz, the remineralization process starts at day 14 and continues until day 70, with osteoblast progenitor cells observed in the periodontal ligament around acellular new bone as early as day 14. These findings emphasize the potential for regeneration in the late postoperative phase and the possible use of the piezoelectric knife as an adjunct for guided bone regeneration, site development, or site preparation for dental implants.

Piezocision can set in motion a cascade of physiologic events that lead to accelerated orthodontics, but do all ultrasonic frequencies generate the same effects on bone? Two different Piezotome modulation frequencies (10 and 30 Hz) were tested on the rat maxilla. The animals were sacrificed at days 1, 3, 7, 14, 28, and 70, and MRI, histologic, and biochemical analyses were performed. The results indicated that at 30 Hz, the demineralization process started at day 1 and peaked at day 7, and was initiated by osteocyte apoptosis. The process was different in the two groups, with bone demineralization increasing significantly in the 30-Hz group compared to the 10-Hz group (P .05). These results could indicate that bone biomodification is frequency-dependent.

Purpose: The purpose of this prospective randomized clinical trial was to test the hypothesis that narrow-diameter titanium-zirconium (Ti-Zr) alloy implants with a chemically modified hydrophilic surface are not inferior in regard to crestal bone level change compared to standard-diameter implants with the same implant surface and material. Materials and Methods: This multicenter study included 50 patients in need of a single tooth replacement in the anterior (canine to canine) or premolar region of the mandible or maxilla. Patients were included if the site could accommodate a 4.1-mm-diameter implant. Implants were temporarily restored at 3 to 4 weeks after placement. Definitive restorations were delivered 4 to 6 months after placement. Patients returned 1 year after implant loading for clinical measurements and radiographic examination. The primary outcome was mean crestal bone level changes measured between implant loading and 12 months postloading. Secondary outcomes included implant success, survival, gingival recession, and patient satisfaction. Results: Fifty patients were enrolled; 47 completed the study. Twenty-three patients were in the narrow-diameter implant group (test), and 24 patients were in the standard-diameter implant group (control). The success and survival rates at 12 months postloading were 100% for both groups. The change in the mean crestal bone level from implant loading to 12 months postloading around narrowdiameter implants was -0.27 ± 0.34 mm. For the standard-diameter implants, the change was significantly higher at -0.48 ± 0.67 mm (P = .02). No significant difference was found in gingival recession and patient satisfaction. Conclusion: The results of this prospective randomized clinical trial suggest noninferiority of the narrow- vs standard-diameter Ti-Zr implant. In addition, bone remodeling was less pronounced for the narrow-diameter implants. Keywords: dental Implant, marginal bone level, prospective study, randomized clinical trial, single implant, soft tissue

This in vitro pilot study was performed to determine whether a treatment algorithm including mechanical debridement, followed by air powder abrasion with glycine, followed by citric acid conditioning with vigorous flushing of the surface with sterile water after each step, is capable of decontaminating an infected implant surface. A total of 14 dental implants that were deemed hopeless due to advanced peri-implantitis were extracted. Of these, 6 implants served as tests and had their exposed surfaces treated with the decontamination protocol, 6 served as untreated controls, and 2 were mechanically treated only, followed by rubbing the surface with sterile saline. All implants were placed in culture with human osteoprogenitor cells for 72 hours, and evaluation was performed using scanning electron microscopy. The 6 test implants all demonstrated attachment and proliferation of the normal human osteoprogenitor cells on their prior exposed and decontaminated surfaces. All of the untreated control and the mechanically debrided, sterile water-treated implants failed to demonstrate this same success. The results suggest that this protocol can decontaminate an implant surface affected by peri-implantitis. Further studies are warranted to determine if this technique would demonstrate similar success over a greater number of implants and whether this outcome may occur in humans.

Different corticotomy surgical procedures have been developed to shorten orthodontic treatment times by stimulating bone remodeling. Although all corticotomy procedures involve physical injury to the bone, the clinical outcomes can vary. Using an ex vivo calvarial bone organ culture model system, the authors evaluated the biologic response of bone to different corticotomies. Bone injuries were generated in 276 calvaria dissected from 5- to 7-day-old neonatal mice using a piezoelectric knife, a bur, and a handheld screw device. The responses were evaluated using chemical, biochemical, and global histomorphometric analyses. Injuries generated by the three approaches induced varying degrees of bone remodeling activities; however, the piezoelectric knife led to the most extensive impact in both bone resorption and formation models.

This study compared the clinical outcomes of recombinant human plateletderived growth factor BB and beta-tricalcium phosphate (rhPDGF-BB/βTCP) with guided bone regeneration (GBR) in immediate implant placement in molar extraction sockets with buccal bone defects versus conventional implant placement. Twenty-eight implants were placed in fourteen patients. Clinical and radiographic evaluations assessed peri-implant soft and hard tissue parameters after 12 months. No implants were lost during the 1-year observation period, yielding a survival rate of 100%. Similar clinical and radiographic parameters were observed for both treatment groups. Use of rhPDGF-BB/βTCP and GBR in immediate implants in molars was as successful as conventional implant placement in fully healed extraction sites.