The evolution of dental implants from an unvalidated mechanistic procedure to a clinically validated intervention has been driven by the integration of material sciences, tissue biology, and clinical expertise, culminating in a remarkable therapeutic innovation whose impact may be comparable to that of fluoride in the prevention of dental caries. The surgical placement of an implant, unfortunately, involves many of the same traits that contribute to dental neglect and subsequent tooth loss that necessitates implant placement: fear of intraoral injections of a local anesthetic, a surgical incision into soft tissue, use of a drill to remove bone, and postoperative pain for several days augmented by the inflammatory cascade. Effective regional anesthesia and judicious use of an anxiolytic medication can overcome patient reticence to having an implant procedure, but postoperative pain must still be managed to reduce the risks of opioid adverse events or triggering substance abuse. This article emphasizes safe and effective strategies to minimize postoperative pain with targeted approaches in the peripheral nervous system (PNS) to lessen the onset and intensity of pain, decrease the incidence of opioid adverse events, and mitigate the development of substance abuse.

Increasing evidence suggests chronic periodontal inflammation may contribute to systemic inflammatory burden, including in medically compromised patients. Studies have demonstrated associations between moderate to advanced periodontitis and numerous chronic medical systemic conditions. As interdisciplinary treatment models become more common, oral health evaluation and periodontal stabilization are emerging as important components of pretreatment medical optimization. This article reviews the relationship between periodontal inflammation and systemic disease, examines current treatment approaches and diagnostic technologies, and presents a multidisciplinary clinical workflow in which medical and dental professionals collaborate to reduce oral inflammatory burden prior to a major medical intervention.

Advances in regenerative dentistry have significantly improved the management of bone deficiencies present at, or resulting from, tooth extraction when implant placement or other prosthetic restoration is planned. The integration of biologic mediators, osteoconductive scaffolds, and resorbable barrier membranes has contributed to more predictable regenerative outcomes in appropriately selected cases. Growth factor-enhanced matrices may provide complementary biologic and structural properties that support site development. Xenografts offer long-term volumetric stability, while allografts demonstrate more active remodeling potential; when combined with biologic stimulation, these materials are intended to enhance angiogenesis, cellular recruitment, and graft incorporation. This article reviews the biologic mechanisms, clinical applications, and handling characteristics of these regenerative materials from clinical, radiographic, and histologic perspectives. When used individually or synergistically they support predictable hard- and soft-tissue regeneration, optimize implant site development, and enhance long-term implant stability and esthetic outcomes.

Maxillary atrophy is relatively common among long-term edentulous patients, especially in older adults. Severe forms, although less prevalent, are still frequently encountered in implant and prosthodontic practice, particularly in patients who have been without teeth for many years or who have worn poorly fitting dentures. This case report presents the treatment of a 77-year-old female smoker who had been missing her teeth for 22 years and had a non-functional prosthesis. The article describes the vertical and horizontal gain in the patient's edentulous maxilla utilizing allograft customized bone blocks to extensively augment the amount of bone. Upon review of a CBCT scan taken after 6 months, the bone gain was evident, revealing a ridge width of between 6.9 mm and 8.9 mm and confirming that the outcome matched the design of the allograft customized bone block. The allograft customized bone block treatment showed itself to be a potential alternative to extensive bone harvesting procedures for treating and augmenting a severely atrophic maxilla while yielding decreased donor site complications and postoperative issues.

Replacing missing anterior teeth presents both functional and esthetic challenges, and selecting the most appropriate treatment requires careful consideration of patient age, specific needs, invasiveness, and long-term prognosis. While dental implants are frequently the treatment of choice, they are not always suitable-particularly in younger patients still undergoing skeletal growth. Cantilever zirconia resin-bonded fixed dental prostheses (RBFDPs) offer a minimally invasive, cost-effective alternative with excellent long-term outcomes, including survival rates approaching 98% at 15 years. This article reviews the current evidence on zirconia RBFDPs, outlines key treatment planning and design principles, and describes clinical and laboratory steps for achieving optimal esthetic and long-term durable results, including soft-tissue augmentation, pontic site management, and proven bonding protocols. A step-by-step clinical case is presented to illustrate how these restorations can successfully restore both white and pink esthetics with minimal intervention.

Surgically facilitated orthodontic therapy (SFOT) has emerged as an interdisciplinary approach to address the limitations of conventional orthodontics in patients with moderate to severe malocclusion. This article reviews the biologic rationale, indications, diagnostic considerations, and clinical protocols underlying SFOT, with emphasis on regional acceleratory phenomenon-mediated bone remodeling and its impact on treatment efficiency. Integration of cone-beam computed tomography, intraoral scanning, and digital treatment planning enables precise evaluation of dentoalveolar boundaries and periodontal phenotype, guiding case selection and surgical design. Techniques including corticotomy, decortication, and adjunctive hard- and soft-tissue grafting are discussed in the context of expanding the envelope of tooth movement while mitigating risks such as dehiscence and gingival recession. Interdisciplinary collaboration is highlighted as essential for optimizing esthetic, functional, and long-term outcomes.

Contemporary pulpotomy in primary molars reflects a shift from the use of devitalizing agents toward biologically driven vital pulp therapy. Advances in pulpal biology and biomaterials, particularly calcium silicate-based medicaments, support healing and preservation of radicular pulp vitality, leading to improved clinical outcomes. Current recommendations emphasize accurate diagnosis through integration of patient history, clinical findings, and radiographic evaluation, along with careful case selection. Achievement of a durable coronal seal remains essential and is most predictably attained with full-coverage restorations. As described in this case report, when modern bioactive materials are combined with appropriate restorative protocols, pulpotomy is a reliable and effective treatment for primary teeth with deep carious lesions.

Obstructive sleep apnea (OSA) is a highly prevalent yet substantially underdiagnosed condition with serious cardiovascular, cognitive, and occupational consequences. Over the past decade, oral appliance therapy (OAT)-particularly the use of mandibular advancement devices-has evolved from a secondary alternative to continuous positive airway pressure (CPAP) into a recognized primary treatment for patients who are intolerant of, or noncompliant with, CPAP or prefer an alternative therapy. Advances in digital fabrication, intraoral scanning, home sleep apnea testing, and embedded device technology have significantly improved appliance fit, titration precision, and treatment monitoring. Meanwhile, the shifting treatment landscape-including the rise of over-the-counter sleep devices, hypoglossal nerve stimulation surgery, and GLP-1-driven weight loss therapies-underscores OAT's unique role as a safe, noninvasive, reversible, and combinable treatment modality. Looking ahead, artificial intelligence, expanded screening protocols, and stronger physician-dentist collaboration promise to extend effective care to millions of OSA patients who remain undiagnosed and untreated.

Patients presenting for esthetic improvement due to progressive tooth wear or after orthodontic treatment may have underlying functional constraints that, if left unresolved, could lead to discomfort and long-term disability. To achieve predictable outcomes, clinicians must identify any potential functional limitations and develop a treatment plan that respects biologic boundaries. This case report illustrates how a structured diagnostic approach rooted in established systematic principles revealed a persistent constricted chewing pattern following orthodontic expansion. By addressing the functional etiology rather than focusing solely on tooth position, a comprehensive treatment plan was able to be developed to improve comfort, restore function, and enhance esthetics in a stable and conservative manner.

Periodontal debridement using ultrasonic instruments and air polishing is a standard procedure in clinical dental practice. While effective in managing periodontal health, these techniques can compromise the integrity of dental restorations. This article reviews laboratory evidence on the effects of ultrasonic instrumentation and air polishing on various restorative biomaterials, focusing on surface roughness and marginal integrity. Findings indicate that high-strength ceramics such as zirconia and lithium disilicate are more resistant to damage than feldspathic ceramics, resin-modified glass-ionomer cements, and resin-based materials, which are more susceptible to damage. The use of low-abrasive powders such as erythritol and glycine is recommended to mitigate adverse effects. Actionable recommendations are provided to inform favorable maintenance protocols for restorations during periodontal therapy.

Artificial intelligence (AI) is rapidly transforming the landscape of dental practice, enhancing both clinical and administrative functions. This article examines the integration of AI across five critical areas: patient safety, scheduling, operations, marketing, and financial management. Through real-world examples and evidence-based discussion, the article explores the successful and unsuccessful implementation of AI tools in modern dental settings. Examples include diagnostic imaging platforms aimed at improving case acceptance, AI scheduling systems intended to reduce no-show rates, emerging ambient AI scribing tools that reduce documentation burden, and AI-powered treatment planning systems for implantology and orthodontics. Challenges such as data integration, system interoperability, algorithmic bias, and ethical concerns are addressed to provide a balanced view. The authors conclude that while AI cannot replace clinical judgment, it serves as a powerful adjunct to human expertise, improving efficiency, accuracy, and the overall patient experience in dentistry.

Resorption following tooth loss often presents challenges to both functional and esthetic outcomes of dental implant treatment for lost dentition, especially in the esthetic zone. Inadequate bone volume at the implant site is common, and bone augmentation is often required. While autogenous bone is often preferred, it is not applicable in many cases. This can necessitate multiple surgeries and extended healing times for patients. In such situations an alternate protocol, the facial allograft shield technique using an allogeneic laminar bone membrane, appears to offer a minimally invasive, effective alternative for managing type II socket defects in the esthetic zone, potentially expanding the pool of candidates eligible for immediate protocols.