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Objectives: This cross-sectional study aimed to evaluate the factors that determine the choice of oral surgeons and periodontists to perform immediate dental implant placement. Material and Methods: An anonymous survey was carried out from January 6, 2024 to February 29, 2024. The questionnaire was distributed online to Lithuanian specialists - oral surgeons and periodontists, who perform implantation procedures. A total of 186 professionals were included in this survey. Chi-square test, its degrees of freedom was used for the analysis of variables. Results: The main reason for refusing immediate implant placement is a periapical lesion greater than 5 mm, reported by 91.7% of oral surgeons and 96.9% of periodontists. Good aesthetics and preservation of anatomical structures are identified as an advantage by 99.2% of oral surgeons and 92.3% of periodontists. In the aesthetic zone, for periodontists, the main criterion for choosing a method is the quantitative and qualitative indicators of the soft tissue of the extraction socket 96.9%, and for oral surgeons - the morphology of the bone walls of the socket 87.6%. Only 43.1% of periodontists and 33.9% of oral surgeons are familiar with and use extraction socket morphology assessment classifications for immediate dental implant placement. Conclusions: Taking into account study's results, it is recommended to adjust the teaching programs at Universities and to increase the knowledge of specialists performing dental implantation procedures, by carrying out continuous educational programs.

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Introduction: This study assessed the effect of low-level laser therapy (LLLT) on the osseointegration of immediately loaded implants with a connective tissue graft (CTG). Methods: This clinical trial was conducted on patients with buccal bone dehiscence requiring dental implants. A CTG was harvested from the palate and placed in the labial side by considering the 2 mm distance between the implant thread and bone. Autogenous bone was harvested from the tuberosity, mixed with the allograft, and implanted at the site. After sufficient torquing of the implant, a customized abutment was fabricated and placed. The patients were randomly assigned to two groups (n=5) of intervention and control. The patients in the intervention group received LLLT with a 940 nm gallium-aluminum-arsenide laser while those in the control group received placebo irradiation. The primary implant stability was measured before the delivery of customized abutment while the secondary implant stability was measured after 12 weeks by Osstell® and reported as the implant stability quotient (ISQ). Results: No significant difference was found in secondary ISQ between the laser and control groups (P>0.05). In the intervention group, a significant difference was found between the primary and secondary ISQ in the buccolingual dimension (P<0.05) but not in the mesiodistal dimension (P>0.05). The two groups had no significant difference in gingival thickness or vertical bone gain (P>0.05). All implants were successful with no complications. Conclusion: LLLT had a significant positive efficacy for the enhancement of secondary stability of implants in the buccolingual dimension. CTG showed optimal efficacy for the treatment of buccal bone dehiscence.

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BACKGROUND: Achieving initial implant stability at the molar extraction site can be challenging due to bone width, quality, and anatomical limitations like the maxillary sinus and inferior alveolar nerve. The implant placement should achieve precise centralization with the interradicular septum to facilitate implant stabilization and preservation/regeneration of the alveolar ridge post-extraction with bone grafting. Immediate non-occlusal crown placement aids peri-implant tissue maturation for the desired outcome. This retrospective series introduces guidelines for treating sockets with alveolar septum types. The approach involves immediate dentoalveolar restoration (IDR) and osseodensification (OD) with an autogenous graft for bone preservation. METHODS: A new protocol for the treatment of the molar interradicular septum during immediate implant placement and/or alveolar ridge preservation/reconstruction was applied in 12 cases. Preoperative and postoperative cone-beam computed tomographic examinations were performed. Socket width was measured and compared between timepoints. RESULTS: The mean preoperative and postoperative (mean, 23.58 ± 9.70 months) socket widths were 9.51 ± 0.40 and 11.16 ± 0.30 mm, respectively (17.35% increase; p <0.05). CONCLUSION: IDR with OD is a predictable approach to the treatment of molar sockets during implant placement.

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Rehabilitating thin jaws without reconstructive surgery entails using narrow implants. The proposed treatment adopted an innovative implant system, allowing the mini-screws to be parallel and immediately loaded. A mandible, wearing an overdenture, was functionalized contextually to the residual dental extraction and the placement of six 2.4-mm thick one-piece implants. Low-profile intermediate abutments, the LEMs, able to rotate over the spherical heads of the fixtures, were connected after suturing, oriented, and blocked in a mutual parallel position. The copings, engaging with a tapered juncture of the LEMs, resulted in their alignment to be intraorally wedged together. The provisional superstructure enclosed the copings and was immediately connected to the implants, and the definitive prosthesis was delivered after three months. No clinical signs of peri-implantitis or radiographically evident bone loss were recorded after a two-year follow-up without any prosthetic complication. No cases have been published regarding mini-implants bearing fixed prosthesis rehabilitation.

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OBJECTIVE: This cohort study aimed to assess the incidence of somatosensory alterations after implant surgery using standardized quantitative and qualitative sensory testing. METHODS: 33 participants with single-tooth loss, undergoing immediate implant loading were included. Quantitative Sensory Testing (QST) and Qualitative Sensory Testing (QualST) were conducted at eight time points over a year (baseline to 1 year). Two-Way Repeated Measures ANOVA and post hoc Tukey test were used on QST values and Cochran Q test on QualST. RESULTS: The study revealed significant increase in thermal thresholds overtime. At the operated side, overall Cold Pain Threshold (extraoral: p = 0.030; intraoral: p < 0.001), and Cold Detection Threshold (intraoral: p < 0.001) increased overtime. In contralateral region, maxilla Cold Detection Threshold (extraoral: p = 0.024; intraoral: p = 0.031), Warm Detection Threshold (extraoral: p = 0.026; intraoral: p = 0.047) and overall Cold Pain Threshold (extraoral and intraoral: p < 0.001) also increased. QualST showed extraoral pinprick (p = 0.032) and intraoral pinprick (p = 0.000), cold (p = 0.000) and touch (p = 0.002) stimuli abnormalities overtime. CONCLUSIONS: Somatosensory alterations after implant surgery were detected in both quantitative and qualitative sensory assessments, but rapidly decreased during the first follow-ups, and then continuously until 1-year. CLINICAL SIGNIFICANCE: This study provides clinical and controlled evidence on the real effect of the somatosensory alterations overtime, leading to a better understanding of neurosensory behaviour after single-tooth dental implant rehabilitation.

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BACKGROUND: The increase in soft tissue (ST) around implants can benefit peri-implant health and aesthetic results. The objective was to compare the gingival and esthetic health benefits of immediate implant placement (IIP) with simultaneous or delayed connective tissue graft (CTG) compared to IIP without CTG. METHODS: A systematic review was carried out by two reviewers in Medline-Pubmed, Scopus, and Cochrane. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Randomized Clinical Trials (RCTs) that were published between April 2017 and February 2024 were used. Studies that analyzed the performance of a simultaneous or deferred CTG after the placement of an implant in the aesthetic zone, with or without immediate provisionalization, without previous regeneration, with a follow-up of 6 months, and that were performed in humans were included. RESULTS: Quantitative analysis was performed using data provided by the RCTs. The five RCTs that were selected analyzed a total "n" of 245 subjects who met the inclusion criteria and focused on the subject of the study. In the quantitative analysis, four RCTs were included. The studies evaluated buccal gingiva levels when placing the IIP with and without CTG, obtaining a mean buccal gingiva level difference of 0.09 mm (95% CI: -0.54 to 0.72, p = 0.05), statistically not significant, but with a favorable trend. CONCLUSIONS: The use of CTG associated with the II can maintain the gum level but not increase the volume. CTG is favorable for achieving successful esthetic results when immediate placement of an implant with a provisional prosthesis is planned.

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BACKGROUND: The purpose of this study was to test how musical flow using baroque (BM) and classical era music (CM) as a non-pharmacological therapy can control anxiety and pain levels among patients undergoing IPI (Immediate post-extraction implants). METHODS: 78 patients who required an IPI were enrolled in this randomized clinical trial. Each patient was assigned to one of the three experimental groups with a simple randomization: Group I (n = 26) listened to BM; Group II (n = 27) listened to CM; and Group III (n = 25) did not listen to music and was the control group (C). The physiological dependent variables analyzed were systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SpO2). The psychological dependent variable analyzed was modified dental anxiety scale (MDAS) and visual analogue scale (VAS), measured before and after surgery. In all cases, the level of statistical significance was set at p < 0.01. RESULTS: Statistically significant differences were found in the SBP decrease in the CM group (p = 0.001, CI = 1.9716-6.5840) and the BM group (p = 0.003, CI = 1.4450-6.4396). Anxiety levels during the intervention decreased in both groups that listened to music: BM group (p = 0.002, CI = 0.645-2.662) and CM group (p = 0.000, CI = 1.523-3.884). CONCLUSIONS: Patients undergoing IPI placement surgery can register lower levels of SBP when listening to BM and CM than patients who were not exposed to the musical flow, improving their anxiety levels.

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Finite element analysis (FEA) has been used to analyze the behavior of dental materials, mainly in implantology. However, FEA is a mechanical analysis and few studies have tried to simulate the biological characteristics of the healing process of loaded implants. This study used the rule of mixtures to simulate the biological healing process of immediate implants in an alveolus socket and bone-implant junction interface through FEA. Three-dimensional geometric models of the structures were obtained, and material properties were derived from the literature. The rule of mixtures was used to simulate the healing periods-immediate and early loading, in which the concentration of each cell type, based on in vivo studies, influenced the final elastic moduli. A 100 N occlusal load was simulated in axial and oblique directions. The models were evaluated for maximum and minimum principal strains, and the bone overload was assessed through Frost's mechanostat. There was a higher strain concentration in the healing regions and cortical bone tissue near the cervical portion. The bone overload was higher in the immediate load condition. The method used in this study may help to simulate the biological healing process and could be useful to relate FEA results to clinical practice.

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Background: Coaxial implants with an inclined neck might overcome some problems related to angulation of the implant axis when using tilted implants. Therefore, the aim of the present work was to conduct a narrative review of the current literature and to present a case series comparing traditional and coaxial external hex implants in full-arch immediate loading rehabilitations of the maxilla. Methods: A total of 13 external hex tapered implants (Southern Implants) was inserted in the upper jaw of 3 patients. Each patient received two tilted implants in distal sites. In one randomly selected quadrant, the tilted implant was a standard implant, while a Co-Axis® implant with a 24° inclination of the implant shoulder was inserted on the other hemi-arch. Straight conical abutments were screwed on coaxial implants while multiunit abutments of appropriate inclination were screwed as needed on the other implants to correct their axes. Peri-implant bone level was recorded radiographically at T0 (delivery of the immediate loading prosthesis), and at 3, 6, 12, and 24 months of healing and then annually. Plaque index, probing depth, and bleeding on probing were also evaluated. Cumulative implant survival rate (CSR) was calculated, and biological or technical complications were recorded as well as the operator satisfaction towards the use of coaxial implants. Results: The preliminary data collected did not show significant differences in peri-implant tissues health and maintenance over time between the two implant types. No implants failed, and both implant types proved to be favorable for full-arch rehabilitation using tilted implants. Coaxial implants facilitated the prosthodontic procedures. However, a learning curve is required in order to optimize their insertion. Conclusions: Both implants proved to be reliable and suitable for achieving clinical success in full-arch immediate loading rehabilitations, but further research with longer follow-up and larger sample size is needed to confirm these preliminary outcomes.

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New surgical techniques using narrow, tilted implants positioned through a magneto-dynamic tool in guided surgery for a Toronto restoration. A 69-year-old woman wanted fixed rehabilitation to replace her removable complete dentures. A cone-beam computed tomography showed significant bone resorption in both the maxillary and mandibular regions. The plan was to load the entire upper arch with six implants immediately, while removable partial dentures were recommended for the lower jaw. The guided surgery project was aligned with the new dentures, and the laboratory created a printed cast with dental implant analogues in planned positions. A metal-reinforced denture was constructed, and surgery was performed to place six narrow implants using the magneto-dynamic instrument. The denture was directly screwed onto multi-unit abutments. Final rehabilitation was completed after 6 months. Narrow implants can be a good option for fixed, full-arch rehabilitations. Further research is needed to confirm these findings on a larger scale.

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PURPOSE: To assess the complications, satisfaction, and quality of life of patients rehabilitated with delayed and immediate loading of single crowns. MATERIALS AND METHODS: An electronic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase databases up to February 2023. Only prospective studies and randomized and nonrandomized clinical trials comparing immediate and delayed loading were included. For the quantitative analysis, dichotomous and consistent variables were evaluated with a 95% confidence interval. RESULTS: A total of 20 studies were evaluated. No statistically significant difference was observed between protocols: satisfaction (I2: 0%; P = .42), quality of life (I2: 0 %; P = .05), biologic complications (I2: 9%; P = .17), mechanical complications (I2: 58%; P = .84), and survival rate (I2: 0%; P = .38). The subgroup analysis showed significant differences only for marginal bone loss (MBL) when immediate implants were placed in the mandible (I2: 15%; P = .01) and posterior zone (I2: 0%; P = .001). CONCLUSIONS: Complications and patient-centered outcomes for immediate single-implant crowns were comparable to delayed loading. Scientific evidence showed no significant difference between loading protocols for survival rates. Note that several factors could interfere with the complication events, implant failures, and MBL. The subgroup analysis showed that only immediate implants placed in the posterior mandible had a higher and statistically significant mean MBL.

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PURPOSE: To evaluate the influence of immediate loading on osseointegration and bone density of implants installed in a healed alveolar bone crest and supporting single crowns. MATERIALS AND METHODS: Two solid titanium transmucosal mini-screws were inserted in the distal regions of the mandible in 14 patients. One mini-implant was immediately functionally loaded, whereas the other was left unloaded. After two months of healing, biopsies were retrieved and new bone, old bone, and total bone (new and old bone) were assessed. RESULTS: Histological examination was performed on biopsies This peer-reviewed, accepted manuscript will undergo final editing and production prior to print publication. from 12 patients (n=12). New bone-to-implant contact percentage (BIC%) was 40.3 ± 16.8 % and 55.1 ± 19.1 % (p=0.043) at the unloaded and loaded sites, respectively, while the total BIC% was 44.9 ± 17.0 % and 59.5 ± 18.8 %, respectively (p=0.034). The new bone density was 45.9 ± 11.6 % and 45.9 ± 16.7 % in the unloaded and loaded implants, respectively (p=0.622). CONCLUSIONS: Immediate loading positively affected bone apposition on the implant surface, while no effect on bone density was observed after 2 months of healing.

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PURPOSE: To evaluate the peri-implant parameters of immediately placed and loaded mandibular overdentures over a 5-year follow-up period. MATERIALS AND METHODS: All subjects who had been advised and planned for two-implant mandibular overdenture treatment were included in this study. The peri-implant parameters -including plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) as well as marginal bone loss (MBL) - were assessed. In addition, prosthodontic parameters including abutment-, implant- and denture-related complications were assessed. Patients were evaluated at follow-up visits, scheduled at 1, 12, 24, 36, 48, and 60 months. The data distribution was analysed with the Shapiro-Wilk test. Data within follow-up categories were compared using ANOVA and the Tukey-Kramer test. A p-value < 0.05 was considered statistically significant. RESULTS: Among the 32 participants, 19 were males and 13 were females, with a mean age of 60.5 ± 7.33. The mean plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) varied over time. However, no statistically significant difference was observed in the plaque index, bleeding index and peri-implant pocket depth over time (p > 0.05). The mean value at baseline was found to be -0.9 ± 0.3. The values increased over time, with the highest value observed at 60 months 2.6 ± 0.7, which was statistically significant (p < 0.001). CONCLUSION: Immediately placed and loaded mandibular implant overdentures using two un-splinted implants with locator attachments showed acceptable PI, BI and PIPD at the 5-year follow-up. Statistically significantly greater marginal bone loss was observed from baseline to follow-up, but it was within acceptable limits. A moderate number of restorative and abutment complications were observed during the follow-up of IODs.

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BACKGROUND: It is necessary to investigate the application of polymer materials in implant dentistry. The aim of this study was to examine the outcome of full-arch polyetheretherketone (PEEK)-acrylic resin implant-supported prostheses. METHODS: Seventy-six patients were rehabilitated consecutively with 100 full-arch implant-supported prostheses of PEEK-acrylic resin (a development group (DG): 37 patients with 5 years of follow-up; a routine group (RG): 39 patients with 1 year of follow-up). The primary outcome measure was prosthetic survival. Secondary outcome measures were implant survival, marginal bone loss, biological complications, prosthetic complications, veneer adhesion, plaque levels, bleeding levels, and a patient subjective evaluation (including the Oral Health Impact Profile for the RG). RESULTS: In both groups, prosthetic (DG: 93.6%; RG: 100%) and implant survival (DG: 98.9%; RG: 99.5%) were high, and marginal bone loss was low (DG: 0.54 mm; RG: 0.28 mm). The veneer adhesion rate was 28.6% of prostheses in DG (RG = 0%). Mechanical complications occurred in 49% and 11.8% of prostheses in DG and RG, respectively. Biological complications, plaque, and bleeding levels were low in both groups. The subjective patient evaluation was excellent in both groups (8.6 < DG < 8.8; 9.3 < RG < 9.5; OHIP = 1.38). CONCLUSIONS: Within the limitations of this study, PEEK can be considered a viable prosthetic alternative.

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PURPOSE: This pilot study was conducted to develop a novel test setup for the in vitro assessment of the primary stability of dental implants. This was achieved by characterising their long-term behaviour based on the continuous recording of micromotions resulting from dynamic and cyclic loading. METHODS: Twenty screw implants, each 11 mm in length and either 3.8 mm (for premolars) or 4.3 mm (for molars) in diameter, were inserted into the posterior region of 5 synthetic mandibular models. Physiological masticatory loads were simulated by superimposing cyclic buccal-lingual movement of the mandible with a vertically applied masticatory force. Using an optical 3-dimensional (3D) measuring system, the micromotions of the dental crowns relative to the alveolar bone resulting from alternating off-centre loads were concurrently determined over 10,000 test cycles. RESULTS: The buccal-lingual deflections of the dental crowns significantly increased from cycle 10 to cycle 10,000 (P<0.05). The deflections increased sharply during the first 500 cycles before approaching a plateau. Premolars exhibited greater maximum deflections than molars. The bone regions located mesially and distally adjacent to the loaded implants demonstrated deflections that occurred synchronously and in the same direction as the applied loads. The overall spatial movement of the implants over time followed an hourglass-shaped loosening pattern with a characteristic pivot point 5.5±1.1 mm from the apical end. CONCLUSIONS: In synthetic mandibular models, the cyclic reciprocal loading of dental implants with an average masticatory force produces significant loosening. The evasive movements observed in the alveolar bone suggest that its anatomy and yielding could significantly influence the force distribution and, consequently, the mechanical behaviour of dental implants. The 3D visualisation of the overall implant movement under functional cyclic loading complements known methods and can contribute to the development of implant designs and surgical techniques by providing a more profound understanding of dynamic bone-implant interactions.

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OBJECTIVES: The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. MATERIALS AND METHODS: An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. RESULTS: A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). CONCLUSIONS: Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.

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Immediate implant placement is well-known science and treatment in implant dentistry. It is a multitasking treatment consisting of surgical, prosthodontic, and periodontal aspects, implemented to obtain long-term clinically esthetic and functioning prosthesis. Immediate placement enables clinicians to reduce the number of surgical steps and shorter treatment duration. It has become a standard surgical protocol in modern implant practice. According to existing literature, dual implant placement can be done to avoid any cantilever effect in a single implant and to distribute masticatory forces. This clinical report describes the extraction of an infected mandibular right first molar, (46, Federation Dentaire Internationale) followed by immediate dual placement of dental implants in the rinsed and cleansed sockets. The tooth was atraumatically extracted from the socket, and the latter was prepared to the required depth, and endosseous implants were placed in both the mesial and distal sockets. This atraumatic graft-free operating technique and immediate placement resulted in the preservation of hard and soft tissues. It also increased the patient's comfort, acceptance, and satisfaction due to immediate loading with a provisional removable prosthesis. This was later replaced with a dual screw-retained hybrid implant crown.

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The objective of this study was to report a clinical case of dental implant failure with significant bone loss that was treated using reconstructive surgical techniques. We present a 58-year-old man with a history of implant surgery and implant failure on the mandible. Data collected using cone beam computed tomography (CBCT) and intraoral scans were exported into Exoplan (exocad GmbH, Darmstadt, Germany), from which a standard tessellation file was obtained. To create a customized mandible mesh design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used. Based on guided bone regeneration, the method involved bone reconstruction and the application of a custom titanium mesh. The bone mix was obtained by combining a xenograft (Cerabone, Bottis biomaterials Gmbh, Zossen, Germany), an allograft (Max Graft, granules Bottis biomaterials Gmbh, Zossen, Germany), and an autograft. The titanium meshes were fixed to the bone using self-drilling screws and covered with a resorbable membrane. Immediately after surgery, an impression was recorded, and the next day, the patient received a milled polymethyl methacrylate interim denture. Based on our case study, the presented custom-made implant can be considered a temporary solution, during which guided bone regeneration is expected to take place.

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AIMS: The primary aim of the present study was to measure the discrepancy between the virtual and the actual position of the single-unit implants placed via a digitally-designed fully-guided surgical template using a flapless surgical technique. Prefabricated provisional restorations and periodontal factors were evaluated after the immediate loading of implants and 3 months after the surgery, respectively. MATERIALS AND METHODS: Fourteen implants in nine patients were virtually planned after importing intraoral scans and cone-beam computed tomography (CBCT) records into 3D planning software. Accordingly, fully-guided surgical templates, customized abutments, and provisional restorations were designed and fabricated. The implant position after the surgery was compared with its virtual counterpart in terms of angular and apical linear deviations. Implants were immediately loaded after the surgery, and the occlusal level of the delivered provisional restorations was compared with their designed positions. Early implant failure, bleeding on probing, and peri-implant pockets were documented on the 3-month follow-up. RESULTS: A mean angular deviation of 5.07 ± 2.06° and a mean apical linear deviation of 1.74 ± 0.63 mm resulted. Two out of 14 implants failed within the first 3 months of the surgery, and the occlusal level difference was calculated for nine prefabricated provisional restorations. CONCLUSIONS: DIONAVI protocol has been evaluated regarding its accuracy, and an estimation of the expected deviation is presented to the clinicians using this protocol. However, before widespread use, immediate-loading protocols and provisional restorations must be studied further. TRIAL REGISTRATION: IRCT, IRCT20211208053334N1. Registered 6 August 2022.

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This study proposes a simple, off-the-shelf ancillary method for application in the dental rehabilitation of severe maxillary atrophy with zygoma implants, allowing simultaneous improvement of lip support in cases with a moderate lack of premaxillary projection. Three consecutive patients with an atrophic maxilla were evaluated retrospectively. All were treated with a fixed rehabilitation over four zygomatic implants and the pillow technique. The study variables included radiological assessment of the premaxilla volume, upper lip and perinasal soft tissue changes, clinical complications, and subjective evaluation of functional and aesthetic patient satisfaction based on a visual analogue scale. All of the zygomatic implants showed osseointegration. The survival rate was 100%. The immediate postoperative course was uneventful, and no surgical complications were noted at the follow-up visits. Radiological assessment of the premaxilla volume enhancement showed a final mean skeletal projection improvement of +9.4 mm, while the nasolabial angle decreased an average of + 0.6 mm. On the other hand, only small changes in nasal width were detected. Patient satisfaction with the functional and aesthetic outcomes at the 1-year follow-up was excellent. The pillow graft is an easy-to-handle technique that can be included in the armamentarium for moderately incrementing the maxillary sagittal dimension and enhancing lip support in the context of zygoma implant rehabilitation.

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