The dental industry is embracing a new paradigm due to advancements in digital technology. Including complex procedures like crowns, inlays, and laminates, treatments that were once impossible to complete in a 1-day are now a reality. The development of digital equipment and treatment techniques has made these processes faster and more efficient. Notably, the introduction of the 3D facial scanner RAYFace and its digital mock-up technology are leading these changes. The digital mock-up capabilities of RAYFace enhance the precision of aesthetic treatments, radically improve patient experience, and maximize clinical efficiency, setting new standards in digital dentistry and transforming every stage of the aesthetic treatment process.

In today's rapidly evolving dental landscape, digital technologies have revolutionized the way we approach patient care. When aiming for excellence in complex restorative treatments the key lies in listening carefully to the patient’s needs and wishes and combining correct diagnosis with meticulous planning and then using the best tools to reach a successful, long-lasting result.

This case report demonstrates the successful rehabilitation of a periodontal compromised patient with multiple missing teeth using an innovative digital workflow. The workflow is characterized by its model-less approach, seamless data integration, and the ability to digitally duplicate the patient's existing prosthesis for planning. The patient received a temporary prosthesis within 24 hours, enhancing both aesthetic and functional outcomes.

Implants placed in fresh extraction sockets were first documented more than 25 years ago, so one might wonder why “immediacy” took so long time to mature into the mainstream implantology. The progress of a scientific protocol however, is rarely a straight line to implementation. Perceived breakthroughs are ohen followed by backlash and enthusiasm can be at times interchangeable with periods of caution. In the end, technology is also a major catalyst to help a vision make it safe to the mainstream practice. In these two articles we review the major developments from the first “immediate” implants into the current modern concept of “immediacy” and we discuss the important benchmarks, as well as how and why modern “immediacy” is a workflow which extends well before and aher the extraction socket placement.

Success is a matter of definition; and when it comes to implant dentistry we have developed some complex criteria to assess it. But do patients understand implants the same way we do? What do they expect and what is it that makes them satisfied or unhappy? Patient Reported Outcomes or PROs covers a wide field of research, helping us understand what patients experience when under medical care and thus deliver better treatments and reach better outcomes. In the case of implant dentistry, this has taught us some invaluable lessons on how to design treatments, how to proceed - and even more importantly when to not proceed with implant treatment.

Robotic Surgery, once a theme of science fiction, entered the practice of medicine about two decades ago. Implant dentistry could not be an exception and six years after the first robotic placement of a dental implant, commercially available systems now promise to place implants accurately and tirelessly in your patients. But is this a real gamechanger or mostly hype? How close are we to turning point in implant surgery as we know it? Will the implant surgeon of the future be a... machine?

Designing the optimal emergence profile is among the “hottest” areas in Implant Dentistry, with much ongoing research and debate. Although some studies have connected the contour of the abutment / prosthesis with inflammation and peri-implantitis, little is understood about where to look and what to avoid when designing an implant prosthesis. A recent clinical study from the team of Drs Mattheos and Janda utilising 3D imaging technology comes to shed light to this topic, showing how specific angles of the prosthesis can increase x30 the risk for inflammation!

Maxillary canines are the most commonly impacted teeth after the third molar and affect approximately 1-3% of the population. Maxillary canine impaction commonly occurs at a young age in between 1% and 3% of patients and is more common in females than males. Canine impaction is twice as likely to occur in the maxilla than in the mandible, and 8% of patients affected by maxillary canine impaction have bilateral impaction. About one-third of maxillary canine impaction is located labially, whereas two-thirds are located palatally. The main causes of canine impaction are genetic, localized, or systemic. The treatment options for impacted canines include no treatment, surgical exposure, orthodontic treatment, and extraction.

espite progress in both diagnostics and therapeutics, Periodontitis remains the main cause for loss of teeth in adults in Hong Kong. As the treatment is often neglected in the early stages of the disease, many patients end up with a “terminal” periodontitis later in life, a condition that can have serious implications to their health and quality of life, but also pose significant challenges to the dental team who will devise the treatment. Today we discuss the implications of stage IV Periodontitis for patients and clinicians with Dr. Pelekos, Assistant Professor and Programme Director of Periodontology at the University of Hong Kong!

3D functional appliances and mandibular advancement with Invisalign are commonly used to correct Class II malocclusion in young children before the peak growth spurt. This report presents 2 cases of using the Carriere Motion 3D Appliance (CMA) to correct Class II malocclusion with satisfactory results.

The purpose of this report is to present a 30 months experience in using a high torque bi-directional bone cutting implant in a private oral & maxillofacial surgery practice since March 2020. Promising clinical outcome in complex sites including fresh extraction socket for immediate implant placement by this newly evolved implant was evidenced by follow up x-ray and Cone Beam CT monitoring. In this cohort of patients, thorough analyze the pattern of the complex sites & immediate implant to fresh extraction sockets to elucidate the sophistication of the implant design & its biomechanical innovations.

Orthodontic tooth movements take long time to complete, the average treatment time is usually about 24-36 months to achieve and this has been one of the main reasons to hinder patients receiving treatment. To avoid long term suffering and to enhance patient co-operation and compliance, mechanical vibrations have been used to accelerate tooth movement and shorten treatment times. Although different clinician holds different views regarding accelerate orthodontics effects and outcomes, 2 complicated cases were reported here, and they were performed by using 0.2N 30Hz vibrator for 20mins daily. It was found that there were 50% treatment time gained for the whole Invisalign treatment course with acceptable results.

In the last issue of the Dental Diaries we introduced the concept of “Overload” and discussed how it has been related to of complications and failures since the early days of implant dentistry. We focused in discussing problems with bone and peri-implant tissue, but we also concluded that problems due to loading are manifested more frequently on the mechanical implant components. In particular, what we see as “overloading” failures are often connected with some design flaws or deficiencies. Today Drs. Mattheos and Janda will focus the discussion managing technical problems which can occur as results of adverse loading. More importantly, we will discuss the important underlying design principles which will help us prevent problems and reduce complications with the components, frameworks and veneering of implant prostheses.

Maxillectomy for malignant or aggressive oral maxillofacial tumor is the gold standard of surgical treatment. However, the resection of maxilla could lead to both oral and cosmetic incapacity in this group of patients. The Weber Ferguson incision could leave conspicuous scar and ipsilateral facial depression due to the loss of skeletal support in addition to the loss of oral dental speech function. With the technological advancement in past few decades, 3D printing & digital planning of jaw reconstruction seems provide twilight of full functional reconstruction. This manuscript will report a 36-year-old female patient suffered from a huge right maxilla myxoma abutting to the orbital floor superiorly need maxillectomy as radical treatment. She had a serious concern about both cosmetic and function sequalae once she committed herself to this devastating ablative treatment. Furthermore, she wished to resume her normalized life shortly and requested for no further major bone grafting forrestoring jaw defect. All her concerns posed extreme challenges to the attending surgeon. Finally, a 2-phased Scarless maxillectomy with later zygomatic implant Graftless immediate dental implant reconstruction had performed with an excellent aesthetic and functional outcome after 6th year follow-up in 2022.

A lack of vertical dimension of alveolar bone at the posterior maxilla is a common challenge in implant dentistry. Typical causes are the atrophy of the alveolar bone after tooth loss, or a pneumatized maxillary sinus, or both. Advances in material science and nanotechnology now allow for stronger implants with shorter length. Short implants of 8 mm or less are commonly used in cases of limited vertical space, with a promising survival rate that is comparable to more standard length implants (Lemos, Ferro-Alves, Okamoto, Mendonca, & Pellizzer, 2016). In other cases, however, it is impossible to place an implant without performing a sinus floor elevation (SFE). The lateral window sinus lift is the classical approach to improving residual bone height, first described over 40 years ago (Boyne & James, 1980). Development and refinement of surgical instruments and techniques then allowed us to elevate the sinus floor, albeit to a lesser extent, with predictable results using a transalveolar approach (Pjetursson & Lang, 2014). Both approaches result in implant survival rates comparable to implants placed in normal bone (Jensen & Terheyden, 2009). The clinical decision as to the surgical approach is mainly based on anatomical parameters including subantral bone height, sinus width, sinus floor anatomy, the presence of sinus septum, etc. (Stacchi et al., 2020).