Lean Sigma methodology was an effective tool for reducing RBC wastage in a large academic hospital.

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Focused Clinical Question For a generally healthy patient with no risk indicators for postoperative infection, what is the most appropriate perioperative antibiotic regimen for sinus elevation surgery in terms of reducing postoperative infection risk and minimizing untoward effects? Clinical Scenario A 38‐year‐old female patient in good general and periodontal health presents missing tooth #14 (Fig. ). She reports no systemic conditions, no history of sinusitis, and no allergies. Medications include acetaminophen and ibuprofen as needed for pain. The patient's dentition is minimally restored, with no active caries. Cone‐beam computed tomography reveals a clear, pneumatized left maxillary sinus and inadequate bone volume to support dental implant placement (Fig. ). No septa or pathologic lesions are present, the ostium appears patent, and no thickening of the Schneiderian membrane is appreciable. The patient states that she wants to replace her missing molar without restoring adjacent teeth (Figs. and ). Baseline clinical appearance (example sinus elevation case). The patient is a healthy 38‐year‐old female missing tooth #14. Inadequate bone volume is present for dental implant placement due to pneumatization of the left maxillary sinus. Preoperative cone‐beam computed tomography images. 2a Sagittal view. 2b Coronal view. Cone‐beam computed tomography images at postoperative month 6. 3a Sagittal view. 3b Coronal view. Definitive implant‐supported restoration, tooth #14.

Introduction Whether or not laser use provides any meaningful benefit at immediate implant and ridge preservation sites remains an open question in periodontics. However, various lasers have been used in conjunction with tooth extraction and immediate implant placement. Evidence supporting adjunctive laser irradiation at immediate implant and ridge preservation sites is mostly limited to preclinical studies and a small number of case reports. Case Series Adjunctive neodymium‒doped: yttrium, aluminum, garnet (Nd:YAG) laser irradiation was used at six immediate implant sites and five ridge preservation sites. Three immediate implants were in maxillary incisor positions and three were in premolar positions, two maxillary and one mandibular. All cases exhibited favorable healing and satisfactory clinical outcomes. Conclusions Nd:YAG laser energy application with 650‐µs pulse duration consistently supported rapid clot formation and graft containment at immediate implant and ridge preservation sites. Histologic analyses and controlled clinical trials comparing ridge preservation and immediate implant procedures with and without laser use are needed. Because cellular responses and clinical outcomes may be exquisitely sensitive to irradiation parameters, studies should report materials and methods in detail.

Introduction The epithelialized palatal graft (EPG), introduced in 1963, has persisted as the gold standard for gingival augmentation, and in the present era, mucosal augmentation around dental implants has become an important concern. A limited body of evidence suggests peri‐implant mucosal augmentation may favorably impact bone and mucosal stability and peri‐implant health under some circumstances. Although more contemporary procedures for peri‐implant mucosal augmentation are often preferred based on convenience and esthetic considerations, EPG augmentation at dental implant sites is distinguishable from methods which do not deepen the vestibule and eliminate unfavorable superficial soft tissue. Implant sites augmented with EPG are qualitatively distinct from sites augmented using other methods. Case Series Seven generally healthy patients received EPG augmentation before dental implant placement, at implant placement, before implant uncovering, or after implant uncovering. In each case, the patient exhibited a favorable zone of attached peri‐implant mucosa following treatment. Conclusions Reliable mucosal augmentation with EPG is achievable at multiple phases in the course of dental implant therapy. EPG augmentation offers distinct clinical advantages and may be preferable to other mucosal augmentation strategies at some dental implant sites.