This report describes a digital workflow and two-year follow-up of an immediately loaded implant-retained overdenture using flapless surgery and a computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guide. A prosthetically-driven approach, utilising a three-dimensional (3D) planning software and a CAD/CAM surgical guide, was used to place four implants in the edentulous maxillary arch of a 59-year-old male patient. All four implants were inserted through the surgical guide without raising soft tissue flaps. After placement, the patient was delivered an immediately loaded maxillary overdenture. Surgical implant placement was well tolerated by the patient, who reported no discomfort. Following a four-month period, a new implant-retained maxillary overdenture reinforced by a metal framework was fabricated and delivered to the patient. There were no adverse issues noted with neither the implants nor the maxillary overdenture during the two-year follow up period. The technique using the workflow described in this report may be a predictable and affordable alternative in the restoration of edentulous arches as compared to full-arch fixed restorations.

Dental care practitioners are often the first port of call for patients presenting with acute dental pain. Due to the increasing backlog of patients in the UK resulting from the COVID-19 pandemic, it is expected that an increasing number of patients will present to dental care practitioners with acute dental problems. This article aims to provide an overview of common presentations of acute dental pain, the importance of thorough assessment and accurate diagnosis, and the management of such conditions.

Dental extractions are one of the most commonly undertaken procedures in dentistry. However, for some dentists it can be a stressful and daunting treatment to undertake. This paper explores the importance of planning and the salient aspects in the assessment that should be considered. A methodical approach to assessment will avoid important factors from being overlooked.

As life expectancy and the number of people living with chronic illness increases, the medical complexity of patients requiring oral surgery will also increase. This and the continuously evolving range of medical treatments used to manage their conditions will increasingly challenge dentists in both primary and secondary care to avoid complications and treat this patient group safely.This paper will describe the importance of careful treatment planning including consideration of the timing and location in which oral surgery is undertaken for medically complex patients. The risk of acute medical events, bleeding, infection, and impaired healing which may complicate oral surgical procedures in this group of patients is discussed and the role in their care played by general dental practitioners explored.

Dental implants react biomechanically to the occlusal forces placed on them, in a different fashion to teeth, which can make them prone to overloading. This can lead to a range of mechanical problems, including screw loosening, ceramic chipping, and fracture of components, but it can also be associated with biological complications such as later peri-implantitis. Appropriate occlusal loading is essential to maintain long-term stability of implant-retained restorations. Clinicians must be aware that, to varying extents, complications do occur with single implant-retained crowns. Dental implants are not a panacea; it is unwise to describe implants as being either perfect or permanent because they are neither. Patients need to understand, well in advance of having implant-based treatment, that the placement of titanium in their jaw(s) will not stop their parafunctional habits, such as clenching or bruxism. Insertion of titanium screws of various types and roughness will certainly not alter their susceptibility to their own plaque-induced inflammatory periodontal disease which is often manifested as peri-mucositis, or later as peri-implantitis in susceptible patients. Based on the available data, this paper provides recommendations to optimise clinical outcomes for single implant-supported crowns. When designing implants, the focus should be on achieving axial forces during chewing. It is wise to minimise horizontal and non-axial loads to avoid potential damage to ceramic or other prosthetic components, and to minimise the risks of bone resorption occurring around the implants themselves at a later stage. Occlusal relationships of implant-retained restorations should be carefully evaluated on a regular basis. Accurate occlusal records of the starting point are extremely helpful in assessing the ongoing status of any restorations.

Arthritis is a common condition affecting millions of people in the UK and worldwide. All members of the dental team will be seeing and treating patients with this condition, and it is important to understand the disease, its management and medications used. This article outlines the five most common types of arthritis: osteoarthritis (OA), rheumatoid arthritis (RA), axial spondyloarthritis (sPA), juvenile idiopathic arthritis (JIA), and gout. It further discusses the medications used to treat these conditions and any dental implications. Finally, advice is offered on considerations for the dental team when treating such patients.