The experience of the rigid lockdown in the dental emergency room and urgency care during COVID-19 pandemic: a transnational multicenter observational study

OBJECTIVE

The COVID-19 pandemic had a major impact on our lives all over the world. Changes have occurred in daily life as well as in all medical services. The aim of the present study was to evaluate the emergency accesses in four universities' emergency services during the lockdown period from March to June 2020 during the COVID-19 pandemic.

SUBJECTS AND METHODS

A cross-sectional study was carried out on 44,787 patients to evaluate the emergency services of university centers. The medical data of Medical Emergency Service Data (MESD) were assessed by five independent operators considering the epidemiological findings for statistics methods.

RESULTS

A lower level of emergency access was reported in March-July compared to the pre-COVID period. The epidemiological data confirmed that female pathologies were more frequent compared to male patients. A fluctuation for almost all urgent healthcare centers was detected, showing one/two peaks per year during the years 2017-2019. The COVID-19 pandemic period did not influence the variety of pathology detected.

CONCLUSIONS

After the lockdown period, the emergency services slowly increased in cases. The pre-COVID period showed an overlapping of the most frequent pathologies compared to the post-COVID period: periodontitis (Bari and Tirana), dental fractures (Bari and Bucharest), odontogenic abscess (Bari, Cluj and Tirana).

Ceramic biomaterials in dentistry: chemical structure and biosafety - a review and a bibliometric visual mapping on Scopus database

OBJECTIVE

A biomaterial is any non-pharmaceutical substance or a mixture of synthetic or natural substances used independently or as part of a system for any amount of time with the aim of mending, supporting the growth, or replacing tissues, organs, or functions of the body. It is a non-renewable material that interacts with biological systems. The purpose of this study was to assess the advances in ceramic biomaterials and perform a bibliometric mapping of the literature on the subject.

MATERIALS AND METHODS

The Scopus database was used for manuscript screening (Elsevier, Amsterdam, The Netherlands). The effect of the scientific production has been assessed using scientometric citational metrics.

RESULTS

A total of 2,554 pieces of literature, including 2,234 papers, 170 conference proceedings, 109 reviews, 35 book chapters, 3 editorial letters, and 3 short surveys, were retrieved. Based on the research conducted, it is noted that ceramic materials are high-performing by being porous or glassy and can, therefore, serve as fillers, covering materials, and scaffolds in medicine and biotechnology. They are frequently employed not only in orthopedic and maxillofacial surgery but also in dentistry for dental prostheses.

CONCLUSIONS

Materials monitoring methods enable us to track the three-dimensional evolution of ceramics' volume, as well as flaws or micro-cracks.

Orofacial-Myofunctional therapy after lingual frenectomy in patient with tongue-tie: a systemic postural approach with mezieres method and postural bench

AIM

In this study we present the new postoperative oro-myofunctional protocol following frenectomy by atmospheric plasma associated with a systemic postural approach, which determines functional recovery through body symmetry restoration based on the concepts of the French "Mezieres Method" and postural bench.

METHODS

A total of 130 patients (76 female, 54 male) affected by ankyloglossia of class III/IV, according to Kotlow's Tongue Tie Classification have been treated with atmospheric plasma followed by oro-myofunctional therapy associated with a systemic postural approach. The overall change, improved/worsened speech, feeding, or sleep has been evaluated through the 10 points Parents Speech Satisfaction (PSS) Score after one week and two months.

CONCLUSION

Based on the findings of the current investigation, myofunctional therapy in tongue-tie results in a consistent significant functional ameliorating of feeding capability, speech and sleeping of subject treated as reported with traditional oro-myofunctional therapy.

Wettability of mg-ha/Chitosan-based membrane surfaces: blood vs. autologous platelet liquid (APL)

OBJECTIVE

The physical and physical chemistry is able to influence the interaction of the scaffolds and bone substitutes with the body fluid and blood. The aim of the present investigation was to evaluate the wettability properties of an Mg-HA Chitosan-based Gel with blood vs. autologous platelet gel.

MATERIALS AND METHODS

A total of 6 study groups were evaluated according to the Mg-HA Chitosan-based Gel thickness (1, 2 and 3 mm) and the fluids (blood vs. autologous platelet gel). The biomaterial wettability was conducted through the sessile drop technique.

RESULTS

The study findings showed a significant difference in contact angle between the APL and blood groups (p<0.05). The MG-Ha Chitosan-based membrane thicknesses seem to produce no significant effects on contact angles measurement for all groups (p>0.05).

CONCLUSIONS

In the present investigation, a similar MG/Ha gel membranes wettability was reported between APL and blood groups. In addition, a high hydrophilicity of MG/Ha gel membranes was reported with a potential advantage in terms of a more effective osteogenic capability in the clinical practice.

Topical hemostatic agents in oral surgery: a narrative review

Sufficient hemostasis during oral surgical procedures is crucial for successful outcomes and to reduce healthcare resource utilization. The purpose of this narrative review is to give a rational insight into the management of bleeding in oral and dental practice through modern drugs. A narrative literature review has been performed on the present topic identifying all articles on Pubmed/Medline and Google Scholars. Acceptable hemostasis during oral surgery is also required to improve visibility and provide a dry operational area. Many oral surgeons, in their daily practice, encounter problems in controlling postoperative bleeding and use a topical hemostatic agent to promote platelet activation or aggregation to form a stable clot.

Volumetric evaluations of the maxillary sinus before and post regenerative surgery

OBJECTIVE

The purpose of this study was to investigate possible differences in the filling of the various recesses of the maxillary sinus after the procedure of sinus floor elevation in relation with the initial volume of the same and if the sinus volume can influence long-term graft dimensions, by using cone beam computed tomography (CBCT) as diagnostic analysis device.

PATIENTS AND METHODS

This study included 32 sinuses corresponding to 16 patients referred for bilateral maxillary sinus augmentation procedures needing to increase the volume of the surgical site with the porcine cortical bone for dental implant placement in the posterior maxilla. The sinuses were analyzed by preoperative and postoperative (15 days and 6 months after sinus surgery) cone beam computed tomography.

RESULTS

No statistically significant relations were observed between initial sinus dimensions and the entity of the contraction of the graft between T1 (15 days after surgery) and T2 (180 days after surgery). The behavior was the same either for the large sinus (> 15.65 cm3) and for the small one (< 15.65 cm3). Instead, about the filling of the various sinus recesses, a linear regression model was used to explain the difference between the mean preoperative and postoperative surgical spaces; in most of the samples, the filling of the anterior recess was ~15% of the total volume of the graft, i.e., the minor one among the main recesses.

CONCLUSIONS

Our findings suggest that: (1) in the procedure of sinus floor augmentation by a lateral approach with deproteinized porcine bone there are no relations between the initial dimensions of the sinus and the long-term dimensional changes of the graft, and (2) that, among the main recesses of the sinus, the anterior one is generally the less filled.

Chronic lip edema and pain secondary to lip augmentation procedure: histological, scanning electron microscopy and X-ray microanalysis evaluation

BACKGROUND

In parallel with the increase in requests for filler injections, reported complications (immediate or delayed and transient or permanent) increased too.

CASE REPORT

In the presented case report, a patient reported a delayed complication of filler injection. The complaints of the patient and the objective evaluation revealed the presence of multiple lip nodules, that were painful both spontaneously and at the touch, after 10 years from a lip filler injection. The surgical excision of the neoformations permitted the complete healing of the lesions. The histological analysis showed a not specific pattern, showing a material encapsulated by a tissue reaction, confirming that the possible cause of the multiple injuries could be attributable to the injection received years earlier.

CONCLUSIONS

The professional who intends to perform filler injections needs a complete training process, both from a theoretical and practical point of view. Also, the patients must be informed of the possible risks associated with each product.

Experience on biocompatible artificial hair implant

OBJECTIVE

In Europe, a great number of investigations and studies followed up to develop safer techniques performed by physicians only. Successful dedicated medical protocols included the implant of single fibers with extractable root. The aim of our study was to evaluate the efficacy of biocompatible artificial hair implants in patients with androgenetic alopecia.

PATIENTS AND METHODS

682 patients (488 males and 184 females) aged between 25 and 70 years old, with diagnosed AGA, requiring no invasive nor surgical hair restoration, with problems of baldness and refusing surgical options appealed to the Second Opinion Medical Consulting (Modena, Italy), and were included in the present protocol. Before the treatment, all patients underwent a test implant to rule out hypersensitivity by implanting 100 fibers on a selected skin spot. If no reaction was detected, five weeks later 500-1,200 fibers were further implanted per session at a minimum interval of 5 weeks until the required aesthetic result was achieved.

RESULTS

The average number of sessions for each patient was 5. The average number of implanted fibers was 2,100 (ranging from 800 to 12,000). The treated scalp area returned to normal appearance and tenderness in 3 days.

CONCLUSIONS

The socio-phycological benefit and the life quality improvement of our patients have been the focus of the study. On our side, the accurate selection, small hair units for each implant session, customized dermatological consultation and the use of highly biocompatible fibers have been the proper strategy to achieve the goal.

Microleakage and mechanical behavior of conical vs. internal hexagon implant-abutment connection under a cyclic load fatigue test

OBJECTIVE

The aim of the present investigation was to evaluate, by an in vitro simulation, the mechanical behavior of the conical vs. internal hexagon under cyclic load and the microleakage of the prosthetic connection of the fixture.

MATERIALS AND METHODS

A standardized cyclic loading was performed considering the implant with conical connection (diameter 4 mm - length 10 mm) (CS) and internal hexagon connection (diameter 4 mm - length 10 mm) (IH). The toluidine blue infiltration has been evaluated with the paper cone test.

RESULTS

After a total of 5x104 loads, the screw has been removed and the abutment appears solid and stable to the implant fixture for CS, while the IH was unstable. There was no infiltration of the toluidine marker in the connection interfaces of CS implants, while the IH was positive to the paper cone test.

CONCLUSIONS

The study data showed that the conical connection showed higher stability compared to the internal hexagon connection under the loading and it is able to prevent bacterial microleakage. This effectiveness should be considered for the long-term maintenance of the peri-implant soft and hard tissues around the fixture.

Rehabilitation of patients with thin ridges by conical expanders and immediate cone morse dental implant: a case report

BACKGROUND

Horizontal atrophic ridges need a regenerative procedure for implant positioning and fixed rehabilitation. Cone Morse taper implants are characterized by the intimate fitting of the prosthetic interface with the absence of microgaps and micromovements of the interfaces. The aim of this case report was to evaluate the clinical outcome of Cone Morse implant design in split crest augmentation treatment.

CASE REPORT

A female patient with partial edentulism of atrophic posterior maxilla was treated for split crest procedure and implant-supported rehabilitation. A full-thickness flap was elevated, and horizontal and vertical osteotomic lines were produced with piezoelectric device. A total of 4 Cone Morse Taper implants (Universal III, Implacil de Bortoli, Brasil) were positioned and the site was grafted with bone substitute and covered by a heterologous membrane.

CONCLUSIONS

A complete healing of the surgical site was evident at the follow-up with no evidence of bone resorption. No radiolucency or inflammatory aspects of the treated site were evident in the radiographic control. Simultaneous Cone Morse implants positioning with split crest technique seems to be a promising treatment for posterior maxillary rehabilitation of atrophic edentulous ridges.

Use of electrical field for biofilm implant removal

OBJECTIVE

New methods for biofilm removal are being investigated. A recent new one involves the use of the electric field for biofilm removal. In particular, electrolytic cleaning works on the adhesion forces of the biofilm on the surfaces, with few studies showing promising results in decontamination and implant re-integration in the bone. This study aims at assessing the effect of a new decontamination device that implies the electric field for implant-biofilm removal.

MATERIALS AND METHODS

Three implants affected by peri-implantitis were selected for the study. After the treatment, the implants were observed by the Scanning Electron Microscopy.

RESULTS

All three samples showed no microbial biofilm in the application area, while the rest of the surface observed was covered with microbial biofilm, with an intensely thickened bacterial population.

CONCLUSIONS

Peri-mucositis and peri-implantitis prevention and early treatments are essential for implant maintenance, thus saving the surrounding hard and soft tissues. The technological innovation is providing electrolytic devices which act not only on the microbial population but on the biofilm adhesion to the implant surface, with promising results for a new and valid therapeutic option.

Reduction of double chin without surgery using ascorbic acid and ascorbyl-palmitate solution: a clinical study

OBJECTIVE

The purpose of the present clinical study is to assess the effectiveness of a lipolytic solution containing sodium salt of ascorbic acid at 0.24% and a surfactant agent at 0.020% ascorbyl-palmitate (SAP) for the treatment of double chin.

PATIENTS AND METHODS

A total of 10 healthy adult subjects affected by double chin (8 female and 2 male) were evaluated in the present investigation. The patients were admitted to a total of 4 sessions, with biweekly procedures, without no other active agents addiction.

RESULTS

In all the subjects a reduction of the convexity of the chin after the treatment with SAP was observed. Improvement in submental appearance was achieved in 90% (9/10) of the patients. One patient did not see any improvement in submental appearance after two section treatments and withdrew from the treatment.

CONCLUSIONS

In conclusion, in the present study, a new adipocytolytic solution consisting of sodium ascorbate mixed with ascorbyl-palmitate was used with success as a surfactant agent for the treatment of double chin.

Histological aspects of cellulite: shedding light on 100 years of uncertainties

Cellulite is a common topographic condition of the skin manifested as lumpy, dimpled flesh resembling an orange peel on some zones such as the thighs, hips, buttocks and abdomen. The aetiology of this cosmetic issue is multifactorial, with hormonal, anatomical, environmental and genetic factors influencing its origin, although the exact mechanisms which cause this condition are still unknown. In the present work, a bibliographic analysis of the cellulite etiology has been updated and exposed, as well as the multiple classification grade scales established over the decades. In addition, a new method to classify cellulite severity, in which the clinical manifestations are correlated to the histological aspects more frequently found in the patients, has been presented. Several theories regarding its appearance, structure and clinical aspects have arisen with the aim of developing and establishing a valuable therapeutic approach. However, the lack of a consensus regarding the classification of cellulite severity has complicated the developments within this field.

Evaluation of the efficacy and safety of hyaluronic acid and supplemented with amino acids, and glutathione or colin, for the prevention and treatment of wrinkles on the face, neck, décolleté and hands

OBJECTIVE

Hyaluronic acid has been used for a long time as a biorevitalizer to treat skin aging both in single formulation and in association with other compounds such as amino acids or vitamins. The purpose of this study was to evaluate the efficacy and safety of class III medical devices SKIN B, SKIN R, SKIN OX, SKIN COLIN, for the treatment of wrinkles on the face, neck, décolleté and hands. These medical devices are all based on hyaluronic acid and supplemented with amino acids (SKIN B and SKIN R) and glutathione (SKIN OX) or colin (SKIN COLIN). This gives broader possibilities to the aesthetic surgeon for personalization and pharmacological diversification based on the patient's deficits to treat.

PATIENTS AND METHODS

A total of 60 subjects affected by skin damage such as rhytidids, dehydration, reduced sebum production and skin hypoxia were enrolled. The patients were treated with a session of mesotherapy every 7 days for 30 days, followed by other 2 sessions every 15 days for 30 days and the follow-up on day 90. The primary efficacy endpoint was evaluated by means of a 0-10 visual analog scale at day 60; the secondary efficacy endpoint was evaluated by means of a 0-10 visual analog scale at day 90.

RESULTS

All patients completed the 3-month follow-up. Treatment with SKIN B, SKIN OX, SKIN COLIN and SKIN R medical devices for the prevention and treatment of wrinkles on the face, neck, décolleté and hands were associated with favorable and positive results. A clear reduction of wrinkles has been clinically observed with improvement in the texture, brightness, and turgor of the skin. No adverse events were reported.

CONCLUSIONS

The medical devices SKIN B, SKIN SKIN OX, SKIN COLIN produce an aesthetic improvement in patients affected by skin defects, when administered by mesotherapy technique. This study confirms the safety and efficacy of the medical devices based on hyaluronic acid supplemented with amino acids and glutathione or colin.

Stabilized zirconia ceramics for dental applications

The research is aiming to obtain at room temperature a new ceramic material containing partially stabilized zirconia with different oxides after sintering used for dental and other technological purposes. Our research proposes a new method based on the use of stabilized zirconia with other oxides to obtain optimized dental material with a lower cost price and / or improved properties to allow wider use of these products to an increased number of patients in dental offices. X-ray diffraction, SEM analysis. FTIR spectroscopy, UVVis and density measurements were accomplished for the three ceramic systems. The correlation between the microstructure and the spectroscopic properties of zirconium stabilized by FTIR spectroscopy, UV-Vis helps understanding the mechanisms associated with the formation of high (tetragonal and / or cubic) temperature zirconia. Along with the simple, less costly preparation method and high purity of the ceramic products our study offers a highly desirable product for technological applications.

Management of anterior open-bite in the deciduous, mixed and permanent dentition stage: a descriptive review

Anterior open bite is one of the most complex malocclusions to manage. The interaction of skeletal, dental, and soft tissue effects can contribute to develop an anterior open bite. The skeletal open bite requires a more complex approach of treatment to reach function, aesthetics, and stability. The approaches vary depending on the causative factors and the age of patients. Treatment approaches for open bite patients differ when dealing with adults and growing patients. The aim of this descriptive review was to summarize the main existing treatment strategies for anterior open bite, from the noninvasive behavioural shaping to the orthodontic intrusion with skeletal anchorage.

Malar augmentation with Hyaluronic acid enriched with glycine and proline: a clinical evaluation

The aging process causes skin modification and wrinkle formation with an alteration of the face harmony and imperfections. The aim of the present investigation was to evaluate a cross-linked hyaluronic acid enriched with glycine and proline for zygomatic malar region infiltrations. A total of twenty healthy female patients were treated for zygomatic hypotonia. The level of patients and surgeon satisfaction was evaluated by global aesthetic improvement scale (GAIS) at baseline, immediately after the procedure and at 6 months from the treatment. The healing phase was uneventful, and no complications were reported in the perioperative and follow-up periods. No significant differences were reported between patients and surgeon GAIS score (p<0.05). A significant difference of GAIS score was reported immediately after the procedure and at 6 months if compared to the baseline (p<0.05). The cross-linked hyaluronic acid enriched with glycine and proline is a useful biomaterial for zygomatic- malar augmentation with no significant local complications and a high stability and satisfaction level of the procedure.

The bad relationship, osteo-decay and diabetes type 2 searching for a link: a literature review

The diabetes and osteoporotic metabolic diseases are characterized by a wide prevalence of the population worldwide and correlated to alteration of the bone tissues. Several cofactors could influence the clinical course and the biochemistry of the pathologies such as human microbiome, nutrition characteristics, gut microbiota activity and interactions with vitamin K and D across IGF/GH and TP53 signaling pathways and the glucose/energy as mechanism for bone tissue health. Moreover, also the calories and sugar consumption seem to be correlated to an increased inflammatory state with several consequences for hematopoiesis and host tissues response. The aim of the present literature review was to highlight the role of osteoporotic diseases and diabetes type 2 link for the bone metabolism. The literature cases showed that a correlation between bone-gut-kidney-heart-CNS-Immunity crosstalk seems to be linked with bone metabolism and health regulation. Moreover, also the aging process could represent a valuable co-factor for the sustaining of the metabolic disorders upon a multi-systemic level.

Correlation between occlusal trauma and oral microbiota: a microbiological investigation

The occlusal trauma has been defined as an injury to the periodontium resulting from occlusal forces that exceeds the reparative capacity of the attachment apparatus. Currently, the effects of occlusal trauma on tooth support tissues, the onset and the progression of periodontal disease are still debated. In fact, researchers started evaluating the possible effects of occlusal discrepancies on incidence, progression, and treatment outcomes of periodontitis, but all the results underlined the more significant role played by microbiological flora. The results of this study show that after 60 days of treating the occlusal trauma, a significant reduction was achieved in the periodontal bacterial flora.

The effectiveness of autologous demineralized tooth graft for the bone ridge preservation: a systematic review of the literature

Resorption of alveolar ridge after tooth extraction often compromises dental implant placement and esthetic. Alveolar ridge preservation is a common procedure performed in order to preserve the pontic site for a prosthetically ideal position. This procedure has already become an indisputable need. Tooth matrix as bone substituted material poses osteoconduction and osteoinduction properties and as autologous graft, this material is free of antigenic reaction. This biomaterial allows the threedimensional reconstruction of the bone, is easy to prepare and has a low cost. The aim of this review is to summarize and put in evidence the properties of tooth as bone substitute and its use in alveolar ridge preservation. Keyword: autologous tooth, autologous graft, bone regeneration, bone substitute, alveolar ridge preservation, alveolar ridge augmentation, socket preservation.

The integumentary system and its microbiota between health and disease

The aim of the present investigation was to evaluate the essential physiological functions of the skin microbiota in human health and diseases. The main characteristics of the normal microbiota in the different anatomical sites have been reported in relation to the main factors, such as the effect of age, on its composition and stability for the eubiosis condition. Moreover, the present overview analyzed the functions and composition and the correct functionality of the skin microbiota in the light of current knowledge. According to several evidence is important preserving the eubiosis of the commensal microbes of the microecosystem (symbiotic and pathogenic), and probiotics are able to counteract the conditions of dysbiosis. Also, it has been shown that there is a crosstalk between gut and skin microbiota that affects human health and is still being studied, and its relationship to the current pandemic SARS-CoV-2.

Xanthelasma palpebrarum removed with Atmospheric Plasma technique: 11-year follow up

Xanthelasma palpebrarum is a subcutaneous lesion of the lid and cause a cosmetical issue. The aim of the present study was to evaluate the atmospheric plasma treatment for the treatment of xanthelasma with an 11-year follow up. Seventy-two patients with bilateral xanthelasma and 26 patients with unilateral xanthelasma by atmospheric plasma technique known also as voltaic arc dermabrasion (VAD, Europe Medical s.r.l. Montesilvano (PE), Italy). Photographs were obtained at the baseline and after the procedure and analyzed by an independent observer. The evaluation of the results was made 2 months after this single treatment with 11 years of follow up. The subjects average age was 48.5 years (range 41-63 years). All subjects were elected for a single session for the lesion removal. The erosion is epithelialized from the lesion margins and the dermal basal cells. After 2 months from the treatment, the result was scored as 4 (clearing of lesions > 75%, complete resolution) in 66 patients for a total of 104 lesions treated; scored as 3 in 24 patients for a total of 48 lesions, and as 2 in nine patients for a total of 18 lesions. No subjects scored 0 or 1. A total of 8 lesions showed mild erythema in the treated areas for 1 month. Numerous approaches were proposed for xanthelasma exeresis such as a surgical treatment especially in case of excessively large lesions or lesions involving the medial canthus that could produce a more limited skin laxity rapidly induces a risk of ectropion. In conclusion, the effectiveness of the present investigation suggest that the atmospheric plasma is a useful therapeutic option for the treatment of xanthelasma palpebrarum.

White spot lesions in orthodontics: prevention and treatment. A descriptive review

White spot lesions (WSL) are demineralizations of the enamel found on the tooth surfaces. WSL are considered incipient non-cavitated caries caused by bacterial plaque activity. Subjects with malocclusion such as dental crowding and fixed orthodontic appliances have a greater number of retention sites and consequently difficulty in cleaning and greater predisposition to caries. In fact, WSL are a frequent side effect of orthodontic fixed treatments. The prevention and resolution of this problem is the goal of any orthodontist because untreated WSL can lead to the formation of deeper dental caries and restorative treatment with consequent compromise of patient satisfaction with the aesthetic result obtained at the end of the orthodontic treatment. This review is intended not only for orthodontists but also for general and pediatric dentists who want to learn how to correctly prevent, and treat this unsightly problem. On the market there are many products sold to achieve this goal, some of them can be managed independently by the patient at home, others require the intervention of the dentist. The purpose of this literature review is to understand how these substances work, to identify with which of the currently most widespread the best results have been obtained and then to provide useful information to guide the clinician in choosing the most suitable one for the patient.

Clinical evaluation of efficacy and tolerance of a skin reconditioning compound for anti-aging

Facial aging involves all facial structures located at different levels: bones soft tissues and skin with a reduction of the extracellular matrix. The aim of the study was to evaluate the efficacy of the injectable solution antiaging complex composed by non-reticulated hyaluronic acid (HA) and amino acids vitamins and antioxidants conveyed with mesotherapy technique in subjects with different expressions of aging. 114 patients with different expressions of aging were enrolled in this study with mean age (49±6). HA and amino acids vitamins and antioxidants complex solution Neofound (Love Cosmedical, Castagneto, Italy) was injected on the dermal plane or superficial subdermal plane. Among the various imperfections, fine roughness surface irregularities skin firmness brightness/discoloration cutaneous hydration were those with the greatest response to therapy. The clinical data showed that the medical device Neofound is effective and safe to treat various skin signs of chrono and photoaging thanks to its ability to protect tissues from oxidative stress and hydrate the skin.

Bacterial adherence to silk and expanded polytatrafluorethilene sutures: an in vivo human study

After oral surgery, bacterial adhesion to suture can cause surgical site infections and delay wound healing. Microbial adherence to the suture is influenced by its physical configuration and chemical structure. The aim of this study was to compare in vivo the bacterial adhesion to two suture materials used in oral surgery: silk and monofilament expanded polytetrafluoethilene (e-PTFE). After sinus lift surgery, 15 flaps were sutured with silk (nonabsorbable, organic, braided, 4.0) and 15 were sutured with e-PTFE (nonabsorbable, synthetic, monofilament, 4.0). Seven days after surgery, bacterial adherence, in terms of percentage of the surface covered, was evaluated for each suture material by scanning electron microscope (SEM). Onto silk suture, plaque consisted of a few cocci and a higher proportion of rods and filamentous-shaped bacteria, with some mineralized plaque. Onto e-PTFE speciments, only small colonies of a few cocci or no bacteria were observed, with empty spaces between the colonies and no plaque mineralization. The surface covered by bacteria on e-PTFE specimens was significantly lower than that of silk sutures. (22.1% ±4.96% vs 54.3% ± 7.9%; P =0.0001). The results of the present study suggest that multifilament structure of silk favours a greater bacterial adherence, proliferation, and persistence, so monofilament and e- PTFE suture should be preferred in oral surgery.

Peri-implant disease caused by residual cement around implant-supported restorations: a clinical report

Cement-retained restorations on implants ensures better passive fit and aesthetics, simplicity of fabrication and a homogenous load distribution during function, compared to screw-retained restorations, but it is associated to biological complications following the difficulty to remove cement excess. In fact, residual cement is a predisposing factor to peri-implant tissue inflammation and periimplantitis, because promotes plaque retention of bacteria, due to rough surface. This is especially true since radiographs should not reveal the cement excess and cements commonly used for the cementation of implantsupported prostheses have poor radiodensity. This report documents a case of clinical and radiographic findings of peri-implant disease associated with excess cement extrusion. Two months after cement removal, resolution of inflammation occurred. A good method of cementation, an accessible margin of restoration and the use of ZnOE cement instead of methacrylate cement, should help to prevent cementrelated peri-implant disease.

Compliance of children with removable functional appliance with microchip integrated during covid-19 pandemic: a systematic review

Treatments with removable appliances are widely used in Europe to correct dento-skeletal dysgnatia in the growth phase that is a period of poor cooperation of the patients. Adherence to the wear-time prescription is often not achieved and it represent the main argument against the use of removable devices. Suspected non-compliant behavior with the wear time prescription is often the subject of medico-legal disputes, which can deteriorate doctor-patient relationship. The use of microchips allows to document objectively and clarify the patient's behavior. To conduct a systematic review of the orthodontic literature to identify the factors associated with compliance in orthodontic treatment. We conduct a systematic review that aimed to identity the factors associate with compliance in orthodontic treatment. The main purpose was to assess the objective levels of time of use of the removable appliances and the self-reported levels. A literature search was conducted by the electronic databases PubMed and Cochrane Library. The following search terms were used: compliance functional removable orthodontic appliance. Randomized and nonrandomized controlled trials, prospective cohort studies, case series, qualitative and mixed-methods studies objectively assessing compliance levels were included in the study. A total of 94 articles were identified by PubMed and 14 articles by Cochrane. The papers selected were included for the qualitative analysis and categorized according to the subjects age, the clinical appliance, compliance factors, wear time and monitoring. Removable appliances are an important part of orthodontic treatment, used in growth phase of the patient. Collaboration with removable functional devices determines success / failure in treatment.

Graphene-doped Poly(methyl-methacrylate) as an enhanced biopolymer for medical device and dental implant

Graphene-doping procedure represents a useful procedure to improve the mechanical, physical and biological response of several PMMA-derived polymers and biomaterials for dental applications. The aim of the study was to evaluate measure water sorption, water solubility and tolerance trough the rabbit pyrogen testing pyrogen detection of Graphene doped Poly (methyl methacrylate) (PMMA) compared with PMMA as potential materials for dental implant device. A total of 8 aged and unaged samples Graphene doped PMMA and PMMA were tested for water sorption and water solubility of the specimens. The experimental condition was evaluated according to the ISO 20795-1:2013 protocol. The biopolymer tolerance was evaluated in vivo on animals through the pyrogen detection test, acute intracutaneous and systemic irritation test. After wet conditioning both of Graphene doped PMMA and PMMA reported an increase of the weight. All the experimental samples showed a drastic low level of water sorption and solubility. Graphene doped PMMA unaged specimens showed a stability of physical and optical feature after the treatment. The Graphene doped PMMA has not shown pyrogens, an intradermal and systemic irritant effect on animals. The Graphene-doped PMMA satisfy the standard requirements and provide a physical and optical stability of the compound after the treatment. Further in vivo findings are required for future clinical application of the compound.

Effect of probiotics on the occurrence of nutrition absorption capacities in healthy children: a randomized double-blinded placebo-controlled pilot study

OBJECTIVE

Recent advances in the translational research showed that dietary nutrients have critical importance to the microbioma balance in the gastrointestinal tract. Therefore, the alteration of the intestinal microbiota in order to achieve, restore, and maintain favorable balance in the ecosystem, and the activity of microorganisms present in the gastrointestinal tract is necessary for the improved health condition of the host. The objective of this translational study was to evaluate, in a pediatric population, the efficacy and safety of prophylactic probiotics for a better nutritional absorption capacity in the view to enhance their overall health and immunity.

PATIENTS AND METHODS

A total of 40 pediatric patients between the ages of 14 and 18 years were enrolled in the study and divided under two categories (treated/active group and placebo group). Three-time points clinical evaluations were performed: a baseline assessment (Time 0), a second evaluation at 5 weeks after the start of probiotic use (Time 1), and a final evaluation at the timeline after 10 weeks (Time 2). In the initial phase of the study, the recruited subjects underwent a panel of initial T0 clinical tests. For each of the patients, a blood sample was taken in order to evaluate the following biochemical measurements: Vitamin D, Vitamin A, Calcium, Zinc, and Iron. Moreover, an initial nutritional evaluation was carried out through which the nutritionist estimated the body composition of the subject (weight and body mass index), the caloric needs and dietary behaviour of each recruited patient.

RESULTS

Eligible participants were randomized into placebo (n = 20) or treated/active (n = 20) treatment conditions by random allocation using a computerized random number generator, ensuring all investigators remained blind to the treatment distribution. The data were compared within and between groups using statistical methods. The results confirmed that the probiotic supplementation was effective in increasing the overall blood biomarkers levels of vitamins, calcium, and mineral absorption from baseline to 10 weeks of treatment, compared with the placebo.

CONCLUSIONS

Probiotics may be suggested as supplements to improve biomarkers serum concentration if administered for a period of at least ≥ 5 weeks. However, further studies are required for optimal recommendations in patient treatment.

Steroids and growth factors in oral squamous cell carcinoma: useful source of dental-derived stem cells to develop a steroidogenic model in new clinical strategies

OBJECTIVE

Head and neck region is involved in a high percentage of malignant lesions, and oral squamous cell carcinoma (OSCC) is undoubtedly the most frequently found, accounting for over 90% of malignant tumors. Hormone receptor overexpression, like Estrogen Receptor (ER), Progesterone Receptor (PR) and Endothelial Growth Factor Receptor (EGFR), and signaling have been related to the pathogenesis of OSCC. For metastasis of OSCC, Cancer Stem Cells (CSCs) undergo epithelial to mesenchymal transition (EMT) under the influence of growth factors, cytokines, and regulation of cadherins from the tumor's microenvironment. In this context, the stem cells may become a potential therapeutic target for OSCC through modulation of cytokines and RAS pathway, which is involved in intracell signal transduction. The objective of this study was to suggest an experimental steroidogenic model for OSCC in translational research.

PATIENTS AND METHODS

Dental-derived Stem Cells (D-dSCs) have been obtained from apical papilla tissue that surrounds the developing tooth of healthy donors and cultured in vitro. The cells have been exposed to different concentrations of Estradiol (E2 - 10 nM and 40 nM) in order to verify their response. The number of cells and cell viability has been evaluated up to 96 hours of treatment.

RESULTS

The results showed that cell growth was increased under estradiol treatments compared with cells maintained without estradiol. Moreover, no significant difference in cell death levels was detected among treatments.

CONCLUSIONS

This work underlines as D-dSCs could represent a useful steroidogenic model for the development of the target and gene therapies in OSCC.

Stemness genes expression in naïve vs. osteodifferentiated human dental-derived stem cells

OBJECTIVE

Mesenchymal stem cells (MSCs) have been deeply investigated in regenerative medicine because of their crucial role in tissue healing, such as tissue regeneration. Dental-derived stem cells (d-DSCs) are easily available from dental tissues, which can be isolated from all age patients with minimal discomfort.

PATIENTS AND METHODS

Normal unerupted third molars tooth buds were collected from adolescents' patients underwent to extractions for orthodontic reasons. The expression of the genes Kruppel-like factor 4 (Klf-4), octamer-binding transcription factor 4 (Oct-4), homeobox transcription factor Nanog (NANOG) was investigated in d-DSCs obtained from dental bud (DBSCs), differentiated toward osteoblastic phenotype and not.

RESULTS

Our results showed that DBSCs expressed Oct-4, Nanog, and Klf-4 in undifferentiated conditions and interestingly the expression of such genes increased when the cells were kept in osteogenic medium.

CONCLUSIONS

These attractive stemness properties, together with the effortlessly isolation, during common oral and maxillofacial surgical procedures, from undifferentiated tissues such as dental bud, make this kind of d-DSCs a promising tool in regenerative medicine, having the potential for clinical applications, and reinforcing the present challenge to develop new preventive and healing strategies in tissue regeneration.

A pilot study of human mesenchymal stem cells from visceral and sub-cutaneous fat tissue and their differentiation to osteogenic phenotype

OBJECTIVE

To evaluate the different behavior of two different human adult adipocytes derived stem cells (hASCs) during proliferation and osteogenic differentiation.

PATIENTS AND METHODS

Human adult adipocytes stem cells (hAT-SCs) from visceral (hAV-SCs) and subcutaneous (hAS-SCs) sites were obtained after surgery procedures of seven patients. All samples were fully investigated and the different proliferation rates were evaluated. All MSCs clusters were cultured with an osteogenic and adipogenic differentiation medium. Homogeneous pools of Mesenchymal Stem Cells (MSCs) were confirmed by Flow-Cytometry Analysis (FACS) and Spectrophotometric Assay. The differentiated cells were eventually assessed for the expression of Alkaline Phosphatase (ALP), Alizarin Red (AR) and Oil Red-O (OR-O) detection, and analyzed by the Spectrophotometric Assay. After osteogenic differentiation, the cell clusters were incubated and analyzed with Real Time-Polymerase Chain Reaction (qRT-PCR) and fluorescence microscopy.

RESULTS

The FACS analysis performed on hAT-SCs confirmed the homogenous presence of MSCs in all samples. The ALP, AR stain confirmed the osteogenic differentiation capacity of MSCs towards osteoblast-like-cells. The colorimetric cell metabolic activity (MTS) assay showed an increase in the proliferation rate with different values in both sets hAS-SCs vs. hAV-SCs.

CONCLUSIONS

These in vitro findings of both hAS-SCs and hAV-SCs suggested an important role of these stem cells for future clinical use in bone regeneration. Indeed, the final outcomes suggested a better performance of cells coming from subcutaneous adipose tissue vs. those from visceral fat tissue.

A comparative study on different stemness gene expression between dental pulp stem cells vs. dental bud stem cells

OBJECTIVE

The clinical use of mesenchymal stem cells (MSCs) in regenerative medicine either in tissue repair or tissue reconstruction has given highly interesting results thanks to their particular nature. Sources that have attracted the attention of medical scientists from where stem cells (SCs) in adults could be obtained are different and, dental tissues have certainly become an optimal source of MSCs. Dental tissue is a main reservoir of two types of MSCs dental bud (DBSCs) that constitute the immature precursor of the tooth and dental pulp (DPSCs) that are derived from dental inner pulp and partly from dental follicle tissue and can differentiate into several cell phenotypes as osteoblast, chondrocyte, hepatocytes, cardiomyocytes, neuron and β cells.

PATIENTS AND METHODS

Normal impacted third molars and tooth buds were collected from adults and adolescents underwent to extractions for orthodontic reasons. The expression of the five stemness genes Nanog, OCT4, Sox2, c-Myc and Klf4 were investigated by qRT-PCR in two different dental stem/progenitor cells: dental pulp stem cells (DPSCs) and stem cells from dental bud (DBSCs), differentiated toward osteoblastic phenotype and not.

RESULTS

Both DPSCs and DBSCs are easy to access and we found their expression of the typical mesenchymal stemness makers and osteogenic capacity due to the effective presence of embryonic gene regulators like Nanog, OCT4, Sox2, c-Myc and Klf4. Both DBSCs and DPSCs could represent a valid tool in regenerative medicine and translational applications.

CONCLUSIONS

The results depicted here provide, for the first time to our knowledge, a comparative outcome about the stemness properties generated from accessible tissues such as DPSCs and DBSCs. These two types of SCs showed few different distinctive genetic traits supposedly in relation to their origin, location and stage of maturation. Certainly these SCs reserve solid potential for human clinical application in autologous procedure for bone, hard tissue and soft tissue regeneration, easy to isolate, ready availability, high-biocompatibility and safety and no ethical restrictions.

Liquid biopsy

During the early formation and growth of primary tumor (e.g., breast, colon, or prostate cancer), cells are shed from the primary tumor and then circulate through the bloodstream. Many of the major recent advances in targeted therapies have relied on the acquisition of tumor tissue via biopsy before initiation of therapy or after the onset of resistance. The advantage of physical properties is that they allow circulating tumor cells separation without labelling. Methods based on physical properties include density gradient centrifugation, filtration through special filters. In addition to using somatic point mutations as markers for the detection of tumor DNA, strategies to detect tumor-derived rearrangements and chromosomal copy number changes in the plasma of patients with cancer have been developed. Several studies have shown that metastatic cells might have unique characteristics that can differ from the bulk of cancer cells in the primary tumor currently used for stratification of patients to systemic therapy. In conclusion, the molecular and functional analysis of circulating tumor cells and circulating nucleic acids can be used as companion diagnostics to improve the stratification of therapies and to obtain insights into therapy-induced selection of cancer cells..

Cortical bone lamina approach for mandibular large cystic defect: a case report

This study evaluated the bone healing of the residual cavity after enucleation of mandibular inflammatory cyst by using only a coverage with cortical bone barrier. This study was conducted at the dental clinic of the Medical, Oral and Biotechnology Sciences Department of Chieti in February 2015. A 36-year-old male patient, D.G.M., had a mandibular inflammatory cyst (with a diameter of about 33.9x20.3mm) treated by surgical enucleation, subsequent apicectomy of the elements involved (4.1, 3.1, 3.2, 3.3, 3.4) and coverage of residual defect with a porcine cortical bone barrier (Bone Lamina). Postoperative clinical and radiographic examinations were performed at 3 and 9 months (panoramic radiographs) and at 12 and 24 months (CBCT Dental scan) respectively after cystic enucleation surgery. Uneventful healing and filling of the residual cavity was carried out. The computed analysis of the postoperative radiographs showed bone regeneration of cortical in terms of thickness increase at 12 and 24 months and showed mean values of reduction in size of the residual cavity of 92.1% after 12 months and 96.53% after 24 months. The volume of residual cavity (3123 mm3 in 2015) was seen to decrease (243.6mm3 at 12 months and 108.5 mm3 at 24 months). In this case report the Bone Lamina prevented tissue collapse within the defect and could maintain structural integrity throughout the period required for bone regeneration; it also has the advantage of resorbable membranes, avoiding a second surgery for its removal.

Bone decay and beyond: how can we approach it better

Osseo-degeneration is a disorder related to several factors, that may lead to the disruption of several skeletal regions providing support, such as the femur head, the vertebrae and the alveolar bone. The functional condition can be restored by means of grafting procedures, using different materials: calcium powder, xenografts, ceramics and metals. Such procedures aim at reforming an adequate bone volume and strength, that is necessary to support loading forces. Bone regeneration requires that the basic biological principles of osteogenesis, osteoinduction, osteoconduction and biocompatibility are followed. The success of regenerative procedures may depend on the inner structural, mechanical and metabolic condition of the host's bone on which implants should be inserted, on the surgical technique, and on the biomaterial used. Among these, the aging process of the patient appears to be relevant. It can be associated with metabolic disease leading to systemic functional decay, which involves a gradual steady decline of hormonal, immune function and osteo-metabolic activity. The latter can affect the positive outcomes of bone reconstruction and implant therapy. This review will analyze the biological and physiological factors involved in the bone tissue break-down, such as the influences from gut microbiome unbalance and the consequent metabolic, endocrine, immune dysfunctions, the surgery procedures and the quality of the grafting material used. The decline of bone architecture and strength should be corrected by using an appropriate clinical regenerative approach, based on a bio-endocrine, metabolic and immunologic know-how. The final characteristics of the regenerated bone must be able to support the loading forces transmitted by the implants, independent of the body location, and should be individualized according to the different condition of each patient.

Soft tissue augmentation by means of silicon expanders prior to bone volume increase: a case series

In guided bone regeneration (GBR) interventions, the incorrect manipulation of the soft tissues may lead to exposure of graft due to insufficient amount of tissue needed for a free-tension flap closure. The aim of this investigation was to evaluate the clinical and radiographical effectiveness of soft tissue augmentation in aesthetic areas. A total of 6 patients were treated in the Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, with a radiographical follow-up at 1 year from the loading. At the follow up, no soft tissue dehiscence was observed This study presented an innovative approach for soft tissue augmentation prior to bone regeneration in aesthetic areas. Augmentation of soft tissue with a silicon expander device before bone regeneration is a simple technique and also allows to obtain greater bone tissue in selective cases.

Hyaluronic acid fillers in lip augmentation procedure: a clinical and histological study

Several approaches have been proposed for soft tissue augmentation using injectable materials for lip and soft-tissue augmentation due to their physical and biological properties. Hyaluronic acid represents a natural component of the connective tissues, related to wound healing and skin regeneration. The aim of this research was to investigate the clinical and histological effectiveness of cross-linked hyaluronic acid for lip augmentation. A total of 8 patients were treated for lip augmentation with a clinical follow up of 60 days. After this period a histological evaluation was performed to evaluate the healing of the treated regions. The healing phase reported no inflammatory response, tissue contractions and no local flogistic evidence in the treated areas, where the filling volume appeared maintained. The 60 days histological evaluation showed evidence of filler resorption with few infiltrated inflammatory cells. The clinical and histological findings suggested that cross-linked hyaluronic acid represents a safe and effective tool for lip augmentation.

Evaluation of the effectiveness and safety of peppermint peel (PMP) soft peeling for skin ageing

Turning to peeling in a dermatological sphere is extensively common and has been used for a long time. From the use of single acids moving on to the so-called compound peelings (associations of more than one substance in the same product) and the combined peelings which take advantage of the action of different substances in a synergistic manner (different products are applied sequentially) in order to best guarantee a greater effectiveness of the treatment for the recommended target. Superficial peelings, combined and not, have led to a drastic reduction in the percentage of incidence of adverse events typical of medium and deep peels. Nevertheless, it has been demonstrated that superficial peels bring about a rejuvenating effect through the mechanical stimulation of the Skin Stress Response System (SSRS), system designated to repairing the damaged tissue and restoring of the normal homeostasis. Clinical trials aims to evaluate the effectiveness and safety of the peppermint peel (PMP) medical device in subjects with different ageing expressions both in qualitative terms (different blemishes such as discolouration, fine wrinkles, elastosis, atony and skin inelasticity, laxity, scarce superficial hydration) and in quantitative terms (degree, extension and number of lesions). A non-controlled multi-centric clinical trial was done in 121 subjects. The use protocol calls for a session every 2 weeks for a total of 4 sessions. Subjects were evaluated before each subsequent session at the first and at 2-4-8 weeks of the fourth and last treatment. During the study there were no adverse events. Only a minimal scurfy flaking and a very slight redness were reported. From an effectiveness point of view, the percentage of therapeutic failure, judged with a score equal to or greater than 4 or 5 in Global Aesthetic Improvement Scale (GAIS) scale was 0%. Best score was obtained in subjects ranging in ages between 38 and 57 (2.02) and in women (2.02) years, while the less satisfactory one was obtained in males (2.14). The study has demonstrated that PMP and the proposed protocol are effective and safe to treat subject with skin signs of chrono and photo ageing, thanks to its capabilities of carrying out a mechanic action indicated as a coadjuvant in the treatment of the dermoepidermic revitalisation through chemical exfoliation and hydration.

Non-surgical treatment of lower eyelid fat pads with an injectable solution acid deoxycholic based

The use of sodium deoxycholate (DC) in aesthetic medicine for reducing unwanted localized fat deposits is a procedure in use for over 30 years. Lower eyelid fat pads are one of the main imperfections of the middle third of the face. The purpose of the study is to assess the effectiveness and the safety of a second-generation injectable solution containing sodium deoxycholate 1.25% (DB125) for the treatment of lower eyelid fat pads. A multi-centre observational prospective study was carried out between May and October 2017. Patients presented various forms and degrees of lower eyelid fat pads. They were treated montly apart until the clinical result was obtained. The technique was explained. The study treated 120 patients for a total of 306 infiltration sessions (average 2.55 per patient). Patients gave the effectiveness of the treatment an average score of 7.125 (7.28 in men and 7.03 in women). The greatest successes were in patients under the age of 40. The medical evaluation showed therapeutic success in 85.83%. Adverse events were reported. The results of the study are encouraging since they have shown a therapeutic success from both the viewpoint of specialist medical assessment and from the personal, subjective view of the patients treated. This success did not show any significant differences between sex. On the other hand, outcome has been better in the younger age groups. The high degree of effectiveness shown in the study was associated with a minimal occurrence of adverse events. Therefore DB125, used with the right technique and dosage, is effective and safe to treat lower eyelid fat pads.

Narrow single tooth implants for congenitally missing maxillary lateral incisors: a 5-year follow-up

INTRODUCTION

The maxillary lateral incisor epidemiologically represents the second most common congenitally absent teeth. In literature, different approaches have been proposed, such as canine teeth substitution, traditional prosthetic rehabilitation, adhesive restoration or single-tooth implant. The aim of this investigation was to evaluate the clinical and radiographical effectiveness of narrow single tooth implant treatment for missing maxillary lateral incisors.

MATERIALS AND METHODS

A total of 11 subjects, in seven cases bilaterally, were treated in the Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, with a radiographical follow-up at 5 years from the loading.

RESULTS

At the follow up, no bone defects or pathological gingival probing were present around the peri-implant tissues. No mechanical complications, such as loss of the crown fixation screws or fracture, were reported.

CONCLUSIONS

Narrow implants represent a predictable optional treatment for maxillary lateral incisor restoration, with a high-level aesthetic and functional outcome of the rehabilitation.

Drug-induced gingival overgrowth: an in vitro study on cyclosporine and human gingival fibroblasts

Gingival overgrowth is a serious side-effect that accompanies the use of cyclosporine. Up to 97% of the patients submitted to immunosuppressant drugs have been reported to suffer from this side-effect. Several conflicting theories have been proposed to explain the fibroblast's function in gingival overgrowth. To determine whether cyclosporine alter the inflammatory responses, we investigated its effects on gingival fibroblast gene expression as compared with untreated cells. Fragments of gingival tissue of healthy volunteers (11-year-old man, 68-year-old-woman and 20-year-old-man) were collected during operation. Cells were incubated with cyclosporine and gene expression of 29 was investigated in gingival fibroblasts cell culture, compared with untreated cells. The gene expression level was significantly deregulated only for 10 genes (CCL1, CCR1, CCR4, CCR5, CCR10, IL1A, IL1B, IL5, IL6R and TNFSF10) that were found to be downregulated except for TNFSF10. These results seem to demonstrate that cyclosporine has no inflammatory effect on healthy gingival fibroblast. In the future, it would be interesting understand, the possible effect of the drug on inflammation of patients affected by gingival hyperplasia.

In vitro interface changes of two vs three narrow-diameter dental implants for screw-retained bar under fatigue loading test

The mechanical failure of a dental implant is clinically related to a prosthetic overload dissipated on the fixture/abutment complex. The aim of this investigation was to evaluate the fracture strength of two vs three narrow-diameter dental implant configurations for screw-retained bars. Different configurations of screw-retained bars on two narrow-diameter dental implants (Group I) and screw-retained bars on three narrow-diameter dental implants (Group II) were tested under a static fracture loading. A total of 20 specimens, 10 for each group were evaluated. The fracture loading point was significatively higher in Group I (p<0.05). The experimental groups reported high levels of fracture strength under loading that encourages the clinical application of screw-retained bars supported by multiple narrow-diameter implants.

Complication in third molar extractions

Mandibular third molars (MM3s) are responsible for pericoronitis, primary and/or secondary crowding of the dentition, odontogenic tumors and cysts, periodontal defects associated with the posterior part of mandibular second molars. Tooth extraction is indicated for prophylactic and therapeutic purpose in patients with problems caused by impacted teeth. Common postoperative complications associated with third molar extraction are alveolitis (0.5e32.5%), infection (0.9e4.2%), postoperative bleeding (0.2e1.5%), transient dysfunction of the inferior alveolar nerve (0.6e5.5%), and permanent dysfunction of the inferior alveolar nerve (0.1e0.9%). A literature review reveals number of individual case reports of accidental displacement to various anatomical locations, namely, the infratemporal fossa, pterygomandibular space, lateral pharyngeal space, submandibular space, and sublingual space.

A 10-year retrospective comparative human study on screw-retained versus cemented dental implant abutments

The aim of this 10-year retrospective study was to evaluate the long-term reliability, survival rate and mechanical and biological complications of single-crown implant rehabilitations with two different types of fixture-abutment connections: screw-retained abutments (SRAs) with internal hexagonal connection, and cemented retained abutments (CRAs). A total of 300 single implant-supported crowns were analysed, which had been inserted between 2004 and 2007. Patients were classified according to two groups: the SRA group (n = 150) and the CRA group (n = 150). The primary outcome was marginal bone loss (MBL) on peri-apical radiographs. Bleeding on probing (BOP) and probing depth (PD) were also evaluated. Moreover, prosthetic complications were recorded. Analysis of variance (ANOVA) was used to evaluate the differences between the groups. The overall implant failure rate was 4.2%. The overall positive BOP index was 81.9% of the sites under investigation, as 83.4% for SRA and 80.4% for CRA. Moreover, >5 mm PD demonstrated a rate of 21.0% for CRA, and 13.8% for SRA. The primary outcome of mean MBL was 2.09±1.07 mm for SRA and 1.54±1.20 mm for CRA. Analysis of variance of MBL showed statistical significance for the difference between these two groups (P less than 0.001). For the mechanical aspects, an overall 12.5% of complications occurred. No implant or abutment fractures were recorded. Although complications occurred, the results from this 10-year retrospective study show that these two methods have positive long-term follow-up. With MBL significantly greater for the SRA group than the CRA group, the clinical use of CRA is encouraged in terms of the lower bone resorption rate.

A novel technique to prevent sinus membrane collapse during maxillary sinus floor augmentation without bone graft: technical note

Different surgical techniques have been developed to reconstruct the posterior maxilla without bone graft. A barrier membrane usually placed internal to the sinus, without stabilizer or bone window, pushed inside the sinus cavity as the ''roof'' of the sinus cavity to preserve the space and help bone regeneration has been used with success. In the present technical report, the heterologous cortical lamina is used for the mechanical support of sinus membranes. The membrane is placed through two lines of 2-3 mm, mesial and distal, created at the top of the antrostomy. The half heterologous membrane is positioned on these lines and pushed to the nose wall of the sinus, and the other half is folded to cover the window. In this way the bone lamina is stable. Cone Beam Computed Tomography was used to evaluate the efficacy of bone lamina to preserve the space in sinus lifting which contributes positively to wound healing and is effective in bone formation without biomaterials.