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Quantum tunnelling plays a crucial role in heavy-ion fusion reactions at sub-barrier energies, especially in the context of nuclear physics and astrophysics. The nuclear structure of the colliding nuclei and nucleon transfer processes represent intrinsic degrees of freedom. They are coupled to the relative ion motion and, in general, increase the probability of tunnelling. The influence of couplings to nucleon transfer channels relatively to inelastic excitations, on heavy-ion fusion cross sections, is one of the still open problems in this field. We present a new analysis of several systems, based on the combined observation of the energy-weighted excitation functions E σ in relation to their first energy derivatives d (E σ) / d E . The relation between d (E σ) / d E and E σ removes the basic differences due to the varying Coulomb barrier when comparing different systems. We show that, depending on the nuclear structure and/or the presence of strong transfer channels, this representation reveals characteristic features below the barrier. The possible presence of cross section oscillations makes this analysis less clear for light- or medium-light systems. [ABSTRACT FROM AUTHOR]

The systematics of the lowest 2 + energies of even-even nuclei, and the B(E2) rates connecting those levels to the ground states, give essential information about the degree of collectivity in various regions of the nuclide chart. The B(E2) rates provide crucial tests of theoretical predictions, such as the quenching of shell structure in neutron-rich nuclei. Measurements of such rates are in progress using multi-nucleon transfer reactions and radioactive ion beams. We have measured the fusion excitation functions for the three systems 48 Ca + 116 Cd, 118 Sn, 120 Te, in the relevant energy range from above to below the Coulomb barrier. The magic projectile 48 Ca has been chosen in view of its spherical and rigid structure, while the three targets have proton numbers Z = 48 , 50 , 52 . We observe that the cross sections are smallest for the target 118 Sn, thus indicating the effect on sub-barrier fusion of crossing the major shell closure at Z = 50. This suggests the possibility of using near-barrier fusion reactions of radioactive ion beams with suitable stable targets, as a complementary technique to evidence the low-lying nuclear structure of exotic nuclei, besides well established methods. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and network meta-analysis aimed to answer to the following questions: (a) In patients undergoing alveolar ridge preservation after tooth extraction, which grafting material best attenuates horizontal and vertical ridge resorption, as compared to spontaneous healing?, and (b) which material(s) promotes bone formation in the extraction socket? Materials and methods: The MEDLINE, SCOPUS, CENTRAL, and EMBASE databases were screened in duplicate for RCTs up to March 2021. Two independent authors extracted the data and assessed the risk of bias of the included studies. Primary outcomes were ridge horizontal and vertical dimension changes and new bone formation into the socket. Both pairwise and network meta-analysis (NMA) were undertaken to obtain estimates for primary outcomes and compare different grafting materials. Results: Eighty-eight RCTs were included, with a total of 2805 patients and 3073 sockets. Overall, a total of 1740 sockets underwent alveolar ridge preservation with different materials (1432 were covered by a membrane). Pairwise meta-analysis showed that, as compared to spontaneous healing, all materials statistically significantly reduced horizontal and vertical shrinkage. According to the multidimensional scale ranking of the NMA, xenografts (XG) and allografts (AG), alone or combined with bioactive agents (Bio + AG), were the most predictable materials for horizontal and vertical ridge dimension preservation, while platelet concentrates performed best in the percentage of new bone formation. Conclusions: Alveolar ridge preservation is effective in reducing both horizontal and vertical shrinkage, as compared to untreated sockets. NMA confirmed the consistency of XG for ridge dimension preservation, but several other materials and combinations like AG, Bio + AG, and AG + alloplasts, produced even better results than XG in clinical comparisons. Further evidence is needed to confirm the value of such alternatives to XG for alveolar ridge preservation. Bio + AG performed better than the other materials in preserving ridge dimension and platelet concentrates in new bone formation. However, alloplasts, xenografts, and AG + AP performed consistently good in majority of the clinical comparisons. Clinical relevance: XG and Bio + AG demonstrated significantly better performance in minimizing post-extraction horizontal and vertical ridge dimension changes as compared with other grafting materials or with spontaneous healing, even if they presented the worst histological outcomes. Allografts and other materials or combinations (AG + AP) presented similar performances while spontaneous healing ranked last. [ABSTRACT FROM AUTHOR]

Objective. The objective of the present review is to assess the implant survival, marginal bone loss, and biomechanical features of narrow-diameter implants (2.5-3.5 mm) supporting or retaining full-arch fixed or removable restorations. Materials and Methods. Three operators screened the literature (PubMed, Cochrane Library, and Google Scholar) and performed a hand search on the main journals that focus on implantology until 24 March 2019. Only articles that considered full-arch restorations supported or retained by narrow-diameter implants (2.5-3.5 mm) were considered if they have a minimum of 10 patients and a mean follow-up of at least 6 months. The outcome variables were survival of implants and marginal bone loss. The review was performed according to the PRISMA statements. Risk of bias assessment was evaluated. Failure rates were analyzed using random effect Poisson regression models to obtain the summary estimate of 5-year survival rate and marginal bone loss. Results. A total of nine papers were finally selected, reporting a high survival rate of the implants. Eight studies focused only on the mandible while one study reported data from both mandible and maxilla. All studies reported on removable restorations; none focused on fixed rehabilitations. The estimated survival rate for 5 years of follow-up was calculated to be 92.25% for the implants. The estimated marginal bone loss after 5 years was calculated to be 1.40 mm. No study reported implant fractures. Conclusions. With the limitations of the present study, there is evidence that 2.5-3.5 mm narrow-diameter implants retaining a removable restoration can be a successful treatment in fully edentulous patients. No data on fixed restorations was available. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the antimicrobial, toxicity and cleaning effectiveness of ethylenediaminetetraacetic acid (EDTA) and maleic acid (MA) alone and combined with cetrimide (CTR). Methodology: Cytotoxic and genotoxic effects were assessed on Chinese hamster cells V79 using the MTT, clonogenic and micronucleus assays, respectively. The bacterial inhibitory and bactericidal concentrations (MIC and MBC, respectively) were determined on a strain of Enterococcus faecalis. Antimicrobial tests were performed on a biofilm model after treatment with the chelating agents by using a biofilm eradication concentration (MBEC) and confocal laser scanning microscope (CLSM) assays. Quantification of cell biomass and percentage of live and dead cells in the biomass were assessed for each group. The percentage reduction of accumulated hard‐tissue debris (AHTD) after root canal preparation and final irrigation protocols was evaluated by micro‐CT. Statistical tests of one‐way analysis of variance (anova), Bonferroni test, Kruskal–Wallis test, Dunn's multiple comparison test and Wilcoxon matched‐pairs signed‐rank tests were used. Results: Cetrimide alone as well as in combination with EDTA and MA at dilutions of 1/10 and 1/100 was significantly more toxic as compared to untreated controls (P < 0.001). All tested mixtures were nontoxic at a dilution of 1/1000. EDTA retained a weak inhibitory and bactericidal effect against planktonic cells, whilst MA inhibited cells growth and killed 99.9% of the cells when diluted. CTR revealed the most prominent effect, being inhibitory and bactericidal, also when diluted. Cetrimide alone or combined with EDTA was able to remove, respectively, 40% (P < 0.01) and 60% (P < 0.001) of the entire biomass after 1 min. Conversely, MA alone and in combination with CTR did not have a significant effect on biomass reduction. After final irrigation, the AHTD volume was significantly decreased in all groups (P < 0.05). EDTA + CTR and MA + CTR were associated with a significant reduction in the percentage of AHTD on the entire root canal compared to the same solutions without surfactant. Conclusions: 7% MA was less cytotoxic in comparison with 17% EDTA. The addition of cetrimide to EDTA and MA removed accumulated hard‐tissue debris effectively from the canal walls and increased their antimicrobial activity when compared to the same solutions without detergents. [ABSTRACT FROM AUTHOR]

Purpose: This article reports preliminary results of a single-cohort prospective study that sought to evaluate a new surgical protocol for the immediate rehabilitation of edentulous maxilla without using bone grafting. Materials and Methods: Twenty consecutive patients in need of a full-arch maxillary rehabilitation were included in the study. Each patient received four tilted implants that engaged the posterior and the anterior sinus wall and two axial implants in the anterior maxilla. A total of 120 implants (30 Brånemark System MK IV and 90 NobelSpeedy Groovy) was inserted. Acrylic resin provisional prostheses were delivered within 4 hours of implant placement, and definitive restorations were placed 4 to 6 months later. Follow-up visits were scheduled every 6 months for the first 2 years and yearly thereafter. At each follow-up appointment, plaque and bleeding indexes were scored, periapical radiographs were obtained to assess marginal bone level changes, and patient satisfaction was recorded by means of a questionnaire. Results: The follow-up ranged between 18 and 42 months (average, 27.2 months). No implants failed. All prostheses were stable and functional. No adverse events occurred. At 1 year, mean marginal bone loss around axial and tilted implants was similar: 0.8 mm for axial implants (SD 0.4, n = 30) and 0.9 mm for tilted implants (SD 0.5 mm, n = 60) (P > .05). Plaque and bleeding scores decreased over time, and patient satisfaction with both esthetics and function increased. Conclusions: This technique can be considered a viable treatment modality for the immediate rehabilitation of the edentulous maxilla, as it provides optimal support in the posterior region, minimizes distal cantilevers, and avoids bone grafting or sinus augmentation. [ABSTRACT FROM AUTHOR]

Bisphosphonates are pharmacologic compounds characterized by high tropism to bone tissue. They affect bone metabolism by inhibition of osteoclast recruitment, proliferation, differentiation, and function. Because they can reduce bone resorption, bisphosphonates are used mainly for the treatment of osteometabolic conditions, particularly osteoporosis, Paget disease, multiple myeloma, and other solid tumors with bone metastases. Their use has conferred great benefits to patients affected by these diseases, significantly improving their quality of life. Bisphosponates' inhibition of bone resorption might be exploited to maintain implant primary stability during the process of implant osseointegration. The aim of this histologic clinical study was to compare the response of bone tissue around an implant treated with a bisphosphonate solution (test) to that of the bone around an untreated implant (control). The bisphosphonate-treated implant showed more contact with newly formed bone than the control implant. [ABSTRACT FROM AUTHOR]

The purpose of this prospective study was to assess the outcome of periradicular surgery with or without guided tissue regeneration (GTR) for the treatment of through-and-through lesions. Thirty-four teeth were included according to specific selection criteria. In the test group (using GTR), after root-end filling, the defects were filled with anorganic bovine bone and covered with a resorbable collagen membrane. Healing was assessed according to specific criteria and graded as successful, doubtful, or failed. In the control group, neither grafts nor membranes were used. After 1 year, 31 teeth were evaluated. Of these, 22 (71%) healed successfully, 6 (19%) showed doubtful healing, and 2 were recorded as failures. The outcomes of the defects treated with GTR (88% successful) were significantly better than those of the control group (57% successful). The present study showed that the use of GTR associated with anorganic bovine bone in the treatment of through-and-through lesions may positively affect the healing process. [ABSTRACT FROM AUTHOR]

The most frequent intraoperative complication with sinus elevation is perforation of the schneiderian membrane. In most instances, the repair of this perforation is necessary to contain particulate grafting material and complete the procedure. New techniques are presented here for the management of large perforations of the schneiderian membrane. A bioabsorbable collagen membrane is stabilized outside the antrostomy and then folded inward to create either a new superior wall that can obliterate a large perforation or a 'pouch' that can completely contain the particulate material. This can make it possible to complete a procedure that otherwise may have had to be aborted by preventing dispersion of the particulate graft within the sinus cavity. Clinical cases are shown, along with follow-up at 6 to 9 months, demonstrating histologic and/or radiographic evidence of success, continued sinus health, and superior vital bone formation. The authors have used this technique on 20 consecutive patients without experiencing any procedural failures. [ABSTRACT FROM AUTHOR]

PURPOSE: The aims of this study were to assess the treatment outcome of immediately loaded full-arch screw-retained prostheses with distal extensions supported by both upright and tilted implants for the rehabilitation of edentulous jaws and to compare the outcomes of upright versus tilted implants. MATERIALS AND METHODS: At 4 study centers, 342 Osseotite NT implants were consecutively placed in 65 patients (96 implants were placed in 24 mandibles and 246 implants in 41 maxillae). The 2 distal implants were tilted by 25 to 35 degrees. Provisional full-arch restorations made of a titanium framework and acrylic resin teeth were delivered within 48 hours of surgery and immediately loaded. The final prosthesis was delivered after 3 months of healing. RESULTS: Three implants failed during the first year and another 2 within 18 months of loading in the maxilla. The cumulative implant survival rate for the maxilla was 97.59% for up to 40 months of follow-up. No implant failure was recorded for the mandible. The prosthetic success rate was 100%. Marginal bone loss around upright and tilted implants was similar. Patients were satisfied of their esthetics, phonetics, and function. CONCLUSION: The preliminary results of this study suggest that immediate rehabilitation of the edentulous maxilla and mandible by a hybrid prosthesis supported by 6 or 4 implants, respectively, may represent a viable treatment alternative with respect to more demanding surgical procedures. The clinical results indicate that immediately loaded tilted implants may achieve the same outcome as upright implants in both jaws. [ABSTRACT FROM AUTHOR]

The primary goal of this paper was to determine the survival rate of immediately loaded (IL) dental implants based on a systematic review of the literature. Secondary goals were to determine the influence of several factors on the implant survival rate, such as the type of reconstruction, implant location, and implant surface characteristics. An electronic search of databases was performed, in addition to a hand search of the most relevant journals. All relevant articles were independently screened according to specific inclusion criteria. The selected papers were reviewed. The literature search yielded 270 applicable articles up to December 2005. Of these, 71 met the inclusion criteria for qualitative data analysis. Eight articles were randomized controlled trials. The overall implant survival rate for the included studies was 96.39%. The database included 10,491 IL implants placed in 2,977 patients, with a maximum follow-up of 13 years. IL is well documented and predictable for the edentulous mandible (overdentures and full-arch prostheses) and for maxillary single crowns. Fewer data were found for maxillary full-arch reconstructions, fixed partial prostheses, and mandibular single crowns. For the latter two types of reconstructions, implants placed in anterior sites generally displayed a higher survival rate versus those placed in posterior sites. Rough surfaces displayed a higher survival rate than machined surfaces in all types of reconstructions. Most failures (97.1%) occurred within the first 12 months of loading. This review showed that it is possible to apply IL with excellent survival rates. Implant micromorphology and careful patient selection may affect treatment outcomes. [ABSTRACT FROM AUTHOR]

When maximum precision is required in performing surgery to satisfy particular esthetic demands, a surgical microscope that enhances complete visualization of the operative field may represent a useful tool. Twenty-four cases of gingival recession (depth 2 to 5 mm) were treated by different mucogingival surgical techniques in 24 patients: 12 procedures were performed with the aid of a surgical microscope (test group), whereas the other 12 patients were treated without the microscope (control group). Recession depth, probing depth, periodontal attachment loss, and keratinized gingival tissue width were recorded at baseline and 12 months following surgery. Three examiners separately evaluated pictures of the final cases on a scale from 1 to 3, focusing on three esthetic parameters (scarring, gingival margin, and papillae appearance). All parameters significantly improved from baseline to 12 months in both groups, except for probing depth, which did not significantly change. Although the outcomes of the test group always showed a major improvement over the controls, no significant differences could be detected between test and control groups. Mean defect coverage at 12 months was 86% and 78% for test and control groups, respectively; complete coverage was achieved in 58.3% and 33.4% of cases, respectively. Qualitative esthetic evaluation showed: (1) high concurrence among examiners; (2) significantly better scarring and marginal profile in the test group; and (3) no significant difference in papillae appearance. The application of magnification in mucogingival surgery accomplished better results in terms of success and predictability compared to conventional techniques and might help achieve excellent esthetic outcomes. [ABSTRACT FROM AUTHOR]

Based on a systematic review of the literature from 1986 to 2002, this study sought to determine the survival rate of root-form dental implants placed in the grafted maxillary sinus. Secondary goals were to determine the effects of graft material, implant surface characteristics, and simultaneous versus delayed placement on survival rate. A search of the main electronic databases was performed in addition to a hand search of the most relevant journals. All relevant articles were screened according to specific inclusion criteria. Selected papers were reviewed for data extraction. The search yielded 252 articles applicable to sinus grafts associated with implant treatment. Of these, 39 met the inclusion criteria for qualitative data analysis. Only 3 of the articles were randomized controlled trials. The overall implant survival rate for the 39 included studies was 91.49%. The database included 6,913 implants placed in 2,046 subjects with loaded follow-up time ranging from 12 to 75 months. Implant survival was 87.70% with grafts of 100% autogenous bone, 94.88% when combining autogenous bone with various bone substitutes, and 95.98% with bone grafts consisting of bone substitutes alone. The survival rate for implants having smooth and rough surfaces was 85.64% and 95.98%, respectively. Simultaneous and delayed procedures displayed similar survival rates of 92.17% and 92.93%, respectively. When implants are placed in grafted maxillary sinuses, the performance of rough implants is superior to that of smooth implants. Bone-substitute materials are as effective as autogenous bone when used alone or in combination with autogenous bone. Studies using a split-mouth design with one variable are needed to further validate the findings. [ABSTRACT FROM AUTHOR]

This article describes two different surgical techniques of root coverage using Emdogain and shows preliminary results on 26 shallow recessions in 14 patients. For the treatment of 13 recessions, Emdogain was used in combination with a coronally advanced flap (CAF+EMD group). In the other 13 recessions, Emdogain and the flap were used in combination with a subepithelial connective tissue graft (CAF+CTG+EMD group). For the CAF+EMD group, the root coverage at 6 months was 93.97%, with an attachment gain of 3.2 mm; for the CAF+CTG+EMD group, the root coverage was 93.59%, with an attachment gain of 3.4 mm (no statistically significant difference between groups). When complete root coverage was not achieved, the residual recession was 1 mm in four cases and 2 mm in one case. Keratinized gingiva was increased for both groups, but more for the CAF+CTG+EMD group (1.38 mm versus 0.69 mm; statistically significant difference). Clinical attachment level decreased significantly in both groups, from 4.46 to 1.23 mm in the CAF+EMD group, and from 4.62 to 1.23 mm in the CAF+CTG+EMD group. Preliminary results show that Emdogain, in combination with CAF or CAF+CTG for the treatment of Miller Class I or II gingival recessions, displays good clinical results, with percentage of root coverage comparable or superior to other techniques. Further experimental studies on the dynamics of wound healing are needed to prove that EMD is really responsible for improving the percentage of regenerated versus repaired tissues with respect to other techniques. [ABSTRACT FROM AUTHOR]

A growing number of clinical reports show that early and immediate loading of endosseous implants may lead to predictable osseointegration; however, these studies provide mostly short- to mid-term results based only on clinical mobility and radiographic observation. Other methods are needed to detect the possible presence of a thin fibrous interposition of tissue that could increase in the course of time and lead to clinical mobility A histologic evaluation was performed on two immediately loaded Osseotite implants retrieved after 4 months of function from one patient. He had received a total of 12 implants in the mandible, of which six were immediately loaded and six were left to heal in a submerged way Clinical and histologic osseointegration was consistently achieved for both of the retrieved immediately loaded implants. Osteogenesis and bone remodeling on the Osseotite surface were not impeded by immediate loading as shown by histomorphometric evaluation, which revealed high levels of bone-to-implant contact ranging from 78% to 85%. This immediate loading protocol involving bilateral splinting of six Osseotite implants in the mandible proved to be successful after 4 months of loading. Further long-term clinical and histologic studies are needed before introducing this immediate loading protocol as a routine procedure in implant therapy. [ABSTRACT FROM AUTHOR]

The article focuses on the development by the European Society of Endodontology (ESE) of S3-level guidelines for treating pulpal and apical diseases. It states that clinical guidelines are useful to improving dental care quality for patients through evidence-based recommendations relevant to clinicians and patients. It comments that the guidelines will assist decision making of treatment for specific diseases.

Abstract: Aim: To evaluate retrospectively the prevalence of vertical root fractures (VRFs) in a cohort of patients during apical surgery and the factors possibly associated with VRF. Methodology: The sample consisted of 944 root filled teeth belonging to 768 patients (49.3% males and 50.7% females; mean age 43.5 ± 11.2 years, range 22–68 years), consecutively referred for endodontic surgery over a six‐year period. All patients underwent a clinical assessment of their signs and symptoms. Periapical radiographs of teeth that were candidates for endodontic surgery were taken. Sixty‐eight teeth with VRF were identified. Vertical root fractures were identified in pre‐surgical screenings in 32 cases (47.1%), and these did not undergo surgery. Another 36 cases of VRF were noted during the intervention for root‐end resection. The influence of posts, post type, tooth type, periodontal probing defects, spontaneous pain, sinus tract and follow‐up duration was assessed using a logistic regression analysis. Results: Vertical root fractures occurred significantly more frequently (P < 0.001) when a post was present (61 VRF out of 377 teeth with post, prevalence 16.2%) than in teeth without a post (1.2%). Threaded posts and cast posts were significantly more involved in VRF than fibre, silica or carbide posts (P < 0.001). Most fractures (80.9%) occurred 1–5 years after root canal treatment. Sinus tracts, probing defects and spontaneous pain were significantly more associated with VRF cases than with nonfractured teeth. Conclusions: In the present group of teeth, the major risk for VRF was represented by posts retained by actively engaging the canal via mechanical design (thread) or by frictional fit (cast). [ABSTRACT FROM AUTHOR]

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Abstract: Aim: To evaluate the intratubular antimicrobial activity of several oxidant and chelating agents associated with or without surfactants in experimentally infected root canals, using confocal laser scanning microscopy. Methodology: Twenty‐four dentine blocks from bovine incisors were contaminated for 5 days with Enterococcus faecalis (ATCC‐ 29212). Ten contaminated dentine specimens were irrigated for 5 min with 5.25% NaOCl followed by 17% EDTA for 2 min, and the other 10 with Hypoclean for 5 min followed by Tetraclean NA for 2 min. The remaining four specimens were used as positive and negative controls (two samples each). Then, dentine blocks were stained with Live/Dead BacLight for analysis of the remaining live or dead bacteria using confocal laser scanning microscopy. Comparison between and within groups was performed using the Mann–Whitney test for independent samples and the Wilcoxon signed‐rank test, respectively. Results: After exposure to irrigants, the positive control group had a median of 67.41% of viable bacteria (95% CI: 48.15, 78.9), whilst the NaOCl+EDTA group and Hypoclean+Tetraclean NA group had 3.77% (1.28, 15.92) and 0.87% (−0.42, 4.30) of viable bacteria, respectively. These results were significantly different from each other, both overall and distinct by region (cervical and medium third), or depth (superficial and deep layer) (P < 0.01 in all cases). Conclusions: The use of adjunctive agents reducing the surface tension associated with oxidant and chelating agents improved the antimicrobial activity of irrigating solutions and intratubular decontamination against Enterococcus faecalis, possibly due to better removal of the smear layer and deeper penetration into dentinal tubules. [ABSTRACT FROM AUTHOR]

Aim To compare the impact of rotary and reciprocating instrumentation on postoperative quality of life ( POQoL) after single-visit primary root canal treatment. Methodology A randomized controlled clinical trial was designed and carried out in a University endodontic practice in northern Italy. Healthy subjects with asymptomatic irreversible pulpitis, symptomatic irreversible pulpitis or pulp necrosis with or without apical periodontitis (symptomatic or asymptomatic) scheduled for primary root canal treatment were enrolled. Single-visit root canal treatment was performed with ProTaper™ S1-S2-F1-F2 (rotary group, n = 23) and WaveOne™ Primary (reciprocating group, n = 24). Irrigation was performed with 5% Na OCl and 10% EDTA. Root canal filling was performed with the continuous-wave technique and ZOE sealer. POQoL indicators were evaluated for 7 days post-treatment. The variation of each indicator over time was compared using anova for repeated measures ( P < 0.05). The impact of each variable on POQoL was analysed with a multivariate logistic regression model ( P < 0.05). Results Pain curves demonstrated a more favourable time-trend in the rotary group (mean, P = 0.077; maximum, P = 0.015). Difficulty in eating ( P = 0.017), in performing daily activities ( P = 0.023), in sleeping ( P = 0.021) and in social relations ( P = 0.077), was more evident in the reciprocating group. Patients' perception of the impact of treatment on POQoL was more favourable in the rotary group ( P = 0.006). Multirooted tooth type and pre-existing periradicular inflammation were associated with a decrease in POQoL. Conclusion Reciprocating instrumentation affected POQoL to a greater extent than rotary instrumentation. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to make a comparative evaluation of professional oral hygiene with or without the adjunct of glycine air-powder system for the treatment of peri-implant mucositis. Methods After the application of inclusion and exclusion criteria, patients were divided in two groups: in control group, patients were treated with professional oral hygiene manoeuvres ( POH) while in the test group, glycine air-powder system ( SGA) was adjuncted to professional oral hygiene. Probing depth ( PD), bleeding index ( BI) and plaque index ( PI) were measured at baseline, and 3 and 6 months after the treatment. Results A total of 30 patients (15 per group) were selected for the study. In POH e SGA group, PD was, 2.86 ± 0.37 and 3.00 ± 0.36 mm at baseline, 2.90 ± 0.53 and 2.62 ± 0.50 mm after 3 months, 2.96 ± 0.56 and 2.41 ± 0.54 mm after 6 months, respectively, significantly lower in SGA group in the last follow-up visit. In both groups, both PI and BI decreased over time. Conclusions The present reports showed that both techniques were useful for the treatment of peri-implant mucositis. In the test group (with glycine powder), a significant reduction of probing depth was observed. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this retrospective investigation was to evaluate the postoperative quality of life after endodontic surgery in maxillary molars when a sinus membrane perforation occurred and platelet concentrates were used. Materials and methods: Included patients were treated by microsurgical endodontic treatment in molar and premolar maxillary regions between 2007 and 2010. Patients who fulfilled the inclusion criteria were screened. Data from the quality of life questionnaire were analyzed. The use of plasma rich in growth factors (PRGF) (test group) was compared with a control group when a Schneiderian membrane perforation occurred during endodontic surgery performed with a modern technique in maxillary molars and premolars. Results: A total of 20 patients (12 in the control group and eight in the test group) fulfilled the inclusion criteria. No differences were evaluated at baseline for clinical parameters. Significantly improved patients' quality of life was observed in the test group considering symptoms as swelling, bad breath or taste, and pain. Functional activities were less impaired in the test group and swelling was significantly higher in the control group. In the test group, pain was significantly lower than the control group during the first 6 days after surgery and also, the consumption of painkillers was lower for patients belonging to the test group even if it was not statistically significant. Discussion: In general, a small sinus membrane perforation (less than 6 mm) during endodontic surgery did not cause severe complications. The use of platelet concentrates could be effective in reducing the impact on patients' quality of life, decreasing pain and surgery side effects as well as swelling. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to evaluate the effect of mouthrinses containing 0.05% chlorhexidine + 0.05% fluoride solution on early dental plaque regrowth. Materials and methods Thirty periodontally healthy subjects were included in the study. A crossover 4-day plaque regrowth protocol was adopted. The test product was initially used in 15 patients, while a placebo was administered to the other 15 patients. Then, after a washout period, each patient used the other product. No other oral hygiene manoeuvre was allowed. Full-mouth plaque and bleeding scores ( FMPS and FMBS) were evaluated at baseline and after 4 days. Results All subjects completed the study. The mean age was 27 ± 8.4 years. Five patients were smokers with a mean daily consumption of 1 ± 2.5 cigarettes. FMPS at baseline was 8.0 ± 4.4 for control group and 7.9 ± 3.8 for test group, without significant difference. After the 4-day plaque regrowth the mean FMPS significantly increased to 31.9 ± 16.5 and 36.3 ± 16.1 for control and test group, respectively (no significant difference between the two groups). Conclusions The test product was safe and well tolerated by subjects. The similar outcomes of the two experimental groups suggest that the two products have an equivalent effect on early dental plaque regrowth. Studies with longer follow-up are needed to clarify whether there is a beneficial long-term effect of daily rinses with the tested solution. [ABSTRACT FROM AUTHOR]

The maxillary sinus grafting procedure has proven to be an acceptable modality for bone augmentation to provide a base for endosseous implants, routinely used for the rehabilitation of posterior maxilla. Perforation of the membrane is the most common complication in this type of procedure. This paper presents a technique for repairing a perforated Schneiderian membrane with a conjunctive connective tissue graft harvested from the palate and shows the histological and radiographic evaluation of the results. Ten consecutives cases with the occurrence of membrane perforation were included in this study. All were repaired with a flap of tissue removed from the palatine portion near to the surgical site. The technique is demonstrated through a clinical case. The results showed successful integration of 88.8% of the implants after 12 months from prosthesis installation. Histological evaluation of the samples showed that the use of nanocrystalized hydroxyapatite showed an adequate stimulation of boné neoformation within 6 months. Radiographic evaluation revealed a small apical implant bone loss, not compromising their anchorages and preservation. Thus, it can be concluded that the use of conjunctive technique with collected palate flap for sealing the perforation of the membrane of the sinus may have predictable result. [ABSTRACT FROM AUTHOR]

Objective: The aim of this prospective study was to assess the outcomes of an implant maintenance protocol for implants supporting a full-arch rehabilitation. Materials and methods: Sixtyone patients (28 women and 33 men) treated with immediately loaded full-arch rehabilitation, both mandibular and maxillary, supported by a combination of two tilted and two axial implants, were included in the study. Patients were scheduled for follow-up visits every 6 months for +2 years, then yearly up to 4 years. Each patient received professional oral hygiene treatment and detailed oral hygiene instructions. During each visit, modified plaque index, bleeding index and probing depth were assessed. The presence of peri-implant tissue inflammation was also evaluated. Results: Mean observation time, considering both mandible and maxilla, was 18.3 months ranging from 6 months to 5 years. Both plaque and bleeding indexes frequency decreased over time. Probing depth was stable (2.46 ± 0.5 mm at 4 years). Only three implants were lost due to periimplantitis (1.4% at 12 months), whereas the incidence of peri-implant mucositis was less than 10% in each considered period. Conclusions: The adoption of a systematic hygienic protocol is effective in keeping low the incidence of peri-implant mucositis as well as in controlling plaque accumulation and clinical attachment loss. [ABSTRACT FROM AUTHOR]

The paper reports the comparison of the results of laboratory tests conducted on reconstituted samples of high-plasticity lagoon sediment before and after ultrasonic treatment. The purpose of the work was to evaluate the effects of ultrasonic treatment on the compressibility and velocity of sedimentation and consolidation. The improvement of these geotechnical characteristics may lead to the storage of a greater volume of dredged material in the confined disposal facilities. Tests in a sedimentation column were performed in salt water to investigate the influence of ultrasonic treatment on the occurrence of two different sedimentation processes: zone settling and compression settling. The zone settling velocity of sediment subject to ultrasonic treatment was six times slower than that of natural soils and a significant variation of grain size of the particles was noted. The mechanical effect of sonication produced a reduction in coarse particles, with enrichment of the silty fraction. Different methods of consolidation testing were conducted on reconstituted samples of sediment treated with ultrasound: oedometer with standard loading sequence, with small stress increments and with constant rate of strain. Comparison of the results confirms an appreciable increase in the compression index and a reduction in the permeability of sonicated samples. [ABSTRACT FROM AUTHOR]

Weinstein T, Rosano G, Del Fabbro M, Taschieri S. Endodontic treatment of a geminated maxillary second molar using an endoscope as magnification device. International Endodontic Journal, 43, 443–450, 2010. Aim To describe endodontic treatment for a rare case of gemination. Summary A case of complex endodontic treatment in a geminated tooth is presented. With the assistance of microinstruments and magnification devices, a geminated maxillary second molar was successfully treated. In such a case, ultrasonic tips and the use of an endoscope were essential to detect the peculiar anatomy of the tooth involved. Key learning points • Knowledge of anomalies concerning fused teeth is essential. • Using an endoscope as a magnification device is useful during the inspection of pulp chambers. • Ultrasonic tips are safe and useful to detect canal orifices. [ABSTRACT FROM AUTHOR]

Aim To monitor the quality of life of patients after periradicular surgery when two different flap designs were used. Methodology Forty patients with teeth having a periradicular lesion of endodontic origin were included according to specific selection criteria. Patients were randomly assigned to two groups. In one group a sulcular incision (SI) with complete papilla mobilization was made, and in the other group a papilla-base incision (PBI) was used. Periradicular surgery was performed using a surgical microscope. Parameters related to life quality were recorded daily in the first week post-surgery using a questionnaire. Pain was evaluated with a 0–100 visual analog scale (VAS). Other symptoms (swelling, bleeding and nausea), plus functions (chewing, speaking, sleeping, daily routine and work) were assessed using a five-point scale. Analgesic intake was recorded. Fisher’s test and unpaired t-test were used to assess the difference between groups. Results The VAS score for pain, and the scores for swelling, chewing and phonetic impairment, peaked on days 1 and 2 postoperatively. A significant difference in favour of the PBI group was found for chewing and swelling in the first 4 days. Starting from day 3 post-surgery, the PBI group reported a significantly more rapid decrease in pain levels and analgesics use than the SI group ( P < 0.05). The other parameters were similar in the two groups. Conclusions The papilla-base incision technique may be preferred as reduction of pain levels, swelling and drug intake were more rapid in the first week postoperatively compared with cases in which a sulcular incision was used. [ABSTRACT FROM AUTHOR]

The role of reticulocytes (Ret) in sports medicine became important when the count of immature erythrocytes has been introduced in protocols used and officially approved for antidoping purposes. The use of modern automated analysers, which allow the easy count and the description of characteristics of reticulocytes, increased the possible use of these parameters in sports medicine. We studied the behaviour of Ret and immature reticulocyte fraction (IRF) in top-level athletes practising rugby, ski, soccer and cyclism, throughout a competitive season. We aimed at increasing the knowledge of physiological characteristics of these sportsmen and supplying valuable suggestions to trainers and sports physicians. We observed a stability of Ret counts, also during training and competitions, although some modifications, namely decrease during competitions periods in cyclists, and in rugby and soccer players, occurred. No significant correlation was found between Ret count and Hb in each sport discipline. IRF values tend to be high in athletes owing to continuous bone marrow stimulation linked to haemolysis, typical of sports activities. We confirm the validity of the use of Ret counts for antidoping purposes and also for evaluating health status and iron metabolism of sportsmen. [ABSTRACT FROM AUTHOR]

Objectives: To document the relation between serum creatinine concentration and body mass index in elite athletes from five different sports, and to study potential differences among athletes performing different sports with different features and requirements. Methods: Before the start of the competitive season, serum creatinine was measured in 151 elite athletes from five different sports: rugby (n = 44), soccer (n = 27), alpine skiing (n = 34), sailing (n = 22), cycling (n = 24). Pearson's correlation analysis was used to evaluate the relation between serum creatinine and body mass index (BMI). Analysis of variance and unpaired Student's t test were used to compare creatinine concentration and BMI in different sport disciplines. Results: In the whole group of athletes, a positive correlation between serum creatinine and BMI was found (r = 0.48, p<0.001). Significant differences in creatinine concentration and BMI were found between athletes competing in different sports: their mean (SD) values were respectively 1.31 (0.12) mg/dl and 28.83 (2.41) for rugby players, 1.27 mg/dl (0.10) and 23.10(1.01) for soccer players, 1.15 (0.11) mg/dl and 25.8 (1.50) for skiers, 1.08 (0.11) mg/dl and 26.93 (2.36) for sailors, and 0.91 (0.07)mg/dl and 21.33 (1.21) forcyclists. Conclusions: There is a correlation between creatinine concentration and BMI in elite athletes competing in different sports characterised by different kinds of training, competitive season, and involvement of aerobic and anaerobic metabolism. Interpretation of creatinine concentrations in male athletes should consider professional status as well as the specific sport performed. All athletes should be monitored with consecutive creatinine assessments, using as the baseline the concentration determined before the start of training and the competitive season, but taking into consideration the specific sport performed and the BMI until equations that include creatinine and factors that affect its concentration are used. [ABSTRACT FROM AUTHOR]

BACKGROUND/PURPOSE: This randomized clinical trial was aimed at comparing two different means of delivering chlorhexidine digluconate (CHX) for plaque control during the 2 weeks following implant surgery. MATERIALS AND METHODS: Twenty patients selected for implant therapy were randomly divided into two groups: 10 subjects used 15 ml of 0.12% CHX mouthrinse (control group) and 10 used 0.2% CHX spray (test group). Professional oral hygiene was carried out immediately before surgery. During the 14 days following surgery mechanical oral hygiene was performed only at the teeth not surgically involved. Plaque index (PI), stain index (SI), modified gingival index and taste alteration were assessed on the 7th and 14th day after surgery. The clinical parameters were evaluated at four tooth surfaces by a single examiner. Teeth proximal to surgical site and teeth not involved were statistically compared. RESULTS: In both groups, the PI increased similarly, with respect to the baseline, at days 7 and 14. There was no significant difference between the two groups at either time point. On the contrary, in the control group, the SI increased significantly when compared with baseline over the 14 days both at teeth nearest to surgical sites and at not-involved sites. In the test group pigmentation was consistent only at teeth proximal to the surgical site. When considering not-involved sites, tooth staining was significantly lower in the test with respect to the control group. CONCLUSIONS: The present study indicates that the efficacy of CHX spray in the post-surgical control of dental plaque is similar to that of CHX mouthwash. Tooth staining, however, is significantly lower in the spray group at sites not surgically involved. These effects might be related to the route of CHX delivery, as well as the total dose administered that was significantly lower in the spray group with respect to the rinse group. [ABSTRACT FROM AUTHOR]

Taschieri S, Del Fabbro M, Francetti L, Testori T. Effect of root-end resection and root-end filling on apical leakage in the presence of core-carrier root canal obturation. International Endodontic Journal, 37, 477–482, 2004. To evaluate the apical seal of canals filled with a core-carrier obturator following root-end resection with and without a root-end filling. Thirty single-rooted human teeth with single canals were used. Root canal treatment was performed and canals filled with a core-carrier obturation technique. The teeth were then randomly assigned to three groups ( n = 10). In the first group root canal filling only was performed. After orthograde filling, the teeth of the second group were resected apically, perpendicular to the major axis of the root. In the third group after apical resection, a root-end cavity was prepared using ultrasonic diamond retrotips and the cavities filled with Super-EBA cement. During a period of 3 h and with a headspace pressure of 0.12 atm, methylene-blue solution was forced through a tube that was connected to the apical end of each tooth specimen. The coronal end of the tooth was connected to a capillary tube containing an air bubble. Leakage was evaluated by observing the distal displacement of the air bubble. The roots were then sectioned along their long axis. Using a stereomicroscope, linear dye infiltration at the dentine–cement interface was determined. Kruskal–Wallis and Mann–Whitney tests were used to compare the three groups. Linear dye infiltration was significantly greater in root canals filled with the core-carrier obturators and resected apically (0.9 ± 0.9 mm) when compared with those that had root-end fillings (0.2 ± 0.4 mm). Air bubble displacement was not observed. Root-end filling improves the sealing of roots with core-carrier obturation following root-end resection. [ABSTRACT FROM AUTHOR]

BACKGROUND: A growing flow of recent evidence indicates enamel matrix derivative (EMD, Emdogain) as a useful tool for the regeneration of periodontal tissues. This prospective clinical study aimed to evaluate the efficacy of EMD combined with surgical treatment of periodontal intra-bony defects, as compared with surgery alone, up to 24 months of follow-up. METHODS: Twenty-four intra-bony defects were treated in 24 patients in a single clinical centre. Each defect had intra-bony depth (IBD) > or = 4 mm and probing pocket depth (PPD) > or = 6 mm. Patients were randomly assigned to either test or control group. Plaque index (PI), gingival index (GI), PPD and periodontal attachment level (PAL) were assessed at baseline pre-surgical examination at the site to be treated. Full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) were also evaluated. Twelve patients were treated by simplified papilla preservation flap technique (control group), while 12 patients were treated with the same surgical technique plus EMD after ethylenediamine tetraacetic acid root conditioning (test group). Any probing at the involved sites was avoided in the first year post-surgery. Radiographs were taken at baseline, 12 and 24 months after surgery using customized bite blocks. Intra-bony defect depth (IBD) and angle (IBA) were measured from X-rays by a computer-aided technique. At 12 and 24 months post-surgery, FMPS, FMBS, PI, GI, PPD, PAL and radiographic IBD and IBA were assessed. The difference between each follow-up and baseline, and between groups at each follow-up was evaluated for the above parameters by standard statistical methods. RESULTS: In both groups, clinical and radiographic parameters were improved at either 12 or 24 months when compared with baseline. The test group displayed better outcomes when compared with the control group for IBD, PPD, and PAL gain at 12 months, and only for PAL and IBD gain at 24 months. No adverse event related to the use of EMD was reported. CONCLUSIONS: The surgical procedure used in the present study, aiming for maximum preservation of the regenerative potential of periodontal tissues, showed per se excellent results. The use of EMD as an adjunct to periodontal surgery in the treatment of angular defects possibly enhances periodontal regeneration rate. [ABSTRACT FROM AUTHOR]

The aim of this study was to test the difference in efficacy between chlorhexidine mouthrinse and spray. Twenty patients (35 to 68 years of age) in need of implants to restore partially dentate maxilla or mandible were enrolled in the study. Exclusion criteria included: (1) severe systemic disease; (2) chronic diseases requiring antibiotic therapy; (3) smokers consuming more that 10 cigarettes a day; (4) parafunctional habits; (5) need for bone augmentation at proposed implant site; (6) known allergy to chlorhexidine. Patients were randomly assigned to either the spray or mouthwash groups using a computer generated 1:1 randomization list. A baseline prophylaxis was performed on all patients prior to implant placement. One to 5 implants were placed in each patient to total 45 implants (21 implants in the mouthwash group and 24 in the spray group). For 2 weeks following implant placement, patients in the mouthwash group were instructed to rinse with 15 mL of 0.12% chlorehexidine mouthwash twice daily for at least 1 minute. The patients in the spray group were instructed to administer 4 consecutive sprays of 0.2% chlorhexidine to the surgical site twice daily. Antibiotics were given for 2 days as part of postsurgical therapy. The following were evaluated at 7 days and 14 days postsurgery: (1) plaque index of Silness and Loe; (2) stain index; (3) modified gingival index; (4) taste alteration. The difference between groups was analyzed using the nonparametric Mann-Whitney test, and the Wilcoxon test was used to evaluate the differences between the 7- and 14-day observations. Results show that the plaque index increased for both groups, although no significant difference was noted. The mouthrinse group showed a significant increase in the stain index among all teeth as opposed to the spray group. This study shows that the efficacy of the spray chlorhexidine is comparable to the mouthrinse with the added advantage of minimizing generalized tooth staining. [ABSTRACT FROM AUTHOR]

Background: After the introduction of microsurgical principles in endodontics, involving new techniques for root canal treatment, there has been a continuous search for enhancing the visualization of the surgical field. It would be interesting to know if the technical advantages for the operator brought in by magnification devices like surgical microscope, endoscope and magnifying loupes, are also associated with advantages for the patient, in terms of improvement of clinical and radiographic outcomes. Objectives: The purpose of this systematic review was to evaluate and compare the effects of endodontic treatment performed with the aid of magnification devices versus endodontic treatment without magnification devices. We also aimed at comparing among them the different magnification devices used in endodontics (microscope, endoscope, magnifying loupes). Search strategy: The Cochrane Oral Health Group Trials Register, CENTRAL, MEDLINE and EMBASE were searched with appropriate search strategies. Handsearching included nine dental journals. The bibliographies of relevant clinical trials and relevant articles were checked for identifying studies outside the handsearched journals. Seven manufacturers of instruments in the field of endodontics and/or endodontic surgery, as well as the authors of the identified randomized controlled trials (RCTs) were contacted in order to identify unpublished or ongoing RCTs. There were no language restrictions. The last electronic search was conducted on 2nd April 2009, and the last handsearching was undertaken on 31st January 2009. Selection criteria: All randomized and quasi-randomized trials comparing endodontic therapy performed with or without using one or more types of magnification device, as well as randomized and quasi-randomized trials comparing two or more magnification devices used as an adjunct to endodontic therapy were considered. Data collection and analysis: Screening of studies and data extraction were conducted independently and in duplicate. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis. Main results: No trial could be included in the present review. All of the prospective trials that were identified, all dealing with endodontic surgery, had to be excluded for various reasons. Only one RCT was identified comparing three magnificators (magnifying loupes, surgical microscope, endoscope) in endodontic surgery. No RCT was found that compared the outcome of endodontic therapy using or without using a given magnification device. Authors’ conclusions: No objective conclusion can be drawn from the results of this review as no article was identified in the current literature that satisfied the criteria for inclusion. It is unknown if and how the type of magnification device affects the treatment outcome, considering the high number of factors that may have a significant impact on the success of endodontic surgical procedure. This should be investigated by further long-term RCTs with large sample size. Technical advantages of magnificators have been widely reported in low evidence level studies, but they should be systematically addressed to know if there can be the clinical indication for using a given magnification device for specific clinical situations, such as for molar teeth, or if they can all be used interchangeably. Well-designed RCTs should also be performed to determine the true difference in terms of treatment success rates between using or not using a magnification device in both conventional and surgical endodontic treatment, if any exist. Plain language summary: Magnification devices for endodontic therapy. There are no data to draw a sound conclusion on the effect of adopting either a microscope, an endoscope, or magnifying loupes for better visualization in endodontic therapy, in terms of clinical outcomes. [ABSTRACT FROM AUTHOR]