Search

Aim: This study examines the prevalence and severity of orofacial disorders in patients with fibromyalgia syndrome (FMS). The research assesses the correlation with the Fibromyalgia Assessment Status (FAS) index. The goal is to improve the clinical approaches to these patients. Methods: A cross-sectional study was conducted using a structured questionnaire focused on the correlation between FMS and orofacial problems. The research involved 107 rheumatology patients diagnosed with FMS. Statistical analyses, including Spearman’s correlation, were utilized to investigate the relationships between the FAS index scores and various orofacial symptoms. Results: Of the participants, 11.2% responded that they were aware of the correlation between fibromyalgia and oral health. The statistical analysis showed statistically significant correlations between the FAS index and symptoms such as gum bleeding, teeth grinding during the day, and neck pain (p < 0.05). The correlation between the FAS index and joint noise upon opening the mouth, as well as dissatisfaction with one’s smile, also proved to be highly significant (p < 0.001). Conclusion: The outcomes demonstrate that, as the FAS index increases, the likelihood of developing orofacial disorders also increases among FMS patients. This highlights the importance of a multidisciplinary treatment approach.

Background: The aim of this systematic review was to evaluate the therapeutic potential of probiotics in patients with halitosis and to assess whether probiotics can also be implemented as a preventative tool in oral health. Secondary objectives included the effect of probiotics on oral-health-related quality of life, as well as their safety. Materials and methods: An electronic literature search in Medline (PubMed), Scopus, Web of Science, and the Cochrane library was carried out for the identification and selection of relevant randomized controlled trials. Eligibility was based on inclusion criteria, which included RCTs published after 2013, and the outcome variables were volatile sulfur compound (VSC) levels, organoleptic scores, plaque, or saliva samples to assess cariogenic bacteria counts and/or pH levels. Results: Out of 192 identified records, 16 randomized controlled trials were included. Ten of those studied the effects of probiotics on halitosis and the other six analyzed the effect of probiotics on oral health parameters, such as cariogenic bacteria counts, pH levels, and salivary flow and quality. A total of 921 patients were evaluated. The risk of bias was assessed using the Cochrane risk-of-bias assessment tool version 2. Conclusions: Probiotics exhibit the potential for oral health management by reducing VSC levels, improving saliva quality, and enhancing oral-health-related quality of life. Combining probiotics with tongue scraping may sustain VSC reduction, while symbiotics show potential in reducing tongue coating. However, different bacterial strains have been used in the included studies; hence, the conclusions cannot be generalized, being one of the main limitations of this review. Future research should explore the probiotics’ potential to persist in the oral cavity post-treatment and employ standardized methodologies for conclusive efficacy assessment.

Background: All endodontic treatment techniques are associated with the extrusion of debris into periradicular tissues through the apex. The extrusion of apical debris can lead to delayed healing or even therapy failure. It is possible to reduce the extrusion into periapical tissues through various approaches. The objective of this systematic review is to evaluate whether, in cases of non-surgical endodontic retreatment, reciprocating instruments cause greater extrusion of debris compared to instruments with continuous rotation. Methods: A search was conducted on PubMed, Ovid MEDLINE, and the Web of Science. The inclusion criterion was in vitro studies comparing apical extrusion in endodontically treated elements using continuously rotating and reciprocating files. Results: The search on scientific databases yielded 164 results, out of which only 16 were eligible for evaluation after screening. Conclusions: The authors of the research included in this review do not agree on the results obtained. Based on the articles analyzed in this systematic review, it remains unclear whether continuous rotation or reciprocating movement of the endodontic instrument can lead to significant differences in apical debris extrusion; it is not possible to provide a clear clinical recommendation regarding the choice of instrument movement for endodontic procedures.

Background: The phenomenon of vapor lock, characterized by the formation of gas bubbles, poses challenges in achieving effective cleaning and debridement during endodontic treatments. This study aimed to evaluate the presence of vapor lock and to quantify its volume in the root canal system. Methods: Ten single-rooted teeth were selected, and their root canals were shaped using the Protaper Next system and irrigated with 5% NaOCl and 17% EDTA. Then, the canals were irrigated with a solution made of contrast medium (8 M cesium chloride solution) mixed in equal proportions with 5% sodium hypochlorite. CBCT scans were performed to analyze the presence and volume of bubbles in different canal thirds. Statistical analysis was conducted to compare the number of bubbles and the percentage of space occupied by them. Results: The results demonstrated the presence of vapor lock in all treated teeth, with a higher concentration of gas bubbles in the apical canal third. The formation of gas bubbles hindered the cleaning and debridement procedures, particularly in the apical region. Conclusions: This study provides evidence of the occurrence of vapor lock and highlights the importance of enhancing the cleaning phase in endodontic treatments to minimize bubble formation or eliminate them once formed. These findings contribute to a better understanding of the challenges posed by vapor lock and suggest avenues for optimizing endodontic procedures.

The technological advancements in orthodontics and oral rehabilitation are continuous and consistent [...]

Endodontic shaping can lead to canal and apical anatomical alterations, which may compromise the outcome of root canal treatment. The objective of this systematic literature review is to assess whether the use of martensitic endodontic instruments can result in less apical transportation compared to austenitic instruments during endodontic therapy. A search was conducted on PubMed, Ovid MEDLINE, and the Web of Science. The inclusion criteria were in vitro studies comparing apical transportation using endodontic instruments with austenitic or martensitic alloys. The search of the scientific databases yielded 592 results, of which only 10 were eligible for evaluation after screening. Based on the analysis of the selected articles, it can be concluded that martensitic endodontic instruments result in less apical transportation compared to austenitic instruments during the shaping phase of endodontic treatment. This behavior can be attributed to the increased flexibility of martensitic instruments. Further research is warranted to further explore this topic and provide additional evidence supporting the use of martensitic instruments in clinical practice.

(1) Background. Drug-induced sleep endoscopy (DISE) is currently regarded as the gold standard diagnostic procedure to assess the site(s) of upper airway collapse in subjects affected by Obstructive Sleep Apnea Syndrome (OSAS). During DISE, a jaw thrust maneuver is performed to advance the mandible and to predict the effectiveness of outcomes of treatment with mandibular advancement devices (MADs). However, the maneuver is not predictable and could be influenced by specific patients’ anatomical/functional conditions. The aim of this work is to propose a full-digital workflow for customizing an individual mandibular advancement fork, usable by otorhinolaryngologists during DISE. (2) Materials. Two patients with a diagnosis of mild-to-moderate OSAS (AHI ≥ 5 to ≤30/h of sleep) underwent orthodontic examination to verify the usability of the MAD. Intra-oral scans and registration were performed, including bite registration with 65% of mandibular advancement. The latter measurement was used as a reference to design a 3D-printed fork for DISE, as well as for the future MAD. Both patients underwent DISE in the operating room in the presence of an anesthesiologist, otolaryngologist, orthodontic specialist and neurophysiopathology technician. (3) Results. In the intraoperative polysomnography recording, during sleep, the presence of obstructive apnea was confirmed based on respiratory parameters (PNG1, PNG2, PNG3) with associated desaturation and increased muscle activities on PNG4 (mylohyoid muscle), EMG1 (right masseter muscle) and EMG2 (left masseter muscle). With the advancement fork in place, the immediate improvement effect on all respiratory parameters with normal saturation values and the complete suppression of masseter muscles were observed. Accordingly, both patients were considered potential good-responders to the MAD treatment. (4) Conclusions. The preliminary data shown are encouraging and would suggest that the fork represents a stable reference for the otorhinolaryngologist to evaluate the airway patency within the physiological range of movement. The efficiency of the work-flow from data registration to the DISE procedure and laboratory process represent two significant advantages that justify the integration of a digital system in the management of patients affected by OSAS.

Background: Reverse engineering (RE) or back engineering is a process that analyzes a physical object to obtain the primary data of the same project. RE technologies have different applications in industrial settings and productive chains; however, with the advent of digital technologies in dentistry and orthodontic fields, they are involved in the new diagnostic and clinical digital workflow. For example, 3D model scanning, 3D facial scanning, models superimposition, digital orthodontic setup, anatomical volumetric assessment, soft tissue analysis, orthodontic digital guided systems, and prototyped orthodontic appliances represent a few examples of the application of RE in orthodontics. Moreover, clinicians can manipulate the data derived from original digital file to enhance diagnosis and communication with other clinicians and dental technicians; however, RE and digital technologies systems are not exempt from shortcomings, including costs and knowledge curve. In this regard, the aim of the present manuscript was to describe the use of reverse engineering technologies in modern digital orthodontics and provide helpful information for those specialists who are at the beginning of the transition from analogic to digital orthodontic workflow.

The present umbrella review aimed to assess the prevalence of cases diagnosed with lesions potentially due to Titanium (alloy) and other metal nanoparticles released from dental implants and implant-supported restorations, characterizing lesions’ macroscopic, imaging, and microscopic features. Secondary aims were to categorize the reported lesions as resembling or ascribable to peri-implant mucositis and peri-implantitis, reactive lesions of the peri-implant mucosa, or hypersensitivity reactions, and to evaluate their relationship with cases’, dental implants, and implant-supported restorations’ characteristics, and with the evidence of Titanium allergy. The study protocol, developed in advance and compliant with the PRISMA statement, was registered on PROSPERO (CRD42022354676). Systematic reviews were searched through the Web of Science, Scopus, MEDLINE/PubMed, Cochrane library databases, and the PROSPERO register until 19 August 2022; reference lists were also screened. Data from four systematic reviews of critically low/low quality (AMSTAR 2), one including a meta-analysis, were analyzed qualitatively. An overall prevalence of 16.9% of cases was estimated. Reported lesions resembled or were ascribable to peri-implant mucositis and peri-implantitis (55.17%), reactive lesions (17.22%), and hypersensitivity reactions (24.12%); no oral contact lichenoid lesions were described. Titanium allergy was hardly and heterogeneously investigated. Due to the severely incomplete data, no definitive conclusions could be drawn on the potential role of cases’ and implant characteristics and Titanium allergy on lesions onset, development, and treatment responsiveness.

This paper discusses the size and shape optimization of a guyed radio mast for radiocommunications. The considered structure represents a widely industrial solution due to the recent spread of 5G and 6G mobile networks. The guyed radio mast was modeled with the finite element software SAP2000 and optimized through a genetic optimization algorithm (GA). The optimization exploits the open application programming interfaces (OAPI) SAP2000-Matlab. Static and dynamic analyses were carried out to provide realistic design scenarios of the mast structure. The authors considered the action of wind, ice, and seismic loads as variable loads. A parametric study on the most critical design variables includes several optimization scenarios to minimize the structure’s total self-weight by varying the most relevant parameters selected by a preliminary sensitivity analysis. In conclusion, final design considerations are discussed by highlighting the best optimization scenario in terms of the objective function and the number of parameters involved in the analysis.

Salivary gland disorders are uncommon in children; they show a lower prevalence when compared to adults. The literature has a relative lack of information about the management and the different treatment protocols regarding these diseases. The aim of this research is to investigate the prevalence of both benign and malignant salivary gland disorders, focusing on diagnostic and therapy. An audit of patients diagnosed with salivary gland disorders was conducted from 2000 to 2020. 99 patients’ records were selected and analyzed: 51 males’ and 48 females’, age 10 ± 4 SD. Obstructive pathologies were the most frequently diagnosed (49 patients) followed by oncologic (21 patients), inflammatory (20 patients), rheumatologic (4 patients), malformative (3 patients) and infective disorders (2 patients). The parotid was the most affected major gland in 47 cases with a prevalence of diagnosis of juvenile recurrent parotitis (JRP) (40.4%), followed by the sublingual gland in 14 cases of ranula (100%) and the submandibular gland in 11 patients suffering from sialolithiasis (84.6%). Swelling was the most common symptom (75.7% of patients). Seven different neoplasms were documented. A greater prevalence of low-grade mucoepidermoid carcinoma among the malignant group (38.1% of oncologic cases) was noted. In regards to benign tumors, pleomorphic adenoma was the most common diagnosis (47.6% of cases). The symptoms and outcomes showed statistical significance concerning gender. Although salivary gland diseases in children and adolescents are rare, it is essential to observe and monitor all of the symptoms to intervene if necessary, as painless swelling is a symptom common from both benign and malignant diseases.

Background: SFRS1 is a member of the splicing factor protein family. Through a specific sequence of alteration, SRSF1 can move from the cytoplasm to the nucleus where it can work autonomously as a splicing activator, or as a silencer when interacting with other regulators. Alternative splicing (AS) is a fundamental biological process that ensures protein diversity. In fact, different proteins, produced by alternative splicing, can gain different and even antagonistic biological functions. Methods: Our review is based on English articles published in the MEDLINE/PubMed medical library between 2000 and 2021. We retrieved articles that were specifically related to SRSF1 and cancers, and we excluded other reviews and meta-analyses. We included in vitro studies, animal studies and clinical studies, evaluated using the Medical Education Research Study Quality Instrument (MERSQI) and the Newcastle–Ottawa Scale-Education (NOSE). Result: SRSF1 is related to various genes and plays a role in cell cycle, ubiquitin-mediated proteolysis, nucleotide excision repair, p53 pathway, apoptosis, DNA replication and RNA degradation. In most cases, SRSF1 carries out its cancer-related function via abnormal alternative splicing (AS). However, according to the most recent literature, SRSF1 may also be involved in mRNA translation and cancer chemoresistance or radio-sensitivity. Conclusion: Our results showed that SRSF1 plays a key clinical role in tumorigenesis and tumor progression in several types of cancer (such as Prostate, Lung, Breast, Colon, Glioblastoma), through various mechanisms of action and different cellular pathways. This review could be a starting point for several studies regarding the biology of and therapies for cancer.

Among the various therapeutic options for the treatment of tear trough deformities, the use of hyaluronic acid-based fillers has constantly been increasing. The aim of this research is to conduct a systematic review of the published literature related to the use of hyaluronic acid-based dermal fillers for the treatment of tear trough deformities and possible related complications. A search of the published literature was conducted following the PRISMA guidelines, including PubMed, Cochrane Library, and Ovid databases. Text words and Medical Search Headings (MeSH terms) were used to identify nine articles included in our analysis. The most used filler was Restylane (Galderma). The injection technique was performed through the use of a cannula or, more frequently, with a needle, through the execution of boluses or retrograde release. The injection plane was predominantly the supra-periosteal layer. The most observed side effects were mild and included redness, edema, contour irregularities, bruising, and blue-gray dyschromia. The degree of patient satisfaction was high, with an optimal aesthetic result that was maintained for 6 to 12 months. Although the duration of treatment of tear trough deformities with HA fillers is not comparable to surgical treatment, this is a minimally invasive, safe procedure, quick to perform, and with a high degree of patient satisfaction.

The “Vaccines and Related Biological Products Advisory Committee 17 December 2020 Meeting Briefing Document”, formulated by the FDA, reported three cases of swelling in areas previously injected with HA filler, introducing the possible relationship between a COVID-19 vaccine and adverse events in areas previously injected with HA fillers. The aim of this research is to report a case of an adverse event following a COVID-19 vaccine in a patient previously injected with facial filler. Furthermore, a scoping review on the same topic was performed. The research was carried out on the electronic databases PubMed, Cochrane Library, Web of Science, Google Scholar and Scopus. The selection process identified four articles as eligible for inclusion in the review. Nineteen patients, including the described case report, who experienced an adverse event following a COVID-19 vaccine in areas previously injected with facial filler were identified. Adverse events following a COVID-19 vaccine in patients previously injected with facial filler appear to be rare. A high BDDE cross-linking rate and/or a low-molecular-weight hyaluronic acid filler may have a higher tardive adverse event rate when triggered.

Lipodystrophy is an alteration of fat metabolism that commonly affects HIV-1 positive patients treated with antiretroviral therapy (ART). The facial area is most commonly affected by peripheral lipoatrophy, thus becoming a social stigma related to chronic HIV. Several treatments have been proposed, such as modification of diet, lifestyle and both surgical and nonsurgical procedures. The goal of our systematic review is to examine published clinical studies involving the use of polyacrylamide filler for the treatment of HIV FLA, and to provide evidence-based recommendations based on published efficacy and safety data. Our research was performed on published literature until April 2021. Polyacrylamide gel is a volumetric gel that has been proven stable, nontoxic, nonallergenic, nonembryotoxic and nonabsorbable. Poly-l-lactic acid (PLA) is a biocompatible, biodegradable, synthetic polymer derived from lactic acid. We believe it is essential to draft a pre- and post-injection and operative protocol to define an even setting for the clinical condition. It is desirable that such specifications are included in a large randomized controlled trial and the follow up is longer than the studies that we found, because as we have seen in the literature there are reported adverse events even 3 or 5 years after the injections.

The aim of this study is to analyze surgical and functional outcomes in order to verify the applicability of surgical treatment guidelines as foreseen by MASCC/ISOO/ASCO 2019. Patients affected by stage 2 MRONJ refractory to conservative management were grouped if underwent surgical resection (Group A) or debridement (Group B). Health-related quality of life was evaluated by using the European Organization for Research and Treatment of Cancer questionnaires, QLQ-C30 and H&N35. Statistical analysis was performed using Wilcoxon/Mann–Whitney test, Kaplan–Meier test, Cox regression model and Cox multivariate regression. Group A showed higher complete healing cases vs. group B. Recurrence rate difference in group A vs. group B was statistically significant. Debridement is an unfavorable prognostic factor when compared to surgical resection (p = 0.0032, HR 4.9). Quality of life mean values showed a marked improvement in Group A and a slight improvement in Group B. Debridement has 4.9 times more risk to develop recurrence when compared to surgical resection. A more satisfactory quality of life was shown in patients subject to resective surgery with an improving trend from baseline. Debridement patients showed more variability of results and an overall negative trend at the end of the 6-month follow-up.

Masseter Muscle Hypertrophy (MMH) is a well-known clinical benign condition that is not gender-specific and it can be monolateral or bilateral. Botulinum Toxin type A (BoNTA) injection has been widely described for MMH treatment and non-surgical facial slimming. BoNTA masseter injections have high efficacy and safety profile, but the risks of side effects remain. Muscular bulging during mastication is a complication due to the superficial overcompensation of masseteric fibers in response to neurotoxic weakening of the deep masseter. We present a biphasic-injection technique for BoNTA administration, based following anatomical concept and developed in order to prevent paradoxical bulging. A total of 98 treatments from 2015 to 2020 were performed with this technique. No remarkable complications occurred in our study. No cases of loss of full smile, difficulty in mouth opening, dizziness, headache, neurapraxia, and xerostomia were reported. A case of asymmetric smiling was self-resolved within a week. No patient claimed transient muscle weakness as distressing. No cases of paradoxical bulging were observed. Extensive knowledge of muscular anatomy and appropriate injection technique are key factors in achieving the desired result and avoiding complications. We feel that sharing this tip could be helpful for all the physicians involved in MMH treatment with BoNTA.

The aim of this study was to estimate the overall viability of the islanded facial artery myomucosal flap (iFAMM) compared to the facial artery myomucosal flap (FAMM). A systematic review of English articles was performed on PubMed and Cochrane Library electronic databases. Search terms included every nomenclature variant for FAMM flap and iFAMM flap. A total of 373 articles were identified, and 20 articles were considered eligible for inclusion in the review. A total of 486 flaps were evaluated (350 FAMM and 136 i-FAMM flaps). In all studies, the primary outcome assessed was flap viability, collecting the rate of total and partial flap necrosis and then comparing FAMM to i-FAMM. Overall reported partial/total necrosis rate for FAMM flap was 9.7%, 1.4% as total and 8.3% as partial necrosis. Overall partial/total reported necrosis rate for iFAMM flaps was 2.2%, 1.5% as total and 0.7% as partial necrosis. FAMM flaps, both as classical or islanded variants, are an effective option for intraoral small/medium sized defect reconstruction. Outcomes from the present review show a higher partial/total survival rate when this flap is harvested as islanded flap.

(1) Background: There is an increasing demand for a reversal of the aging process and, nowadays, more patients are seeking minimally invasive methods instead of surgery to meet this goal. The purpose of this paper is to evaluate the predictability of the off-label aesthetic use of botulinum toxin type A (BoNTA) reconstituted with lidocaine. (2) Methods: One thousand treatments, between January 2010 and January 2020, with BoNTA reconstituted with lidocaine for the rejuvenation of the upper third of the face, were performed and retrospectively evaluated. (3) Results: A few seconds after the BoNTA injections, the effect of muscle paralysis was seen in all cases; this allowed providing an optimal symmetric result with no need for a touch-up procedure at the control after three weeks. A burning sensation during the injections was claimed by almost all patients. Major complications were not registered. No touch-up procedures were required. (4) Conclusions: The results of this study show how the reconstitution of BoNTA with lidocaine may avoid imperfect results after the injections; the immediate feedback on the extent of paralysis to be expected from the chemodenervation action of BoNTA allows the physician to have immediate control of the final result.

Detectors are a key feature of the contemporary scientific approach to cultural heritage (CH), both for diagnostics and conservation. INFN-CHNet is the network of the Italian National Institute of Nuclear Physics that develops and applies new instrumentation for the study of CH. This process results in both optimized traditional state-of-the-art and highly innovative detection setups for spectrometric techniques. Examples of the former are X-rays, gamma-rays, visible-light and particles spectrometers tailored for CH applications, with optimized performances, reliability, weight, transportability, cost, absorbed power, and complementarity with other techniques. Regarding the latter, examples are ARDESIA, the array of detectors at the DAΦNE-Light facility, the MAXRS detection setup at the Riken-RAL muon beamline and the imaging facilities at the LENA Laboratory. Paths for next-generation instruments have been suggested, as in the case of the X-ray Superconductive Detectors and X-ray Microcalorimeter Spectrometers, allowing astonishing improvement in energy resolution. Many issues in CH can now be addressed thanks to scientific techniques exploiting the existing detectors, while many others are still to be addressed and require the development of new approaches and detectors.

Since the advent of HIV antiretroviral therapies at the end of the 20th century, the morbidity and mortality rates associated with HIV infection have decreased dramatically. Unfortunately, these benefits are associated with substantial morphologic changes in the body, such as abnormal fat distribution with peripheral lipohypertrophy and facial lipoatrophy. Facial wasting is considered the major stigma for HIV–infected people and may result in reduced antiretroviral adherence. Patients suffering from the stigmata of HIV infection can benefit from non-surgical aesthetic treatments performed with fillers or lipolytic agents that provide a quick and reliable service for facial rejuvenation, with high patient satisfaction and a low risk of complications. In the present paper, a retrospective analysis of complications following non-surgical aesthetic treatments (calcium hydroxyapatite-based filler, hyaluronic acid filler, polyacrylamide hydrogel filler and dehoxycholic acid injections), in a cohort of 116 consecutive HIV+ patients, treated over a period of 12 years, was performed. With the exception of the tardive swelling reported after calcium hydroxyapatite injections, complications were recorded just after polyacrylamide hydrogel treatment as small, palpable, nonvisible nodules or aseptic abscess. Our experience is consistent with those already published in the literature and the complication rate seems to be comparable to non-infected patients.

At present, the use of non-destructive, non-invasive X-ray-based techniques is well established in heritage science for the analysis and conservation of works of art. X-ray fluorescence (XRF) plays a fundamental role since it provides information on the elemental composition, contributing to the identification of the materials present on the superficial layers of an artwork. Whenever XRF is combined with the capability of scanning an area to provide the elemental distribution on a surface, the technique is referred to as macro X-ray fluorescence (MA-XRF). The heritage science field, in which the technique is extensively applied, presents a large variety of case studies. Typical examples are paintings, ceramics, metallic objects and manuscripts. This work presents an uncommon application of MA-XRF analysis to furniture. Measurements have been carried out with the MA-XRF scanner of the INFN-CHNet collaboration at the Centro di Conservazione e Restauro “La Venaria Reale”, a leading conservation centre in the field. In particular, a chinoiserie lacquered cabinet of the 18th century and a desk by Pietro Piffetti (1701–1777) have been analysed with a focus on the characterisation of decorative layers and different materials (e.g., gilding in the former and ivory in the latter). The measurements have been carried out using a telemeter for non-planar surfaces, and with collimators of 0.8 mm and 0.4 mm diameter, depending on the spatial resolution needed. The combination of the small measuring head with the use of the telemeter and of a small collimator has guaranteed the ability to scan difficult-to-reach areas with high spatial resolution in a reasonable time (20 × 10 mm2 with 0.2 mm step in less than 20 min).

Background: Bone regeneration is a reliable technique when the bone volume is insufficient to provide a functional and aesthetic outcome in surgery and implantoprosthesis procedures. When bone blocks are used but do not match the shape of the defect, the block must be adapted. The aim of our research was to evaluate, by Scanning Electron Microscopy (SEM) morphological observation, how different cutting devices modify the bone surface. Method: Four equine bone blocks were divided into 15 cubic shape samples with ultrasonic and sonic tips, as well as diamond, tungsten carbide, and Lindemann burs. The uncut surface of the obtained bone block was used as a control. Two observers independently analyzed the SEM observation recording, including cut precision, depth of incision, thermal damages, and presence of bone debris. For each group, sharpness, depth, carbonization, and bone debris were expressed as mean values. Results: The osteotomy performed with an ultrasonic tip shows the best results, preserving the bone morphology in both quantitative and qualitative analyses. The bone surface appeared sufficiently clean from debris and showed a reduced presence of carbonization. Conclusion: The shaping of the bone block as in vivo osteotomy respects the bone morphology and allows it to achieve the relevant biological and clinical outcome.