Search

Objective. To propose a new procedure to restore both hard and soft tissues in the vertical defects of the jaws. Methods. A tenting screw was inserted in a mandibular vertical bone defect in the molar region. A titanium mesh was trimmed and stabilized to a tenting screw with its cover screw. The mesh was shaped not to cover the whole defect but just the area above the tenting screw, like an umbrella, with the aim to help a resorbable membrane not to collapse over the defect. A collagen membrane, stabilized with tacks both on the lingual and buccal side, covered the defect, filled with particulate autogenous graft mixed with a xenograft in a 1:1 ratio. After 3,5 months, a split thickness flap was raised, the mesh and the tenting screw were removed, a palatal graft was harvested from the palate and stabilized with sutures on the recipient site to augment the band of keratinized tissue. Nine months after bone augmentation the site was re-opened for implants and healing abutments application. Results. At implant insertion stage, both hard and soft tissue grafts were completely healed and matured. Conclusion. This procedure shortens the overall treatment time, inserting the implant in matured and stable augmented hard and soft tissues. [ABSTRACT FROM AUTHOR]

Background. To evaluate the clinical and radiographic outcomes of upper jaws fixed cross-arches prosthesis on 6 implants installed with 3D software planning, flapless guided surgery, and immediate loading. Methods. Healthy patients aged 18 years or older at the time of implant placement, in need to be re-stored with an immediately loaded implant-supported screw-retained cross-arch fixed dental prosthesis in the maxilla were included in the present study and treated using computer-assisted template-guided surgery. In order to be immediately loaded implant sites were prepared and an insertion torque ranging between 35-45 Ncm was applied. A prefabricated screw-retained temporary prosthesis was delivered the day of the surgery. The evaluated outcomes were: implant cumulative survival rate (CSR), prosthe-sis survival, any technical and biologic complications, and peri-implant marginal bone level changes, probing pocket depth (PPD), and bleeding on probing (BOP). Results. Twenty-two patients (16 females and 6 males) with a mean age of 63.4 years received 132 im-plants to support 22 cross-arch screw-retained fixed dental prostheses. At the end of the study, no pa-tients dropped out. Three implants failed in 3 patients resulting in a CSR of 97.77%. No final prosthe-sis failed resulting in a CSR of 100%. No major biological or prosthesis complications were recorded. After an initial mean marginal bone loss of 1.10±0.38 mm, (95% CI 0.95 to 1.25 mm), at 12 months follow-up, slightly marginal bone loss was reported with time, resulting in a mean marginal bone loss of 1.58 ±0.41 mm, (95% CI 1.41 to 1.75 mm), at the 5-year follow-up. At 60 months follow-up mean PPD value was 2.44±0.49 mm, (95% CI 2.24 to 2.64 mm), mean BOP value was 1.34±0.87, (95% CI 0.98 to 1.70 mm). Conclusion. Within the limitations of this study it can be concluded that computer guided surgery and immediate loading on 6 implants seem to represent a viable option for the immediate fix rehabilitations of completely edentulous upper jaws. [ABSTRACT FROM AUTHOR]

There are many techniques to regenerate a sufficient bone thickness, in both vertical and horizontal direction, when bone is reabsorbed after extractions or after a long period of edentulism. The present study wants to evaluate from a clinical point of view results obtained using the GBR technique with a e-PTFE titanium reinforced membrane in posterior jaw (4.5-4.7). A 57-years-old male patient presented the failure of two implants in zone 4.6-4.7; after the latter's removal and a healing period of 6 months, the wide bone defects have been filled with heterologous bovine bone mixed with autologous bone and covered with e-PTFE titanium reinforced membrane fixed to the alveolar ridge. After 6 months the site was opened to remove the fixing screws and to place two new dental implants in zone 4.5-4.7; after the osseointegration period of 6 months, the implants were uncovered and two healing-screw were positioned. A significant increase in alveolar bone both vertical and horizontal was observed, such as to allow excellent aesthetic and functional result, testifying the success of the procedure. [ABSTRACT FROM AUTHOR]

Aim. The aim of this in vitro study was to compare the loading force at the fracture of monolitithic zirconia cantilever substructure in complete arch-prostheses supported by tilted or parallel implants. Material and methods. Ten anatomical models of edentulous mandible were fabricated. Five of these models had five screwtype implants embedded vertically in the intraforamica area (Brånemark protocols). The other five models had four screwtype implants in the intraforaminal area, two in front were placed vertically and two rear were tilted 30 degrees distally (All-on-4). Twelve superstructure in monolithic zirconia were fabricated, ten for the Brånemark protocols and ten All-on-4, with two cantilever for each superstructure. A static load was applied on the cantilever with a universal machine. The fracture load was monitored and the sites of fracture were identified. Results. No statistical significant difference was found between the two techniques. Mean fracture load values was 998 N (SD 83N) for Brånemark protocols while 905 N (SD 37N) for All-on-4. Most fractures occurred at the mesial connector attack to the last abutment. Conclusion. Zirconia cantilevered frameworks on vertical implants may tolerate higher occlusal forces before fracturing. [ABSTRACT FROM AUTHOR]

Objective. Good peri-implant tissue-health indicates that an implant is well-osseointegrated, the marginal bone levels are being maintained, and it maximizes the esthetic outcome of the restoration. This retrospective study investigated the impact of a rigid hygiene maintenance program and implant design on bone levels and peri-implant mucosa health. Methods. The study included edentulous patients who received a full-arch implant-supported prosthesis and who reported for the 3-year follow-up. Here reported are clinical and radiological outcomes as well as patient satisfaction. Results. 112 variable-thread tapered implants were placed in 28 patients according to the All-on-4 treatment concept. At 3 years, all implants were stable and the implant survival rate was 100%. The mean marginal bone level was -0.92±0.79 mm at baseline and -0.94±0.92 mm at the 3-year follow-up. All patients had healthy peri-implant mucosa with no signs of bleeding or visible inflammation. In addition, there were no signs of plaque on any of the prostheses. No adverse events were reported during the study period. Conclusion. Three years post-implant placement, there was no marginal bone loss and the soft tissue exhibited excellent health, suggesting that combining good oral hygiene maintenance with an implant geometry designed to positively impact bone response can demonstrate excellent clinical and radiological outcomes [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to investigate the type and incidence of TMD in adolescents with idiopathic scoliosis (IS) disease. Methods. The sample consisted of 50 patients, selected using simple random sampling, and included 26 females and 24 males (mean age: 13.5 ± 2.1 years) from Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul University. Diagnostic Criteria for Temporomandibular Disorders: Clinical Protocol and Assessment Instruments (DC/TMD) form was utilised to assess the signs and symptoms of TMD in idiopathic scoliosis patients. The pressure pain threshold (PPT) values for the muscles were measured through a hand-held pressure algometer. Parameters and obtained values were evaluated statistically by using paired samples t-test and independent samples t-tests. Results. According to the results, 94.7% of the samples had pain related TMD, 36.8% had headache on temporal region, and 81.6% had no intra-articular or degenerative joint disorder. A statistically significant difference was found regarding muscular TMD between genders (Female: 95.2%, Male: 68.2%) (p=0.02). In patients with myalgia, it was determined that the most painful muscle was the masseter. Conclusion. It can be concluded from this study that diseases which can cause postural changes like scoliosis in the region of the head and shoulders have relationship to the adaptation of the muscles and following alterations in the temporomandibular joint (TMJ) area. Therefore, patients with IS should be routinely controlled in terms of TMD and necessary measures should be taken early to reduce the need for further treatment options. [ABSTRACT FROM AUTHOR]

Continuous transesterification of linseed oil was examined in order to maximize the fatty acid methyl esters (FAMEs) yield. The continuous process was conducted in a packed bed reactor using calcium oxide as a heterogeneous catalyst. In addition, the impact of three variables, namely the molar ratio of diethyl ether (DEE) to methanol, the molar ratio of methanol to oil and the flow rate (ml/min), on the FAMEs yield were studied. The effectiveness of DEE will reveal after comparing transesterification yield in the presence and absence of the co-solvent. The optimum conditions for in continuous method were reported as follows: a molar ratio of DEE to methanol of 1.19:1, a molar ratio of methanol to oil of 9.48:1, a flow rate of 1.37 ml/min, and temperature of 30 °C. Under the optimum conditions, a FAMEs yield of 98.08% was achieved. All the properties such as flash point, pour point, cloud point, and viscosity of the biodiesel from linseed oil were measured by the related specific standards. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is responsible for a growing subset of oropharyngeal squamous cell carcinomas (OPSCCs) in the United States and abroad. At the time of the primary diagnosis, HPV-positive tumor status is associated with improved response to chemo-radiation, progression-free survival, and overall survival. Patients with HPV-related cancer look very different than the prototypic patient with tobacco-related SCC of the oral cavity. They tend to be white males that are younger, of higher socioeconomic status, and more highly educated. Moreover, they are often non-smokers who do not abuse alcohol. HPV-related SCC has a strong predilection for the oropharynx, particularly the lingual and palatine tonsils. HPV-16 genotype is the most common genotype, accounting for up to 92% of HPV-positive oropharyngeal squamous cell carcinomas. The need for routine HPV testing of oropharyngeal carcinomas is urgent and compelling. First, HPV status is a powerful indicator of patient prognosis. HPV positivity correlates with a lower risk of tumor progression and death, reflecting in part an enhanced sensitivity to ionizing radiation with or without chemotherapy. In our understanding, HPV status, which is easily acquired with routine investigations, should be included in the standard operational procedures for the diagnosis and treatment of head and neck cancer patients. [ABSTRACT FROM AUTHOR]

Various diseases and conditions can cause bony defects in the maxillofacial region. Since microvascular bone graft transfers were introduced in 1970, new possibilities in reconstructive surgery have arisen. Various methods of treatment have been described for severely atrophic mandibles. These methods are: (1) the placement of four endosteal implants of short length, (2) the placement of a trans-mandibular implant (3) the placement of endosteal implants in combination with vertical distraction osteogenesis or (4) the placement of endosteal implants in combination with an onlay or interpositional bone graft. The patient was operated on to harvest bone for dental implant insertion at the Galeazzi Institute (Milan, Italy) in August 2016. He presented high resorption of edentulous mandible. Bone from the anterior approach was harvested started with a saw, and then a chisel and mallet were used. After 6 months removal of the screws of synthesis (1 fractured is left in place). Insertion of endosseous implants After 3 months loading with mixed prosthesis (bar + overdenture) with locator. Several Authors have reported pain on walking, weakness of the abdominal wall, frank herniation, and disturbances of gait. A few other approaches have been suggested to reduce impairments at the donor site such as taking only the inner cortex, which will reduce the amount of bone available and its implantability. Others have suggested leaving the iliac crest and harvesting the underlying bone. It is concluded that in treatment combining an onlay graft and simultaneous implant placement in the extremely resorbed mandible, considerable graft resorption must be anticipated. [ABSTRACT FROM AUTHOR]

Objectives. This study describes a method for the measurement of the marginal gap between abutment and prosthetic crown and analyses the influence of different variables influencing the fitting precision. Methods. The extent of marginal gap between titanium or dental abutment with different implant types composed of sintered titanium, milled titanium alloy, zirconia and translucent zirconia was evaluated. The gap at implant-abutment interface was analysed by optical stereomicroscope observation. To optimise measurement precision, samples were oriented with a specific inclination angle and properly stained to limit reflection phenomena. Captured images was processed by ImageJ virtual measuring instruments. The correlation between various factors including type of tooth (molar, canine), stump type (artificial, natural), prosthesis type (sintered titanium, titanium, zirconia and translucent zirconia), and gap type (proximal, distal) was statistically evaluated performing the study of variance (ANOVA). Results. There was a significant correlation between the type of abutment and the different materials used for implant on fitting accuracy. The variables type of tooth and gap type do not significantly correlate with the marginal gap size. Results of the ANOVA test demonstrated that the association titanium abutment and titanium implant represent the best fitting with a minimum level of marginal gap at the junction interface. Conclusions. The measurement of marginal gap with stereoscopic observation associated with the analysis of variance has been demonstrated to be a valuable method for marginal gap evaluation. This approach demonstrated that the best abutment-implant fitting is represented by the association between titanium abutment and titanium implant. This model could be used to perform preliminary evaluation in order to help the clinician to select the best match of components for prosthetic implant. [ABSTRACT FROM AUTHOR]

Different implant-abutment connections have been developed in the effort of reducing mechanical and biological failure. The most frequent complications are screw loosening, abutment or implant fracture and marginal bone loss due to overload and bacterial micro-leakage. Ideal connection should work as a one-piece implant avoiding the formation of a micro- gap at the implant-abutment interface. Different in vitro and in vivo researches have been published to compare the implant-abutment connections actually available: external hexagon, internal hexagon and conical finding different amount of micro-gap, micro-leakage and marginal bone loss. The aim of this article is to describe, according to the most recent literature, different kind of fixture-abutment connections and their clinical and mechanical advantages or disadvantages. [ABSTRACT FROM AUTHOR]

Periodontal disease (PD) is an inflammatory disease of the tissues supporting the teeth. PD affects 65 million adults over the age of 30 years in the USA, and worldwide 5 to 70% of adults. Women who develop PD during pregnancy, it's estimated 1 woman in 5, may have a higher risk of adverse pregnancy outcomes. PD during pregnancy starts by dental plaque and is increased by the action of pregnancy hormones. In order to study the effect of PD on adverse pregnancy outcomes, we have performed this narrative review summarising the current studies about the influence of PD on pregnancy. Periodontal pockets are a reservoir of oral microbiota. Modifications in oral microbiota may be considered as a potential mechanism for developing PD during pregnancy. PD is surely caused by bacteria, but the progression and worsening are due to a host immune response. The inflammation caused by PD is not limited to the oral cavity. It is hypothesized that episodes of bacteraemia and dissemination of endotoxins from periodontal pockets can induce the activation of the systemic immune response. In conclusion our narrative review shows that there's no relationship between PD and adverse pregnancy outcomes, and PD treatment during pregnancy does not confer a general protection against adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

The study evaluated the antibacterial and anti-inflammatory efficacy, domiciliary oral hygiene, of a mouthrinse containing Tea Tree Oil (TTO) comparing it with two mouthrinses containing chlorhexidine 0,12% respectively and essential oils and a placebo. Materials and methods. A pilot study, randomized 4 × 4, controlled, cross-over, double-blind. 16 subjects with gingivitis (7 males and 9 females) aged 21-37 years, were randomly divided into four groups based on mouthwash that had to be used for domiciliary oral hygiene: mouthwash with essential oils, mouthwash with chlorhexidine 0,12 %, mouthwash containig tea tree oil and mouthwash placebo. Clinical evaluation was performed by: Full Mouth Plaque Score (FMPS), Full Mouth Bleeding Score (FMBS), Gingival Index (GI), discolorations, language examination and alteration of taste. The data were recorded before and 2 weeks after treatment. Results. Statistical analysis shows that treatments with tea tree oil, essential oils and chlorhexidine are effective. Comparing treatments should be noted that the tea tree oil gives a greater improvement in the GI and FMBS, while it is the least effective in the control of bacterial plaque. Conclusion. Although further studies are needed, the anti-inflammatory properties of the mouthwash made from TTO would seem to be a valuable non-toxic adjunct in the management of gingivitis. [ABSTRACT FROM AUTHOR]

Purpose. The aim of this paper was to evaluate the histological and histomorphometric outcome of Preformed Titanium Foil (PTF) to perform Guided Bone Regeneration (GBR) in posterior mandibular atrophies. Materials and methods. 10 subjects (1 male; 9 females; mean age 58±11.37 years), with distal mandibular atrophies were selected to perform GBR by means of PTF, using a moldable allograft paste as graft material. The devices, made of a 0,2 mm thick pure titanium foil, were pre-shaped using stereolithographic models obtained from CT-scan of the patients' recipient site. In the second stage, performed at 6.7±2.33 months, 18 cylindrical two-piece implants were placed and the devices removed, at the same time bone biopsies were harvested. At 4 months, the implants were exposed and submitted to progressive prosthetic load for a span of 4 months. The cases were finalized by means of metal-ceramic cementable restorations. The post finalization follow-up was at 12 months. Results. Survival rate (i.e. SVR) was 100% since none fixtures were lost. At the one-year follow up the clinical appearance of the soft tissues was optimal and not pathological signs on probing were recorded. The success rate (i.e. SCR) was 88.2% and the average peri-implant bone reabsorption was 1.17±0.41 mm. The average rate of graft contraction was 19.4±10.55%. The mean percentage occupied by mineralized bone was 48.03±5.93%, while the bone marrow and graft material were 36.1±2.81% and 15.87±4.87 %, respectively. Conclusion. The results suggest good potentialities of the method for GBR in distal mandibular atrophies, allowing to maximize the outcome and simplifying the surgical phase. [ABSTRACT FROM AUTHOR]

Purpose. The aim of this article is to make a comparative assessment between the modification of the soft-tissue profile, around the healing cap screws (HCSs), following both the traditional flapless surgery (TFS) and a new modified flapless surgery, named Modified Connective Tissue Punch (MCTP) technique. Materials and methods. 8 patients (3M and 5F) (mean age 54.25±11.247years) were enrolled in this study. Sixteen twopiece implants were placed on upper jaws, 2 for each patient, 8 with TFS and 8 with MCTP technique. In each patient the implants were placed in edentulous areas, of 2 or 3 adjacent teeth long. MCTP technique was performed on the front implant site (FIS) while the TFS was performed on the rear implant site (RIS). All implants were inserted and covered with healing cap screws (HCSs). Alginate impressions were carried out at the moment of the surgery, at 1 month and 4 months post-operative. Plaster models were poured and subsequently digitally scanned, in order to measure the distance between the gingival outline and the free margin of the HCS. The recorded values were analyzed with the ANOVA test. Results. The use of MTCP technique, in comparison to TFS, showed a significative better outcome, in terms of vertical increments, of gingiva, on the VS toward the HCSs, during the entire observation period (p = 0.000 for all). Conclusion. The Authors recommend the use of MCTP technique for a better vestibular soft tissue outcome in flapless implant surgery. [ABSTRACT FROM AUTHOR]

Purpose. The edentulous severely atrophic maxilla, as consequence of alveolar bone resorption and pneumatisation of the maxillary sinus, represents a serious limitation to the implant rehabilitation. Implants insertion via palatal approach (PA), in combination with relatively minimally invasive techniques aimed at increasing bone volume without the use of autologous bone harvesting is a valid alternative among the options for the rehabilitation of the upper jaw. Clinical case. In a 70-year-old female, with a severe maxillary atrophy, 6 spiral taper implants were placed with the PA, combined with the bilateral transcrestal elevation of both the sinus floors and nasal cavities; a further GBR, with resorbable pericardium membrane covering a termoplastic allograft associated to a xenograft, was performed. The second stage was performed after 6 months. Implant prosthetic functionalization was carried out in 4 months by placing the removable prosthesis in direct contact with the healing cup screws. After that period the case was finalized with a hybrid prosthesis. Clinical and radiographic follow-ups were carried out at 6 months and at one year after prosthetic finalization, during which no pathological signs were recorded. Conclusions. The PA implant insertion described by the Authors, combined with bone augmentation procedures, performed in the same stage, may represent a valid and reliable solution to rehabilitate maxillary edentulous patients. [ABSTRACT FROM AUTHOR]

Purpose. To identify potential antigenic targets for Porphyromonas gingivalis vaccine development. Materials and methods. In the present study, we analyzed the Porphyromonas gingivalis, fimA type II primary amino acid sequence and characterized the similarity to the human proteome at the pentapeptide level. Results. We found that exact peptide-peptide profiling of the fimbrial antigen versus the human proteome shows that only 19 out of 344 fimA type II pentapeptides are uniquely owned by the bacterial protein. Conclusions. The concept that protein immunogenicity is allocated in rare peptide sequences and the search the Porphyromonas gingivalis fimA type II sequence for peptides unique to the bacterial protein and absent in the human host, might be used in new therapeutical approaches as a significant adjunct to current periodontal therapies. [ABSTRACT FROM AUTHOR]

This paper is the first article in a new series on digital dental photography. Part 1 defines the aims and objectives of dental photography for examination, diagnosis and treatment planning, legal and forensic documentation, publishing, education, marketing and communication with patients, dental team members, colleagues and dental laboratory. [ABSTRACT FROM AUTHOR]

Objective. This prospective clinical case series on peri-implantitis therapy reports on clinical and radiographic changes occurring after the use of an innovative technique of surgical degranulation combined with a thorough detoxification of the implant and local antibiotics application. Methods. In 14 partially edentulous patients, 18 implants diagnosed with peri-implantitis were treated. Implant detoxification was performed mechanically and chemically with citric acid at pH 1. Thereafter, tetracycline powder and chlorexidine gel by way of a collagen sponge carrier were applied on the implant surface, filling the bone defect. Neither resective nor regenerative surgery were performed. Clinical and radiographic parameters were recorded prior to and three years after treatment. Results. Clinical parameters improved after three years observation period. A statistically significant (p<0.001) reduction of probing pocket depth (PPD) was found. Bone recovery was 35% in respect to baseline (prosthesis loading). The bone variation expressed in millimetres at time of surgical treatment and 3-year follow up was statistically significant (p<0.001). No implant was lost in the observation period. Conclusion. Surgical degranulation combined with mechanical and chemical detoxification of the implant and local antibiotic therapy seems to be a reliable method for stopping and controlling peri-implantitis. [ABSTRACT FROM AUTHOR]