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Objectives: over the years a device has been developed, the Magnetic Mallet, which allows a very high control and stability of the applied forces, able to perform procedures that were the safest possible for the patient and the surgeon himself. The handpiece has been designed so that different shock waves are emitted according to the type of surgery, with the possibility of inserting different inserts according to the technique/procedure that is being applied. The Magnetic Mallet can be used in different surgical procedures; Dental extractions, implant placement, implant site preparation (osseodensification), maxillary sinus lift procedures or crestal expansion procedures. Materials and methods: In the following clinical case, the extraction of element 2.7 is conducted with the simultaneous insertion of two implant fixtures in place 2.6 and 2.7 and simultaneous regenerative therapy. The implant in site 2.6 was positioned with a traditional method, with the help of the implant motor, while the post-extraction implant in site 2.7 was inserted with the use of the Magnetic Mallet. Results: At one week the sutures were removed and the tissues showed good healing. The patient is then placed in a maintenance and follow-up program to monitor healing after some time.

The aim of the present narrative review was to summarize the main indications of antibiotic prophylaxis in dentistry.

Aim: The objective of this in vitro study was to compare reused and sterilized versus new healing abutments to assess whether a decontamination and sterilization process performed on resued healing abutments was sufficient to remove residual proteins. The two groups were comparable with respect to patient safety., Materials and Methods: During the period from September 2022 to October 2023, healing abutment screws were selected and divided into two groups according to whether they were new or previously used in patients. The samples were subjected to a decontamination and sterilization protocol, and results from sample sterility evaluation and assessment of surface protein levels were recorded., Results: The obtained results revealed a significant difference in the OD562 nm values between new and reused healing abutment samples. The assay demonstrates how treated healing abutments were still contaminated by residual proteins., Conclusion: Within the limitations of the present study, although from an infectious point of view sterilization results in the total eradication of pathogens, surface proteins remain on reused healing abutments.

Aim : The rising average age increases edentulous cases, demanding more implant-prosthetic rehabilitation, with cardiovascular diseases being significant factors. This study compared healthy patients (CG = Control Group) and those with cardiovascular disease (TG = Test Group) for implant survival, Marginal Bone Loss (MBL), peri-implant tissue level parameters as Periodontal Screening and Recording (PSR), Plaque Index (PI), Bleeding on Probing (BoP) Peri-implant Probing Depth (PPD), and surgical complications. Smoking impact on both groups and medication influence in the TG were secondary outcomes. Patients underwent full-arch implant prosthetic rehabilitation. Methods : Implant survival rate, MBL, and surgical complications were recorded during the monitoring period (7 years), while peri-implant parameters were assessed at the end of the observational time. A total of 26 and 28 CG and TG patients were recruited, respectively. Results : A total of 128 implants were placed in CG, while 142 in the TG. Implant survival and MBL showed no significant differences ( p > 0.05). Nevertheless, peri-implant parameters were more unfavorable in TG. The only significant surgical complication was higher bleeding rates in the TG ( p < 0.05). Conclusions : Cardiovascular patients showed similar implant survival and MBL but had adverse peri-implant parameters and increased bleeding rates. Higher smoking levels may relate to unfavorable implant outcomes. Further investigation is needed on drug impact with larger samples.

The aim of this comparative retrospective clinical study was to assess the effect of age on immediate loaded full-arch mandibular rehabilitation in younger vs. elderly patients. Patients with an age between 45 and 60 years (younger group, YG) or with an age more or equal to 75 years (older group, OG), requiring a mandibular full-arch rehabilitation were scheduled for the present study. Implant and prosthetic failure, biological and prosthetic complications, and peri-implant marginal bone level changes were recorded until a 7-year follow-up. Sixty-six patients were included in the study; a total of 264 implants were placed and, in total, 66 "all-on-four" rehabilitations were delivered. In total, 33 patients were scheduled in the YG and 33 patients in the OG. At the 7-year follow-up, an overall implant failure rate of 1.14% was reported. Moreover, at the 7-year radiographic evaluation, peri-implant crestal bone loss averaged 1.12 ± 0.91 mm for the YG and 1.04 ± 1.01 mm for the OG. No statistically significant differences were found between the YG and OG except for the rate of peri-implantitis, which was statistically higher in the YG. The present study reported that immediate fixed mandibular full-arch rehabilitation is a viable procedure in elderly people of equal or more than 75 years of age.

The aim of this study was to assess and compare the marginal bone loss between two different categories of implants (Winsix, Biosafin, Ancona, Italy) having the same diameter and belonging to the Torque Type ® (TT ® ) line, in the internal hexagon version (TTi, Group A) and in the external hexagon configuration (TTx, Group B). Patients with one or more straight implants (insertion parallel to the occlusal plane) in the molar and premolar regions in association with tooth extraction at least 4 months prior to implant insertion, who have a fixture diameter of 3.8 mm, who followed up for at least 6 years, and whose radiographic records were available were enrolled in this study. Depending on implant connections (externally or internally), the sample was divided into groups A and B. For externally connected implants (66), the marginal resorption was 1.1 ± 0.17 mm. The subgroup of single and bridge implants showed no statistically significant differences with a marginal bone resorption of 1.07 ± 0.15 mm and 1.1 ± 0.17 mm, respectively. Internally connected implants (69) showed an overall marginal resorption of 0.91 ± 0.17 mm, while the subgroup of single and bridge implants showed resorption of 0.90 ± 0.19 mm and 0.90 ± 0.17 mm, respectively, with no statistically significant differences. According to the obtained results, internally connected implants showed less marginal bone resorption than externally connected implants.

The aim of this retrospective clinical study was to evaluate and compare implant survival, marginal bone loss, and clinical and prosthetic complications in healthy patients and patients with type I diabetes undergoing full arch implant-prosthetic rehabilitation. A total of 47 patients needing total fixed rehabilitation of one or both arches were enrolled for this study. Based on the absence of any systemic diseases (Group A) or the presence of type I diabetes (Group B), the sample was divided into two groups. According to the grade of bone atrophy in the posterior region, patients received full arch rehabilitation (of one or both jaws) with 6 axial implants or, if the residual posterior bone height was insufficient, All-on-Four rehabilitation and a total 236 dental implants were placed. Follow-up visits were performed 1 week after surgery, at 3 and 6 months and then once a year for the next 10 years. No statistically significant differences between groups were recorded about implant survival rates, marginal bone loss, or clinical and prosthetic complications. However, concerning complications, post-surgical bleeding and wound infection were recorded in Group A more than in Group B. In cases of compensated diabetes compensation, implant placement could be considered a safe procedure.

The aim of the present study was to evaluate the efficacy of an air purifier device (professional XXl inn-561 innoliving) with HEPA 14 filter in reducing the number of suspended particles generated during dental procedures as a vector of COVID-19 transmission. The survey was conducted on 80 individuals who underwent Oral Surgery with dental Hygiene Procedures, divided into two groups based on the operational risk classification related to dental procedures: a Test Group (with application of filtering device) and a Control Group (without filtering device). All procedures were monitored throughout the clinical controls, utilising professional tools such as molecular particle counters (Lasair III 350 L 9.50 L/min), bacteriological plates (Tryptic Soy Agar), sound meters for LAFp sound pressure level (SPL) and LCpk instantaneous peak level. The rate of suspended particles, microbiological pollution and noise pollution were calculated. SPSS software was used for statistical analysis method. The results showed the higher efficacy of the TEST Group on pollution abatement, 83% more than the Control fgroup. Additionally, the contamination was reduced by 69-80%. Noise pollution was not noticeable compared to the sounds already present in the clinical environment. The addition of PAC equipment to the already existing safety measures was found to be significantly effective in further microbiological risk reduction.

Limited data are available on the clinical outcomes of patients with edentulism treated with predominantly monolithic zirconia fixed complete dentures (FCDs) compared to traditional restoration materials. The purpose of this study was to analyze the differences in terms of complications and failures of definitive full-arch implant rehabilitations made in metal-acrylic versus those made in monolithic zirconia with porcelain veneering limited to non-functional areas. This retrospective clinical study included 50 patients treated between January 2015 and December 2018, with 222 implants inserted in fifty edentulous jaws. All patients were treated with immediately loaded full-arch fixed prostheses (22 maxillary; 28 mandibular) each supported by four to six implants (two/four axial, two distally tilted). All 25 zirconia prostheses were predominantly monolithic with ceramic veneering limited to non-functional areas. The primary outcome measures were prosthetic success of the definitive restoration and implant survival. The secondary outcome measures were full mouth plaque score, full mouth bleeding score, peri-implant probing depths and periimplant keratinized tissue. All implants and prostheses analyzed had a minimum of 2 years of followup. No chipping of the veneered facial porcelain or other technical complication was observed over the study period achieving a prosthesis survival and success rate of 100%. No implants were lost, achieving a 100% survival rate. Bleeding on probing was positive in 33% and 13% of probing sites for metal-acrylic prosthesis and zirconia prosthesis, respectively (p = 0.0445). Plaque index was positive in 76% and 53% of probing sites for metal-acrylic prosthesis and zirconia prosthesis, respectively (p = 0.0491). Mean probing depth was 1.74mm (SD 0.89mm) for the 106 implants supporting metal-acrylic prosthesis and 1.52mm (SD 0.63mm) for the 116 implants supporting zirconia prosthesis (p=0.0412). No other statistically significant differences were found between the two groups. The results of this retrospective evaluation showed that predominantly monolithic zirconia is a feasible alternative to the conventional metal framework acrylic for full arch implant-supported prosthesis. The restauration material did not influence the failure rate and complication risk of both prosthesis and implants., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The aim of this article is to describe how, during the provisional and definitive prosthetic phases, using new digital technologies, it is possible to improve the ergonomics of the prosthetist's work and reduce the discomfort of patients, subjecting them to the fewest possible appointments at the dentist. The proposal of a full digital protocol, described by the following case report, for the realization of a definitive prosthetic rehabilitation supported by a reduced number of implants, in fact, allows to considerably reduce the number of appointments and reduce any bias. A 67-year-old male patient presents for the first visit to the Department of Dentistry of the San Raffaele Hospital, wearing a removable upper prosthesis and with the request to heal the aesthetic and functional situation through prosthetics fixed. An initial panoramic radiograph was performed, intra and extra oral photos were taken and also intraoral impressions. A stereo-lithographic models are obtained from intraoral scans, and two total prostheses, upper and lower, were packaged for the provisional post-surgical phase was performed. In accordance with the All-on-4 method 8 implant fixtures were placed. For the final prosthetic phase, the patient underwent only two operative sessions. In the first session, scans were taken with the provisionals in situ, of the patient's mucous membranes and with the Scan-abutments in place. In the second session using specific CADSoftware the matching of the STL files of the three scans were created, the opposing arches of the patient were related on a digital articulator, and the milled titanium bars were immediately constructed and finished with the resin. Finally, the definitive prostheses were delivered to the patient without any other test. Digital technology has allowed a clear reduction in working times and costs and has allowed the reduction of stress for patients who undergo invasive and extensive treatments to recover aesthetics and function, and for clinicians who must manage complex cases with fewer appointments possible., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The fundamental moment of prosthetic rehabilitation is the "temporary". Although the meaning of the term diminishes its importance, the provisional has fundamental biological, aesthetic and functional functions. The oral cavity must maintain an adequate level of oral hygiene to carry out this delicate phase in the best possible way; a result achieved only with the collaboration of the prosthetic dentist with the hygienist and the patient, as if they were a biological system in motion. The different methods of hygiene are effective in maintaining a good level of oral health; but they could, if too aggressive, affect the prosthetic restoration. Our objective in vitro is to understand, after applying a known bacterial load, which hygiene method is the most effective in removing bacterial biofilm but at the same time is less aggressive towards resinous material., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Several conditions as trauma, cancer surgical resection, fractures, congenital malformations and periodontitis could bring alveolar bone defects. To avoid more invasive and less predictable regenerative procedures, Stem cells of different origins as pluripotent Embryonic Stem Cells (ESCs), undifferentiated multipotent Mesenchymal Stem Cells (MSCs) and Induced Pluripotent Stem Cells (iPSCs) were proposed as possible alternative. IPSCs have potential for proliferation and differentiate into all derivatives of the three primary germ layers: ectoderm, endoderm and mesoderm. According with their ability to involve in several cells type, Induced Pluripotent Stem Cells (iPSCs) could be proposed as alternative in regeneration either of mineralized tooth components or supporting tissue. The aim of this brief review is to describe clinical applications of Induced Pluripotent Stem Cells (iPSCs) in oral bone regeneration to employ their use in tissue regeneration in dentistry., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Purpose: This prospective study aims to evaluate the clinical outcomes of 'All-on-four' rehabilitations in controlled human immunodeficiency virus (HIV)-positive patients., Materials and Methods: Edentulous patients requiring an implant prosthetic restoration of one or both jaws were enrolled in the present study. Each patient received at least one fixed full-arch prosthesis. Four implants, immediately loaded, were placed in each jaw using the 'All-on-four' protocol. Marginal bone loss, implant and prosthetic failure, biological and mechanical complications, and serological levels (CD4 cell count, CD4/CD8 ratio, and HIV viral load) were recorded up to 7-year follow-up., Results: A total of 116 implants were placed in 24 patients, and 29 rehabilitations based on the 'All-on-four' concept were achieved. Implant failures were registered in four patients (10 of 116 implants), and the implant survival rate was 91.37%. At the 7-year radiographic evaluation, peri-implant crestal bone loss averaged 1.91 ± 1.3 mm for upright maxillary implants (n = 30 implants) and 1.79 ± 1.28 mm for tilted maxillary implants (n = 30 implants). In the mandible, mean peri-implant crestal bone loss was 1.54 ± 1.27 mm for upright implants (n = 28) and 1.5 ± 1.3 mm for tilted implants (n = 28). No statistically significant correlation was found between serological parameters and marginal bone levels at 6 months, or through 7 years of annual follow-up (P > 0.05). A statistically significant linear correlation (P < 0.001) was found between early implant failure and HIV viral load. The CD4/CD8 ratio was significantly correlated with late implant failure (P = 0.009)., Conclusions: Within the limitations of this prospective 7-year longitudinal study, HIV-positive patients with a stable immune system can be candidates for the 'All-on-four' treatment concept., Competing Interests: Conflict of interest statement: The authors declare there are no conflicts of interest.