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Background: As oral health has gained a crucial role in low grade inflammation control, new techniques were tested to achieve a better control of periodontal homeostasis. Ultrasound scaling and root planing by means of Gracey curettes were the established techniques, while air-polishing was mostly used on prosthetic surfaces., Methods: In the present study, an in-vitro comparison between roughness of enamel and root surfaces after air polishing and curettes was performed. Six extracted teeth were examined for air polishing effects and curettes effects at Scanning Electron Microscope to evaluate the superficial roughness. This aspect was assessed by a dedicated software analyzing roughness indexes such as Ra, Rq, Sa and fractal dimension., Results: According to our results, air polishing produced a smoother root surface in comparison with the curette's root planing. Although Gracey curette scaling represent the gold-standard so far. Moreover, air polishing did not produce root cementum damage or scratches, as with curette's scaling, and this aspect seems to be related to particles diameter and nature., Conclusions: Further studies, both in vitro and in vivo, are needed to better evaluate the real outcome of this kind of management.

Aim: The aim of this work was to clinically and radiographically evaluate survival and success rate of zirconia dental implants positioned in premolar area during a follow-up period of at least 12 months up to 24 months., Methods: Sixteen patients were treated with 26 zirconia implants. All implants received immediate temporary restorations and 6 months after surgery were definitively restored. Twelve to 14 months after implant insertion, a clinical-radiographical evaluation was performed in order to estimate peri-implant tissues health and peri-implant marginal bone loss., Results: The survival rate was 96.16%. The success rate was 91.6%., Conclusion: Because of the limited number of implants, conclusions may not be considered significant even if results are encouraging. Further scientific information regarding clinical use of zirconia dental implants are needed, as well as prospective long-term clinical studies in order to understand if zirconia implants may represent a valid alternative to titanium implants.

Aim: The aim of this study was to present authors' two-year clinical experience with Yttrium-stabilized zirconium dioxide implants placed in native bone or regenerated bone., Methods: Yttrium-stabilized zirconium dioxide implants made of brezirkon (whiteSKY, Bredent medical, Senden, Germany) were used for the treatment of edentulous ridge rehabilitation in the Dental Clinic of the University of Milan (Head of the Department, Prof. F. Santoro). Zirconium dioxide is a highly resistant ceramic material obtained by cleaning zirconium dioxide and zirconium silicate. The implant used in the clinical study featured a conical one piece implant with double cylindrical thread with a sandblasted rough surface. The prosthetic section was smooth., Results: Forty-six implants have been inserted in 18 patients from January 2007 to January 2009, the follow-up period was comprised between 6 and 24 months. The overall success rate was 89%; the success rate in native bone was 97% and 74% in augmented bone. It can be stated that the success rate is comparable to titanium fixtures., Conclusion: It would be logical to use a ceramic material for the esthetic regions; zirconium dioxide is particularly suitable since it features tissue friendliness and resistance comparable to titanium. The good mechanical properties, possibility of easy fabrication of the prosthetic restoration and the good integration into the tissue and the esthetics provide perfect preconditions for yttrium-stabilized zirconium dioxide to become the most commonly used material in implant dentistry.

Dental implants placed in the maxilla risk failure because of the low density of the maxillary bone and the shortness of the maxillary ridge. Moreover, inadequate implant preparation, drilling or installation can easily lead to complications related to the maxillary sinuses. Displacement of dental implants into the maxillary sinus can cause serious complications, but there are few reports of such cases. The aim of this paper is to present three cases of a migrated dental implants into the maxillary sinus: in the first two cases the dental implant was found close to the medial wall of the maxillary sinus and was removed through a surgical approach, whereas in the third case the dental implant was spontaneously expelled from the nasal cavities through the mucociliary clearance. The most frequent adverse effect is the local infection of tissue around the implant. For this reason, implants placed close to the maxillary sinus offer a route for infection from the oral cavity to the sinus. While in some cases implant migration causes sinusitis in other, the patients remain asymptomatic; anyway, the treatment depends on the symptoms of maxillary sinusitis. In the third case the dental implant was spontaneously expelled from the nasal graves. Our report illustrates that a powerful mechanism of mucociliary action can cause relatively heavy objects within the maxillary sinus to migrate naturally to the sinus ostia against gravitational force and then to be expelled from the nasal cavities.

The authors discuss the possible vascular lesions that may occur during mandibular sagittal split ramus osteotomies with particular regard to the maxillary artery. A case of surgical lesion of the maxillary artery is presented and its course and anastomoses are analyzed. The ligation of the external carotid artery and its principal branches is the treatment of choice in case of maxillary artery lesion which is a life threatening event and needs immediate intervention.

The authors review the oxytalan fibers, that belong to the elastic system fibers of the connective tissue. They are observed in many structures of the stomatognathic system, particularly in the periodontal ligament and TMJ disc.