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OBJECTIVE: SARS-CoV-2 is a new Coronavirus identified as the cause of Corona- virus disease in 2019 (COVID-19). The epidemic spread in China and beyond its borders, involv- ing 114 countries with more than 5 million dead. On March 11, the WHO declared the spread of SARS-CoV-2 to be a pandemic and encouraged nations to adopt harsh restrictive measures. Therefore, patients more and more often turn to dental offices only for emergencies. Healthcare professionals, including dentists, are at high in- fectious risk. In fact, the closeness to the oral cavity and nasopharynx and the use of drills or ultrasonic devices that cause aerosol release, make dental professions at high risk of bacterial and viral infections. The way patients are treat- ed has changed. In fact, it should be mandato- ry to carry out a pre-treatment telephone triage and the use of mouthwashes to reduce bacterial load. In the current pandemic, it is necessary to adopt specific safety protocols that can protect dental operators as well as limit the spread of the virus. The purpose of this review is to pres- ent an overview on ways to reduce the risk of SARS-CoV-2 contagion in dentistry by focusing on the immediate situation as well as by look- ing towards the future. MATERIALS AND METHODS: To reach the review purpose, we selected a series of studies using keywords “COVID-19” OR “SARS-CoV-2” in association with “dentistry” AND “safety proto- cols” AND “healthcare procedures” AND “individ- ual protection dispositive” AND “air transmission” AND “droplet”. We selected papers exclusively in English language, up to 1st January 2022. RESULTS: During future phases of the pan- demic, everywhere in the World, it is necessary to impose all dentistry team both a serological screening and the vaccination, as already estab- lished for all health staff in Italy. CONCLUSIONS: For own safety, it is an import- ant for the whole dentistry category constantly update the devices and the protocols adopted, as well as monitoring the real infectious threats, which may occur.

Loeys-Dietz syndrome (LDS) is a connective tissue disorder first described in 2005 featuring aortic/arterial aneurysms, dissections, and tortuosity associated with craniofacial, osteoarticular, musculoskeletal, and cutaneous manifestations. Heterozygous mutations in 6 genes (TGFBR1/2, TGFB2/3, SMAD2/3), encoding components of the TGF-&beta, pathway, cause LDS. Such genetic heterogeneity mirrors broad phenotypic variability with significant differences, especially in terms of the age of onset, penetrance, and severity of life-threatening vascular manifestations and multiorgan involvement, indicating the need to obtain genotype-to-phenotype correlations for personalized management and counseling. Herein, we report on a cohort of 34 LDS patients from 24 families all receiving a molecular diagnosis. Fifteen variants were novel, affecting the TGFBR1 (6), TGFBR2 (6), SMAD3 (2), and TGFB2 (1) genes. Clinical features were scored for each distinct gene and matched with literature data to strengthen genotype-phenotype correlations such as more severe vascular manifestations in TGFBR1/2-related LDS. Additional features included spontaneous pneumothorax in SMAD3-related LDS and cervical spine instability in TGFB2-related LDS. Our study broadens the clinical and molecular spectrum of LDS and indicates that a phenotypic continuum emerges as more patients are described, although genotype-phenotype correlations may still contribute to clinical management.

To compare in vivo Titanium Alloy (TiA) with Stainless Steel (SS) miniscrews Temporary Anchorage Devices (TADs) using removal torque and Scanning Electron Microscopic (SEM) analysis.15 subjects (6 males and 9 females) who required maximum anchorage were recruited. For each patient, a TiA TAD and a SS TAD with same length and width were implanted following a randomized split-mouth study design. Retraction was carried out with nickel-titanium spring ligated directly from the anterior hooks of the archwire to the TADs to produce 90 to 100 g of force. When no further anchorage supplementation was needed, the TADs were removed. The removal torque values were registered with a digital screwdriver. After removal, the TADs were collected in a fixed solution and examined using SEM and X-ray microanalysis.All TADs remained intact, with a 100% success rate. There was no difference in removal torque between TiA and SS miniscrews (4.4 ± 1.3 N-cm and 5.1 ± 0.7 N-cm, respectively). All specimens' loss of gloss with signs of biological contaminations resulted in a dull implant surface. SEM photomicrographs of TiA miniscrews showed predominantly blood cells while SS miniscrews showed the precipitation of an amorphous layer with low cellular component. There was no difference in spectroscopic analysis between TiA and SS miniscrews.TiA and SS miniscrews had comparable removal torque values. SEM photomicrographs showed no evidence of osseointegration with both TADs having similar biological responses.

The purpose of this retrospective investigation was to evaluate the use of a prefabricated bar system for immediately loaded implants placed and restored according to the All-on-Four concept with up to 24-month follow-up.A total of 51 patients (31 males and 20 females; mean age 63.4 years) presented with edentulous or partially edentulous jaws with severe atrophy of the posterior regions. All patients were treated with full-arch fixed prostheses (28 maxillary, 34 mandibular) each supported by four implants (two vertical, two distally tilted). The implants were immediately loaded with screw-retained full-arch restorations. Each prosthesis was supported by a prefabricated metal bar combined with high-density acrylic resin. Follow-up visits were scheduled at 6, 12, and 24 months after initial prosthetic loading. Intraoral radiographs were obtained immediately after surgery and at each follow-up visit by using a custom radiograph holder and parallel technique. Marginal bone levels were assessed using digital image analysis. Implant and prosthetic survival and success rates were evaluated. Patient satisfaction was further assessed using a 100-mm visual analog scale (VAS). Data were compared by means of the Mantel-Haenszel test.No drop-outs occurred. The overall implant survival rates were 100% and 98.38% for the vertical and tilted implants respectively. Two of the 62 definitive fixed prostheses were lost during the observation period due to implant failure. Since restoration replacement due to implant failure was not judged a prosthodontic failure according to the survival criteria provided in this study, the overall prosthetic survival rate was 100%. No statistically significant differences in marginal bone levels between vertical and tilted implants were detected at 24-month follow-up evaluation in either jaw. All participants were functionally and esthetically satisfied with their definitive restorations after 2 years functioning, as confirmed by the average VAS scores (masticatory function: 99.7; phonetic function: 99.5, esthetics: 99.2).The preliminary 24-month results indicate that immediate loading of vertical and tilted implants using the evaluated prefabricated bar system may be a viable solution for edentulous jaw rehabilitation; however, more long-term prospective clinical trials are needed to affirm the effectiveness of this surgical-prosthetic protocol.

Purpose: Reduction of alveolar height and width after tooth extraction may present problems for implant placement, since bone volume is important for biologic and esthetic reasons. The aim of this study was to assess bone healing of large bone defects grafted with collagen sheets and maintenance of reactive soft tissue, evaluating cone beam computed tomography (CBCT) scans and histomorphometric results. Materials and Methods: Patients presented large bone defects after tooth extractions. Reactive soft tissue was left in the defects filled by collagen sheets. Vertical bone volume was assessed by CBCT examinations before tooth extractions and 3 months later. At 3 months, cylinder bone samples were obtained for histology and histomorphometry analysis. Results: Twenty-six patients were included in the clinical study. Examined defects reported mean bone gain of 12.13 ± 3.91 mm, and mean vertical bone levels showed a statistically significant increase (P < .05) at 3 months after extraction. Histologic examinations revealed bone formation; mean vital bone measurements were 41.59% ± 5.80%, and connective tissue percentages averaged 50.37% ± 7.73%. Conclusion: Reactive soft tissue left in large bone defects after tooth extraction and grafted collagen may support a significant vertical bone gain and vital bone formation.

In oral surgery, the last phase of a surgical operation is represented by the tissues suture, that allows the wound lips edges approximation and their stabilization, to promote haemostasis, to avoid the alimentary residues accumulation on the incision line and allow the first intention healing. A good suture avoids that the displacing forces generated by the muscular insertions, functional movements and by the external agents destabilize or cause the surgical wound deiscence. The purpose of this study was to re-examine the suture threads characteristics, properties and biological interactions evaluating the different studies published in literature results and conclusions. In conclusion, the authors recommended the use of the different suture threads on the dependence of the oral surgery operation type that must be performed, of the patient compliance and of the various suture materials physical and biocompatibility characteristics.

The goal of mucogingival surgery is to correct certain tissue defects. The state of the art and therapeutic goal of this type of surgery are described.

To evaluate the impact of a new formulation of probiotic mouthwash (PM), using Biocult strong® dissolved in neutral mouthwash.Forty-two patients with cardiovascular disease (CVD) or type 1 and type 2 diabetes were enrolled. Plaque Control Record (PCR) and Bleeding on Probing (BOP) were assessed at baseline and after two weeks of PM or positive control treatment in intervention group (IG) and control group (CG). Food intake was estimated by 3-day diet record.BOP was significantly reduced in all treatments and samples, except for IG in CVD sample (p=0.15). PCR decreased significantly in all treatments and samples (p0.01). No significance was obtained for BOP and IP in the time x group interaction. Food intake was not significantly different between IG and CG in all samples. Nutrients such as fats and simple carbohydrates were correlated with BOP in patients who received positive control, rather than PM, indicating a lack of food influence on BOP and PCR in IG.PM treatment was effective in relation to the reduction of PCR and BOP. Probiotics represent a good, but additional, tool for prophylaxis, because they cannot completely substitute the classic oral hygiene methods. Moreover, one week of treatment was not sufficient to draw firm conclusions about the efficacy of the treatment itself.

Chemotherapy and hematopoietic stem cell transplantation (HSCT) are the current treatments for patients with hematological diseases; they result in myelosuppression, and increase the susceptibility of patients to severe infections. The oral cavity is a potential site of complications in HSCT patients, because it is the entrance for agents that can cause systemic infections; it is one of the most frequent locations for side effects deriving from conditioning therapy. The importance of dental pre-chemotherapy and transplant prescription is often stressed, since both therapies depress the immune system and platelets, making each intervention at this stage a high risk. The aim of this article is to review the potential complications of HSCT, and to extrapolate from the scientific literature the treatments and timeframes in which dental therapies can be performed, avoiding important risks for patients.

Due to the brittleness and limited tensile strength of the veneering glass-ceramic materials, the methods that combine strong core material (as zirconia or alumina) are still under debate. The present study aims to evaluate the fracture strength and the mechanism of failure through fractographic analysis of single all-ceramic crowns supported by implants. Forty premolar cores were fabricated with CAD/CAM technology using alumina (n = 20) and zirconia (n = 20). The specimens were veneered with glass-ceramic, cemented on titanium abutments, and subjected to loading test until fracture. SEM fractographic analysis was also performed. The fracture load was 1165 (±509) N for alumina and 1638 (±662) N for zirconia with a statistically significant difference between the two groups (P = 0.026). Fractographic analysis of alumina-glass-ceramic crowns, showed the presence of catastrophic cracks through the entire thickness of the alumina core; for the zirconia-glass-ceramic crowns, the cracks involved mainly the thickness of the ceramic veneering layer. The sandblast procedure of the zirconia core influenced crack path deflection. Few samples (n = 3) showed limited microcracks of the zirconia core. Zirconia showed a significantly higher fracture strength value in implant-supported restorations, indicating the role played by the high resistant cores for premolar crowns.

Aims: To evaluate the prognostic impact of tumour angiogenesis assessed by vascular endothelial growth factor (VEGF), microvessel density (MVD), and tumour vessel invasion in patients who had undergone radical resection for stage IB-IIA non-small cell lung cancer (NSCLC). Methods: Fifty one patients (42 men, nine women; mean age, 62.3 years; SD, 6.9) undergoing complete surgical resection (35 lobectomy, 16 pneumonectomy) of pathological stage IB (n = 43) and IIA (n = 8) NSCLC were evaluated retrospectively. No patient underwent postoperative chemotherapy or neoadjuvant treatment. Tumour specimens were stained for VEGF and specific MVD markers: CD31, CD34, and CD105. Results: VEGF expression significantly correlated with high CD105 expression (p < 0.0001) and tumour vessel invasion (p = 0.04). Univariate analysis showed that those patients with VEGF overexpression (p = 0.0029), high MVD by CD34 (p = 0.0081), high MVD by CD105 (p = 0.0261), and tumour vessel invasion (p = 0.0245) have a shorter overall survival. Furthermore, multivariate Cox regression analysis showed that MVD by CD34 (p = 0.007), tumour vessel invasion (p = 0.024), and VEGF expression (p = 0.042) were significant predictive factors for overall survival. Finally, the presence of both risk factors, tumour vessel invasion and MVD by CD34, was highly predictive of poor outcome (odds ratio, 3.4; 95% confidence interval, 1.7 to 6.5; p = 0.0002). Conclusions: High MVD by CD34 and tumour vessel invasion are more closely related to poor survival than the other neoangiogenetic factors in stage IB-IIA NSCLC. This may be because these factors are more closely related to the metastatic process.