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Purpose:This 3-year study aimed to evaluate hard and soft tissue modification around a two-piece implant characterized by a transmucosal hyperbolic neck in healthy consecutive patients with a need for single-tooth replacement. Materials and Methods: Two-piece implants (n = 66) were placed with a flapless technique in 56 patients (27 men; 29 women; mean age 55 ± 9 years): 16 immediately after root extraction (immediate group), 20 after 8 to 12 weeks (early group), and 30 after 10 or more months (delayed group). The transmucosal hyperbolic neck was exposed 1 to 1.5 mm above gingival level. Customized abutments were positioned 3 months later with the implant-abutment connection located approximately 1 to 1.5 mm above soft tissue level. Provisional cemented resin crowns were designed with the finishing line at the hyperbolic neck and then positioned to avoid excessive compression of soft tissue, to guide gingival contours. Twenty days later, a definitive metal-ceramic crown was cemented. In all patients, the gingival biotype (thin or thick) was also evaluated. The primary outcomes were as follows: 36-month implant survival rate, peri-implant marginal bone level (MBL, in mm) changes observed in single-blind on radiographs at 1, 3, 6, 12, 24, and 36 months (T1, T3, T6, T12, T24, and T36), and pink esthetic score (PES) at T6, T12, and T36 to analyze soft tissue adaptation after loading and crown application. The secondary outcomes were as follows: plaque score and bleeding on probing (BOP). Linear regression models and multilevel mixed logistic regression were used to detect any statistical difference of MBL according to operative parameters. Kruskal-Wallis one-way analysis of variance (ANOVA) on ranks was performed to assess statistical differences of PES at T6, T12, and T36. Results: The survival rate was 100%. The dropout rate was 1.79%. No infections, mucositis, or peri-implantitis were reported. Implants placed in thick-biotype tissues showed a statistically different lower bone loss at 36 months with respect to the thin biotype (P

Dental professionals often perform physically and mentally demanding therapeutical procedures. They work maintaining muscular imbalance and asymmetrical positions for a long time. The aim of the study was to describe the prevalence and the factors associated to work-related musculoskeletal disorders (WMSD) among Italian dental professionals and the most affected body regions. A cross-sectional observational study was conducted between March 2019 and February 2020. The Nordic Musculoskeletal questionnaire (NMQ) was implemented with questions related to working habits (dental occupation, working hours per week and per days, years of work) and lifestyle (practiced physical activity, including frequency and duration, mobilization activities, and knowledge of ergonomic guidelines) was used. The-chi square test was carried out to detect any statistically significant difference (p &lt, 0.05). Logistic regression was carried out to detect the most significant factors associated to WMSD occurrence. A total of 284 questionnaires have been used for the analysis. A high proportion of dental professionals (84.6%) were affected by WMSD in the last 12 months. A higher prevalence was found in females (87%) when compared to males (80%). The prevalence of WMSD was correlated to the working hours/day and hour/week, with a higher risk for operators working &gt, 5 h/day and &gt, 30 h/week. In addition, a high prevalence was found in operators working for 2–5 years after graduation. Most of the surveyed dental professionals practiced physical activity (70.1%) but only a few had satisfactorily knowledge of ergonomic guidelines (12.7%). Interestingly, participants who practiced yoga or stretching as physical activities demonstrated lower WMSD (77%) when compared to other physical activities (84%). We can highlight that generic physical activities have no functional effect on WMSD for dental professionals. The most affected body areas were neck (59.9%), shoulders (43.3%), lumbar region (52.1%), dorsal region (37.7%) and wrists (30.6%). Considering the magnitude of the problem, there is an urgent need to implement the education in ergonomics among dental professionals, that may be achieved by teaching biomechanics, posturology and integrative functional therapies (such as yoga) during the university education and by promoting holistic health of dental operators.

Tissue regeneration in dentistry has demonstrated impressive progress over during the last decades compared to other medical sciences [...]

Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur through saliva and aerosol droplets deriving from the upper aerodigestive tract during coughing, sneezing, talking, and even during oral inspection or dental procedures. The aim of this study was to assess in vitro virucidal activity of commercial and experimental mouthwashes against a feline coronavirus (FCoV) strain. Commercial and experimental (commercial-based products with addition of either sodium dodecyl sulfate (SDS) or thymus vulgaris essential oil (TEO) at different concentrations) mouthwashes were placed in contact with FCoV for different time intervals, that is, 30s (T30), 60s (T60), and 180s (T180); subsequently, the virus was titrated on Crandell Reese Feline Kidney cells. An SDS-based commercial mouthwash reduced the viral load by 5log10 tissue culture infectious dose (TCID)50/50µl at T30 while a cetylpyridinium (CPC)-based commercial mouthwash was able to reduce the viral titer of 4.75log10 at T60. Furthermore, five experimental mouthwashes supplemented with SDS reduced the viral titer by 4.75–5log10 according to a dose- (up to 4mM) and time-dependent fashion.

Dental-care workers operate very close to the patient&rsquo, s mouth and are at high risk of contamination by SARS-CoV-2. Droplets may be contaminated by patient&rsquo, s saliva and exhaled breath particles. All asymptomatic patients should be considered as Coronavirus positive. All dental procedures must be revised after positive identification of SARS-Cov-2. Novel recommendations as the use of novel suction cannula designed for fast spray/saliva aspiration, use of Tyvek suits and innovative sprayhoods designed for dental-care worker protections are proposed to prevent virus transmission. New tailored operative and clinical procedures are being currently developed by university dental clinics and hospitals in attempt to reduce risk for dental workers and patients.

Zygomatic implant rehabilitation is a challenging procedure that requires an accurate prosthetic and implant plan. The aim of this study was to evaluate the malar bone available for three-dimensional zygomatic implant placement on the possible trajectories exhibiting optimal occlusal emergence. After a preliminary analysis on 30 computed tomography (CT) scans of dentate patients to identify the ideal implant emergencies, we used 80 CT scans of edentulous patients to create two sagittal planes representing the possible trajectories of the anterior and posterior zygomatic implants. These planes were rotated clockwise on the ideal emergence points and three different hypothetical implant trajectories per zygoma were drawn for each slice. Then, the engageable malar bone and intra- and extra-sinus paths were measured. It was possible to identify the ideal implant emergences via anatomical landmarks with a high predictability. Significant differences were evident between males and females, between implants featuring anterior and those featuring posterior emergences, and between the different trajectories. The use of internal trajectories provided better bone engagement but required a higher intra-sinus path. A significant association was found between higher intra-sinus paths and lower crestal bone heights.

Aim: This 60-month prospective study aimed to evaluate tooth survival and healing rates after root canal treatment in patients taking bisphosphonates (BPs). Secondary outcomes were complications and clinical variables observed during and after treatment. Methods: Root canal treatment was performed using manual K-file canal instrumentation and a carrier-based filling technique with an epoxy resin-based sealer. Teeth without adequate root/crown integrity were restored by trained operators at the tissue level (TL group) to prevent occlusal/mechanical stress and to enable periapical lesion healing without the risk of root fracture. Other teeth were restored with normal occlusal contacts (OC group). Healthy patients who had undergone one or more root canal treatments of the same type constituted the control group. The relationships of the following variables to survival and health status were examined (chi-squared test and multivariate analysis, P=0.05): age, gender, smoking habit, tooth location, treatment type, BPs treatment, BPs exposure, initial periapical index (PAI) and occlusal restoration. Survival curves were constructed using Kaplan–Meier analysis, with extraction serving as the end-point. Results: In total, 65 patients with 109 root canal-treated teeth who were taking BPs were included. At 60months, data from 57 patients (52F, 5M; median age 65.7±8.6years) who had undergone 96 root canal treatments were analysed (drop-out rate=16.9%). The survival rate was 85%, and the success rate was 76%. The control group consisted of 46 patients (21F, 25M; median age 60.3±7.2years) who had undergone 102 root canal treatments. The survival rate was 88%, with 12 teeth lost during follow-up. The success rate was 73%. In the BP group, 55 teeth were restored normally (OC group) and 41 teeth were restored at the tissue level (TL group). No difference in the success or survival rate was observed between the BP and control groups (P>0.05). Univariate Kaplan–Meier analysis revealed that only tooth type significantly affected survival status in the BP group. The analysis revealed the clinical relevance of smoking, tooth location and initial PAI on patients’ health status (P&nbsp

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Purpose: To evaluate the factors affecting peri-implant marginal bone level of single platform-switched implants with a smooth neck placed at gingival level (tissue level) using a flapless technique. Materials and Methods: Consecutive healthy patients requiring dental implant rehabilitations were enrolled in this study. Titanium implants with a zirconium-oxide-blasted surface and a platform-switch neck tulip configuration were used. Loading was performed 3 months after insertion with a provisional resin crown and after approximately 15 days with a definitive ceramic crown. Peri-implant marginal bone level (MBL) was measured on periapical radiographs at 1, 3, 6, 12, 24, 36, and 48 months by a blinded assessor. The following parameters were evaluated: location (maxillary/mandibular), position (anterior/posterior), sex (male/female), smoke (yes/no), implant placement timing (immediate, early, delayed), gingival thickness (thin/thick), endodontically treated adjacent teeth (yes/no), and diameter (3.8/4.25/5.0 mm). Multilevel analyses exploring factors associated with MBL at 36 and 48 months were performed. Results: A total of 76 patients (42 women, 34 men; mean age: 55.6 ± 10.7 years) received 128 implant rehabilitations. The survival rate was 98.4%. MBL displayed an initial increase during the first months from insertion (preload period). Cumulative mean MBL at T48 was 0.99 ± 0.68, which was not statistically significant from the values at T24 to T36 (P >.05). Mandibular location, delayed implants, and presence of adjacent endodontically treated teeth showed higher bone loss at 36 months (P .05). Conclusion: Platform-switched implants placed nonsubmerged with a flapless approach showed a reduced bone loss progression in the first 4 years, as MBL remained stable at longer times (36 and 48 months). Implants placed with early and immediate timing showed reduced bone loss compared with delayed implants.

BACKGROUND: One to 6 months after implant placement is a critical time/period responsible for crestal bone loss that may affect implant osseointegration. The study aims to explore the effectiveness of provisional adhesive Maryland-bridge (AMB) applied to prevent marginal bone level (MBL) around implants placed in edentulous crestal bone in posterior area during osseointegration period. METHODS: Healthy, non-smoker patients (N.=18) were included in the study. Titanium implants were placed nonsubmerged (i.e. tissue-level) with cover screws at gingival level in edentulous crestal bone with flapless technique. Nine patients randomly received an AMB, while 9 patients did not receive any AMB. Each AMB remained in place for 3 months and removed before impression. After 3 months abutments were applied, and provisional resin crowns cemented and definitive metal-ceramic crowns were cemented after 2-3 months. Periapical Rx were taken using paralleling technique before and after implant insertion, at 1, 3 months (pre-loading time) and after 6 months (post-loading time). MBL was evaluated in double-blind on scanned periapical radiographs and assessed at mesial and distal side of implants (M-MBL and D-MBL). Area of bone loss on mesial and distal side of implants (Area-M and Area-D) and Cervical Enamel Junction migration of mesial and distal adjacent teeth were also measured (CE J-M and CE J-D). Linear regression models were fitted to evaluate the existence of any significant difference. RESULTS: Two drop-out was observed in AMB group. A total of 16 patients completed the study. After 6 months, all implants were safe and free from complications. AMB group showed the most stable MBL at 1-6 months, statistically different from non-AMB and resulted in a reduced crestal bone loss from baseline compared to Non AMB group. Area-M and Area-D were not statistically different between the groups. CE J-M and CE J-D were stable in both groups. CONCL USIO NS: The use of Adhesive Maryland Bridge to protect non-submerged post-extractive implants is a safe procedure that prevents bone loss around implants and preserve the 3D architecture of crestal bone ridge.

Aim: This retrospective study explored survival and periapical healing outcomes in teeth root filled with Thermafil obturators. Methodology: Root canals of 213 teeth (94 subjects, mean age 48±13years), instrumented with a step-down technique, irrigated with 5% NaOCl and 10% EDTA and filled with Thermafil and AH Plus sealer, were involved in a recall programme. Teeth were retrospectively re-examined after 5±1years in a controlled environment. Clinical and radiographic data that were collected included the following: preoperative Periapical Index (PAI) score and signs/symptoms, treatment type, root filling length and presence/absence of voids, restoration type, follow-up PAI score and signs/symptoms. Teeth were considered ‘healthy’ (PAI≤2, no signs/symptoms) or ‘diseased’ (PAI≥3, signs/symptoms present, retreated, extracted for endodontic reasons). Two PAI-calibrated examiners assessed outcomes blinded to preoperative status. Bivariate and multilevel analyses were performed at level of patient and tooth (α=5%). Results: Of 213 teeth treated, 187 (88%) survived and 26 were extracted, six (3%) for persistent endodontic infection (considered ‘diseased’), and 20 (9%) for root fracture, periodontal disease or coronal fracture (excluded from analysis). Whilst survival was significantly associated with tooth type (P=0.015), type of treatment (P=0.012) and pulpal/periapical diagnosis (P=0.035), none of these variables were substantiated as survival predictors by the multilevel analysis. A total of 164 of 193 teeth (85%) were assessed as ‘healthy’, with significantly higher (chi-square; P&nbsp

Aim: To evaluate the number of healthy and functional root filled teeth of patients included in a recall programme for at least 20years. Methodology: Teeth were root filled by a single specialist following manual canal instrumentation, lateral/vertical compaction of gutta-percha and restored with glass–ionomer cements and bonding system/composite resin. In a large percentage of teeth, a metal-ceramic crown was placed during follow-up. Patients included in the recall programme (n=130) were blindly assessed both clinically and radiographically (every 2years) to evaluate clinical symptoms and periapical status (PAI). The following variables were analysed: age, tooth location, tooth type, initial diagnosis, PAI, root filling length and coronal restoration type. Chi-square test and multilevel analysis were performed to detect variables associated with treatment functionality and disease/lesions (P&nbsp

AIM To test a novel calcium silicate cement mixed with a water-based gel (NeoMTA Plus) with regard to chemical-physical properties and apatite-forming ability. METHODOLOGY NeoMTA Plus (Avalon Biomed Inc. Bradenton, FL, USA; lot. 2014090301) and a commercial MTA-based material with similar properties (MTA Plus, Prevest Denpro Limited, Jammu, India; lot. 41001) were tested for ion-releasing ability, initial and final setting times, radiopacity, open and impervious porosity and apparent porosity, water sorption, weight loss, solubility, ability to nucleate calcium phosphates (CaP) after immersion in HBSS (Hank's Balanced Salt Solution) by ESEM-EDX and micro-Raman spectroscopy. The results were analysed statistically with the anova test (P

Objective To study the in vivo osteoinductive potential, bone-bonding ability (bioactivity) and bone biomineralization of current hydraulic calcium silicate cements used as graft materials and placed in contact with medullary bone. Methods ProRoot MTA, MTA Plus and Biodentine were used to fill surgical bone defects (2-mm diameter through the entire cortical thickness to reach the medullary bone) in the tibia of mature male rabbits. Tibiae were retrieved after 30 days and submitted to histological analysis and microchemical characterization using Optical Microscopy (OM) and Environmental Scanning Electron Microscopy with Energy Dispersive X-ray analysis (ESEM-EDX). Bone neoformation and histomorphometric evaluations, degree of mineralization (by Ca/P, Ca/N and P/N ratios) and the diffusion of material elements were studied. Results Bone neoformation was observed in response to all materials. No sign of necrosis were found on the walls of the pre-existing cortical bone. No osteoclasts and no formation of fibrous tissue were evident. Sign of angiogenesis were present. EDX (element content, line profile and element mapping) showed the increase in Ca and P and decrease in C, S and N from the mature bone towards the mineralizing interface. Ca/P, Ca/N and P/N ratios showed differences in the degree of mineralization/maturation stage of bone. MTA Plus and ProRoot MTA exhibited close contact with the pre-existing bone and good bone-bonding with neoformed bone juxtaposed on the medullary side of the materials without interposed connective tissue or resorption lacunae or gaps. The materials showed a dense appearance with 100% of residual materials and no colonization by fluids and cells. No migration of Bi or Al material elements to the newly formed bone was found. Biodentine showed newly formed trabecular bone with marrow spaces and sparse traces of residual material (≈9%). Significance The in vivo osteoinductive properties with dynamic biomineralization processes around these calcium silicate materials extruded in medullary bone in appropriate animal model have been demonstrated by ESEM-EDX in association with OM. Good biocompatibility was evident as only slight inflammatory infiltrate and no sign of necrosis at the interface with the pre-existing bone were found. MTA Plus and ProRoot MTA exhibited bioactive potential as they can bond to bone directly without interposed connective tissue. Biodentine was replaced by newly formed bone. Clinical significance The results of the study demonstrate the capacity of calcium silicate cements to allow osteoid matrix deposition by activated osteoblasts and favour its biomineralization, and to achieve a direct bond between the (bioactive) materials surface and the mineralized bone matrix.

A pulp capping material must perform as a barrier and protect the dental pulpal complex by inducing the formation of a new dentin bridge or dentin-like tissue. Being a favorable condition for the healing process, the apatite forming ability of TheraCal (light-curable Portland-dimethacrylate cement) and Dycal (calcium hydroxide-based) pulp capping materials was studied in two simulated body fluids, i.e. Dulbecco’s Phosphate Buffered Saline (DPBS) and Hank’s Balanced Salt Solution (HBSS). The cements were analyzed before and after soaking in these media for different times (1–28 days) by ESEM-EDX, micro-Raman and IR spectroscopy. This data article refers to “An in vitro study on dentin demineralization and remineralization: collagen rearrangements and influence on the enucleated phase” (Di Foggia et al., 2019).

Purpose: The aim of this retrospective study was to examine the clinical outcome of Primaconnex implants system (KeystoneDental,MA,USA) after their insertion inmaxilla and mandibular of adults human subjects. Methods andmaterials: Fifty-four patients, (28male and 26 females; aged from 21 to 81 years) were enrolled in this study. A total of 118 implants were inserted. Sixty-five implants were placed in healed site with a full thickness flap surgical procedures, 38 implant were placed in healed sites with a flapless procedure, and 15 implant were placed in conjunction with tooth extraction. Before implant placement and after 3, 6, 12 and 24months intraoral radiographswere taken using a paralleling technique. The distance from the first spire of implant to themarginal crest of the periimplant bone (MCPB), obtained by radiographic evaluation, was measured using a scale divided in 0.1mm. Results: After 2 years, 115 implants were successfully osseointegrated and in place. A total of implants were lost at 3 months, 6 months and 16 months after the insertion. Success rate at 24 month was 97.47%. The total MCPB was 0.25mm at 3 months, 0.46mm at 6 months, 0.60mm at 12 months and 1.04mm at 24 months after implant placement. Table reports the MCPB for the three groups. Conclusion: Primaconnex implants showed a limited reduction of MCPB, suggesting that all the three surgical techniques may preserve the integrity of marginal bone. Further studies are still in progress to compare these data with other implants.