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To evaluate the effectiveness of antiseptic mouthwashes in reducing SARS-CoV-2 load clinically and in vitro. A systematic electronic search (MEDLINE/Scopus/Cochrane) was conducted to identify prospective clinical and in vitro studies published between 2019 included and 16 June 2023 assessing the effectiveness of mouthwashes in reducing SARS-CoV-2 load in saliva or surrogates. Data were summarized in tables and a network meta-analysis was performed for clinical trials. Thirty-five studies (14 RCTs, 21 in vitro) fulfilled the inclusion criteria. The risk of bias was judged to be high for 2 clinical and 7 in vitro studies. The most commonly test product was chlorhexidine alone or in combination with other active ingredients, followed by povidone-iodine, hydrogen peroxide and cetylpyridinium chloride. Overall, the descriptive analysis revealed the effectiveness of the mouthwashes in decreasing the salivary viral load both clinically and in vitro. Network meta-analysis demonstrated a high degree of heterogeneity. Among these studies, only chlorhexidine 0.20% was associated to a significant Ct increase in the saliva 5 min after rinsing compared to non-active control (p = 0.027). Data from clinical and in vitro studies suggested the antiviral efficacy of commonly used mouthwashes. Large well-balanced trials are needed to identify the best rinsing protocols., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors.)

Sphene is an innovative bone graft material. The aim of this study was to investigate and compare the physicochemical and biological properties of Bio-Oss® (BO) and in-lab synthesized and processed sphene granules. BO granules of 1000-2000 μm (BO-L), 250-1000 μm (BO-S) and 100-200 μm (BO-p) for derived granules, and corresponding groups of sphene granules obtained from 3D printed blocks (SB-L, SB-S, SB-p) and foams (SF-L, SF-S and SF-p) were investigated. The following analyses were conducted: morphological analysis, specific surface area and porosity, inductively coupled plasma mass spectrometry (ICP-MS), cytotoxicity assay, Alizarin staining, bone-related gene expression, osteoblast migration and proliferation assays. All pulverized granules exhibited a similar morphology and SF-S resembled natural bone. Sphene-derived granules showed absence of micro- and mesopores and a low specific surface area. ICP-MS revealed a tendency for absorption of Ca and P for all BO samples, while sphene granules demonstrated a release of Ca. No cellular cytotoxicity was detected and osteoblastic phenotype in primary cells was observed, with significantly increased values for SF-L, SF-S, BO-L and BO-p. Further investigations are needed before clinical use can be considered.

Biobanks are not-for-profit services for the collection, processing, storage and distribution of biological samples and data for research and diagnostic purposes. In dentistry, biological materials and data obtained from questionnaires investigating oral conditions can be stored and used for large-scale studies on oral and systemic diseases. To give some examples: gene expression microarrays obtained on biobanked specimens were used in the identification of genetic alterations in oral cancer; efforts to identify genetic mechanisms behind dental caries have been based on an integrative analysis of transcriptome-wide associations and messenger RNA expression. One of the largest studies on facial pain was conducted using Biobank data. Cryopreservation of dental pulp stem cells is a common practice in tooth biobanks. With the exception of teeth and pulp, also leftover oral soft and hard tissues may represent a source of healthy samples that has rarely been exploited as yet. While biobanks are increasingly attracting the attention of the scientific community and becoming economically sustainable, a systematic approach to this resource in dentistry seems to be lacking. This review illustrates the applications of biobanking in dentistry, describing biobanked pathological and healthy samples and data, and discussing future developments., (© 2021 The Authors.)

The aim of this in vitro study was to investigate the commitment and behavior of dental pulp stem cells (DPSCs) seeded onto two different grafting materials, human dentin particulate (DP) and deproteinized bovine bone matrix (BG), with those cultured in the absence of supplements. Gene expression analyses along with epigenetic and morphological tests were carried out to examine odontogenic and osteogenic differentiation and cell proliferation. Compressive testing of the grafting materials seeded with DPSCs was performed as well. DPSC differentiation into odontoblast-like cells was identified from the upregulation of odontogenic markers (DSPP and MSX) and osteogenic markers (RUNX2, alkaline phosphatase, osteonectin, osteocalcin, collagen type I, bmp2, smad5/8). Epigenetic tests confirmed the presence of miRNAs involved in odontogenic or osteogenic commitment of DPSCs cultured for up to 21 days on DP. Compressive strength values obtained from extracellular matrix (ECM) synthesized by DPSCs showed a trend of being higher when seeded onto DP than onto BG. High expression of VEGF factor, which is related to angiogenesis, and of dentin sialoprotein was observed only in the presence of DP. Morphological analyses confirmed the typical phenotype of adult odontoblasts. In conclusion, the odontogenic and osteogenic commitment of DPSCs and their respective functions can be achieved on DP, which enables exceptional dentin and bone regeneration.

The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology., Competing Interests: The authors declare no conflict of interest.

About 50% of vascular malformations are located at the head and neck region where they can usually be associated with functional and/or aesthetic limitations. Laser treatment has proven to be effective in treatment of small low-flow vascular malformations, but little is known about the use of this therapy for high-flow larger arteriovenous malformations (AVMs). A congenital high-flow vascular malformation of the upper lip had to be treated because it was causing functional impairment and deformity which were affecting the quality of life. The mainstay of treatment is surgical therapy after embolization of the lesion, but the treatment of high-flow lesions is difficult because of the high risk of mortality and morbidity. The lesion was then treated with transmucosal diode laser applications in multiple sessions. The lesion progressively reduced in dimension without any sign of recurrence after multiple sessions of transmucosal diode laser applications. The clinical examination and the ultrasound scan performed four years after the last treatment demonstrated that no complications or further recurrence occurred. Multiple sessions of diode laser application can be a safe, effective and minimally-invasive treatment for oral mucosa vascular malformations, even if characterized by high flow.

This scoping review aimed at reporting the outcomes of the bone lid technique in oral surgery in terms of bone healing, ridge preservation, and incidence of complications. Bone-cutting instruments and stabilization methods were also considered. PubMed, Scopus, and the Cochrane Register of Controlled Trials were searched using a combination of terms, including bone lid, bony window, piezosurgery, microsaw, cysts, endodontic surgery, impacted teeth, and maxillary sinus. A hand search was also performed. The last search was conducted on 30 November 2021. No date limitation was set. Searches were restricted to human clinical studies published in English. All types of study design were considered except reviews and case reports. After a two-step evaluation, 20 (2 randomized studies, 2 case-control studies, 3 cohort studies, 13 case series) out of 647 screened studies were included, reporting on 752 bone lid procedures. The bone lid technique was associated with favorable bone healing when compared to other methods, and with a very low incidence of major complications. Clinical indications, surgical procedures, study design, follow-up duration, and outcomes varied among the studies. Overall, favorable outcomes were reported using the bone lid approach, though evidence-based studies were scarce.

Background: The management of eruption anomalies affecting second molars, although quite uncommon, may represent a real challenge for the clinician. The aim of this study is to present a novel technique that combines the surgical and orthodontic approach in order to obtain the retrieval of impacted second molars through a complex distalizing movement and skeletal anchorage., Methods: Nineteen consecutive patients with impacted second molars were treated according to this technique, which involved extraction of the third molar followed by the placement of a distally positioned screw, and the subsequent use of a coil spring to connect the screw to an eyelet directly bonded on the second molar. In selected cases, it proved to be necessary to reposition the second molar through traditional orthodontics. All of the parameters were recorded: the time required for completing the treatment, the initial angle between the second molar and the adjacent tooth, and treatment related-complications., Results: Twenty impacted second molars were correctly repositioned. The mean initial angle of the second molar was 55.7° (SD 22.6°, min 13.3°, max 104.8°). The mean treatment time was 10 months. There were no major complications., Conclusions: Given that periodontal tissues were minimally affected, the temporary anchorage device was fully controlled, and there was no unwanted movement of adjacent teeth, the presented technique not only proved effective but also minimally invasive.

Craniofacial tissue reconstruction still represents a challenge in regenerative medicine. Mesenchymal stem cell (MSC)-based tissue engineering strategies have been introduced to enhance bone tissue repair. However, the risk of related complications is limiting their usage. To overcome these drawbacks, exosomes (EXOs) derived from MSCs have been recently proposed as a cell-free alternative to MSCs to direct tissue regeneration. It was hypothesized that there is a correlation between the biological properties of exosomes derived from the dental pulp and the age of the donor. The aim of the study was to investigate the effect of EXOs derived from dental pulp stem cells of permanent teeth (old donor group) or exfoliated deciduous teeth (young donor group) on MSCs cultured in vitro. Proliferation potential was evaluated by doubling time, and commitment ability by gene expression and biochemical quantification for tissue-specific factors. Results showed a well-defined proliferative influence for the younger donor aged group. Similarly, a higher commitment ability was detected in the young group. In conclusion, EXOs could be employed to promote bone regeneration, likely playing an important role in neo-angiogenesis in early healing phases.

Background: Odontogenic cutaneous sinus tracts are frequently misdiagnosed as cutaneous non-dental related pathologies, due to their lack of a typical morphology, their extraoral location, and the frequent absence of concomitant dental symptoms. An erroneous diagnosis may lead to long-lasting, invasive, and not resolutive surgical and medical treatments., Methods: Four patients referred to our department lamenting the presence of a recurrent facial cutaneous sinus tract. They all had already had different wrong diagnoses and were treated with not resolutive therapies or surgeries. After a clinical and radiographical oral examination, the cutaneous fistulas were found to have a dental etiology, and the extraction of the compromised tooth was performed., Results: One week after the tooth extraction, all the patients presented good healing of the intraoral mucosa. At the long-term follow-up in all four cases, the definitive closure of the extraoral sinus tract and a reduction of the scar was found., Conclusions: If a facial sinus tract is present, the odontogenic etiology should always be considered, since it can easily bring to the correct diagnosis, leading to a rapid resolution of the fistula. Once the dental origin has been confirmed, the suggested treatment for a conclusive resolution of the cutaneous sinus tract is the endodontic treatment or the extraction of the affected tooth.

Purpose: To assess the efficacy of different preventive dental visits and treatments in reducing the risk of medication-related osteonecrosis of the jaws (MRONJ)., Methods: In this retrospective study, patients diagnosed with MRONJ were divided into 5 groups based on available data: no preventive dental visits (group 0); dental visits and compliance with recommended treatments, at the university hospital's dental clinic (group 1) or maxillofacial surgery unit (group 2), or at a private dentist's (group 3); dental visits at one of the above and noncompliance with proposed treatments (group 4); patients judged eligible by the oncologist on panoramic radiography (group 5). Patients were classified on severity of MRONJ according to the Italian SIPMO/SICMF 2.0 staging system. A descriptive analysis was performed on the results. Fisher's exact test was applied (p < 0.05)., Results: Ninety-three patients diagnosed with MRONJ were considered for the study, but 22 were excluded due to a lack of data, leaving a sample of 71 cases. MRONJ staging was only 0 for some patients (26.92%) in group 0. In all groups, the majority of patients had stage 2 MRONJ. The proportions of cases in stage 3 were 7.69% in group 0, 18.18% in group 3, and 43.48% in group 5. Groups 0 and 3 were somewhat similar as regard MRONJ staging. Most patients in group 5 had MRONJ stage 2 or 3. No statistically significant differences emerged between the groups., Conclusions: Preventive dental care can reduce the risk of MRONJ providing patients comply with the specialist's recommendations., (© 2021. The Author(s).)

Objectives: The purpose of the present survey is to give an update of European experts' opinion on infection control and prevention in dentistry during second wave of pandemic. The secondary aim was to analyze how experts' opinion changed in the light of the new scientific evidence since the first wave., Material & Methods: An anonymous online 14-item questionnaire was sent to a total of 27 leading academic experts in Oral (and Maxillofacial) Surgery from different European countries, who had completed a previous survey in April-May 2020. The questionnaire covered the topics of dental setting safety, personal protective equipment (PPE), and patient-related measures to minimize transmission risk. Data collection took place in November-February 2020/21., Results: 26 experts participated in the follow-up survey. The overall transmission risk in dental settings was scored significantly lower compared to the initial survey (p < .05), though the risk associated with aerosol-generating procedures (AGP) was still considered to be high. Maximum PPE was less frequently recommended for non-AGP (p < .05), whereas the majority of experts still recommended FFP2/FFP3 masks (80.8%), face shields or goggles (88.5%), gowns (61.5%), and caps (57.7%) for AGP. Most of the experts also found mouth rinse relevant (73.1%) and reported to be using it prior to treatment (76.9%). No uniform opinion was found regarding the relevance of COVID-19 testing of staff and patients., Conclusion: With the continuation of dental care provision, transmission risk has been scored lower compared to the first wave of pandemic. However, high risk is still assumed for AGP, and maximum PPE remained advised for the respective treatments., (© 2021 The Authors. Clinical Oral Implants Research published by John Wiley & Sons Ltd.)

Biofunctionalization was investigated for polymers and metals considering their scarce integration ability. On the contrary few studies dealt with ceramic biofunctionalization because the bioactive and bioresorbable surfaces of ceramics are able to positively interact with biological environment. In this study the cell-response improvement on biofunctionalized wollastonite and diopside-based scaffolds was demonstrated. The ceramics were first obtained by heat treatment of a silicone embedding reactive oxide fillers and then biofunctionalized with adhesive peptides mapped on vitronectin. The most promising in vitro results, in terms of h-osteoblast proliferation and bone-related gene expression, were reached anchoring selectively a peptide stable toward proteolytic degradation induced by serum-enriched medium. In in vivo assays the anchoring of this protease-stable adhesive peptide was combined with self-assembling peptides, for increasing cell viability and angiogenesis. The results demonstrated external and internal cell colonization of biofunctionalized scaffolds with formation of new blood vessels (neoangiogenesis) and stimulation of ectopic mineralization., (© 2021 IOP Publishing Ltd.)

Objectives: Implantoplasty (IP) is a treatment option for peri-implantitis. Mechanical concerns were raised on fracture resistance of implants subjected to this procedure. This study aimed to compare two methods of IP in terms of implant wear and fracture resistance, and of surface topography., Material and Methods: Eighteen cylindrical screw-shaped dental implants (4 mm diameter, 13 mm length) with an external hexagonal connection were used. IP was performed on the first 6-mm implant surface with a sequence of burs or diamond sonic tips, both followed by an Arkansas finishing. IP duration and implant weight variation were recorded. Micro-computed tomography (micro-CT) was used to evaluate material loss. Implant fracture resistance was assessed by static compression test. Surface topography analysis was performed with a stylus profilometer. Scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS) was applied for implant surface morphology and elemental characterization., Results: Micro-CT showed less material loss in sonic compared to burs. No statistically significant difference was found between the mean fracture resistance values reached in bur and sonic, both followed by Arkansas, and with respect to control. IP performed with burs led to a smoother surface compared to sonic. Equivalent final surface roughness was found after Arkansas in both IP procedures. SEM-EDS showed a deburring effect associated to sonic and revealed carbon and aluminum peaks attributable to contamination with sonic diamond tips and Arkansas bur, respectively., Conclusions: IP with sonic diamond tips was found to be more conservative in terms of structure loss. This could have a clinical relevance in case of narrow-diameter implants., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: The current COVID-19 outbreak in conjunction with the need to provide safe dental treatments and the limited knowledge on the efficacy of protective measures has posed dentists into a challenging situation. Therefore, the present article aimed at collecting experiences and recommendations of frontline clinical experts on critical aspects of dental treatment provision during pandemic., Material & Methods: From a total of 32 European countries, one leading academic expert in Oral and Maxillofacial Surgery or Oral Surgery per country was asked to participate in an anonymous online 10-item survey on COVID-19 covering the topics of safety of dental settings, personal protective equipment (PPE), and patient-related measures to reduce transmission risk. Data collection took place from April 12th to May 22nd, 2020., Results: A total of 27 experts from different European countries completed the survey. The transmission risk of SARS-CoV-2 in dental settings for aerosol-generating procedures was considered high by all experts except two. For aerosol-free and aerosol-generating procedures, more than 80% of the experts recommended face protection and caps for every single treatment. For aerosol-generating procedures, additional measures (FFP2/FFP3 masks and gowns) were suggested by the vast majority of the experts. To reduce transmission risk, all experts recommended limiting aerosol-generating procedures and reducing the number of patients in waiting areas as well as hand hygiene for the patients., Conclusion: The limitation of aerosol-generating procedures along with the usage of adequate personal protection equipment was considered to be crucial to protect dental healthcare providers and patients, thus reducing the transmission risk of COVID-19., (© 2020 The Authors. Clinical Oral Implants Research published by John Wiley & Sons Ltd.)

Introduction: Oligometastatic disease has emerged as an intermediate state between localized and systemic cancer. Improvements in diagnostic modalities such as functional imaging allow a greater frequency of oligometastases diagnosis. Patients with selected oligometastatic epithelial ovarian carcinoma (EOC) may be treated with metastasis-directed stereotactic body radiotherapy (SBRT) rather than chemotherapy., Case Description: We describe a 58-year-old woman who underwent surgery and chemotherapy for an EOC. The patient underwent 3 chemotherapy lines for recurrence of disease, but had allergic reactions and serious hematologic toxicity. During follow-up, lymph node oligometastases were diagnosed and treated with repeated SBRT because the patient refused further chemotherapy. No side effects were observed after each course of SBRT and the patient obtained complete response of all irradiated sites., Conclusions: SBRT is a promising treatment approach for recurrent oligometastatic EOC with a high control rate and irrelevant iatrogenic toxicity. The possibility to repeat SBRT courses when new oligometastases are encountered in other sites resulted in an adequate long-term palliation approach.

Use of the so-called distalizing mechanics is a common treatment to correct class II malocclusion. One of the first appliances made for molar distalization was the pendulum, which resulted immediately efficient. The knowledge of pendulum efficacy, in regards to distalizing treatment in adolescence, has guided the research to analyze pendulum effect in childhood: checking the pre-eruptive, natural and distal movement of upper second premolar following first upper molar distalization in order to obtain an advance resolution on Angle's Class II patient, limited treatment time, reduced periodontal inflammation and stress on permanent teeth root. A pilot study testing the possibility of a prospective study was necessary on 6 patients treated following an accurate protocol (6 months and 1-year Rx control) and 6 patient control after one year. Statistical analysis by T-Test was done. Oral hygiene controls every month were done. Second upper bicuspid vertical (1.6mm) and sagittal (2.5mm) movement mean values allow to emphasize a distal variation of tooth axis inclination of treatment group than control group, and a second upper bicuspid distal departure from "gubernaculus dentis" of second deciduous molar in treated patients. Periodontal inflammation appears inexistent on second and first upper premolar germs after the comparison between RX exam of treatment and control groups because of exploiting deciduous teeth. Besides periodontal inflammation and teeth root stress on first upper molar of treatment group, after RX analysis, results were limited compared to control groups because of the advanced orthodontic interceptive treatment during a previous stage of first upper molar root development., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The purpose was to predict the crown-to-implant ratio variation in the edentulous posterior mandibles rehabilitated with short dental implants. Hence, vertical and horizontal dimensions of dentulous posterior mandibles in a sample of 18- to 25-year-olds were measured, and correlations of these dimensions with sex and site were investigated. Mandibular computed tomography scans from 100 subjects were considered. Vertical and horizontal bone and tooth measurements were taken at the sites of the second premolar (PM), and the mesial and distal roots of the first and second molars (M1m, M1d, M2m and M2d, respectively). A hypothetical crown-to-implant ratio (C/I R) was calculated assuming the insertion of short and extra short implants (5, 6 or 7 mm), at 1.5 mm from the inferior alveolar canal, maintaining the position of the existing occlusal plane. All vertical bone dimensions decreased from the PM to the M2d. Width measurements increased from the mesial (PM) to the distal sites (M1m, M1d, M2m and M2d). Males had significantly greater vertical and horizontal measurements than females at all sites. The mean C/I R was higher than 2 for all sizes of implant. The C/I R was lower for the second molar than for the second premolar, while it was similar for the first molar and the second premolar. Males had a higher C/I R than females. Computed tomography can be used to study the anatomical features of alveolar bone, and to predict some clinical aspects of prosthetic rehabilitation with implants, such as the crown-to-implant ratio in conditions of serious bone atrophy.

Objectives: The purpose of this prospective, single-center randomized pilot study was to histologically evaluate and compare vital bone development in premolar and molar-extraction sites grafted with two different bovine-derived xenografts. The secondary outcome of interest was implant survival in the grafted sites., Materials and Methods: Adult patients in need of at least two tooth extractions were enrolled. A paired design was used; each patient received at least one of each type of graft at different sites. Each extraction site was randomized to one of two xenograft treatment groups. A resorbable membrane was always placed, and primary intention soft tissue closure was achieved. Four months later, implants were placed and a trephine drill was used to remove bone cores for histologic and histomorphometric analysis., Results: Sixteen patients with 40 extraction sites were enrolled; 20 sites were grafted with one type of xenograft and 20 with another. Mean patient age was 53.5 years, and 65% of patients were male. Evaluation of bone core samples taken from grafted sites showed no significant difference in the mean value of percentage of new bone formation between the different grafted sites (33.4% and 32.4%, p = .76). Cumulative implant survival was 97.5% at the 24-month follow-up visit., Conclusion: Within the limitations of this pilot study, no statistically significant differences in new bone growth between sites grafted with two different types of xenograft were found. Both graft materials promoted the formation of new bone and provided osseous support for implant placement after socket grafting., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Silica-based ceramics have been proposed for coating purposes to enhance dental and orthopedic titanium (Ti) implant bioactivity. The aim of this study was to investigate the influence of sphene-based bioceramic (CaO.TiO 2 .SiO 2 ) coatings on implant osseointegration in vivo. Sphene coatings were obtained from preceramic polymers and nano-sized active precursors and deposited by an automatic airbrush. Twenty customized Ti implants, ten sphene-coated and ten uncoated rough implants were implanted into the proximal femurs of ten Sprague-Dawley rats. Overall, cortical and cancellous bone-to-implant contact (BIC) were determined using micro-computed tomography (micro-CT) at 14 and 28 days. Moreover, peri-implant bone healing was histologically and histomorphometrically evaluated. The white blood cell count in the synovial fluid of the knee joints, if present, was also assessed. No difference in the BIC values was observed between the sphene-coated and uncoated implants, overall and in the two bone compartments ( p > 0.05). Delamination of the coating occurred in three cases. Consistently with micro-CT data, the histological evaluation revealed no differences between the two groups. In addition, no synovial fluid could be collected on the test side, thus confirming sphene biocompatibility. In conclusion, sphene coating was found to be a suitable material for biomedical applications. Further studies are needed to improve coating adhesion to the implants.

Bioceramic scaffolds are appealing for alveolar bone regeneration, because they are emerging as promising alternatives to autogenous and heterogenous bone grafts. The aim of this systematic review is to answer to the focal question: in critical-sized bone defects in experimental animal models, does the use of a bioceramic scaffolds improve new bone formation, compared with leaving the empty defect without grafting materials or using autogenous bone or deproteinized bovine-derived bone substitutes? Electronic databases were searched using specific search terms. A hand search was also undertaken. Only randomized and controlled studies in the English language, published in peer-reviewed journals between 2013 and 2018, using critical-sized bone defect models in non-medically compromised animals, were considered. Risk of bias assessment was performed using the SYRCLE tool. A meta-analysis was planned to synthesize the evidence, if possible. Thirteen studies reporting on small animal models (six studies on rats and seven on rabbits) were included. The calvarial bone defect was the most common experimental site. The empty defect was used as the only control in all studies except one. In all studies the bioceramic materials demonstrated a trend for better outcomes compared to an empty control. Due to heterogeneity in protocols and outcomes among the included studies, no meta-analysis could be performed. Bioceramics can be considered promising grafting materials, though further evidence is needed., Competing Interests: The authors declare no conflict of interest.

The objective of this study was to compare the healing of the augmented sinus at which the antrostomy was covered with a membrane or the repositioned bone plate.Eight sheep underwent bilateral maxillary sinus floor augmentation. The control site was covered with a resorbable membrane, while at the experimental site the bone plate was repositioned, and both were secured with cyanoacrylate. Animals were euthanised after 4 months and histomorphometric analysis was performed.A large amount of the graft appeared to be partially interpenetrated by the newly formed bone. Statistical analysis demonstrated different percentages of the new bone and bone interpenetrated to the graft between test and control site in the close-to-window area respectively 22.1 ± 12.6 vs 7.5 ± 4.5 (P = 0.028) and 66.1 ± 14.7 vs 44.2 ± 15.1 (P = 0.046). Other areas showed no difference in the bone and graft amount. More bone was found at the edges of the antrostomy in the experimental site, without statistical significance. In the centre of the antrostomy, the replaced bony window appeared bonded to the newly formed bone. No remnants and no biological response to cyanoacrylate were observed.The repositioning of the bony window after sinus floor elevation in sheep led to a larger amount of newly formed bone in the close-to-window zone of the grafted area. The bony window appeared partially bonded to the new bone. Newly formed bone was found interpenetrating the graft granules.

Background: Bone overheating during osteotomy is a potential cause of necrosis and consequent failure of dental implant osseointegration. The aim of this study is to identify any differences between conventional osteotomy with drills of increasing size and the use of a single drill in terms of the temperature increase in the bone during implant site preparation., Methods: Thirty-eight implant sites were prepared in ex vivo human mandibles, 19 using the conventional method with drills of increasing diameter (group A) and 19 using a single-drill method (group B), with no irrigation in either procedure. An infrared thermometer was used to measure the temperature difference (T°) induced by the drills at each site. Student's t-test (with P<0.05) was used to compare the temperature increase induced by the last drill in group A, and by the single drill in group B., Results: The mean ΔT° in group A was 0.64 °C, while in group B it was 1.47 °C. The difference between the temperatures obtained in the two groups was statistically significant (P=0.0073)., Conclusions: In statistical terms, the two methods differ significantly in the temperature increase induced by the drilling procedure, but this difference is clinically irrelevant.

Purpose: To evaluate the influence of the crown-to-implant ratio (CI) on marginal bone loss (MBL) around short dental implants placed in the posterior mandible., Materials and Methods: All patients treated with short implants (7 mm length) in the posterior mandible between 1994 and 2003 at the Dental Clinic of the Department of Neuroscience of the University of Padua (Italy) were retrospectively included in the analysis. MBL and clinical CI (cCI) were measured on the radiographs. Implant characteristics including implant diameter, prosthetic type, retention mode, antagonist type, veneering material, and implant surfaces were retrieved from local medical records. A generalized linear mixed model was estimated to identify the predictors of MBL., Results: A total of 108 dental implants placed in 51 patients were included in the analysis. Mean follow-up was 16 years (range: 11 to 20 years). Mean cCI was 2.21 (SD = 0.31) with a mean crown height of 10.86 mm (SD = 0.99). Mean MBL was 1.42 mm (SD = 0.38). At multivariable analysis, cCI ≥ 2 was associated with higher MBL (regression coefficient: 0.27; 95% CI: 0.15 to 0.40), while implant characteristics, follow-up, and site were not associated with MBL. The effect of a cCI ≥ 2 was estimated in an increase of 0.28 mm in MBL (95% CI: 0.14 to 0.43 mm)., Conclusion: Higher cCI was associated with greater MBL of implant-supported fixed dental prostheses in short dental implants placed in the posterior mandible, while implant characteristics, follow-up, and site were not associated with MBL. However, the increase of 0.28 mm of MBL in patients with a cCI ≥ 2 may be not clinically relevant.

Introduction: Severe plasminogen (PLG) deficiency causes ligneous conjunctivitis, a rare disease characterized by the growth of fibrin-rich pseudomembranes on mucosal surfaces; gums involvement leads to ligneous gingivitis (LG). Specific therapy for LG is not available yet. We report a prophylactic treatment with enoxaparin and fresh frozen plasma (FFP) for invasive dental procedures in a patient with LG, and a review of literature on LG treatment., Methods: A 43-year-old female with LG was studied. In order to prevent LG recurrence after dental care, FFP before and the day after the procedure, and enoxaparin were administered in addition to proper minimally invasive dentistry techniques and implant surgery., Results: Plasminogen deficiency was confirmed by reduced PLG antigen (25 μg/mL) and activity (20%) levels, and genetic analysis. PLG levels rose to 46% after FFP transfusion and returned to baseline after 48 hours. Minimally invasive dental procedures and implants were performed. Small gingival pseudomembranes developed soon thereafter in some cases but disappeared within a few weeks; no bleeding complications were observed., Conclusions: In our patient with LG, the adoption of combined haematological and dentistry protocols appeared to be safe and effective in preventing abnormal gingival pseudomembranes growth after dental interventions, maintaining a healthy periodontal condition., (© 2019 John Wiley & Sons Ltd.)

Peri-implantitis is an inflammatory disease affecting tissues surrounding dental implants. Although it represents a common complication of dental implant treatments, the underlying mechanisms have not yet been fully described. The aim of this study is to identify the role of titanium nanoparticles released form the implants on the chronic inflammation and bone lysis in the surrounding tissue. We analyzed the in vitro effect of titanium (Ti) particle exposure on mesenchymal stem cells (MSCs) and fibroblasts (FU), evaluating cell proliferation by MTT test and the generation of reactive oxygen species (ROS). Subsequently, in vivo analysis of peri-implant Ti particle distribution, histological, and molecular analyses were performed. Ti particles led to a time-dependent decrease in cell viability and increase in ROS production in both MSCs and FU. Tissue analyses revealed presence of oxidative stress, high extracellular and intracellular Ti levels and imbalanced bone turnover. High expression of ZFP467 and the presence of adipose-like tissue suggested dysregulation of the MSC population; alterations in vessel morphology were identified. The results suggest that Ti particles may induce the production of high ROS levels, recruiting abnormal quantity of neutrophils able to produce high level of metalloproteinase. This induces the degradation of collagen fibers. These events may influence MSC commitment, with an imbalance of bone regeneration.

This study evaluated the arthritogenic effect of lipopolysaccharide (LPS) in a mouse model of periodontal disease. Periodontitis was induced in wild-type CD1 mice by nine LPS injections (10 or 50 ng) into the maxillary mucosa. Untreated mice or injected with LPS at the tail were used as controls. Two weeks after final inoculation, mice were sacrificed to collect blood, maxilla, and paw samples. Development and progression of periodontitis and arthritis were monitored using clinical assessment, micro-computed tomography (micro-CT), ultrasound (US), and histological analysis. CXCL1, IL-1β, IL-6, TNF-α, and anti-citrullinated peptide antibodies (ACPA) serum levels were determined by enzyme immunoassay. Ankle swelling and inflammation manifested after the 5th periodontal injection of 50 ng of LPS and progressed until the end of experiments. Periodontal injection of 10 ng of LPS and LPS tail injection did not induce paw changes. Therefore, the subsequent assessments were conducted only in mice periodontally injected with 50 ng of LPS. Maxillary micro-CT and histological analysis showed that LPS-induced alveolar bone resorption and vascular proliferation in periodontal tissue, but not inflammation. US and histology revealed increased joint space, leukocyte infiltration, synovial proliferation, and mild cartilage and bone destruction in the paws of mice orally injected. Cytokines and ACPA showed a trend towards an increase in LPS mice. This study shows that arthritis and periodontal disease can co-occur in wild-type mice after periodontal injection of LPS at optimal dose. Our model may be useful to improve the understanding of the mechanisms linking periodontitis and arthritis.

Titanium implant surface modifications have been widely investigated to favor the process of osseointegration. The present work aimed to evaluate the effect of sphene (CaTiSiO₅) biocoating, on titanium substrates, on the in vitro osteogenic differentiation of Human Adipose-Derived Stem Cells (hADSCs). Sphene bioceramic coatings were prepared using preceramic polymers and nano-sized active fillers and deposited by spray coating. Scanning Electron Microscopy (SEM) analysis, surface roughness measurements and X-ray diffraction analysis were performed. The chemical stability of the coatings in Tris-HCl solution was investigated. In vitro studies were performed by means of proliferation test of hADSCs seeded on coated and uncoated samples after 21 days. Methyl Thiazolyl-Tetrazolium (MTT) test and immunofluorescent staining with phalloidin confirmed the in vitro biocompatibility of both substrates. In vitro osteogenic differentiation of the cells was evaluated using Alizarin Red S staining and quantification assay and real-time PCR (Polymerase Chain Reaction). When hADSCs were cultured in the presence of Osteogenic Differentiation Medium, a significantly higher accumulation of calcium deposits onto the sphene-coated surfaces than on uncoated controls was detected. Osteogenic differentiation on both samples was confirmed by PCR. The proposed coating seems to be promising for dental and orthopedic implants, in terms of composition and deposition technology.

Lateral periodontal cysts (LPCs) are rare odontogenic cysts of developmental origin. A 52-year-old man presented with an asymptomatic gingival swelling located between the mandibular left canine and first premolar, both of which were vital. Radiography showed a well-circumscribed radiolucent area and loss of the lamina dura around the tooth socket in contact with the lesion and of the interproximal buccal bone. The lesion was enucleated. The defect was immediately grafted with a 1:1 mixed autologous and heterologous bone graft covered with a collagen membrane. Histology confirmed the diagnosis of LPC. At 12- and 24-month clinical and radiologic follow-up, complete bone and periodontal healing was found, with no sign of recurrence.

Background: Alveolar bone cyst enucleation can give rise to critical-size defects whose healing may be incomplete due to the loss of periosteum or bone walls and there is a paucity of studies investigating the use of immediate bone grafts. The aim of this study was to compare spontaneous healing versus a deproteinized bovine bone graft., Methods: In this prospective randomized clinical pilot study, twenty patients requiring the removal of a cyst ≥20 mm in maximum diameter were randomly assigned to one of two groups: deproteinized bovine bone grafting (test) or spontaneous healing (control). Computed tomographies were obtained preoperatively and 12 months after surgery and the radiolucent volumes were compared. Residual radiological morphology and clinical outcomes at 7 days and 1, 6 and 12 months after surgery were also assessed., Results: The median percentage reduction in the volume of the defect was 98% in the test group and 73% in the control group (P=0.001) with an evidence of soft tissue invagination in the latter. There were no differences in the clinical parameters between the two groups., Conclusions: Within the limitations of this pilot study, the healing of critical-size alveolar bone defects is incomplete at 1 year observation and the use of deproteinized bovine bone graft did not influence the clinical outcomes.

Improving soft tissue attachment and reducing bacterial colonization on titanium abutments are key factors for the long-term maintenance of healthy soft and hard peri-implant tissues. This in vitro study was conducted to compare the biocompatibility and antibacterial activity of four different surfaces: uncoated Ti6Al4V, anodized, and coated with titanium nitride or zirconium nitride. Surface topography was investigated with a high-resolution system for measuring surface finishes. Human gingival fibroblast (HGF) adhesion and proliferation were examined using MTT assay, Scanning Electron Microscopy (SEM) imaging, immunofluorescence analysis and real-time PCR for selected target genes. The hemolysis and AMES tests were performed to assess the chemical compounds' blood compatibility and mutagenic potential, respectively. Antibacterial activity was tested against five bacterial strains isolated from the oral cavity (Streptococcus salivarius, S. sanguinis, S. mutans, S. sobrinus, S. oralis), and the percentage of dead bacteria was calculated. Roughness measurements confirmed a substantial similarity between the surfaces and their compatibility with clinical applications. MTT assay, SEM analysis and immunofluorescence staining showed adhesion and proliferation of HGFs cultured on all the examined surfaces. PCR confirmed that HGFs produced extracellular matrix components efficiently on all the surfaces. No hemolytic activity was detected, and the AMES test confirmed the surfaces' clinical safety. For all tested bacterial strains, biofilms grown on the zirconium nitride surface showed a higher percentage of dead bacteria than on the other disks. The titanium nitride surface inactivated bacterial biofilms, too, but to a lesser extent., Competing Interests: This work was partially supported by MegaGen Implant Co. Ltd. (South Korea), which provided the disks. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Implant site preparation through drilling procedures may cause bone thermonecrosis. The aim of this in vitro study was to evaluate, using a thermal probe, overheating at implant sites during osteotomies through 2 different drilling methods (continuous drilling technique versus intermittent drilling technique) using irrigation at different temperatures. Five implant sites 13 mm in length were performed on 16 blocks (fresh bovine ribs), for a total of 80 implant sites. The PT-100 thermal probe was positioned 5 mm from each site. Two physiological refrigerant solutions were used: one at 23.7°C and one at 6.0°C. Four experimental groups were considered: group A (continuous drilling with physiological solution at 23.7°C), group B (intermittent drilling with physiological solution at 23.7°C), group C (continuous drilling with physiological solution at 6.0°C), and group D (intermittent drilling with physiological solution at 6.0°C). The Wilcoxon rank-sum test (2-tailed) was used to compare groups. While there was no difference between group A and group B (W = 86; P = .45), statistically significant differences were observed between experimental groups A and C (W = 0; P =.0001), B and D (W = 45; P =.0005), and C and D (W = 41; P = .003). Implant site preparation did not affect the overheating of the bone. Statistically significant differences were found with the refrigerant solutions. Using both irrigating solutions, bone temperature did not exceed 47°C.

Objective: The current work examined a consecutive series of patients presenting vascular malformations (VMs) and venous lakes (VLs) of the lip and oral mucosa who were treated with transmucosal diode laser applications and assessed over a 1 year period., Study Design and Methods: Fifty-nine patients (31 males and 28 females) presenting low-flow VMs or VLs of the oral cavity were treated transmucosally using a diode laser (with an 830 nm operating wavelength and 1.6 W output power) with a 320 µm diameter flexible fiber. All the lesions were assessed 7 days, 30 days, and 1 year after the laser treatment, and the lesion reduction percentage was scored on a one to five scale. The patients were also asked to assess their pain perception daily during the 7 days following the treatment using a visual analog scale (VAS)., Results: There were no procedure-related intra- or post-operative complications; only modest pain intensity was reported. Thirty days after the treatment, lesion reduction was described as excellent or good in 52 cases; it was fair or poor in 7. Six patients (F:M ratio 2:4) required a second diode laser application. At the 1 year follow-up, volume reduction was complete in 48 out of 59 patients; there were five recurrences (F:M ratio 3:2). No relevant gender-related differences were noted., Conclusion: The use of diode laser application to treat small oral VMs and VLs was associated to shorter operating times and fewer postoperative complications with respect to the scapel surgery approach. More than one session may nevertheless be required if the anomaly is larger than 10 mm. Lasers Surg. Med. 50:111-116, 2018. © 2017 Wiley Periodicals, Inc., (© 2017 Wiley Periodicals, Inc.)

Objective: The study aimed to assess the effect of topical applications of an amino acid and sodium hyaluronate gel after mandibular third molar extraction., Method and Materials: 136 patients requiring mandibular third molar extraction were enrolled. An amino acid and sodium hyaluronate gel was applied to the sockets of patients in the test group immediately following the extraction. The sockets of controls were simply flushed with a sterile saline solution. Patients' outcomes and postoperative complications were assessed 7 and 14 days after surgery. The cumulative incidence of dehiscence and secondary outcome measures were analyzed using a chi-square test., Results: Concerning the primary outcome, the incidence of dehiscence was 27.4% after 7 days in the treatment group and 36.4% in the controls (P = .28), and at 14 days it was 21.4% and 36.0%, respectively (P = .10). No statistically significant differences emerged in other variables (mouth opening range, appearance of soft tissue, presence of pus, pain on palpation of the alveolar socket, alveolitis, local lymphadenopathy, and adverse reactions). Pain perception was always lower in the treatment group during the first 7 days after surgery., Conclusion: Topical applications of an amino acid and sodium hyaluronate gel after mandibular third molar extraction made no statistically significant difference to the variables examined in the test and control groups., Clinical Relevance: This trial focused on postoperative complications after surgical third molar extraction. The use of a gel containing amino acid and sodium hyaluronate was investigated for the management of postoperative pain, edema, alveolitis, wound dehiscence and swelling.

Introduction: During osseointegration process, the presence of an inflammatory event could negatively influence the proper osteogenetic ability of the implant surface. In order to reduce this possibility, an implementation of angiogenetic event through the release of Vascular Endothelial Growth Factor (VEGF) can be a tool as co-factor for osteoblastic differentiation. In this paper, novel dental implant surfaces enriched with VEGF have been tested., Material and Methods: The ability of VEGF-enriched titanium implants to improve the osteogenetic properties of Mesenchymal stem cells (MSC), also in the presence of an inflammatory environment, have been in vitro tested. Molecular biology, morphological analyses, and biochemical tests have been performed in order to confirm biological properties of these surfaces., Results: Our results confirm that the presence of VEGF onto the implant surface is able not only to protect the cells from in vitro aging and from Reactive Oxygen Species (ROS) damage, but it also improves their osteogenic and endothelial differentiation, even in the presence of inflammatory cytokines., Conclusion: This study establishes a biologically powerful novel tool that could enhance bone repair in dental implant integration., Competing Interests: The authors declare no conflict of interest.

Objectives: The purpose of the present study was to investigate the occurrence and clinical features of delayed-onset infections after mandibular third-molar extractions., Method and Materials: An observational cohort study was conducted on 179 patients undergoing mandibular third-molar extraction between January 2013 and December 2015, for a total of 217 extractions. Data were recorded at the time of extraction ( T 0 ), on suture removal seven days later ( T 1 ), and 30 days after the extraction, when patients were contacted and asked about their healing process ( T 2 ). The statistical analysis was performed with nonparametric tests. A p value lower than 0.05 was considered statistically significant., Results: Eight delayed-onset infections were recorded, amounting to 3.7% of all extractions. The median time elapsing from the extraction to the delayed-onset infection was 35 days (IQR 28-40; min 24-max 49). Younger age and longer surgical procedures seemed to be more often associated with this complication., Conclusion: Delayed-onset infections after third-molar extractions are relatively rare postoperative complications characterized by a swelling, usually with a purulent discharge. Patients should be informed of this possibility, which might develop even several weeks after the extraction.

Background: Patients with suspected recurrence of prostate cancer undergoing [18F]fluoromethyl choline ([18F]FCH) PET/CT were retrospectively evaluated to investigate the influence of hormonal therapy (HT) in [18F]FCH uptake., Methods: [18F]FCH PET/CT was performed in 102 surgically treated patients with suspected recurrence (PSA increase >0.2 ng/mL) of prostate cancer, divided in two groups: under HT (N.=54) and without HT (N.=48) at the time of PET scanning. PET/CT was carried out by an integrated system (Biograph 6, CTI/Siemens, Knoxville, TN, USA) intravenously by administering 4.1 MBq/kg of [18F]FCH to each patient; images were acquired 60 minutes later., Results: On the total number of patients, 66 were found to be true positives (TP), 9 false positives (FP), 5 false negatives (FN) and 22 true negatives (TN), sensitivity to [18F]FCH PET/CT was 93%, specificity 71%, accuracy 86%, positive predictive value (PPV) 88%, negative predictive value (NPV) 81%. In the 54 patients under HT, 38 were TP, 6 FP, 3 FN and 7 TN, sensitivity was 93%, specificity 54%, accuracy 83%, PPV 86% and NPV was 70%. In the 48 patients receiving no HT, 28 were TP, 3 FP, 2 FN and 15 TN, sensitivity was 93%, specificity 83%, accuracy 90%, PPV 90% and NPV 88%. A χ2 test showed that sensitivity, accuracy and PPV did not differ among patients with and without HT, while specificity and NPV were significantly lower (P<0.001) in HT treated patients., Conclusions: Sensitivity, accuracy and PPV were similar in patients with and without HT. Specificity and NPV were reduced in patients under HT, but further data are necessary to support if this reduction is casual or related to therapy and it could be confirmed in a larger series of patients.

Surface topography of Titanium (Ti) dental implants strongly influences osseointegration. In the present work, we have analyzed the influence of two Ti implant surfaces characterized by similar microtopography but different nanotopography and chemistry on the osteoblastic phenotype of Dental Pulp Stem Cells (DPSCs). The effect on osteogenic differentiation, extracellular matrix (ECM) and cell adhesion molecules production have been evaluated by means of molecular biology analyses. The morphology of the cells grown onto these surfaces has been analyzed with SEM and immunofluorescence (IF), and the safety of the surfaces has been tested by using karyotype analysis, Ames test and hemocompatibility assay. Results showed that starting from 15 days of DPSCs culture, a substantial expression of osteoblast specific markers and a strong increase of cell adhesion molecules can be detected. In particular, when DPSCs are seeded on the Ti implants expression of microRNA (miRNA)-196a, which is involved in osteoblastic commitment of stem cells, and of Vascular Cell Adhesion Molecule 1 (VCAM1), a factor involved in angiogenesis, is strongly enhanced.

By definition, osseointegration means close contact between bone and implant. Bone response is related to implant surface properties. Various surfaces have been studied and applied to improve the biological properties of the implant and thereby favor the mechanism of osseointegration. This strategy aims to promote osseointegration by means of a faster and stronger bone formation, improving stability during the healing process, and thus allowing for earlier loading of the implant. Dental implant osseointegration has so far been studied in various animal models. The development of a method based on tissue engineering for assessing the osseointegration process in vitro could prove a valid biomimetic alternative to sacrificing animals. In this study, flat cylindrical dental implants with moderately rough surfaces and machined implants were set in bovine bone blocks. Then, adipose-derived stem cells (ADSCs) were three dimensionally cultured onto these blocks in osteo-endothelial medium for up to 30 days to mimic the osseointegration process in vitro. Scanning electron microscopy (SEM) and gene expression were used to examine stem cell commitment. Mechanical pull-out tests were also performed. SEM analysis identified cells with an osteoblast morphology adhering to the surface of the implants after their removal. Gene expression analysis showed that ADSCs seeded onto the bone blocks were able to express osteoblast and endothelial markers. The implants with the moderately rough surface generated higher pull-out strengths when compared with the machined implants. Nevertheless, the pull-out test values were higher for implants placed in bone blocks with ADSCs than for those set in scaffolds without stem cells. Our results demonstrate the validity of the method adopted and its potential for use in the in vitro assessment of the biological behavior of dental implant surfaces.

Peripheral Ameloblastoma (PA) is the rarest variant of ameloblastoma. It differs from the other subtypes of ameloblastoma in its localization: it arises in the soft tissues of the oral cavity coating the tooth bearing bones. Generally, it manifests nonaggressive behavior and it can be treated with complete removal by local conservative excision. In this study we report a case of PA of the maxilla in a 78-year-old female patient and we describe the four different histopathological patterns revealed by histological examination. After local excision and diagnosis, we planned a long term follow-up: in one year no recurrence had been reported. The choice of treatment is illustrated in Discussion.

Aim: Anxiety is a relevant problem in dental practice. The Modified Dental Anxiety Scale (MDAS) is a brief, simple questionnaire consisting of five questions with a total score ranging from 5 to 25, the Italian version of which is not available yet. The aim of the study was to provide an Italian version of the MDAS and check its reliability in oral surgery, which is a major cause of dental anxiety due to the expected perception of pain and suffering., Methods: The Italian version of the test was administered to 230 patients (98 male and 132 female patients, ages 14-88 years) undergoing oral surgery. Further recorded data were: American Society of Anaesthesiologists physical status classification (ASA-PS), frequency of visiting the dentist and any previous distressing experiences in dental or medical setting., Results: The internal consistency of the test was high, with a Cronbach's alpha=0.92. The MDAS score was significantly higher in females (P<0.0001) and in patients with previous distressing experiences in medical and/or dental settings (P<0.0001); the correlation with age (P=0.01) and frequency on visiting the dentist (P=0.02) were also significant., Conclusions: The patients' selection (oral surgery only) may be a limit of the study, which might not provide an estimation of anxiety prevalence in the general dental population; however our result agree with those of studies performed in other Countries in the generic population, suggesting the absence of major differences with respect to the surgical setting and show the reliability and manageability of the Italian version of MDAS.

Despite progress in surgery, radiotherapy, and in chemotherapy, an effective curative treatment of brain cancer, specifically malignant gliomas, does not yet exist. The efficacy of current anti-cancer strategies in brain tumors is limited by the lack of specific therapies against malignant cells. Besides, the delivery of the drugs to brain tumors is limited by the presence of the blood-brain barrier. Nanotechnology today offers a unique opportunity to develop more effective brain cancer imaging and therapeutics. In particular, the development of nanocarriers that can be conjugated with several functional molecules including tumor-specific ligands, anticancer drugs, and imaging probes, can provide new devices which are able to overcome the difficulties of the classical strategies. Nanotechnology-based approaches hold great promise for revolutionizing brain cancer medical treatments, imaging, and diagnosis.

Purpose: The study aims to evaluate three-dimensionally (3D) the accuracy of implant impressions using a new resin splinting material, "Smart Dentin Replacement" (SDR)., Materials and Methods: A titanium model of an edentulous mandible with six implant analogues was used as a master model and its dimensions measured with a coordinate measuring machine. Before the total 60 impressions were taken (open tray, screw-retained abutments, vinyl polysiloxane), they were divided in four groups: A (test): copings pick-up splinted with dental floss and fotopolymerizing SDR; B (test): see A, additionally sectioned and splinted again with SDR; C (control): copings pick-up splinted with dental floss and autopolymerizing Duralay® (Reliance Dental Mfg. Co., Alsip, IL, USA) acrylic resin; and D (control): see C, additionally sectioned and splinted again with Duralay. The impressions were measured directly with an optomechanical coordinate measuring machine and analyzed with a computer-aided design (CAD) geometric modeling software. The Wilcoxon matched-pair signed-rank test was used to compare groups., Results: While there was no difference (p = .430) between the mean 3D deviations of the test groups A (17.5 μm) and B (17.4 μm), they both showed statistically significant differences (p < .003) compared with both control groups (C 25.0 μm, D 19.1 μm)., Conclusions: Conventional impression techniques for edentulous jaws with multiple implants are highly accurate using the new fotopolymerizing splinting material SDR. Sectioning and rejoining of the SDR splinting had no impact on the impression accuracy., (© 2015 Wiley Periodicals, Inc.)

The development of new orally administered anticoagulants, such as dabigatran, rivaroxaban, and apixaban, in the past few years has focused on avoiding some of the drawbacks associated with warfarin. This work aims to illustrate the main features of the most commonly used new oral anticoagulants, reviewing the current literature on the management of patients taking these drugs and needing oral and implant surgery, and discussing the currently proposed related guidelines.