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Two conditions are necessary for a correct and functional prosthetic implant rehabilitation: maintaining pre-implant soft tissue health and stability of bone tissue, in terms of implant osseous-integration and maintenance of optimal crestal attachment levels. In addition to these parameters - necessary for the longevity of the restoration - one of the main aspects of therapy is the achievement of a final aesthetic that reproduces as faithfully as possible the natural anatomy of the lost tooth and the associated soft tissues. To achieve this last objective, an implant system was designed and used by our group. This implant is characterized by a convergent trans-mucosal emergence fixture associated with a progressive closing system of trans-mucosa healing pillars (healing abutment). This guarantee, together with the micro and macrostructure of the implant, an immediate and highly aesthetic condition of the peri-implant soft tissues, and in the same time an optimal seal on the convergent neck of the implant itself., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The articular disc is an important component of the temporomandibular joint, whose morphology has been studied on autopsy and biopsy materials. The normal posterior attachment of the disc is usually described as having two layers, one upper and one lower. The upper layer consists of elastic fibres, collagen fibres, fat deposits and blood vessels. It is connected posteriorly to the anterior face of the post-glenoid tubercle, the tympanic wall of the temporal bone, the cartilaginous meatus and the parotid gland lining. The lower layer, on the other hand, consists of a compact lamina of non-elastic collagen fibres, attached to the posterior surface of the condyle. Elastic fibres are one of the main constituents of the extracellular matrix of many connective tissues, and they are believed to play a very important role in the normal functions of many tissues such as blood vessels, lungs and dermis. The existence and functional importance of a fibroelastic tissue in the upper layer of the posterior portion of the articular disc has been described in human TMJ and in joints of many animal species. In human TMJ, it is believed that elastic fibres in the posterior and anterior attachment regions may play an important role in the repositioning of the disc during jaw closure. This study presents a review of the current literature on the morphology of elastic fibres in the posterior portion of the joint disc and the role attributed to them during all functions., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Purpose: To evaluate implant and prosthetic survival rates, complications, patient satisfaction, and biological outcomes of patients rehabilitated with a ball attachment system for implant retained- and supported-overdentures (IOV), which was in function for 3 to 5 years., Methods: This retrospective study evaluated data collected from patients treated between April 2001 and May 2018 with IOV on splinted and non-splinted implants and a ball attachment system. Patients were followed for 36 to 206 months (mean follow-up was 128.1 ± 51.9 months). Data were collected at the 3- and 5-year follow-up examination. Outcome measures were implant and prosthetic survival rates, technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), and periodontal parameters (bleeding on probing and plaque index)., Results: A total of 46 patients (16 males and 30 females) with 124 implants were included in this study. Twenty-five implant-retained overdentures were delivered on 53 unsplinted implants, while the other 21 patients received an implant-supported overdentures and the implants were splinted. At the five-year follow-up examination, one implant and one prosthesis failed in the unsplinted group, resulting in a cumulative survival rate of 97.8% at the patient level. Two minor technical complications were experienced., Conclusions: Implant overdenture retained or supported by ball attachment systems showed high implant and prosthetic survival and success rates. A low number of complications, high patient satisfaction, and successful biological parameters were experienced in the mid-term follow-up. Data need to be confirmed by further randomized trials.

Background: The aim of the present prospective case series study was to evaluate the implant and prosthetic survival rates, complications and marginal bone loss using ultra-fine titanium mesh membrane with simultaneous implant placement, to provide space maintenance mandatory for guided bone reconstruction of alveolar bone defects., Materials and Methods: patients were recruited and treated at a private clinic in Rome, Italy, between March 2016 and October 2017. Self-tapping tapered implants were placed through a computer-guided template-assisted approach. Autogenous bone was placed alone over the exposed implant surface, then mixed with inorganic bovine bone material. Finally, the membrane was connected and shaped in order to securely enclose the graft area, and the healing cap was connected and screwed onto the height connector. Outcome measures were: implant and prosthetic failure, biological and mechanical complications, marginal and volumetric bone level changes, esthetic evaluation performed according to the pink aesthetic score (PES)., Results: in total, seven patients (five women, two men) with a mean age of 52.7 ± 20.3 years (range: 27-71) received 10 self-tapping tapered implants and simultaneous guided bone regeneration with ultra-fine titanium mesh membranes. No implants and no prostheses failed during the entire follow-up period. One slightly membrane exposure was observed one month after implant placement in one patient. The mean marginal bone loss (MBL) at implant loading was 0.13 ± 0.09 mm (95 % CI 0.08-0.19). At the 18-month follow-up examination, the mean MBL was 0.28 ± 0.33 mm (95 % CI 0.07-0.50) The difference was not statistically significant (0.15 ± 0.31; 95% CI 0.05-0.35; P = 0.1888). The mean horizontal alveolar ridge width was 3.72 ± 1.08 mm (95% CI 3.22-4.22 mm). At the II-stage surgery, the mean bone width was 8.79 ± 0.98 mm (95% CI 8.51-9.07 mm). The mean bone gain was 5.06 ± 1.13 mm (95% CI 4.68-5.44 mm; P = 0.000). The mean volume of the grafted bone calculated using the superimposition technique was 0.99 ± 0.38 CC (95% CI 0.75-1.23 CC). The mean PES at implant loading was 8.2 ± 0.8 mm (95 % CI 7.7-8.7). At the 18-month follow-up examination, the mean PES was 12.0 ± 0.7 mm (95 % CI 11.5-12.5) The difference was statistically significant (3.8 ± 0.4; 95 % CI 3.5-4.1; P = 0.0000); Conclusion: with the limitation of the present prospective study, the guided bone reconstruction using an ultra-fine titanium mesh membrane with simultaneous implant placement seems to provide good and stable results in implant/prosthesis success. Further research with a longer follow-up and a higher sample size are needed to confirm the results from this preliminary report., Competing Interests: The authors declare no conflict of interest.

Introduction: Atypical swallowing has a high incidence in adult and child populations. The treatment of the latter is generally achieved by the adoption of orthodontic appliances in conjunction with speech therapy. The aim of this article is to describe the clinical protocol of Froggy Mouth, an innovative myofunctional appliance designed to correct the atypical swallowing., Materials and Methods: The Froggy Mouth appliance has been tested by the authors Di Vecchio at the Orthognatodontics department of Fatebenefratelli San Pietro Hospital in Rome, Italy, and by Manzini at the Orthodontics department of Carlo Poma Hospital in Mantova, Italy. This article will illustrate the clinical protocol of the appliance with therapeutic indications, clinical phases, instruction and patients and parents motivation and follow-up results., Results: Froggy Mouth has proven effective in the correction of atypical swallowing, from both the clinical and the functional standpoints. The fastest and most predictable results were obtained in patients during their physiological developmental age. This appliance, compared to the traditional logopaedic therapy, requires less commitment in terms of time for the patient (only 15 minutes per day), with more predictable and durable results over time., Conclusions: The clinical evidences indicate that the Froggy Mouth is effective in the myofunctional correction of the atypical swallowing mechanism, providing the clinician a new therapeutic approach for neuromuscular re-training of atypical deglutition and dysfunctional deglutition in patients during their growth phase. However, further scientific evidences are needed to support the results of this investigation.

Nowadays, autograft and allograft techniques represent the main solution to improve bone repair. Unfortunately, autograft technique is expensive, invasive and subject to infections and hematoma, frequently affecting both donor sites and surgical sites. A recent advance in tissue engineering is the fabrication of cell-laden hydrogels with custom-made geometry, depending on the clinical case. The use of ECM (Extra-Cellular Matrix)-derived Hydrogels from bone tissue is the new opportunity to obtain good results in bone regeneration. Several micro-engineering techniques and approaches are available to fabricate different cell gradients and zonal structures in hydrogels design, in combination with the advancement in biomaterials selection. In this review, we analyse the stereolithografy, the Bio-patterning, the 3D bioprinting and 3D assembly, the Laser-Induced Forward Transfer Bioprinting (LIFT), the Micro-extrusion bioprinting, the promising Electrospinning technology, the Microfluidics and the Micromolding. Several mechanical properties are taken into account for bone regeneration scaffolds. However, each typology of scaffold presents some advantages and some concerns. The research on biomaterials is the most promising for bone tissue engineering: the new biomimetic materials will allow us to obtain optimal results in the next clinical application of basic research., Competing Interests: Competing Interests: The authors have declared that no competing interests exist.

The present study was designed to identify a relationship between temporomandibular joint and tympanic cavity and potentially justify the possible clinical correlations between these two anatomical entities. For this reason the authors conducted an anatomic-pathological study about the temporomandibular joint (TMJ) and the neighboring anatomical areas of the middle ear by autopsy finds of human adults.

This study has tested the effects of hyperbaric oxygen in periodontal structures in agreement with the theories supported by literature research. Eight patients, from 30 to 50 years-of-age, were tested with pure oxygen inhalation, at the 2.5 ATA absolute pressure. Main approved tests of periodontal health were evaluated before and after HBOT’s cycles. The results in all patients treated with HBOT, have founded clear improvement of clinical and instrumental parameters.

In this study, the authors examined the capsular structures of 20 human temporomandibular joints (TMJ) macroscopically and microscopically, in order to improve knowledge of these structures, as part of their possible participation in the genesis of TMJ dysfunctions.

In literature, there is no unanimous agreement about the anatomical and functional characteristics of the temporomandibular joint (TMJ) and its components. The aim of this work is to increase the knowledge about components of the temporomandibular joint, starting from the revision of classical anatomy, through macroscopic and microscopic study, 20 samples of human dissected temporomandibular joints.

Bone is a complexly structured tissue and hierarchically organized from macro to nano levels of dimensions. Biomaterial devices developed to replace and interact with bone tissues have been designed from the macro to nano perspective to provide suitable performance in acquiring primary and biological stability. Macro level designed features provide mechanical interlock and primary stability to implants inside the bone. Surface micro and nano structures influence cells behavior to promote the secondary or biological stability, reaching successful osseointegration.

Purpose: The aim of this paper was to evaluate the histological and histomorphometric outcome of Preformed Titanium Foil (PTF) to perform Guided Bone Regeneration (GBR) in posterior mandibular atrophies., Materials and Methods: 10 subjects (1 male; 9 females; mean age 58±11.37 years), with distal mandibular atrophies were selected to perform GBR by means of PTF, using a moldable allograft paste as graft material. The devices, made of a 0,2 mm thick pure titanium foil, were pre-shaped using stereolithographic models obtained from CT-scan of the patients' recipient site. In the second stage, performed at 6.7±2.33 months, 18 cylindrical two-piece implants were placed and the devices removed, at the same time bone biopsies were harvested. At 4 months, the implants were exposed and submitted to progressive prosthetic load for a span of 4 months. The cases were finalized by means of metal-ceramic cementable restorations. The post finalization follow-up was at 12 months., Results: Survival rate (i.e. SVR) was 100% since none fixtures were lost. At the one-year follow up the clinical appearance of the soft tissues was optimal and not pathological signs on probing were recorded. The success rate (i.e. SCR) was 88.2% and the average peri-implant bone reabsorption was 1.17±0.41 mm. The average rate of graft contraction was 19.4±10.55%. The mean percentage occupied by mineralized bone was 48.03±5.93%, while the bone marrow and graft material were 36.1±2.81% and 15.87±4.87 %, respectively., Conclusion: The results suggest good potentialities of the method for GBR in distal mandibular atrophies, allowing to maximize the outcome and simplifying the surgical phase.

Purpose: The aim of this article is to make a comparative assessment between the modification of the soft-tissue profile, around the healing cap screws (HCSs), following both the traditional flapless surgery (TFS) and a new modified flapless surgery, named Modified Connective Tissue Punch (MCTP) technique., Materials and Methods: 8 patients (3M and 5F) (mean age 54.25±11.247 years) were enrolled in this study. Sixteen two-piece implants were placed on upper jaws, 2 for each patient, 8 with TFS and 8 with MCTP technique. In each patient the implants were placed in edentulous areas, of 2 or 3 adjacent teeth long. MCTP technique was performed on the front implant site (FIS) while the TFS was performed on the rear implant site (RIS). All implants were inserted and covered with healing cap screws (HCSs). Alginate impressions were carried out at the moment of the surgery, at 1 month and 4 months post-operative. Plaster models were poured and subsequently digitally scanned, in order to measure the distance between the gingival outline and the free margin of the HCS. The recorded values were analyzed with the ANOVA test., Results: The use of MTCP technique, in comparison to TFS, showed a significative better outcome, in terms of vertical increments, of gingiva, on the VS toward the HCSs, during the entire observation period (p = 0.000 for all)., Conclusion: The Authors recommend the use of MCTP technique for a better vestibular soft tissue outcome in flapless implant surgery.

This paper is the first article in a new series on digital dental photography. Part 1 defines the aims and objectives of dental photography for examination, diagnosis and treatment planning, legal and forensic documentation, publishing, education, marketing and communication with patients, dental team members, colleagues and dental laboratory.

Three solid materials, [Pb(HL)(SCN)2 ]⋅CH3 OH (1), [Pb(HL)(SCN)2 ] (2), and [Pb(L)(SCN)]n (3), were obtained from Pb(SCN)2 and an unsymmetrical bis-pyridyl hydrazone ligand that can act both as a bridging and as a chelating ligand. In all three the lead center is hemidirectionally coordinated and is thus sterically optimal for participation in tetrel bonding. In the crystal structures of all three compounds, the lead atoms participate in short contacts with thiocyanate sulfur or nitrogen atoms. These contacts are shorter than the sums of the van der Waals radii (3.04-3.47 Å for Pb⋅⋅⋅S and 3.54 Å for Pb⋅⋅⋅N) and interconnect the covalently bonded units (monomers, dimers, and 2D polymers) into supramolecular assemblies (chains and 3D structures). DFT calculations showed these contacts to be tetrel bonds of considerable energy (6.5-10.5 kcal mol(-1) for Pb⋅⋅⋅S and 16.5 kcal mol(-1) for Pb⋅⋅⋅N). A survey of structures in the CSD showed that similar contacts often appear in crystals of Pb(II) complexes with regular geometries, which leads to the conclusion that tetrel bonding plays a significant role in the supramolecular chemistry of Pb(II) ., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Introduction: This paper has evaluated the dental and or facial disorders associated to Goldblatt syndrome, also known as odontochondrodysplasia., Aim: We report the analysis performed on a female young patient affected by this disease. We analyzed her dental and or facial features., Materials and Methods: We adopted several diagnostic criteria: firstly, we performed radiographic investigations, followed by rhinomanometric measurements and by clinical analysis performed in order to determine the salivary flow in this typology of patients. The evidences obtained after a careful clinical, anamnestic, and radiographic analysis of our female patient allowed us to identify a number of odontostomatologic features, which are very likely to be related to this syndrome. Our patient showed some pathognomonic signs of odontochondrodysplasia already identified in the literature, that is, pectus carinatum, joint hyperextensibility, coxa valga and genu valgum, upper and lower limb asymmetry, and vertebral abnormalities. Moreover, we focused our attention on those odontostomatologic aspects that had never been analyzed by other reports in the literature: dentinogenesis imperfecta, ligamentous hyperlaxity of all joints and of temporomandibular joints in particular, poor lip competence, ogival palate, and oral respiration. Besides these, dental crowding and other important elements were identified through cephalometric measurements., Discussion and Conclusions: In the light of all these elements and of their comparison with the existing literature, it is possible to stereotype a few recurrent odontostomatologic and systemic-generalized features in patients with odontochondrodysplasia, which can be considered as closely associated with this syndrome.

Objective: This article presents a case report of restoration of anterior teeth using an indirect technique with composite veneers in order to restore the dental anatomy and to provide aesthetic and function of anterior teeth., Materials and Methods: A treatment of upper anterior teeth with indirect micro-hybrid composite restoration was proposed to a 40-year-old woman with old discolored and fractured ceramic veneers. Upper six anterior teeth were prepared and, after impressions with VPS of maxillary arche, the composite veneers were placed., Discussion and Results: There are several advantages offered by indirect techniques compared to direct techniques. The increased practice of veneering technique with indirect composites is due to improvement in the properties of composite materials in the last years. The results are very favourable and the patient is satisfied., Conclusions: The restorations with composite veneers have proved durable and aesthetic, protect tooth structure and aesthetic and function is predictably re-established.

In recent years the incidence of fungal sinusitis has increased considerably, due both to increased survival of patients at risk and to improved diagnostic equipment. The pathogen responsible in most cases is the Aspergillus in its forms Fumigatus, Flavus and Niger. The diagnosis is often delayed because the symptoms, characterized by headache, cough, and facial algia, are generally similar to that of chronic bacterial rhinosinusitis. It can be divided into invasive and non-invasive forms based on the clinical evolution and extent of the lesion. We report a case of non-invasive fungal rhinosinusitis in a patient with recurrent sinusitis and pain in the left maxillary region, resistant to antibiotic therapy.

Objectives: CHARGE is an acronym referring to the aspects of this rare syndromic condition. Patients with CHARGE association are today considered as subjects lacking in pathognomonic dental alterations. The present study is aimed at adding to the body of evidence of the cases reported in literature and the continuous clinical research which show a clinical picture which is strongly associated with patients afflicted by this syndrome., Patients and Methods: We report a case-series of 8 patients with CHARGE syndrome. The dental features associated with CHARGE syndrome are from case-reports, but without a congruity that can lead to a definition of the dental condition typical of the CHARGE phenotype., Conclusions: The systemic problems affecting these patients are predominant in compromising their quality of life: this is the reason for a frequent lack of a diagnostics and interceptive phase, relative to oral diseases. We report new oral pathological conditions affecting CHARGE patients. Knowledge of these pathological conditions may induce dentists to carry out specific diagnoses of these patients, thus, avoiding the deterioration of oral conditions.

Introduction: An increased production of oxidizing species related to reactive oral diseases, such as chronic apical periodontitis, could have systemic implications such as an increase in cardiovascular morbidity. Based on this consideration, we conducted a prospective study to assess whether subjects affected by chronic periodontitis presented with higher values of oxidative stress than reference values before endodontic treatment, and whether endodontic treatment can reduce the oxidative imbalance and bring it back to normal in these subjects., Materials and Methods: The authors recruited 2 groups of patients from private studies and dental clinics: these patients were recruited randomly. The oxidative balance in both patients with chronic apical periodontitis (CAP) and healthy control patients was determined by measuring the oxidant status, using an identification of the reactive oxygen metabolites (d-ROMs) test, while the antioxidant status in these patients was determined using a biological antioxidant potential (BAP) test. Both these tests were carried on plasma samples taken from enrolled patients. Values were measured both before the endodontic treatment of the patients with chronic apical periodontitis, and 30 and 90 days after treatment, and compared to those obtained from healthy control patients., Results: It was found that, on recruitment, the patients with chronic apical periodontitis exhibited significantly higher levels of oxidative stress than control patients, as determined by the d-ROMs and BAP tests. Furthermore, the d-ROMs test values were shown to decrease and the BAP test values to increase over time in patients with chronic apical periodontitis following endodontic therapy. As the levels of oxidative stress in these patients tended to reduce and return to normal by 90 days following treatment., Conclusions: This study has demonstrated a positive association between chronic apical periodontitis and oxidative stress. Subjects affected by chronic apical periodontitis are exposed to a condition of oxidative stress, which is extremely dangerous to general health. Moreover, one can infer from these findings that through proper endodontic therapy, a good oxidative balance can be restored, thereby avoiding the risk of contracting the abovementioned diseases.

Purpose: To present clinical results with 9 years of follow-up of a protocol of immediately loaded implants with two different surfaces., Materials and Methods: A total of 44 patients received 66 Brånemark System TiUnite and 55 Brånemark machined implants, all immediately loaded. Control examinations were performed on the day of surgery and at 1-, 3-, and 9-year follow-up visits., Results: All implant sites had intact buccal and lingual bone walls. The prefabricated provisional restorations showed an excellent fit. Three TiUnite and 8 machined implants failed within 7 weeks of loading, resulting in a cumulative survival rate of 95.5% and 85.5% respectively after 9 years of load. The survival rate for implants in a partial prosthesis was 98.8% and 92.2% for single restorations in the TiUnite group, and 87.8% and 83.2%, respectively, for partial and single resorations in the control group. The marginal bone resorption in the first year was on average 0.9 mm in the TiUnite group and 1.0 mm in the machined group; at the third year it was 0.4 and 0.5 mm, respectively. On examination at 9 years, there was a general settlement of the bone, with a negligible further loss in height., Conclusions: The unchanged survival rate and the low bone loss after 9 years confirm the feasibility of an immediate loading protocol in the mandible, which included flapless surgery. TiUnite implants obtained a 10% higher success rate compared with machined fixtures .

Unlabelled: Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year., Objective: The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis., Methods: Forty-three patients were selected from the out patient clinic, Department of Dentistry "Fra G.B. Orsenigo Ospedale San Pietro F.B.F.", Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. DISCUSSION AND RESULT: The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn't difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported., Conclusions: The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven't difficulty in removal and insertion of the denture and in oral hygiene. They haven't in both groups problems related to fractures.

Introduction: Grafting of autologous adipose tissue can be recommended in some cases of facial plastic surgery. Rhabdomyosarcoma is a type of cancer that can also affect the orbit. Enucleation of the eye can cause atrophy of the corresponding hemiface and decreased orbital growth., Case Report: We report a case of a female patient with a medical history of surgical enucleation of the right eyeball, who had received rhabdomyosarcoma radiation therapy in her youth. The patient presented with a depression in the right zygomatic region. We took a dermal-fat flap from the abdominal region, which had been previously treated., Results: The surgical outcome, 48 hours, and much clearly 31 days after the surgery, revealed that the right zygomatic region had returned to its proper anatomical shape, although there were still signs of postoperative edema., Discussion: Very damaged tissues, like those exposed to radiation therapy, are generally not suitable for grafting of adipose tissue., Conclusions: In the described case, we achieved a technically and aesthetically satisfying result despite the patient's medical history involving several perplexities about the use of autologous dermal-fat tissues, because of prior radiation therapy exposure. The clinical case shows that even a region exposed to radiation therapy can be a valid receiving bed for dermal-fat grafting.

With our study we wanted to compare the diagnostic accuracy of conventional radiography (orthopanoramic and intraoral radiography) and Cone Beam CT (CBCT) for the diagnosis of periapical lesions on the posterior elements of the upper maxilla endodontically treated.The images were analyzed by a radiologist and an endodontist whose interpretation of radiological examinations is unique. Were examined 34 molars (23 first molars and 13 second molars) with a total of 102 roots. The CBCT detected a significantly higher number of lesions (43%, p <0.001) compared to conventional radiography. Our results demonstrate that the CBCT can be inserted into the diagnostic routine for the evaluation of all pre-prosthetic posterior elements of the upper jaw endodontically treated in addition to the diagnostic techniques 2D, especially when in the treatment plan is provided the realization of an abutment. The CBCT, which has reduction of cost and absorption of radiation with respect to the conventional CT, is also very useful even when there is a need to perform a surgical treatment-endodontic (apicectomy) of a lesion diagnosed with 2D techniques.

Unlabelled: Using the diode laser in the lower labial frenum removal., Objective: The aim of this study is to assess the advantages of the use of diode laser to removal inferior labial frenum., Methods: The treatment with the diode laser was proposed to a female patient of 32 years old in good general health having an abnormal inferior labial frenum that causes retracting of the gingival margin. The incision was carried out with diode laser at a wavelength of 940 nm and was removed the frenum mucosa and the deep tissue constitute of connective fiber and muscle fiber. Before the surgery wasn't used the local anesthetic and after the cutting wasn't necessary the use of suture., Results: The wound had a good healing without scar. The patient didn't have pain and bleeding during the healing and she didn't report complications. It wasn't necessary the use of antibiotic and anti-inflammatory., Conclusions: The use of lasers has proved effective in the removal of labial frenum because it offers several advantages for the patient than traditional surgery.

AIM.: Describe a clinical case of a voluminous asymptomatic fibromatosis lesion present on the cheek mucosa and evaluate the healing of the site after removal of the lesion with use of the laser diode. METHODS.: It was decided to use laser diodes to affect the mucous membrane and remove the lesion without the use of local anesthetic infiltration. The protocol used includes a 300-micron fiber and the emission of continuous light of 1.5 Watt with a range of wave of 940 nm. RESULTS.: THE PROVEN BENEFITS OF USING LASER DIODES FOR MINOR SURGERY ARE: drastic reduction of intraoperative bleeding and in the hours after the surgerywill restrict the swellingbetter and faster healing with no scarring and better cosmetic resultdoes not require suturesreducing the operating time thanks to no need for anesthetic infiltrationin most cases totally absent or less post-operative pain on the surgical site. CONCLUSIONS.: The laser diodes give a significant contribution to improving the surgical treatment of tumors of the oral cavity infact during the surgery reduce bleeding and surgical time, while in the process of healing by reduce swelling and post-operative pain and better results appearance without scarring.

Objective: The aim of this study is a systematic review of the literature on the strength and long-term behavior of zirconia FPDs., Methods: The literature search was performed using as the primary source the Medline database. Were also imposed a set of inclusion and exclusion criteria in order to narrow the search to differentiate the two distinct parts in which it was structured the review. In addition, MeSH terms were applied to further refine the choice of articles more relevant to the review. In the part of the review concerning the long-term behavior of zirconia fixed partial dentures were considered useful only those studies with a minimum follow-up of one year., Results: The search provided a total of 813 articles, but only 25 were considered for the review because they were the only ones who satisfied search criteria. In particular, 13 items relate to the mechanical strength of zirconia prostheses and 12 regarding the long term behavior of zirconia FPDs. The resistance values also exceed the 2000 N while the survival rate reaches to almost 94%., Conclusions: Based on this review, Zirconia FPDs can be considered reliable products in both the anterior and posterior fields with survival rates comparable to traditional metal-ceramic prostheses.

Aim of the Work: Aim of the work was to execute a review of the international literature about the cementation of zirconia restorations, analyzing the properties of the cements most commonly used in clinical activities., Materials and Methods: It was performed, through PubMed, a bibliographic search on the international literature of the last 10 years using the following limits: studies in English, in vitro studies, randomized clinical trial, reviews, meta-analysis, guide-lines. Were excluded from the search: descriptive studies, case reports, discussion articles, opinion's leader., Results: From studies results that common surface treatments (silanization, acid etching) are ineffective on zirconia because it has an inert surface without glassy component (on which this surface treatments act primarily), instead the sandblasting at 1atm with aluminium oxide (Al(2)O(3)) results significantly effective for the resulting roughening that increase the surface energy and the wettability of the material. Furthermore it has been shown that zinc phosphate-based cements, Bis-GMA-based and glass-ionomer cements can't guarantee a stable long-term adhesion, instead resin cements containing phosphate monomer 10-methacryloyloxyidecyl-dihyidrogenphosphate (MDP) have shown higher adhesion and stability values than the other cements. In particular, it has seen that bond strength of zirconia copings on dentin, using MDP-based cement, is about 6,9MPa; this value is comparable to that obtained with gold copings cementation., Conclusions: ANALYZED STUDIES HAVE LED TO THE FOLLOWING CONCLUSIONS: sandblasting with aluminium oxide (Al(2)O(3)) is the best surface treatment to improve adhesion between resin cements and zirconia; resin cements containing phosphate ester monomers 10-methacryloyloxyidecyl-dihyidrogenphosphate (MDP) have shown in the studies an higher bond strength and stability after ageing treatment; the best procedure for cementing zirconia restorations results the combination of sandblasting with aluminium oxide (Al(2)O(3)) at 50μm and MDP-based cements.

Presentation of a clinical case characterized by an atrophic degeneration in the superior maxilla which is very common to observe in the daily routine and wants to demonstrate the excellent results achieved with bone regeneration procedures by using grafting material of a homologous derivation, in this case of a particulate type. In view of the results in here presented and of those achieved in more than 10 years of clinical experience with homologous material, it can be considered an excellent alternative to the autologous grating procedures; and this also thanks to the clinical and histologic behaviour that this material has previously showed in the orthopedic field. The simplicity of the surgical procedures, the reduced invasivity for the patient and the possibility for the clinician to regenerate even the smaller defects contestually to implants insertion, allow many clinicians to benefit of this technique in their own practices.

In the last 15 years the increasing aesthetic demand, push constantly industry and the clinical to entirely look for new solutions for the realization of all-ceramic crowns, with such characteristics to be used for both anterior and posterior restorations. The most greater contribution, in such sense derives from the finished progress in the computer sector, that have allowed the application of the technologies CAD-CAM, also in dentistry (2-5, 11). These systematics have allowed us to get "automatically" structures for dental prosthesis, starting from the scanning of the die and passing for an intermediary phase of computerized planning (CAD, computer aided design), through numerical control millers (CAM, computer aided manufacturing), enslaved to calculating the electronic that drives the movement of it. The aim of this work is therefore that to analyze and to describe the systematic computerized 3SHAPE verifying the degree of precision, through the analysis of the obtainable marginal closing with the zirconia frameworks.

The aim of this study is to evaluate the short time aesthetic and functional outcome of a new implant system, the Nobel Active™. The Nobel Active™ features several innovations such as an extensive self-drilling capacity, axial and radial bone compression and an inward tapered collar allowing for marginal bone maintance an soft tissue stabilization. This design makes it possible to place the implant into narrower osteotomies, thus requiring less drilling, compared to conventional implants. The Nobel Active™ implants are available in two different prosthetic connections: Internal connection and external connection. The Nobel Active™ External connection is a 1.5 piece implant, with a primary abutment included with the implant. The Nobel Active™ internal connection is a two piece implant with a standard hexagonal internal connection. In this study we present a single tooth replacement with immediate loading of Nobel Active External connection.

The aim of this study is to describe the current role of imaging in pre-surgical planning, reporting 25 cases of paranasal sinus tumors examined in our Institute. Between June 2006 and May 2008, we identified 25 patients with malignant tumors of the paranasal sinuses. All of the patients were evaluated with CT and/or MR exams. US were used to assess regional lymph node involvement. When necessary CT-PET scanning using FDG, was done. Diagnostic imaging is essential during the initial work-up of a patient suspected of having a paranasal sinus tumor. The role of imaging is to define the tumor extension, nodal involvement, metastases and recurrences in the postoperative patient. CT and MR imaging are the primary modalities employed; each have advantages and disadvantages but tend to be complementary. The involvement of fine bone structures is best evaluated with CT. In assessing the extent of the tumor, MR provides excellent soft tissue detail, allowing for delineation of neoplasm from surrounding inflammatory tissue and secretions. For evaluation of lymph node enlargement color-Doppler US, CT and MR provide morphologic data, while CT-PET provides metabolic data. CT-PET can be used to stage nodal and metastatic disease and for assessing the efficacy of therapy or recurrent disease.

Background: The advent of modern endosseous implant design and improved surface technology has allowed the development of new restorative techniques that decrease patient's total treatment time. Utilizing the latest scanning, CAD/CAM and manufacturing technolgies we are able to manufacture individualized dental restoration with high accuracy and a perfect precision of fit., Materials and Methods: This report describes the rehabilitation of a completely edentulous patient utilizing a CT-based implant planning with computer-assisted surgical design, simultaneous CAD/CAM fabrication of a surgical template, a flapless surgical placement of the implants, and a prefabricated fixed complete denture for an immediately loaded restoration according to Nobel Biocare's Teeth-in-an-Hour™ (Nobel Biocare Goteborg, Sweden) protocol. This systematic approach to full mouth rehabilitation reduces the time necessary for an edentulous patient to go from severely atrophic alveolar support to implant retained prosthetic restoration. These aspects of minimally invasive and simplified surgery, along with reducing the treatment time and postsurgical discomfort, are beneficial to the patient, and allowing for rehabilitation with the same level of success as in flap surgery., Conclusion: The Teeth-in-an-Hour protocol is a unique solution made possible by the Procera System. With the aid of the CT scans and a virtual planning software, a custom fabricated precision drill guide and a pre-manufactured prosthesis can be made before surgery. The execution of implant placement is performed with a flapless procedure that results in minimal surgical intervention. This results in a short and non-traumatic surgery with a minimum of postoperative complications, allowing the patient to leave the chair with a fixed prosthesis. Utilizing the latest scanning, CAD/CAM and manufacturing technologies the dental team is able to develop individualized zirconia full arch framework with high accuracy and precision of fit.

The aim of the present study was to compare two implant surfaces, the TiOblast (Astra Tech) surface, manufactured by blasting the surface and already present in literature and the Osseospeed (Astra Tech) surface, manufactured by blasting and treating the surface with fluoride ions and recently launched onto the market with the modified surfaces of the latest generation. This study is part of a more extensive research project whose protocol required the insertion of 10 couples of implants; thus in the present discussion partial data are being taken into consideration, with an eye at collecting more data in the future, regarding both microscopy and histomorphometric histological analysis on 5 couples of implants. The purpose of the study is to investigate how the modified surfaces of the latest generation can guarantee a greater osseointegration both from a qualitative and quantitative level compared to the surfaces presently used and that they may represent the first example of "bioactivity", that is, an active interaction with the processes of new bone formation and tissue healing.

Isatin (2,3-dioxoindole) competitively inhibited (27-40%) Na(+)-dependent L-lysine uptake in rat intestine. The value of Kt was increased from 3.04 mM in control to 5.88 mM in presence of 10 mM isatin. Effect of isatin on the Na(+)-independent amino acid uptake was insignificant (12-18%). The inhibitory constant (Ki) was 2.8 mM under these conditions. The observed inhibition was unaffected by -SH group reacting agents. Isatin (1-10 mM) inhibited Na+, K(+)-ATPase activity in intestine in vitro, the maximum inhibition (66%) being at 10 mM isatin concentration. But the drug had no effect on enzyme activity under in vivo conditions.

10 mM isatin (2,3-dioxoindole) inhibited glucose influx into human erythrocytes by over 30%. The inhibition is of the competitive type, where the affinity constant (Kt) was increased from 5.71 (control) to 11.11 mM in the presence of isatin with no change in Vmax (130 nmol/min/ml packed cells). The observed inhibition of sugar transport by isatin was not mediated through membrane -SH groups accessible to iodoacetate, iodoacetamide, DTNB, DNP or sodium arsenite. Isatin inhibited sugar transport in the presence of 2 mM harmaline, an alkaloid inhibitor of Na+, K(+)-ATPase activity. The inhibition was non additive which suggests that these two compounds interact with the same or a similar site on the erythrocyte membrane.

Isatin (10 mM) inhibited the activity of rabbit brush border sucrase by 60% at pH 5.0 but it had no effect on enzyme activity around neutral pH. Isatin inhibition of sucrase was unaffected by Na+ ions but K+ and Cs+ ions reduced enzyme inhibition, partially. Kinetic analysis revealed that sucrase inhibition by isatin at acidic pH was non-competitive with Ki of the order 6.5-7.8 mM. Isatin together with 4 mM harmaline or iodoacetate (3 mM) or dithionitrobenzene (2 mM) yielded 80-85% inhibition of the enzyme. These observations suggest that inhibitory sites for isatin, harmaline and -SH group reacting agents are distinct in rabbit brush border sucrase.

PMF represents today the best solution for the functional rescue of a tooth cured by endodontics. After a careful analysis of the international literature the Authors in this study examined the resistance of four different kinds of PMF under laboratory conditions, applying external pressure to them until a steady rise in lateral direction caused a fracture in the specimens under study. On the basis of the results obtained, the Authors deducted that among different models tested, traditional long modified PMF is the most adapt for tolerating load of compression to preserve the integrity of the dental residual structures.

The Authors wanted to establish which could be for every impression material tested, the most favourable moment for the development of plaster models in a steady environment conditions of temperature and relative humidity. From the analysis of the results obtained, we can clearly conclude that every material examined offers an ideal time interval in which we have to cast the model in plaster. This study aspires to be an invitation to all operator in the sector, to repeat this experience in their work environment to know and better manage the procedures and the materials used, from the taking the impression to the executing of the plaster model.

This study, starting from the revision of traditional anatomy proposed to value TMJ and its components through dissection of human TMJ, and especially to examine the anatomic function of the lateral pterygoid muscle. Twenty dissections of left human TMJ were made. Every block was fixed in solution of 10% of formalin and dissections were made to show every components of articulation. Further thin sections were made for histological examination. The purpose of the study was to evaluate the lateral pterygoid muscle as a single unit compared to the function.

The purpose of this study was to examine and compare, in the same experimental conditions, the effects and the behaviour of two different materials, using them for cementation of a prosthetic reconstruction: a cianoacrilic compound (B20 cianoacrilate 3M); a traditional cement of zinc phosphate (Harvard Cement). The comparative study with the optical microscope between butilcianoacrilate and traditional cement has shown minimum levels of marginal discrepancy for both materials examinated (about 13 microns). The high resistance of cianoacrilate to traction, compared with the other fixing cement, makes us conclude this study in the hope that further research could confirm and introduce this materials in the practice of prosthetic dentistry.