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Background: The literature has described several biomaterials for guided bone regeneration. Some authors have proposed using a material derived from dentin/ enamel among autologous biomaterials. This study aims to test the effectiveness of autologous material derived from deciduous teeth in guided bone regeneration. Case Presentation: A 24-year-old female shows up with missing tooth #1.1 for a domestic accident. This requires implant-prosthetic rehabilitation. It is decided to be performed before implant therapy, a bone regeneration guided using biomaterial resulting from the patient’s deciduous teeth stored in a plastic box. GBR (Guided Bone Rehabilitation) is performed, and after 6 months, the implant is inserted by computer-guided surgery, and then a provisional prosthesis is placed. Discussion: The material deriving from deciduous teeth, not preserved with precautions, has had excellent integration results. This allowed the implant to be placed in the best position for the final prosthetic rehabilitation. Conclusion: This clinical case shows that using biomaterial derived from deciduous teeth has allowed an excellent result with negligible biological cost.

Periodontal disease is a risk factor for the development of bisphosphonate osteonecrosis; in fact, it is present in 84% of patients with osteonecrotic lesions. The aim is to provide the clinician with a diagnostic guide, through the application of the Plaque Index and Bleeding Index, to determine which patients are likely to be candidates for dental extractions prior to antiresorptive drug therapy in cases of elements that are periodontally compromised. The study was carried out by selecting sample subjects from the total pool of patients treated from 2010 to 2016 at the Operative Unit of Odontostomatology, Department of Oncologic Dentistry, IRCCS San Gerardo in Monza, Italy. Selected patients are placed within a protocol of professional oral hygiene sessions, during which their periodontal records are compiled. The results obtained from the study show that a low periodontal health condition, assessed by PI% and BoP%, out of which, however, only BoP% finds statistical significance, appears to be related to the risk of osteonecrosis. In conclusion, in this study, a threshold value of BoP% of 15% has been found. Below this value, the clinician can take into consideration, for dental elements with uncertain periodontal prognosis (fair or poor), a conservative or extractive treatment.

The advancement of digital dentistry has been remarkable thanks to intraoral scanners (IOS), which have improved the accuracy and reliability of dental impressions compared to traditional methods. However, the accuracy of intraoral scans is influenced by numerous operator-related factors and patient-dependent variables, which can compromise the quality of scans and, consequently, the fabrication of prosthetics. This study presents a protocol to provide personalized calibration for intraoral scans used to fabricate definitive dental crowns. The protocol aims to minimize errors introduced by the operator and variables. Initially, a trial model is created, simulating the definitive crown. This model represents a transitional phase between the provisional and final crowns and will continue until accurate calibration of the detected impressions is achieved. The goal is to reduce the time required for delivering definitive crowns, allowing the operator to provide them without the need for further modifications during placement and screwing of the crown.

To understand dentistry for special-need patients, it is crucial to define the population and its complex characteristics. Historically, "disability" had a negative connotation, indicating physical or mental impairments, and led to social marginalization. The WHO's 2001 International Classification on Functioning, Disability and Health (ICF) introduced a more inclusive definition, considering environmental and socio-cultural factors. This shift emphasizes that disability results from both individual conditions and societal influences. The concept of inclusion has evolved, advocating for societal changes to accommodate individuals with special needs. Special-need, disabled, and fragile individuals share greater socio-health vulnerabilities, requiring tailored healthcare services and protocols. The Authors present a clinical protocol and an epidemiological analysis of the patients who presented at the Clinical Center for the Care of Special-need Patients of IRCCS San Gerardo Hospital in Monza, Italy.

BACKGROUND: Implantology represents the therapy of choice for the rehabilitation of a partially or totally edentulous jaw in a healthy patient. Nowadays, it is possible to exploit of modern preoperative planning software, increasingly precise radiographic examinations (CBCT) and CAD/CAM technologies that allow designing devices directly on the computer to be sent to a milling center which produces the desired product, such as stereolithographic templates. METHODS: The prospective clinical study in question aims to evaluate the accuracy between two different surgical guides using peek and metal guide bushings. Twenty-nine implants were placed: for the control group, 17 3i, T3 implants were used, while for the test group, 12 Xive S plus implants were used. RESULTS: The result obtained shows that the deviations in the distribution of the control group and the test group are the same in the apical-coronal, vestibulo-palatal and mesio-distal direction. For the control group, the mean deviation was 1.394±0.644923 at the entry point of the implants and 1.85655±1.0765 at the most apical point of the implants. For the test group the mean deviation was 1.10157±0.312721 at the entry point of the implants and 1.54514±0.572100 at the most apical point of the implants. CONCLUSIONS: The peek guide bushings have the same deviation as the metal ones. There is no difference in the method used, but precision must be sought in other elements, such as the patient's anatomy and maximum precision in the guide production phase.

Background The loss of a tooth causes bone resorption if no alveolar preservation strategies are implemented. The restoration of an adequate bone volume is essential in obtaining a site that allows the subsequent implant-prosthetic rehabilitation. Objective The purpose of this study is to verify the effectiveness of the use of autologous material deriving from the tooth with the aid of the Tooth Transformer in guided bone regeneration. Materials and methods The patient, edentulous in area 2.6, intends to rehabilitate this area through implantology. In the first surgical phase, a guided bone regeneration of the site is performed, making use of the compromised element 3.8, previously extracted, as autologous material to be affixed for grafting through the Tooth Transformer. After 4 months, the surgical site was reopened and the implant fixture was inserted. Results The result obtained demonstrates the effective regenerative power of the Tooth Transformer method: a height of 9.82 mm of bone was obtained which allowed obtaining an adequate bone volume suitable for implant insertion. Conclusions The autologous material derived from the Tooth Transformer is able to recreate a partially atrophic area and this device is establishing itself as an innovative bone regeneration system in the field of tissue engineering.

OBJECTIVES The maxilla plays an important role during chewing, swallowing and phonation. About 13,000 new cases of head and neck cancer are discovered in Italy every year. Prosthetic rehabilitation in edentulous patients with defects caused by maxillectomy is often difficult due to the absence of natural teeth, necessary to retain and support a post-operative obturator prosthesis. The main problems of an obturator prosthesis are weight, phonetics and retention. MATERIALS AND METHODS The definitive obturator prosthesis of a patient undergoing hemi-maxillectomy for squamous cell carcinoma was modified. The prosthesis was emptied to allow weight reduction and to improve phonetics by exploiting the principle of sound transmission of the tuning fork in a rigid body, subsequently with the use of the plaster model, acrylic resin and silicone the wall maintaining the sound box. RESULTS AND CONCLUSIONS The result of this procedure showed how the patient immediately wearing the prosthesis spoke well without having a nasal voice; the follow-up at 6 and at 12 months confirmed the patient’s satisfaction in being able to face a lifetime of normal relationship. CLINICAL SIGNIFICANCE The proposed treatment represents a valid solution to significantly improve the psychological behavioral aspects of hemi-maxillectomized cancer patients. Both traditional and digital prosthetic rehabilitation, maintaining all the advantages of the construction of a prosthesis, can undergo changes over time but only the traditional prosthesis can allow the adaptation of the sound in the chair. However, the precision of this type of work depends on each case and varies according to the complexity of the maxillectomy.

Background: The aim of this study was to evaluate the accuracy of implant placement using static guide surgery. Two methods of were compared: Implant placement in native bone and in post-extraction site. Methods: 47 implants were placed with static surgical template using a flapless technique. Patients were divided into two groups: Group 1 was made by 29 implants placed in extraction socket while group 2 was made by 18 implants placed in native bone. Accuracy of implant placement was evaluated by CBCT superimposition protocol. Results: The study showed differences between two methods of implant placement in two parameters considered. The average real deviation detected at the implant platform level is 1.00 ± 0.91 mm for post-extraction site and 0.49 ± 0.48 mm for native bone (P=0.01). The average angular deviation detected at implant level is 21.94° ± 36.80° for post-extraction sites and 12.80° ± 11.71° for native bone (P=0.006). There were not statistically differences between two methods for 7 parameters left. Conclusion: The present study showed that implant placement in native bone is more accurate than in post-extraction sites using a static surgical template.

Background: Over the years, techniques have been developed that allow bone to be placed where it is deficient, in order to regenerate the area of interest, and one of these involves the insertion of a graft. The iliac crest is one of the most frequently used donor sites in the context of extra-oral autologous blood harvesting, as it allows for the harvesting of a large quantity of both cortical and corticomedullary bone as well as spongiosa alone. Methods: The retrospective study aims to evaluate the implant survival 15 years after a definitive prosthetic rehabilitation on implants, inserted as a result of an autologous bone graft taken from the iliac crest. The 72 implants examined were positioned in two surgical stages in the two upper and lower maxillary arches, some with the classic implant surgical technique and others with a guided implant surgical technique. Controls were performed with radiological examination, in particular orthopantomography, and clinical evaluation. Result: Of the 72 implants placed, none showed implant failure 1 year after placement. At 5 years the success rate is 98.6%, at 10 years it is 94.4% and at 15 years it is 86.1%. The results show a total of 10 implants were lost: 1 at 5 years, 3 at 10 years and 6 at 15 years. Conclusion: Despite the difficulties related to post-operative morbidity and the need for a second operation, the iliac crest graft allows the rehabilitation of large edentulous areas, with a reduced percentage of resorption and ensures faster neoangiogenesis with faster engraftment.

The advent of computed tomography and the development of new pre-surgical programming software has completely revolutionized the surgical approach in dentistry. Through virtual study, it is possible to program the surgery with the aim of obtaining a surgical guide that allows for the insertion of an implant in the ideal position. The purpose of this study is to evaluate the different accuracies obtained using different surgical guides. 16 implants were inserted in four patients. The implants were divided into two groups: the first consisting of 11 implants placed with mucosal support surgical guides, and the second group consisting of five implants placed with dental support surgical guides. The CBCT standard superimposition protocol was used to evaluate accuracy. The result obtained shows how dental support guides presented a lower average deviation in both position and angle. However, values are not such as to preclude the successful outcome of the intervention even after using mucosal support guides. Future randomized controlled studies are necessary to confirm the results of this work and to evaluate possible variables that may affect the accuracy of this technique

The protease encoded by the TMPRSS2 gene facilitates viral infections and has been implicated in the pathogenesis of SARS-CoV-2. We analyzed the TMPRSS2 sequence and correlated the protein variants with the clinical features of a cohort of 1177 patients affected by COVID-19 in Italy. Nine relatively common variants (allele frequency > 0.01) and six missense variants which may affect the protease activity according to PolyPhen-2 in HumVar-trained mode were identified. Among them, p.V197M (p.Val197Met) (rs12329760) emerges as a common variant that has a deleterious effect on the protease and a protective effect on the patients. Its role appears particularly relevant in two subgroups of patients—young males and elderly women—and among those affected by co-morbidities, where the variant frequency is higher among individuals who were mildly affected by the disease and did not need hospitalization or oxygen therapy than among those more severely affected, who required oxygen therapy, ventilation or intubation. This study provides useful information for the identification of patients at risk of developing a severe form of COVID-19, and encourages the usage of drugs affecting the expression of TMPRSS2 or inhibiting protein activity.

A cytokine storm, autoimmune features and dysfunctions of myeloid cells significantly contribute to severe coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Genetic background of the host seems to be partly responsible for severe phenotype and genes related to innate immune response seem critical host determinants. The C9orf72 gene has a role in vesicular trafficking, autophagy regulation and lyso-some functions, is highly expressed in myeloid cells and is involved in immune functions, regulating the lysosomal degradation of mediators of innate immunity. A large non-coding hexanucleotide repeat expansion (HRE) in this gene is the main genetic cause of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS), both characterized by neuroinflammation and high systemic levels of proinflammatory cytokines, while HREs of intermediate length, although rare, are more frequent in autoimmune disorders. C9orf72 full mutation results in haploinsufficiency and intermediate HREs seem to modulate gene expression as well and impair autophagy. Herein, we sought to explore whether intermediate HREs in C9orf72 may be a risk factor for severe COVID-19. Although we found intermediate HREs in only a small portion of 240 patients with severe COVID-19 pneumonia, the magnitude of risk for requiring non-invasive or mechanical ventilation conferred by harboring intermediate repeats >10 units in at least one C9orf72 allele was more than twice respect to having shorter expansions, when adjusted for age (odds ratio (OR) 2.36; 95% confidence interval (CI) 1.04–5.37, p = 0.040). The association between intermediate repeats >10 units and more severe clinical outcome (p = 0.025) was also validated in an independent cohort of 201 SARS-CoV-2 infected patients. These data suggest that C9orf72 HREs >10 units may influence the pathogenic process driving more severe COVID-19 phenotypes.

Under the International Atomic Energy Agency (IAEA) Modelling and Data for Radiological Impact Assessments (MODARIA II) Programme, Working Group 4 activities included collating radionuclide transfer data from Japan following the Fukushima Daiichi Nuclear Power Plant accident and separately collating concentration ratio (CR) data for root uptake of radionuclides by crops grown in tropical and arid climates. In this paper, the newly compiled radiocaesium CR data for fruit from Japan, tropical and arid climates have been combined with the data originally compiled for the IAEA Technical Reports Series No. 472 (TRS 472) and additional data identified from the literature to produce an enhanced MODARIA II dataset of fruit radiocaesium CR values. Statistical analysis of the MODARIA II dataset by climate class (based on the Köppen–Geiger climate classification) indicated that the CR values for tropical climates were significantly higher (p < 0.05) than those for arid, temperate and cold climates. Statistical analysis of the MODARIA II dataset by soil group (based on soil texture) indicated that the CR values for coral sand soil (tropical climates only) and organic soil (temperate climates only) were significantly higher (p < 0.05) than those for the clay, loam and sand soil groups. Statistical analysis of the MODARIA II dataset by plant group (based on plant morphology) indicated that the CR values for non-woody trees (tropical climate bias) were significantly higher (p < 0.05) than those for herbaceous plants, shrubs and woody trees. Comparison of the MODARIA II dataset with original TRS 472 values showed only small changes in the fruit radiocaesium CR values for herbaceous plants and shrubs in temperate climates. There was a decrease in the CR values for woody trees in temperate climate across all soil groups. There was also a decrease in the CR values for tropical climates for all comparable soil groups.

Apicoectomies are Endodontic Microsurgical procedures that require high precision. However, the state-of-the-art method currently used provides for a certain degree of imprecision as it heavily relies on the clinician’s judgment and experience with the sole aid of preliminary radiographic investigations. This clinical study aims to apply the Surgical Guided Approach, frequently used in Implantology, to Apicoectomies, thereby ensuring higher precision and, therefore, a lower amount of bone tissue loss as a by-product of the procedure. The proposed method uses surgical templates with 4 mm in diameter drilling pilot holes in correspondence to the root apices to be treated. This allows to introduce 4 mm trephine surgical burs. This allows the complete removal and retention of the root apices. The method was tested on polyurethane models first and then applied on a patient for clinical trials. The surgical templates allowed for significant gains in precision and accuracy compared to the currently used method for apicoectomies: reaching and removing the apical roots was possible by performing osteotomies with only 4 mm in diameter through which retrograde root-end preparations and fillings were carried out successfully. The proposed method provides a valid alternative for apicoectomies and allows greater precision and healthy tissue preservation.

BACKGROUND: Patients with neuromuscular diseases present a high risk of acute or chronic respiratory failure, such as to require treatment with non-invasive ventilation. Even though non-invasive ventilation (NIV) has proven to be very effective and efficient, the occurrence of therapeutic failures is often reported, generally in association with a low tolerance of the interface used. The aim of this study is to investigate the therapeutic effectiveness and efficiency of a new personalized internal oral device, in support of the open-circuit mouthpiece ventilation (OMV) interface, by comparing it to the oronasal interface. METHODS: The study includes patients affected by neuromuscular diseases, who are already treated with non-invasive mechanical ventilation through oronasal masks. Each patient has undergone two overnight polysomnographies: the first carried out with an oronasal mask, while the second with the personalized oral interface that was designed. Within the study, daytime ventilation with both interfaces has also been evaluated. RESULTS: The use of the personalized oral interface has led to an average increase in air leaks, making the device inadequate for nocturnal use, and adequate for daytime use exclusively. However, the study has surfaced a reduction of facial lesions/irritations, associated to an increase in comfort for the patient. CONCLUSIONS: Considering the results, the personalized oral interface can be considered as an alternative to the ventilation interfaces that are commonly used with patients who suffer from respiratory failure, exclusively in the day-time hours.

Background: This study has been conducted to evaluate the dentin regeneration potential as an autologous graft material for the preservation of the bone volume in the post-extraction socket. Tooth Transformer has been used as the device required to demineralize the dentin got from the extracted elements, which led to obtaining a granular material rich in collagen and growth factors. Methods: All 8 patients selected for the study underwent two surgical procedures. During the first surgery, the affected elements have been extracted, the Tooth Transformer protocol has been run, and the material has been grafted into the existing bone defects and post-extraction socket. After three months, the biopsy of the regenerated areas has been performed and the implants required for prosthetic rehabilitation were placed in the same site. For two of the 8 patients, the implant has been placed with the support of a surgical guide. Result: CBCT and histological analysis’ results after 3 months confirmed the actual replacement of grafted material and the regeneration of bone tissue suitable for implant rehabilitation. Conclusion: Thus, the Tooth Transformer proves to be an effective device to produce an innovative autologous material from dentin, which is capable of predictable viable bone tissue regeneration able to support prosthetic implant rehabilitation in edentulous sites.

BACKGROUND: The aim of this study was to evaluate the accuracy of implant placement using static guided surgery. Two methods of measuring accuracy were compared, the superimposition of CBCTand the non-radiological Superimposition Touch Absolute Precision (S.T.A.P.) method. METHODS: In this prospective clinical study 23 implants were placed with static surgical template using a flapless technique and postextractive procedure. Six months after surgery, a postoperative CBCTwas performed to assess the position of the implants and at the same time dental impressions were taken for the final prosthesis. The plaster models made at this stage have made it possible to obtain the position of the implants inserted using the probe technology. Preoperative and postoperative data were superimposed, deviations in the three dimensions of the space were calculated. The differences between the two measurement methods were assessed. RESULTS: The study showed no statistically significant differences between the two methods of measuring accuracy at the implant platform level, apex, or angles. The average real deviation detected at the implant platform level is 1.16±0.58 mm with CBCT, 1.22±0.55 mm with the S.T.A.P. method; at the apex level is 1.48±0.98 mm with CBCT, 1.47±0.72 mm with the S.T.A.P. method. The average difference between CBCTand S.T.A.P. method for real deviation is 0.06±0.75 mm at the platform level and 0.007±1.24 mm at the apex level. CONCLUSIONS: The present study showed that measuring accuracy by S.T.A.P. method was comparable to that obtained by CBCTsuperimposition.

Background & aims. Several studies report that a low number of teeth is strictly associated with a higher risk of cognitive impairment. Aim of this study is to evaluate the oral condition of a nursing home population, in order to clarify the possible association between tooth loss and cognitive decline. Methods. 444 patients were selected; clinical information were excerpted from their hospital records. Subjects were visited in their nursing home unit, paying particular attention to number of teeth, prosthesis and soft tissues. Results. 378 subjects were visited, 277 with formal diagnosis of dementia and 101 with mild or no impairment in cognition. Age was similar in both group, while education level, MMSE and number of teeth were significantly lower among people with dementia. There was an inverse correlation between age and number of remaining teeth, while MMSE did not seem to be associated with tooth loss. School level was positively associated with number of teeth. Conclusions. There is a significant difference in number of teeth, school level and MMSE between patients with and without dementia. Maybe due to the high prevalence of people with severe cognitive impairment, a significant association between MMSE and number of teeth was not found. The presence of compromise oral conditions is relevant.