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Tooth extractions can result in alveolar bone dimensional changes, necessitating additional bone grafting for implant placement. Alveolar ridge preservation (ARP) aims to counteract postextraction changes. This case series evaluates the bone regenerative properties of a freeze-dried bone allograft (FDBA) and the clinical outcomes of implants in grafted extraction sites. A total of 33 patients were enrolled, undergoing single/multiple tooth extractions followed by ARP. Biopsy samples were harvested during implant placement for histologic and histomorphometric analysis. Clinical outcomes included marginal bone loss and pink esthetic score (PES). Twenty-five patients completed the study. FDBA-augmented sockets exhibited new bone formation adjacent to graft particles. Implants (n = 25) showed 100% survival and success rates at 1 and 2 years. PES improved significantly over time (P < .001), while marginal bone loss did not significantly differ at 1 and 2 years (P = .096). Specimens showed trabecular bone, residual FDBA particles, and marrow spaces. High magnification revealed immature bone and woven bone bridges around graft particles. No inflammatory cells were observed. This case series provides valuable insights into ARP performed with FDBA (as implants were placed after 3 months of healing without any additional bone augmentation), the histologic outcomes were favorable, and implants were successful after a 2-year follow-up period. [ABSTRACT FROM AUTHOR]

Objectives: This retrospective study compared the outcomes of implants placed in alveolar ridge preservation (ARP) treated sites with those in spontaneously healed (SH) sites. Materials and Methods: The study included patients presenting with one implant placed in an ARP‐treated socket and one in an SH site. The primary outcome was the comparison of Marginal Bone Level Changes (MBLC). Statistical analysis was performed to identify factors influencing MBLC, including age, gender, smoking, parafunctional habits, and prosthetic emergence angle. Results: Of these, 28 patients (23 females, 82.1%) were included in this analysis. Sockets in the SH group were classified as type I, whereas type II sockets were more common in the ARP group. The SH group exhibited significantly higher MBLC than the ARP group (p = 0.032), with values, respectively, of 1.00 [0.25; 1.62] and 0.40 [0.00; 1.00] mm. Among all evaluated parameters, the performance of ARP was the only factor significantly affecting MBLC (β = −0.72, SE: 0.32, p = 0.026). Age, gender, smoking, parafunctional habits, and prosthetic emergence angle did not significantly affect MBLC. Conclusions: The study shows the potential role of ARP in maintaining stable marginal bone levels around implants. In our sample, ARP significantly reduced MBLC compared with spontaneous healing, highlighting its possible impact in clinical practice for better peri‐implant bone stability. [ABSTRACT FROM AUTHOR]

Adequate implant primary stability is a key factor to obtain osseointegration and can be measured at insertion by insertion torque (IT) and at different timepoints with resonance frequency analysis (RFA), expressed as an implant stability quotient (ISQ). This retrospective study investigated the correlation between ISQ and IT at implant insertion. All patients who were eligible for this single-cohort retrospective clinical trial were treated with an immediate implant. IT parameters were recorded at implant insertion, and ISQ values were recorded at insertion and at 2-, 4-, and 12-month follow-ups. The study comprised 23 patients who received 32 implants. The mean IT value was 46.87 ± 9.66 Ncm (range: 25 to 65 Ncm), and the mean ISQ value at implant insertion was 71.45 ± 4.24 (range: 63 to 78); these values showed a statistically significant correlation (P < .0001). According to the present data and considering the implant design used in this trial, there is a statistically significant and positive correlation between IT and ISQ values. Thus, ISQ can be used as a reliable method to measure implant stability over time. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review aimed to analyse the published evidence for the use of non-invasive methods for the early detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs). Methods: The literature was systematically searched through several databases: PubMed, Cochrane Library, and Web of Science. Additional exploration was performed through cross-checks on the bibliographies of selected reviews. The inclusion criteria involved studies assessing the application of non-invasive tests on humans in the screening, diagnosis, or surveillance of OSCC or OPMDs and reporting sensitivity (SE) and specificity (SP). The Newcastle–Ottawa scale (NOS) was applied to assess the quality of the studies included. Results: The search strategy resulted in 8012 preliminary records. After a duplicate check, 116 titles remained. After abstract analysis, 70 papers remained. After full text analysis, only 54 of the 70 papers fit the inclusion criteria (28 were original articles and 26 were reviews). Those 26 reviews were used to manually search for further original articles. From this last search, 33 original articles were found. Thus, a total of 61 original studies were included and investigated. Findings from this systematic review indicate useful information, such as a description of the mechanisms, ease of use, limitations, and SE and SP values, to drive the choice of the optimal minimally invasive method to be utilized as an adjunctive tool to examine the suspicious lesions. Conclusions: Each of the analysed tools can be improved or implemented, considering their high SE and low SP. Despite advancements, incisional biopsy continues to be the gold standard for the definitive diagnosis of oral cancer and precancerous lesions. Further research and development are essential to improving the sensitivity, specificity, and reliability of non-invasive tools for widespread clinical application. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the occurrence of intra-, peri-, and post-operative bleeding following tooth extractions in patients treated with direct oral anticoagulants (DOACs). Consecutive patients requiring at least one dental extraction were enrolled. The DOAC regimen was either maintained or suspended. Patients were classified in subgroups depending on the number of teeth extracted per procedure (≤3 or >3), the need for flap elevation, and the performance of osteotomy. Bleeding was recorded intra-operatively; peri-operatively at 20, 40, 60, and 80 min after the procedure; and daily in the first seven days following tooth extractions. Forty-nine patients treated with DOACs (17 with rivaroxaban, 16 with apixaban, 8 with edoxaban, and 8 with dabigatran) were enrolled. Of them, 33 refrained from DOAC administration pre-operatively. The performances of >3 teeth extractions, flap elevation, and osteotomy were significantly associated with higher bleeding rates (p < 0.05). In patients treated with rivaroxaban and apixaban, bleeding episodes were more frequent. Although DOAC treatment may increase the rates of intra-operative, peri-operative, and post-operative bleeding, the recorded episodes were mild and manageable. DOAC suspension may reduce peri-operative bleeding, while no effect could be observed for post-operative bleeding. [ABSTRACT FROM AUTHOR]

Oxidative stress and high levels of reactive oxygen species (ROS) are linked to various age-related diseases and chronic conditions, including damage to oral tissues. Dexamethasone (DEX), a widely used glucocorticoid in dentistry, can have side effects like increased ROS production and delayed wound healing. Resveratrol (RSV) is known for its antioxidant properties, but its limited bioavailability hinders its clinical use. This study investigated the potential of two RSV derivatives (1d and 1h) to address these limitations. The antioxidant abilities of 1d and 1h (5 μM) against DEX-induced oxidative stress (200 μM) were evaluated in human gingival fibroblasts (hGFs) and osteoblasts (hOBs). The effects of these compounds on cell viability, morphology, ROS levels, SOD activity, gene expression, and collagen production were evaluated. RSV derivatives, under DEX-induced oxidative stress condition, improved cell growth at 72 h (191.70 ± 10.92% for 1d+DEX and 184.80 ± 13.87% for 1h+DEX), morphology, and SOD activity (77.33 ± 3.35 OD for 1d+DEX; 76.87 ± 3.59 OD for 1h+DEX at 1 h), while reducing ROS levels (2417.33 ± 345.49 RFU for 1d+DEX and 1843.00 ± 98.53 RFU at 4 h), especially in hOBs. The co-treatment of RSV or derivatives with DEX restored the expression of genes that were downregulated by DEX, such as HO-1 (1.76 ± 0.05 for 1d+DEX and 1.79 ± 0.01 for 1h+DEX), CAT (0.97 ± 0.06 for 1d+DEX and 0.99 ± 0.03 for 1h+DEX), NRF2 (1.62 ± 0.04 for 1d+DEX and 1.91 ± 0.05 for 1h+DEX), SOD1 (1.63 ± 0.15 for 1d+DEX and 1.69 ± 0.04 for 1h+DEX). In addition, 1d and 1h preserved collagen production (111.79 ± 1.56 for 1d+DEX and 122.27 ± 1.56 for 1h+DEX). In conclusion, this study suggests that the RSV derivatives 1d and 1h hold promise as potential antioxidant agents to counteract DEX-induced oxidative stress. These findings contribute to the development of novel therapeutic strategies for managing oxidative stress-related oral conditions. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease is a degenerative and increasingly prevalent condition that includes metabolic abnormalities and is associated with a higher risk of sarcopenia. The conservative approach points primarily to controlling metabolic issues and reducing the risk of malnutrition and sarcopenia, slowing the progression of kidney disease. The present study aims to evaluate the effect of a low-protein diet on malnutrition and sarcopenia. Methods: A total of 45 patients (33 male and 12 female) aged over 70 with chronic kidney disease stage 4–5 in conservative management were considered. All patients had a dietary assessment and prescription of personalized low-protein dietary plans (≤0.6 g protein/kg) and a follow-up control between 4 and 6 months. In preliminary and follow-up evaluations, anthropometric data, blood examinations, body composition results, muscle strength, physical performance, and a 3-day food diary were collected. Results: In the follow-up period, a significant weight loss (p = 0.001) and a decrease in body mass index (p = 0.002) were recorded. Food diaries revealed a significant reduction in protein, sodium, potassium, and phosphorus intake (p < 0.001), with a significant reduction in urea (p < 0.001) and proteinuria (p = 0.01) without any impact on lean mass (p = 0.66). Considerable variations in adherence between food diaries and the prescribed diet were also noted. Conclusions: Providing a personalized low-protein diet led to significant benefits in a short period without worsening the patient's nutritional status. [ABSTRACT FROM AUTHOR]

Objectives: Alveolar ridge preservation (ARP) is a procedure with the aim to reduce bone resorption that occurs after tooth extraction, facilitating the following implant placement. The aim of this cross‐sectional study was to evaluate the prevalence of mucositis and peri‐implantitis around implants inserted in sites treated with ARP and to investigate possible risk factors. Materials and methods: Patients who received at least one dental implant inserted in a grafted socket were considered eligible for this study. Patients were recalled for a follow‐up visit; medical history, clinical and demographic data were collected. Univariate logistic regression analyses have been performed for both implant‐level and patient‐level variables. Indeed, moderation analysis was used to investigate the indirect relationship between age and marginal bone level. Results: Fifty‐one patients who received 61 implants were enrolled in this cross‐sectional study. Thirty‐three implants were classified as "healthy" (54.1%), 23 implants showed signs of peri‐implant mucositis (37.7%), and 5 implants were diagnosed with peri‐implantitis (8.2%). Data analyzed at the patient level showed that 49% of the patients were healthy, 45.1% of the patients had mucositis and 5.9% of the patients were affected by peri‐implantitis. Mandibular sites and type III grafted sockets showed a significant association with peri‐implantitis; in addition, a history of periodontitis and an increase in age showed higher risks of developing mucositis or peri‐implantitis. Conclusions: Implants inserted in grafted sockets showed favorable rates of healthy implants in the long term. Clinical relevance: The ridge preservation procedures do not seem to increase the risk of developing mucositis or peri‐implantitis. [ABSTRACT FROM AUTHOR]

The success of implant-supported fixed complete dental prostheses (ISFCDPs) depends on multiple factors: some are related to the fixtures, such as fixture material, surface characteristics, positioning, and type of connection to prosthetic components; others are related to the prostheses, such as design and materials used. Zirconia is a material widely used in fixed prosthodontics, whether on natural teeth or on implants, with excellent results over time. Regarding the use of zirconia for ISFCDPs, the 2018 ITI Consensus Report stated that "implant-supported monolithic zirconia prostheses may be a future option with more supporting evidence". Since CAD/CAM technology and zirconia are being continuously innovated to achieve better results and performances over time, a narrative review of the literature seems necessary to focus research efforts towards effective and durable solutions for implant-supported, full-arch rehabilitations. The objective of the present narrative review was to search the literature for studies regarding the clinical performance of zirconia-based ISFCDPs. According to the results of this review, the use of zirconia for ISFCDPs showed good clinical outcomes, with high survival rates ranging from 88% to 100% and prosthetic complications that were restorable by the clinicians in most cases. [ABSTRACT FROM AUTHOR]

Objectives: A controlled, single‐blind, randomized clinical trial was performed to evaluate usefulness of antibiotics in preventing pain and complications after tooth extractions and benefits of probiotics in reducing gastro‐intestinal symptoms associated with antibiotic therapy. Materials and methods: A total of 159 patients were enrolled in this trial. After tooth extractions, patients were allocated to one of the groups: group 1 received postoperatively amoxicillin + clavulanic acid; group 2 received the same antibiotic therapy with an adjunctive probiotic treatment; and group 3 received neither antibiotics nor probiotics. Follow‐up visits were planned at 7, 14, and 21 days after tooth extractions (T1, T2, and T3), and parameters assessed were pain, presence of abscess, edema, fever, alveolitis, trismus, pain, difficulty in daily routine activities, and gastro‐intestinal symptoms. Results: The number of patients reporting pain at T1 was significantly higher in the control group when compared to group 2 (p =.016), while no difference for pain intensity was observed between groups. No surgical site infection was observed in any of the groups. Intestinal symptoms seemed to be tackled by probiotic administration. Conclusions: Pain was the most important symptom in the control group. Antibiotics were not necessary after non‐impacted tooth extractions, and probiotics can reduce gastro‐intestinal symptoms associated with antibiotics. [ABSTRACT FROM AUTHOR]

Purpose: Immediate implant placement is a reliable solution to replace hopeless teeth, but this procedure may be associated to an increased risk of soft tissue complications in case of thin biotype. The use of tissue-level implants with a convergent transmucosal profile has been advocated to increase space for soft tissue, contributing to improve their stability and esthetics. The aim of this retrospective study was to evaluate the esthetic outcomes and the Patient-Reported Outcome Measures (PROMs) of immediately placed implants with a convergent transmucosal profile. Materials and methods: This single-cohort, monocentric, retrospective clinical study was conducted on patients treated with an immediately placed implant in the esthetic zone (from premolar to premolar). All the eligible patients were recalled for a clinical and radiographic follow-up visit. Results: This study included 20 patients (8 males, 12 females) with an average age of 55.5± 6.8 years, who received 20 implants, with a mean follow-up of 46.5± 15.3 months. At the time of follow-up, immediately placed implants showed a mean Marginal Bone Loss of 0.42± 0.49 mm, and a statistically significant improvement of the esthetic parameters from baseline to the last available follow-up; in particular, Pink and White esthetic scores (p=.001) and Papilla Index at mesial and distal sites (p<.001). All the patients reported a high satisfaction (VAS>9) both from esthetic and functional point of view. Conclusion: Immediately placed implants with convergent transmucosal profile in the esthetic zone showed good clinical and esthetic outcomes, with stable results over time.

Background: Tooth extraction is a very common procedure in oral surgery. Despite this, very little information is available in the literature as to the antibiotic management of the patient. The aim of this study is to evaluate whether the antibiotic prophylaxis could be beneficial in preventing postextraction local complications and whether the use of a probiotic could help reduce the antibiotic gastro-intestinal side effects., Methods: One hundred eleven patients meeting the inclusion criteria were initially included in this randomized clinical trial and randomly allocated to one of the three experimental groups according to a computer-generated randomization list. Patients allocated to the group 1 were given amoxicillin+clavulanic acid (2 g/day for 6 days), patients allocated to the group 2 received antibiotic + probiotic (Bifidobacterium longum+lactoferrin) and patients allocated to the group 3 received no antibiotic therapy after the extraction. To evaluate post-extractive complications, controls were performed at days 7, 14 and 21 after the extraction., Results: At T1 pain at the surgical site was present in the 48%, 30% and 71.4% of the patients belonging respectively to the antibiotic alone group, to the antibiotic+probiotic group and to the control group. The mean Numeric Rating Score (NRS) score was 1.56±1.91, 1.08±1.93, 2.02±2.27 respectively (P=0.0498). Two patients belonging to the control group experienced dry socket. In addition, 9 patients (33.3%) in the antibiotic-alone group and 1 patient (2.7%) in the antibiotic+probiotic group reported intestinal distension (P=0.0012), 7 days after surgery. Finally, diarrhea was recorded in 5 patients of the antibiotic alone group (18.5%), on the other hand, no patients of the antibiotic+probiotic group and the control group reported diarrhea., Conclusions: Postextractive complications observed in each group have been mild and fast to resolve. The antibiotic administration showed a decrease in pain suffered by patients but a higher incidence of gastrointestinal side effects, such as abdominal distension and diarrhea, which seemed to be relieved by the concomitant use of the probiotic.