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Osteonecrosis of the jaw (ONJ) is a chronic complication affecting long-term bisphosphonate-treated subjects, recognized by non-healing exposed bone in the maxillofacial region. The pathophysiological mechanism underlying ONJ has not been fully elucidated. The aim of the present study was to investigate the role of RANK/RANKL/OPG signaling pathway and, in parallel, to evaluate angiogenic and matrix mineralization processes in jaw bone necrotic samples obtained from bisphosphonate-treated subjects with established ONJ. Necrotic bone samples and native bone samples were processed for Light and Field Emission in Lens Scanning Electron Microscope (FEISEM) analyses, for Real-Time RT-PCR to evaluate the gene expression of TNFRSF11A (RANK), TNFSF11 (RANKL), and TNFSF11B (OPG) and for immunohistochemical analyses of VEGF and BSP expression. Morphological analyses performed by Light microscope and FEISEM show empty osteocytic lacunae and alteration of lamellar organization with degradation of the mineralized bone matrix in necrotic bone samples. A significant increase in TNFRSF11A, TNFSF11, TRAF6 and NFAT2 gene expression, and a reduction of TNFSF11B gene transcription level compared is also showed in necrotic bone compared to control samples. No significant difference of VEGF expression is evidenced, while lower BSP expression in necrotic bone compared to healthy samples is found. Even if the pathogenesis of bisphosphonate-associated ONJ remains unknown, a link between oral pathogens and its development seems to exist. We suppose lipopolysaccharide produced by bacteria colonizing and infecting necrotic bone and the surrounding viable area could trigger RANK/RANKL/OPG signaling pathway and, in this context, osteoclasts activation could be considered as a protective strategy carried out by the host bone tissue to delimitate the necrotic area and to counteract infection.

Background : Rotary Ni-Ti files are susceptible to sudden intra-canal separation due to cyclic fatigue stress, particularly in curved canals. To increase resistance to cyclic fatigue, new heat-treated files have been introduced. This study aimed to compare the performance of four heat-treated Ni-Ti files in two simulated curved root canals by evaluating the effect of the alloy, rotation speed, and diameter of the files on their resistance to cyclic fatigue. Methods : The Ni-Ti files included in the study were the ProTaper Gold ® (Dentsply Sirona) F2, ProTaper Ultimate ® (Dentsply Sirona) F2, FQ ® (Komet) 25.06, and Blueshaper ® (Zarc4Endo) Z4 25.06. Two groups of 30 files were selected for each system and were tested in two simulated canals milled in a specific metal template. One group was tested in a 60° curved canal and the other in a 90° curved canal. Results : In the 60° simulated canal, there were no instrument fractures within the 15 min time limit. In the 90° simulated canal, the Blueshaper Z4 demonstrated a lower resistance to cyclic fatigue, while FQ 25.06 showed statistically higher fatigue resistance based on both the Kruskal-Wallis and Games-Howell tests ( p < 0.05). Conclusions : No differences were found between files when tested in a 60° curved canal for up to 15 min. However, in a 90° canal, the FQ ® files showed significantly higher resistance to cyclic fatigue, especially compared to the Blueshaper ® Z4. The ProTaper Ultimate and ProTaper Gold produced intermediate results, with the ProTaper Ultimate F2 slightly outperforming the ProTaper Gold F2.

Aim: The objective of this in vitro study was to compare reused and sterilized versus new healing abutments to assess whether a decontamination and sterilization process performed on resued healing abutments was sufficient to remove residual proteins. The two groups were comparable with respect to patient safety., Materials and Methods: During the period from September 2022 to October 2023, healing abutment screws were selected and divided into two groups according to whether they were new or previously used in patients. The samples were subjected to a decontamination and sterilization protocol, and results from sample sterility evaluation and assessment of surface protein levels were recorded., Results: The obtained results revealed a significant difference in the OD562 nm values between new and reused healing abutment samples. The assay demonstrates how treated healing abutments were still contaminated by residual proteins., Conclusion: Within the limitations of the present study, although from an infectious point of view sterilization results in the total eradication of pathogens, surface proteins remain on reused healing abutments.

Aim : The rising average age increases edentulous cases, demanding more implant-prosthetic rehabilitation, with cardiovascular diseases being significant factors. This study compared healthy patients (CG = Control Group) and those with cardiovascular disease (TG = Test Group) for implant survival, Marginal Bone Loss (MBL), peri-implant tissue level parameters as Periodontal Screening and Recording (PSR), Plaque Index (PI), Bleeding on Probing (BoP) Peri-implant Probing Depth (PPD), and surgical complications. Smoking impact on both groups and medication influence in the TG were secondary outcomes. Patients underwent full-arch implant prosthetic rehabilitation. Methods : Implant survival rate, MBL, and surgical complications were recorded during the monitoring period (7 years), while peri-implant parameters were assessed at the end of the observational time. A total of 26 and 28 CG and TG patients were recruited, respectively. Results : A total of 128 implants were placed in CG, while 142 in the TG. Implant survival and MBL showed no significant differences ( p > 0.05). Nevertheless, peri-implant parameters were more unfavorable in TG. The only significant surgical complication was higher bleeding rates in the TG ( p < 0.05). Conclusions : Cardiovascular patients showed similar implant survival and MBL but had adverse peri-implant parameters and increased bleeding rates. Higher smoking levels may relate to unfavorable implant outcomes. Further investigation is needed on drug impact with larger samples.

The aim of this comparative retrospective clinical study was to assess the effect of age on immediate loaded full-arch mandibular rehabilitation in younger vs. elderly patients. Patients with an age between 45 and 60 years (younger group, YG) or with an age more or equal to 75 years (older group, OG), requiring a mandibular full-arch rehabilitation were scheduled for the present study. Implant and prosthetic failure, biological and prosthetic complications, and peri-implant marginal bone level changes were recorded until a 7-year follow-up. Sixty-six patients were included in the study; a total of 264 implants were placed and, in total, 66 "all-on-four" rehabilitations were delivered. In total, 33 patients were scheduled in the YG and 33 patients in the OG. At the 7-year follow-up, an overall implant failure rate of 1.14% was reported. Moreover, at the 7-year radiographic evaluation, peri-implant crestal bone loss averaged 1.12 ± 0.91 mm for the YG and 1.04 ± 1.01 mm for the OG. No statistically significant differences were found between the YG and OG except for the rate of peri-implantitis, which was statistically higher in the YG. The present study reported that immediate fixed mandibular full-arch rehabilitation is a viable procedure in elderly people of equal or more than 75 years of age.

The aim of this study is to highlight the properties of ozone as an aid to non-surgical therapy compared to non-surgical therapy alone. This study included thirty Caucasian patients (eighteen women and twelve men) aged between 35 and 65, recruited at the Oral Hygiene and Prevention Center of the Dental Clinic of the Vita-Salute San Raffaele University, at the San Raffaele hospital in Milan. The periodontal probing was recorded with a PC-PUNC 15 manual probe (Hu Friedy) at time 0; the scaling and root planing session was performed at T1 with or without the aid of ozone therapy, and then, the patients were re-evaluated at one month (T2), three months (T3), and six months (T4). The results obtained show that there are not statistically significant differences in terms of reduction in clinical periodontal indices such as plaque, bleeding, and pocket depth between the two groups. Therefore, treatment with ozoral gel would not seem to improve non-surgical periodontal therapy alone. However, clinical periodontal indices significantly improved in patients treated with non-surgical therapy and ozone gel. From this point of view, ozone gel can be used as an aid to non-surgical therapy due to its excellent characteristics, in particular, its powerful virucidal action.

The main objective of this review is to verify the validity of laser therapy in the treatment of dentin hypersensitivity, an extremely common problem in patients, with Nd: YAG lasers or high- and/or low-power diode lasers to obtain a definitive protocol for the treatment of hypersensitivity, given the multiplicity of laser treatments proposed by the numerous authors evaluated. The authors performed an electronic search on PubMed, favouring it as a search engine. Lasers represent a means of treating dentin hypersensitivity, used alone and/or in conjunction with specific products for the treatment of such a pathology. The selected articles that examined diode lasers were divided according to the wattage (w) used: low-level laser therapy protocols, i.e., those using a wattage of less than 1 W, and high-level laser therapy protocols, i.e., those using a wattage of 1 W or more. Regarding the Nd: YAG laser, it was not necessary to subdivide the studies in this way, as they used a wattage of 1 W or more. A total of 21 articles were included in the final selection. Laser therapy was found to be effective in the treatment of dentin hypersensitivity. However, the level of effectiveness depends on the laser used. The results obtained from this review show that both the Nd: YAG laser and the diode laser (high and low power) are effective in the treatment of dentin hypersensitivity. However, the high-power laser appears to be more effective in combination with fluoride varnish and the Nd: YAG laser achieved greater long-term benefits than the diode laser.

The aim of this in vitro study is to try to identify a treatment in the field of professional oral hygiene techniques that is ideal and less invasive with regard to prosthetic restorations, chosen in lithium disilicate and feldspar ceramics. Seventeen veneers were prepared (eight in lithium disilicate and nine in feldspar ceramic) and each of them was attached to an extracted tooth. The treatment groups were initially contaminated in the Microbiology Laboratory of Università Vita-Salute San Raffaele. After 24 h they were treated with four different methods of professional oral hygiene and were then sent to the Microscopy Laboratory, in which they were analysed by SEM, with 180X, 250X, and 500X magnification, to assess any damage caused to the treated surfaces. The SEM analysis produced 64 images that were evaluated by an experienced dentist, and the use of the prophetic cup seemed to be the most suitable among the evaluated treatments. However, from a microbiological point of view, this method was the least effective in terms of reducing bacterial growth. In this regard, the use of a prophylactic rubber cup combined with a 0.20% chlorhexidine gel is recommended during professional oral hygiene sessions for the maintenance of aesthetic prosthetic restorations.

The aim of this retrospective clinical study was to evaluate and compare implant survival, marginal bone loss, and clinical and prosthetic complications in healthy patients and patients with type I diabetes undergoing full arch implant-prosthetic rehabilitation. A total of 47 patients needing total fixed rehabilitation of one or both arches were enrolled for this study. Based on the absence of any systemic diseases (Group A) or the presence of type I diabetes (Group B), the sample was divided into two groups. According to the grade of bone atrophy in the posterior region, patients received full arch rehabilitation (of one or both jaws) with 6 axial implants or, if the residual posterior bone height was insufficient, All-on-Four rehabilitation and a total 236 dental implants were placed. Follow-up visits were performed 1 week after surgery, at 3 and 6 months and then once a year for the next 10 years. No statistically significant differences between groups were recorded about implant survival rates, marginal bone loss, or clinical and prosthetic complications. However, concerning complications, post-surgical bleeding and wound infection were recorded in Group A more than in Group B. In cases of compensated diabetes compensation, implant placement could be considered a safe procedure.

Purpose: The aim of this case-control study was to investigate the occurrence of bleeding events related to maxillary sinus elevation with a lateral window in patients under direct oral anticogulant therapy., Materials and Methods: Seventyseven consecutive patients were scheduled for unilateral maxillary sinus floor elevation using a lateral window approach. Participants were divided into two groups: group A, formed by 37 patients who were under novel oral anticoagulation therapy (rivaroxaban/apixaban), and a control group, composed of 40 healthy subjects. Within group A, assumption of direct oral anticoagulants was not suspended nor modified before surgical procedures. Time (early/delayed) and site (intraoral/extraoral) of bleeding episodes were recorded in both groups of patients, in addition to bleeding severity (mild, moderate, or severe)., Results: Maxillary sinus floor elevation was performed in all patients. One dropout happened due to intraoperative membrane perforation. Overall bleeding episodes were comparable in both groups, chi-square (1) = .68, P = .41. Early intraoral bleeding events were more common in absolute terms, but also occurred with approximately the same frequency in both group A and the control group (Fisher exact tests: P = 1.00 and P = .375, respectively). No severe bleeding was observed in any of the attended patients., Conclusion: Within the limitations of this case-control study, maxillary sinus floor augmentation with a lateral window approach can be safely administered to patients who are under direct oral anticoagulation therapy when specific recommendations are instituted.

The purpose of this randomized controlled trial was to compare the immediate-loading protocol, in single restorations in the esthetic zone, by comparing the digital workflow in a test group (TG) vs. the analogical workflow in a control group (CG). A total of 50 patients were enrolled, requiring single hopeless tooth extraction. Twenty-five patients (TG) were randomly assigned to the immediate-loading protocol using the digital workflow, and twenty-five patients (CG) were assigned to the conventional workflow. Clinical and radiographic parameters were evaluated at the time of implant insertion (baseline) and after 3, 6 and 12 months, respectively. A clinician blind to conditions measured the Pink Esthetic Score (PES), as well as patient satisfaction. At 12-month follow-up, a cumulative survival rate of 100% was reported for all implants. No failures or biological complications were observed. No statistically significant differences were detected in the mean values of marginal bone loss and PES between the TG (0.12 ± 0.66 mm for MBL, 7.75 ± 0.89 for PES) and the CG (0.15 ± 0.54 mm for MBL, 7.50 ± 0.89 for PES). In 11 cases of TG, and 10 cases of CG, a one-year follow-up period showed an increased marginal bone level. No statistically significant differences were found in the mean total PES between test (7.75 ± 0.89) and control (7.5 ± 0.81) conditions. Furthermore, a customer satisfaction survey showed that patients preferred the digital workflow over the conventional workflow procedure (97.6 ± 4.3 vs. 69.2 ± 13.8). Digital workflow was more time-efficient than conventional workflow (97.2 ± 7.3 vs. 81.2 ± 11.3). Within the limitations of this study, no statistically significant differences were found between digital and traditional workflow.

The aim of this retrospective clinical study was to evaluate and compare oral hygiene levels in patients subjected to fixed metal-ceramic or stratified zirconia prostheses, either on teeth or on dental implants. Twenty patients, including 10 with metal-ceramic prostheses and 10 with stratified zirconia, were engaged for the study. Considering the prosthesis positioning phase as zero time, all patients were examined twice a year for a follow-up period of 3 years. During each session, to assess oral cavity state of health, both the Plaque Index (IP) and the Bleeding Index (BOP) were recorded. All patients were instructed in home hygiene maintenance and subjected to professional oral hygiene sessions customized according to prothesis type (on natural teeth or dental implants) and materials (metal ceramic or stratified zirconia). Statistically significant evidence was found in IP values, with an increase in the initial stages in zirconia prostheses and in the final stages in metal-ceramic ones. BOP levels showed a reduction during the follow-up period, but no statistically significant differences were found between examined groups. An adequate patient education in hygiene maintenance associated with professional oral hygiene sessions with special tools could positively affect fixed prostheses' maintenance, both on natural teeth and on dental implants., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

With the beginning of the twenty-first century, population aging has emerged as a major worldwide phenomenon. The dentist must respond to this demographic change by taking into consideration the possibility of restoring oral function in the elderly patient with the use of dental implants. This article aims to provide a narrative review of the literature regarding the implant survival rate in geriatric patients and the relative importance and advantages of implant-prosthetic rehabilitation through a scientific analysis of the literature through online databases and dental journals. Tooth loss can have a significant impact on patients' oral function and significantly affects quality of life, self-esteem, and nutritional status. Although many studies in the past have reported that implant success is age-dependent, more recent studies suggest that they are safe and predictable for geriatric patients, improving quality of life, with similar results to those of younger age groups. Advanced age does not necessarily represent a contraindication for implant placement and osseointegration and success is influenced by patient and site-specific factors. Aging is a process that affects each patient differently, consequently, there should be a specific therapeutic approach for everyone, which must consider the functional and cognitive status of the patient, his medical condition, and his social situation-economic and motivational., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The present study describes an innovative procedure for resolving implant-prosthetic cases in patients with edentulous special needs. In 2017 a 56-year-old female patient came to the Department of Dentistry of Vita-Salute San Raffaele Hospital, Milan, Italy, requiring implant-prosthetic rehabilitation of the dental arches given the difficulty in wearing removable prostheses. The first level radiological examinations were evaluated, two technical photographs were taken with specific reference, the 2D Digital Smile Design (Smile Design) was then carried out, the provisional prosthesis was performed and the CBCT requested with repere and provisional prostheses to realize the computerized implant project and an atraumatic flapless guided surgery. Professional oral hygiene sessions were performed quarterly, and the 3-year follow-up revealed no complications affecting the prosthetic or implant component. We can therefore conclude that the proposed method, exploiting digital technologies and flows and minimally invasive flapless surgical methods, can be considered elective in the treatment of patients with special needs., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The aim of this literature review is to assess the effectiveness of diode laser at a wavelength of 800-980 nm in addition to non-surgical periodontal therapy in periodontitis treatment. The authors performed an electronic research on Pubmed inserting as keywords: (laser OR laser therapy OR diode laser) and (periodontitis OR periodontal disease). The field has been narrowed to select only Randomized controlled clinical trials (RCT) performed from 2010 to 2020. The result of this research was 84 articles, of which eight were included in the review because they respect the inclusion criteria. The clinical, immunological, and microbiological parameters studied in the various clinical random trials were analysed. It has been shown that four out of eight studies have achieved greater benefits, in terms of clinical parameters, with the use of diode laser compared to Scaling and Root Planing. However, the greater increase in clinical parameters in diode laser-treated patients compared to the control group was mainly detected in the short term rather than in the long term. In terms of microbiological parameters, no improvement was detected after six months. Only one study reported six-month improvements in immunological parameters in patients treated with DL compared to the Scaling and Root Planing only group. In conclusion, considering the limitations of this review of literature, there is no evidence that the diode laser at 800-980 nm in addition to non-surgical periodontal therapy is more effective than SRP alone in the long term., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Mast cells play important roles in the maintenance of many physiological functions as well as in the pathophysiology of diseases. Mast cells are involved in the inflammatory mechanisms of many systemic diseases. In this pandemic period, their role in physiological and pathological host inflammatory reactions in tissue disruption following SARS-CoV-2 infection has been stressed. A review of the literature was carried out by entering the key words "Mast Cells" AND "Oral Diseases" AND "Role of Mast Cells in Periodontitis". The results show us that mast cells are definitely involved in many oral diseases including periodontitis. Further in vivo and in vitro studies are needed to further investigate the specific role of the cells in physiological and pathological inflammation., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Chlorhexidine is defined as biocompatible, which is why it is used as a mouthrinse for the patient before starting dental procedures (2). It has the ability to bind well to teeth and mucous membranes and is released for twelve hours, which is why it is used as a treatment for gingivitis and also in post-operative wound healing. The long-term side effects of chlorhexidine are pigmentations. To remedy this, various types of antidiscoloration have been tried out over time. Nowadays there are other types of anti-discoloration systems such as, for example, in our study we used a test group containing an anti-discoloration system called SPPD. A single-center, prospective, double-blind randomized clinical trial on 84 patients. The investigated treatments consisted of 4 mouthwashes (CHX 0.12% SPDD alcohol free; CHX 0.20% SPDD alcohol free; CHX 0.12% alcohol free with ADS; CHX 0.20% alcohol free with ADS). Despite the limitations of the study, all the mouthwashes tested showed good efficacy in reducing the amount of plaque. Comparing the two experimental concentrations (0.12% and 0.20%) tested here demonstrates that the 0.20% chlorhexidine concentration slightly surpasses its 0.12% equivalent with regard to the PI and BI parameters. The SPDD is an innovative anti-discoloration system and gives the mouthwash a great taste., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The clinical picture of coronavirus disease 2019 (COVID-19) in various target organs has been extensively studied and described. However, relatively little is known about the characteristics of oral cavity involvement. This is surprising, considering that oral mucosal and salivary gland cells are known targets for the direct replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and that the presence of the virus in saliva is a source of transmission of the infection. The aim of our study was to investigate the presence and prevalence of oral manifestations in COVID-19 survivors. We profiled the oral involvement in 122 COVID-19 survivors that were hospitalized and followed up at a single-referral university hospital in Milan, Italy, between July 23, 2020 and September 7, 2020, after a median (interquartile range) time from hospital discharge of 104 (95 to 132) d. We found that oral manifestations, specifically salivary gland ectasia, were unexpectedly common, with oral manifestations being detected in 83.9% while salivary gland ectasia in 43% of COVID-19 survivors. Salivary gland ectasia reflected the hyperinflammatory response to SARS-CoV-2, as demonstrated by the significant relationship with C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels at hospital admission, and with the use of antibiotics during acute disease. Both LDH levels and antibiotic administration survived as independent predictors of salivary gland ectasia at multivariable analysis. Temporomandibular joint abnormalities, facial pain, and masticatory muscle weakness were also common. Overall, this retrospective and prospective cohort study of COVID-19 survivors revealed that residual damage of the oral cavity persists in the vast majority of patients far beyond clinical recovery, and suggests that the oral cavity represents a preferential target for SARS-CoV-2 infection. Further studies are needed to clarify the connection between SARS-CoV-2 infection and oral disorders.

Objective: The aim of this study was to evaluate and compare the effectiveness of the ultrasonic piezoelectric inserts of EMS Steel Tip A, EMS Peek, and IS-TiP-STS-3E © in reducing peri-implant bacterial load without compromising the surface of implants during professional oral hygiene in the follow-up., Materials and Methods: Thirteen implants were examined (Winsix, Biosafin, Ancona, Italy). The implants were divided into five groups and analyzed with a SEM microscope and microbiological analysis to evaluate the possible modification of structure and the bacterial load reduction., Results: The control and A, B, and C test groups were initially contaminated in vitro with Streptococcus mutans. Subsequently, the A, B, and C test groups were treated by an only expert operator in standard conditions. Test groups A, B, and C were inoculated for 3 hr and, furthermore, microbiologically analyzed., Conclusion: The gold standard of an implant maintenance is a significant reduction of the bacterial load without becoming aggressive. According to our results, despite the limitations of the study, the authors recommend the least aggressive IS-TiP-STS-3E © , but combined with an antimicrobial agent to reduce the bacterial load, because the IS-TiP-STS-3E © did not show appreciable results versus the EMS Peek in reducing the bacterial load., (© 2020 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

A new Coronavirus, the seventh member of the Coronaviridae family, identified as SARS-CoV-2, spread in late December 2019 in the territory of Wuhan in China. CoV-2019 can be transmitted directly from person to person by respiratory drops, direct contact and contaminated material. Furthermore, 2019-nCov penetrates cells similarly to the SARS coronavirus, i.e., through the ACE2 receptor. This may promote human-to-human transmission. Patients and dental professionals are exposed daily to pathogenic microorganisms, including viruses and bacteria, which infect the oral cavity and respiratory tract. Dental procedures carry the risk of 2019-nCoV infection due to their specificity. Direct transmission regards the distance between operator and patient, exposure to saliva, blood and other body fluids, the use of sharp instruments and "droplet-generating" rotating instruments, contact with the conjunctival mucosa, and finally the contact with droplets produced by coughing and nasal secretion of an infected individual without mask at short distance, increasing the biological risk for the operator. In light of the pandemic linked to COVID-19, although there is no clear scientific evidence in the literature, it is necessary to identify protections with regard to clothing, operating protocols, disinfection of environments and management of waiting rooms and front offices. This paper is a basis for operative indications for dentists and other health care professionals in phase 2 post lockdown for both private and public structures.

Purpose: Some authors have highlighted the danger of intraoral use of rotating instruments which can produce droplets and aerosols. During the Covid lockdown phase, dental operators were limited to providing emergency treatment that could not be postponed. Therefore, it is necessary for the dental team to restart safely to treat neglected oral diseases that may also affect systemic health. The role of the dental hygienist has apparently changed for procedures performed close to the patient's oral cavity, particularly in terms of the droplets and aerosols produced during oral hygiene practices. Through an analysis of the most recent literature on the use of dedicated PPE and changed post-Covid 19 work processes, and a review of the differences between manual causal therapy and mechanical therapy in terms of outcome after oral hygiene treatment, we define how the role of the dental hygienist can change positively. Materials and Methods: Narrative reviews of the literature in terms of PPE adopted and oral hygiene procedures performed were carried out in Pubmed. Results: 188 articles from February 2020 to May 2020 using the search terms 'dentistry' and 'covid-19' were examined. 10 reviews of the literature were performed using the search terms 'mechanical procedures' and 'manual hygiene'. Conclusion: Only continuous update of evidence-based literature on the new standards in oral hygiene procedures and the different results yielded by different procedures can ensure a safe working environment for the dental hygienist while supporting the dentist in this phase of the pandemic.

The fundamental moment of prosthetic rehabilitation is the "temporary". Although the meaning of the term diminishes its importance, the provisional has fundamental biological, aesthetic and functional functions. The oral cavity must maintain an adequate level of oral hygiene to carry out this delicate phase in the best possible way; a result achieved only with the collaboration of the prosthetic dentist with the hygienist and the patient, as if they were a biological system in motion. The different methods of hygiene are effective in maintaining a good level of oral health; but they could, if too aggressive, affect the prosthetic restoration. Our objective in vitro is to understand, after applying a known bacterial load, which hygiene method is the most effective in removing bacterial biofilm but at the same time is less aggressive towards resinous material., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Several conditions as trauma, cancer surgical resection, fractures, congenital malformations and periodontitis could bring alveolar bone defects. To avoid more invasive and less predictable regenerative procedures, Stem cells of different origins as pluripotent Embryonic Stem Cells (ESCs), undifferentiated multipotent Mesenchymal Stem Cells (MSCs) and Induced Pluripotent Stem Cells (iPSCs) were proposed as possible alternative. IPSCs have potential for proliferation and differentiate into all derivatives of the three primary germ layers: ectoderm, endoderm and mesoderm. According with their ability to involve in several cells type, Induced Pluripotent Stem Cells (iPSCs) could be proposed as alternative in regeneration either of mineralized tooth components or supporting tissue. The aim of this brief review is to describe clinical applications of Induced Pluripotent Stem Cells (iPSCs) in oral bone regeneration to employ their use in tissue regeneration in dentistry., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

The systematic analysis of parameters impacting implant primary stability is difficult to achieve with human cadavers or animal models, particularly for complex trans-sinus procedures to determine the effects of cortical layers and bone engagement on implant stability before and after a simulated load in vitro. Solid rigid polyurethane blocks, partially intersected by an 8-mm-thick space, were created to imitate tri-cortical situations, the presence of the sinus cavity, and the posterior maxilla with different degrees of bone atrophy. Implants were inserted through the cavity at an angle of 30˚ (scenarios 1 and 2) to imitate the clinical protocol. Controls simulating uni-cortical anchorage and no sinus cavity were also included (controls 1 and 2). Four parameters were measured: peak insertion torque, insertion work, resistance to lateral bending loads and extraction torque. Scenarios 1 and 2 displayed similar peak insertion torque to control 2, where all three groups anchored equal amounts of bone surrogate. The distribution of surrogate bone in contact with trans-cavity implants influenced both extraction torque and the degree of lateral bending. Sufficient peak insertion torque can be attained with a trans-sinus tricortical implant anchorage providing sufficient apical and coronal bone is engaged., (Copyright 2020 Biolife Sas. www.biolifesas.org.)

Aim: The aim of this study was to evaluate and compare two different techniques for the treatment of plaque-induced gingivitis, demonstrating whether the causal therapy supported by diode laser can allow a resolution of the edema caused by gingivitis in less time compared to the single traditional causal therapy., Materials and Methods: Twenty-five patients between 20 and 60 years of age with a specific diagnosis of gingivitis were evaluated at the CLID-HSR oral hygiene department. Once the clinical parameters (bleeding index, plaque index, recession, and clinical attack level) were recorded, each of them was subjected to a professional oral hygiene session and instructed in correct home hygiene procedures. Through a split-mouth protocol for each individual patient, hemi-arches were treated by simple randomization to be treated with causal therapy supported by the action of the diode laser (experimental therapy) and which with traditional causal therapy (control therapy). A first intraoral scan was performed before therapy (T0), which was repeated 20 min after rinsing with CHX. The intraoral scans were repeated at a control 7 (T1) and 14 days (T2) after the session. For each intraoral scan, a volumetric value was calculated, proportional to the edema of the gingival tissues, using special digital software. The operator who carried out the volumetric measurements on the software was not aware of the therapy implemented on each half-arch. The operator who carried out the statistical analysis was not aware of the therapy applied to each group. The collected data were statistically compared in order to detect any differences between the volumetric variations between the two therapy groups and within the therapy groups over time. After evaluating the distribution of data by means of the Kolmogorov-Smirnov statistical test, the appropriate nonparametric tests were chosen to carry out the statistical comparisons., Results: Based on the analysis of the gingival-periodontal health parameters and the volumetric value of the treated areas, no statistically significant differences were detected between the areas treated with the adjuvant action of the diode laser compared to those treated with causal therapy alone., Conclusions: With the limitations of this study, in accordance with the statistical results obtained, diode laser therapy does not allow a faster resolution of gingival edema compared to traditional therapy; the two treatment techniques for plaque-induced gingivitis, therefore, have the same efficacy.

Atopic dermatitis (AD) is an inflammatory reaction of the skin that can occur in several parts of the body and can be provoked or exacerbated by food and/or environmental compounds. Allergic contact dermatitis (ACD) is a potential enhancer of AD, and an epidermal barrier breaker which induces greater penetration of allergens and other compounds. ACD presents an eczematous rash, red and itchy, with inflammation mediated by cytokines. ACD is an immunological disorder caused by contact with an allergic substance (haptens) that involves immunotoxicity, irritation and inflammation. Mast cells (MCs) are important immune cells that intervene, as effector cells, in allergic and anaphylactic reactions, asthma, autoimmune diseases and cancer. In dermatitis, activated MCs release inflammatory chemical mediators and secrete pro-inflammatory cytokines, including interleukin (IL)-1, TNF, and IL-33. In addition, IL-1 activates MCs to generate a number of cytokines and chemokines, which aggravate inflammation. IL-38 cytokine, an IL-1 family member, is secreted by activated immune cells, including macrophages and lymphocytes, and possesses anti-inflammatory activity. IL-38, by binding IL-36 receptor (IL-36R), provokes suppression of inflammation in many immune diseases. In particular, IL-38 inhibits the generation of IL-1, IL-6 and IL-8 along with other cytokines/chemokines. Here, we hypothesize for the first time that IL-38 may suppresses the inflammatory response in dermatitis, exerting beneficial therapeutic effect., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: HiPS stem cells are commonly used for the study of medical disorders. Thelaboratory in which this study was conducted uses these cells for examining the treatment and cureof neurodegenerative diseases. Bone regeneration poses the greatest challenge for an oral surgeonboth in terms of increased implant osseointegration and reducing bone healing times. The aim ofthis study was to validate the protocol in the literature to produce and then test in vitro osteoblastswith different nanomaterials to simulate bone regeneration., Method: hiPS clones (#2, #4, and #8)were differentiated into an osteoblast cell culture tested for alizarin red staining and for alkalinephosphatase testing at 14, 21 and 28 days, after the cells were plated., Results: The cells showeddiffuse positivity under alizarin red staining and the alkaline phosphatase (ALP)-test, showingsmall formations of calcium clusters., Conclusion: Despite the limitations of our study, it is a startingpoint for further protocols, laying a solid foundation for research in the field of bone regenerationthrough the use of stem cells.&nbsp., Competing Interests: Authors declare no conflict of interest.

Background: Advanced maxillary atrophy is one of the most common clinical scenarios where implant placement could become difficult. Nevertheless, a volumetric evaluation using a suitable diagnostic software could facilitate the implant planning. The purpose of the present study is to suggest the potential application of the maxillary retro-canine area as the designated location for virtual tilted implants., Methods: A sample of Cone Beam Computed Tomography (CBCT) images from the Department of Dentistry (IRCSS San Raffaele, Milan, Italy) was evaluated. After a 3D anatomical evaluation, tilted implants were virtually positioned in the retro-canine regions. All the implants were inserted using the same procedure at 30° and 45° degrees of tilting. The length, palatal angulation and diameter of the placed implant were identified., Results: A total of 220 tilted implants were placed. An average implant measurement of 13.51 mm in length and 3.42 mm in diameter were calculated. Additionally, an average buccal-palatal angulation of 6° was identified. Upon statistical analysis, the implant length was found to be significantly higher at 45° degrees of mesio-distal angulation than at 30° degrees (<0.0001)., Conclusions: A considerable number of patients show a significant degree of bone atrophy. The implant-supported treatment plan can rely on three-dimensional imaging of the residual bone as a guiding tool to establish the most effective implant position for each specific case. In this study, it was found that an implant could have a greater length if its mesio-distal angulation was more accentuated. In addition, owing to the volumetric evaluation, it was possible to virtually insert tilted implants in almost all of the cases of atrophy. This could lead clinicians to consider the retro-canine area as a viable place to insert a longer tilted implant.