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Statement of problem: Conometric retention was developed as an effective and predictable rehabilitative option. However, the clinical performance of conometric retention is still uncertain. Purpose: The purpose of this systematic review and meta-analysis was to analyze the clinical outcomes of patients rehabilitated with conometrically retained, implant-supported fixed prostheses. Material and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines, a systematic review of relevant literature published before September 2022 was conducted in the NIH library, the Cochrane Library, the Web of Science, and MEDLINE, and a manual search was performed. A meta-analysis of the resulting statistical data was carried out. Screening criteria to select the studies to include in the systematic review and meta-analysis were developed. Implant and prosthesis survival rates and probing pocket depth were assessed. Results: The 11 studies included in the meta-analysis showed that changes in pocket probing depths were not statistically significant (P=.32). The analysis of the resulting implant and prosthesis survival rates showed a mean survival rate of 99.17% and 98.73%, respectively. Conclusions: From this systematic review and meta-analysis, conometric retention seems to be a predictable therapeutic option associated with high implant and prosthesis survival rates. However, further long-term, and homogenous studies are required to better understand their clinical and long-term limitations

The advantages of immediate implant placement for patients include a reduced number of surgical procedures and a shorter overall treatment time. Disadvantages include a higher risk of aesthetic complications. The aim of this study was to compare xenogeneic collagen matrix (XCM) versus a subepithelial connective tissue graft (SCTG) used for soft tissue augmentation in combination with immediate implant placement without provisionalization. Forty-eight patients requiring a single implant-supported rehabilitation were selected and assigned to one of two surgical procedures: immediate implant with SCTG (SCTG group) or immediate implant with XCM (XCM group). Marginal changes in the peri-implant soft tissue and the facial soft tissue thickness (FSTT) were assessed after 12 months. Secondary outcomes included peri-implant health status, aesthetics, patient satisfaction, and perceived pain. All of the implants placed were successfully osseointegrated, resulting in 1-year survival and success rates of 100%. The patients in the SCTG group had a significantly lower mid-buccal marginal level (MBML) recession (P = 0.021) and a greater increase in FSTT (P < 0.001) than the patients in the XCM group. Using xenogeneic collagen matrix during immediate implant placement significantly increased FSTT from the baseline, leading to good aesthetic and patient satisfaction results. However, the connective tissue graft yielded better MBML and FSTT results.

Diet and nutrition are generally categorized as modifiable lifestyle risk factors for the development of periodontal disease because diet may influence a person’s inflammatory status. This study aimed to evaluate the efficacy of the application of a diet plan focused on reducing inflammation and oxidative stress in treating periodontitis. Subjects suffering from periodontitis were divided into two groups. Both groups underwent non-surgical periodontal therapy, and in the optimized diet (OD) group, this treatment was associated with a diet plan. The sample consisted of 60 subjects; 32 (53%) were treated in the non-optimized diet group (ND group) and 28 (47%) in the OD group. In both groups, the periodontal treatment significantly improved the recorded periodontal outcomes between T0 and T1 (FMPS, FMBS, CAL, PPD). Inter-group differences were not statistically significant (p < 0.05). The linear regression models showed that the optimized diet was associated with a higher reduction in PPD and FMBS after the treatment, while patients who had higher LDL levels (over 100 mg/mL) had a less favorable improvement of PPD. The application of an improved diet plan can increase the reduction in PPD and FMBS after non-surgical periodontal therapy when compared with periodontal treatment alone.

(1) Background: Ankyloglossia, or tongue-tie is a condition, in which the tip of tongue cannot protrude beyond the lower incisor teeth because of short frenulum linguae, often containing scar tissue. Limitations of movement are the most important clinical symptoms of this condition, together with feeding, speech, and mechanical problems. (2) Methods: the present study included two groups of patients (group A and group B) including, respectively, 29 and 32 patients (61 patients total), aged from 8 to 12 and presenting ankyloglossia classified according to the Kotlow’s classification. The patients in group A underwent a common surgical procedure. For the patients of group B, a diode laser device (K2 mobile laser, Dentium, Korea) with a micro-pulsed wavelength of 980 ± 10 nm and power of 1.2 watts was used. The post-surgical discomfort of the patients (recording the pain perceived immediately after the end of the anesthesia and during the following week, using the Numeric Rating Scale (NRS) system) and healing characteristics (recorded using the Early Wound Healing Score or EHS) were evaluated. (3) Results: The results shows that the pain in the patients who underwent laser-assisted frenectomy is significantly reduced (p < 0.001) when compared to those who underwent conventional surgical frenectomy, both immediately after surgery (with a reduction in the average NRS of 80.6%) and after the first week (with a reduction in the average NRS of 86.58%). Additionally, in the same patients, an augmentation in the average value of the EHS of 45% was recorded, highlighting significantly (p <0.001) better quality in the healing of the wound within the 24 h after surgery. Moreover, other advantages observed in the use of laser assisted-frenectomy are the absence of bleeding and, consequently, a clear operative field; no need to use sutures; no need to take painkillers or antibiotics after surgery; and having a faster recovery and less time needed to perform the operation. (

Angulated screw channels (ASC) allow the clinician to reposition the access hole of screw-retained restorations, improving the design of the rehabilitation and the esthetic outcome. Few clinical studies are available on the efficacy of these restorations, especially at longer follow-ups and with a large number of subjects. The objective of this study was therefore to retrospectively evaluate patients rehabilitated with screw-retained restorations using ASC. The time of delivery and their adherence to the maintenance program was obtained, as well as the characteristics of the restoration and of the patient’s occlusion; a Kaplan–Meier survival curve was then built to investigate the success rate of these restorations and the effects of several variables were evaluated with a Cox model. A total of 105 subjects and 162 implants were enrolled in this study; after 42 months a success rate (92%) similar to what is reported for conventional screw-retained restorations was encountered. Monolithic zirconia restorations (n = 52) had a higher success rate (95%) when compared to partially veneered restorations (n = 53), which suffered a higher number of complications (90%). The other variables had no statistically significant effect. Implant supported prostheses adopting ASC provide a favorable outcome both in the posterior and anterior regions and can therefore be adopted to treat cases where the implant angulation is unfavorable for a conventional screw-retained prosthesis.

AIM: Primary failure of eruption (PFE) is characterized by non-syndromic eruption failure of not ankylosed teeth, which fail in their eruptive process partially or completely, without any systemic disease or mechanical interference identifiable. This condition is different from the mechanical eruption failure (MFE) due to a mechanical obstacle. Primary eruption failure is an eruptive anomaly whose cause must be found in heterozygous variants of the gene encoding the Parathyroid receptor 1 (PTH1R, OMIM * 168468), located on chromosome 3p21.31. Aim of this work is to identify clinical and radiographic characteristics that distinguish PFE from other eruptive disorders, by comparing the clinical characteristics between positive and negative patients for PTH1R variants and by observing the genotype/phenotype correlations in positive patients in light of the differences in the type of variants found. Furthermore variants significance has been analyzed evaluating their pathogenicity through a comparison with those reported in dedicated databases. In this way, the combination of genetic information and clinical data is used to expand knowledge on the genotype-phenotype correlation of PFE. METHODS: A data set of 38 patients (22 males and 16 females) with eruption disorders was collected at the Università Cattolica del Sacro Cuore in Rome. Clinical examination and panoramic x-ray were used to assess the dental phenotype and the localization of the eruption problems. Patients’ selection was based on the clinical characteristics described by Stellzig-Eisenhauer et al. For DNA extraction, salivary cell samples were collected using special "salivary brush" usually used for these types of samples. RESULTS: After mutational analysis, patients with clinical PFE were placed into 2 categories: 17 with PTH1R variants and 21 patients negative for variants in PTH1R. In patients positive for the genetic test, were found typical features in agreement with phenotypic signs suggested by lit

Dental implant placement is a predictable therapy for replacing teeth. Nevertheless, mechanical, biological, and aesthetic complications frequently occur. The aim of this study was to compare the clinical outcomes of a xenogeneic collagen matrix (XCM) used at the time of implant placement as an alternative to a subepithelial connective tissue graft (SCTG), for soft tissue augmentation. This was a prospective clinical trial with 12 months of follow-up. In the control group, soft tissue augmentation at the time of implant placement was performed with a SCTG, while in the test group, a XCM was employed. At 12 months postoperative, all xenografts showed no postoperative complications. In both groups, a significantly greater thickness was observed on the buccal and occlusal sides from preoperative to 3 months postoperative (P < 0.05). No statistically significant difference in pink aesthetic score (P = 0.379, 6 months postoperative) or marginal bone loss (P = 0.449 at 3 months postoperative, P = 0.778 at 6 months postoperative) was observed between the groups. Statistically significant differences in pain perceived by the patients (P < 0.0001) and the time to complete the surgical procedure (P = 0.0008) were detected. At 12 months after surgery, XCM provided similar clinical results in terms of soft tissue augmentation on the buccal and occlusal sides as compared with the SCTG.

Impacted teeth fail to fully erupt in the oral cavity mainly as a result of reduced space in the dental arch. Several studies have shown the mandibular third molar to be the most commonly impacted tooth, with a prevalence reaching 77% (1), followed by the maxillary third molar. An impacted mandibular third molar can cause the development of an infection, commonly called pericoronitis, in the follicular sac of the impacted third molar; this infection can be seen in a percentage as high as 64% (2) of patients with an impacted third molar, and can be quite painful for the patient. The usual therapy for treating an impacted tooth is its extraction, which can be called for not only for treating a tooth that has been the cause of an infection and can negatively affect nutrients intake (3), but also for maintaining the periodontal health of the second molar (4) or for orthodontic and prosthetic needs. Their extraction is particularly important in patients undergoing hematopoietic stem cell transplantation (HSCT) (5). Their extraction is usually a uneventful surgical procedure, but in rare cases it may cause several complications, such as paresthesia of the lower lip or the development of a dry socket (6). These complications have a widely different reported rate. The aim of this study is to retrospectively highlight the prevalence of these events in our clinic.

The novel Coronavirus pandemic defines a new risk for all dental practitioners, hygienists, and dental assistants. As an increasing number of dentists are now developing this disease, we wanted to provide some measures to manage this risk in the dental practice, by undergoing a review of the current literature. This minireview searches the literature for articles that both defined the infection risk in the dental practice and provided evidence on the efficacy of some procedures on reducing the infection risk. Several articles have already pointed out some necessary measures: fewer patients have to be admitted to the practice, a short triage should be carried out, and the appropriate measures of protection have to be used. On the basis of the literature collected, a short questionnaire and a flowchart is proposed to define the risk that each patient carries, and to appropriately adapt each procedure based on the patient’s risk. The literature is still limited on this subject, but on the basis of what is available, dental practices have to adapt to the situation in order to protect dental health professionals. Impact statement: Dentists have always been taught how to protect themselves and their patients from potential blood-borne pathogens, but the Coronavirus pandemic has brought a new unprecedented challenge to the world of dentistry; we therefore reviewed the literature to provide suggestions on how to accordingly change dental practice prevention.

Background: The extraction of the mandibular third molar is one of the most frequent intervention in oral surgery. A common indication for wisdom tooth extraction is represented by pericoronitis, which can determine discomfort and pain in patients. The present study aimed to evaluate the impact of patients’ quality of life by comparing a surgical approach with a periodontal approach. Methods: We evaluated 82 patients diagnosed with pericoronitis that occurred at the third molar site. In total, 41 of them received a periodontal treatment and 41 were treated by extraction. The quality of life (QoL) of the patients was assessed by using the Oral Health Impact Profile-14 (OHIP-14) index. Results: A total of 82 patients were included in the study and were followed up for 6 months. Of the patients, 41 received a periodontal treatment and 41 underwent surgical extraction. At the baseline, the OHIP-14 scores of the surgical group were higher (19.71, SD 9.90) than the periodontal group (14.41, SD 8.71). At 1 week, there was a reduction in terms of OHIP- 14 in both groups, but the periodontal group showed lower values (12.3, SD 8.11). Long-term follow- up showed a reduction of the OHIP-14 values, with a difference in favor of the surgical group (0.10, SD 0.45). However, there was a reduction in OHIP-14 scores in both groups. Conclusion: Although the periodontal treatment offered a rapid improvement in terms of quality of life during the first week after the treatment, after 1 month and 6 months, the extraction of the mandibular third molar extraction remained the best treatment, removing the occurrence of re-inflammation of the site.

OBJECTIVE: We tested and quantified the in vitro effect of silver coating on preventing development of fungal biofilm over titanium, as found in some megaprosthesis used for musculoskeletal oncological reconstruction, to evaluate the antiseptic effect of this additional feature on this class of pathogens. MATERIALS AND METHODS: Different strains and species of Candida (C. albicans, C. tropicalis, C. parapsilosis) were cultured over 6 silver-coated and 6 non silver-coated titanium (Ti-6Al-4V) samples following a standardized procedure. Then spectrophotometrical analysis and viability assay were conducted after 5 days of incubation to quantify the different extension of biofilm produced by pathogens RESULTS: Significant differences between groups (p<0.05) were found in terms of biofilm extension and pathogens viability over the different materials for any single experiment reported, with silver-coating group showing substantially lower values in terms of fungal development in all conducted assays. CONCLUSIONS: The results suggest that silver coating is a reliable and effective implementation for antifungal purpose, in addition to its widely known and demonstrated antibacterial potential. Therefore, the use of silver-coated implants may be an even wiser choice in an oncological surgical procedure where patients are particularly at risk for this infective complication due to immunosuppression caused by pharmacological treatments, although the relevant antifungal potential here shown needs to be confirmed in vivo.

Purpose: The extraction of a tooth is followed by hard and soft tissue changes that can compromise implant placement. The aim of the present retrospective study was to compare the clinical and radiographic outcomes of different ridge preservation procedures based on the use of leukocyte and platelet-rich fibrin (L-PRF). Materials and Methods: The study population consisted of all patients who had undergone surgery from January 1, 2017 to January 1, 2018 for alveolar ridge preservation on single posterior teeth using 3 clinical protocols: L-PRF alone, L-PRF mixed with a bone xenograft, and bone xenograft alone. Clinical and radiographic measures were recorded preoperatively and at 6 months postoperatively to determine the horizontal and vertical ridge resorption. Results: A total of 45 patients were included in the present study. All the surgeries were performed successfully, and no intraoperative complications developed. The L-PRF group experienced significantly greater horizontal and vertical bone resorption. The L-PRF plus bone xenograft group had less vertical and horizontal bone resorption than the bone xenograft alone group. Statistically significant differences in postoperative pain and wound healing were observed, with the bone xenograft alone group, in particular, having higher values for pain and experiencing delayed wound healing. Conclusions: Within the limitations of the present retrospective study, the use of a bone xenograft alone or L-PRF combined with a bone xenograft to perform alveolar ridge preservation procedures significantly limited bone resorption.

OBJECTIVE: This pilot study analyzed the possible changes of periodontal disease status in female patients during the period following pregnancy. Both clinical and laboratory data were collected and analyzed. PATIENTS AND METHODS: A non-randomized controlled clinical trial was conducted by the Periodontal Department of the Dental Clinic in collaboration with the Pediatrics Department, at Fondazione Policlinico Universitario A. Gemelli, Rome, Italy. Ten female patients, who completed the pregnancy without complications, were enrolled in this research protocol forming the experimental group. During the first post-partum days, gingival crevicular fluid (GCF) samples were collected and analyzed with high-performance liquid chromatography associated with high-resolution mass spectrometry (HPLC ESI MS); periodontal parameters as pocket depth (PD), full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) were recorded, and a professional oral hygiene session was performed. The same protocol was applied after three months with the same patients forming the recall group. A control group was created in order to compare the results with GCF samples from 10 not pregnant fertile women. RESULTS: Student's t-test has been used to evaluate the statistical significance of the collected data. Mean levels of PD decreased from 3.75 mm ± 1.2 mm after pregnancy to 2.88 mm ± 0.85 mm at three months post-partum (p<0.01). Mean value of FMPS and FMBS decreased from 21.8% ± 1.35% and 34.27% ± 1.5% after pregnancy to 13% ± 2.81% and 17.55% ± 2.84% at three months post-partum, respectively (p<0.05). The concentration of each analyzed peptide has changed in relation to the general improvement of the periodontal status at three months post-partum. CONCLUSIONS: Pregnancy may be associated with an increased risk of periodontal disease. Both clinical and laboratory data have demonstrated that a professional oral hygiene session can affect the course of pregnancy inducing periodontal

OBJECTIVE: alcohol abuse represents a risk factor for oral diseases, in particular, oral cancer. Periodontal disease has been showed to be involved in the pathophysiology of cardiovascular and metabolic diseases, such as atherosclerosis and liver steatosis. The role of chronic alcohol consumption on periodontitis is still controversial. The aim of the study was to evaluate the effect of chronic alcohol abuse on oral health. PATIENTS AND METHODS: Twenty-three alcohol use disorders (AUD) patients and twenty-three healthy social drinkers underwent an oral examination by trained oral clinicians in order to evaluate oral and dental health. A questionnaire assessing oral hygiene was administered together with the evaluation of DMFT (decayed, missing, filled teeth), SLI (Silness-Loë plaque index) and CPI (community periodontal index of treatment needs) scores. RESULTS: Alcoholic patients showed significantly lower oral hygiene scores compared to controls. Alcoholic patients showed significantly poorer scores at DMFT, SLI and CPI tests. Moreover, among alcoholics, smokers showed a significantly poorer oral health than non-smokers. CONCLUSIONS: Chronic alcohol abuse increases the risk of dental and periodontal diseases. Smoking represents a significant co-factor. The practice of basic oral hygiene and the access to professional dental care should be encouraged among AUD patients in order to reduce oral diseases.

Different ceramics have been proposed as materials for medical devices. Alumina, zirconium oxide and zirconia toughened alumina are the most studied ceramic materials for biomedical applications. These materials were proposed firstly for orthopaedic prostheses and successively for other purpose such as dental restorations. Alumina showed atoxicity and is well tolerated by bone and soft tissue. Solid specimens showed to be well tolerated by fibroblasts and osteocites. Also inflammatory reaction of alumina, compared with titanium appears lower. Alumina biocompatibility resulted to be comparable to other dental ceramic. Zirconia biocompatibility was studied in vivo and in vitro. In vivo studies were the first to be performed since 1970. Bone and muscle reaction after insertion of a zirconia sample was evaluated. No adverse response was evidenced in these studies. In vitro studies focused on different topics: tissue reaction, mutagenic and carcinogenic power, cell behaviour. Tissue reaction was influenced by the specimen, but in general bulk samples didn't result to be citotoxic. Zirconia didn't show ability to generate mutation or degeneration on cell cultures. Moreover fibroblast showed great ability to grow on zirconia surface. Moreover both zirconia and alumina showed less proinflammatory properties if compared with other biocompatible specimens such as titanium and high density polyethylene. © 2012 by Nova Science Publishers, Inc. All Rights Reserved.

Different ceramics have been proposed as materials for medical devices. Alumina, zirconium oxide and zirconia toughened alumina are the most studied ceramic materials for biomedical applications. These materials were proposed firstly for orthopaedic prostheses and successively for other purpose such as dental restorations. Alumina showed atoxicity and is well tolerated by bone and soft tissue. Solid specimens showed to be well tolerated by fibroblasts and osteocites. Also inflammatory reaction of alumina, compared with titanium appears lower. Alumina biocompatibility resulted to be comparable to other dental ceramic. Zirconia biocompatibility was studied in vivo and in vitro. In vivo studies were the first to be performed since 1970. Bone and muscle reaction after insertion of a zirconia sample was evaluated. No adverse response was evidenced in these studies. In vitro studies focused on different topics: tissue reaction, mutagenic and carcinogenic power, cell behaviour. Tissue reaction was influenced by the specimen, but in general bulk samples didn't result to be citotoxic. Zirconia didn't show ability to generate mutation or degeneration on cell cultures. Moreover fibroblast showed great ability to grow on zirconia surface. Moreover both zirconia and alumina showed less proinflammatory properties if compared with other biocompatible specimens such as titanium and high density polyethylene. Recently the development of a new class of ceramics Zirconia Toughened Alumina (ZTA), and more recently Zirconia Plateled Toughened Alumina (ZPTA) combining the mechanical properties of Alumina and Zirconia has improved the use of these ceramics in biomedical applications (especially in orthopaedic surgery). In vitro tests demonstrated the absence of citotoxicity and mutagenic and carcinogenic power of these materials when cocultured with cells. In vivo tests of bulk materials showed the absence of local and systemic toxicity after implantation into bone. there were no statisti