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The final phases of the information systems lifecycle are no less important than the initial ones. However, previous research indicated a lack of studies on information systems discontinuance. This paper aims to verify whether this gap still exists by analysing the literature on enterprise resource planning (ERP) systems, a type of software widely used in many organisations. To identify the relevant literature, the paper involved searching in Scopus and Web of Science databases. Despite several ERP literature reviews suggesting more studies on the retirement phase and no time limits in the search, very few studies have been identified. To sketch the current state of knowledge on the selected topic, the paper developed a scoping review and, based on the results, comments on possible critical issues. The work supports researchers and practitioners interested in information systems discontinuance, as it provides some considerations to develop future research. In addition, it has practical implications because the advancement of the knowledge frontier will help organizations cope with this kind of change.

Objectives To date, the best treatment for Medication Related Osteonecrosis of the jaw (MRONJ) is controversial. Recent studies suggest different therapies, considering the stage of MRONJ; however, sometimes patients, although with remarkable extension of disease, cannot undergo surgery. The purpose of present preliminary study was to evaluate the efficacy of conservative non‐surgical treatment of MRONJ lesions in a cohort of patients ineligible for surgery or refusing any surgical treatment for stage II and III of MRONJ. Materials and methods Patients with MRONJ (staging II or III) ineligible for surgical treatment were selected for a retrospective study. A conservative non‐surgical therapy (antibiotics and antiseptic) was administered for 1 year. Five scheduled checks were performed to assess changes in signs and symptoms during the observational period. Results Our observation was carried out on 12 patients. Improvement of signs and symptoms of disease were observed in population. Conclusion This study suggests that non‐surgical treatment may be a valid therapeutic option in patients ineligible for surgery. The sample size is small, further studies should be carried out to satisfy the aim of a conservative non‐surgical treatment protocol establishment.

Purpose Digital technologies have improved ways to perform aesthetic dentistry in the last few years. The aims of this survey were to investigate the most preferred way to preview the result of an aesthetic dental rehabilitation among a population of dental professionals and laypeople and to compare aesthetic standards of the general population and dentists in terms of the color of teeth for aesthetic dental rehabilitations. Patients and methods A questionnaire was sent to the subjects (dentists and laypeople) during a 1-year period and, together with their demographic data, different ways to preview the result of an aesthetic rehabilitation were submitted, such as digital smile design, dental wax-up and oral explanation. Furthermore, an additional section of the questionnaire investigated the most suitable color for an aesthetic rehabilitation based on the colors of the VITA Scale. Results were statistically analyzed (with Chi-square of independence and Mann-Whitney U-test) highlighting differences of answers based on age groups, educational attainment, gender, and belonging or not to the dental field. Results Findings showed that digital smile design (digital preview) is a high-appreciated method for previewing and communicating with patients both by dental professionals and laypeople. Furthermore, lighter colors were found to be more valued by laypeople and significant differences were highlighted between the two populations assessed. Conclusion It seems to be viable to use digital preview for dentists and laypeople to improve previewing and communicating ways. It might be advisable to better motivate patients in recognizing aesthetical features and to raise their awareness in preferring more mimetic aesthetic results. Great opportunities are opened up by digital smile design in teaching, learning, and routine practice.

Background Nonsurgical aesthetic treatment of the nose is becoming increasingly popular. VYC-25L is a novel hyaluronic acid product with the high G’ and cohesivity required of a nasal filler. Objectives The authors sought to assess the safety and efficacy of VYC-25L for treatment of the nose utilizing a previously published, grid-based protocol. Methods This was a retrospective, single-center analysis of data from adult patients undergoing treatment of the nose with VYC-25L between February and April 2019 utilizing the grid system as the reference for injection quantity and sequencing. Specific procedures included correction of inadequate projection, deep glabella treatment, correction of a nasal hump, and adjustment of the nasolabial angle and columella. Patients were followed-up for 6 to 9 months. Results A total of 61 patients were included in the analysis (mean age, 32 ± 3 years; n = 45 females [74%]). At 2 weeks posttreatment, a high degree of defect correction was confirmed based on independent evaluation, with all patients scoring 9 or 10 on a 10-point visual analog scale. Fifty-nine of 61 patients (97%) self-assessed the degree of correction as “adequate.” Results were stable at 3- and 6-month follow-up visits. Complications recorded were bruising (n = 15, 25%), asymmetry (n = 2, 3%), and hematoma (n = 1, 2%). All resolved rapidly. There were no cases of infection, bumps, or skin necrosis. Conclusions VYC-25L is safe and efficacious for treatment of the nose, with high levels of patient satisfaction. It has potential to be a valuable tool in nonsurgical rhinoplasty. Level of Evidence: 4

Purpose To clinically evaluate a recently developed, standardized, three-implant-supported full-arch treatment concept for fully edentulous mandibles. Materials and methods This ongoing multinational prospective cohort study is evaluating the performance of the treatment concept over 5 years in patients who were fully edentulous or had failing dentition of the mandible. The primary outcome was the cumulative survival rate of implants (CSRI). Secondary outcomes included the cumulative survival rate of the prostheses (CSRP), marginal bone level change, soft tissue outcomes, impact on quality of life, and patient and clinician satisfaction. The 1-year report is presented here. Results In total, 110 patients (330 implants) were included. Prostheses underwent immediate loading in 76.4% of cases and early loading in 23.6% of cases. The mean surgical time was 1.60 ± 0.78 hours, and the mean laboratory time was 3.99 ± 1.74 hours. At 1 year, eight implants and three prostheses failed, yielding an implant-level CSRI of 97.5% and a CSRP of 97.3%. All prosthetic failures were due to loss of two implants in the patient. The mean marginal bone level change at 1 year was -0.62 ± 1.39 mm. Among soft tissue outcomes, the Bleeding Index improved significantly between the 6-month and 1-year follow-up, and 242 implants (75%) were surrounded by keratinized mucosa by the 6-month follow-up. Patients reported a significant improvement in quality of life between prosthesis placement and the 6-month follow-up based on the Oral Health Impact Profile for Edentulous 21 questionnaire. Both patient and clinician satisfaction with function and esthetics were high throughout treatment. Conclusion This novel treatment concept using a passively fitting standardized framework with simplified surgical and prosthetic workflow demonstrated high survival and excellent outcomes at 1 year while reducing chair and fabrication time. This concept may offer patients a safe and efficient option for full-arch mandibular prostheses.

Among healthcare workers, oral and maxillofacial surgeons are some of the most exposed to coronavirus disease (COVID-19). The aim of this retrospective study was to develop suggestions for continuing the work of oral and maxillofacial surgeons using a safe protocol for elective and urgent aerosol-generating procedures that could prevent the onset of new clusters. Based on the results obtained and a guidelines review of those Asian countries that had promptly managed the current pandemic, the following safety protocol was developed.

Since the bulk-fill composites were produced, there was a progressive diffusion of their use for direct conservative treatment in posterior teeth. Their chemical structure increases the depth of cure and decreases the polymerization contraction; in this manner, bulk-fill composites can be placed in 4 mm single layers and the treatment times are considerably reduced. However, aesthetic and mechanical properties and impact on microleakage of bulk-fill resins are still unclear.This systematic review and meta-analysis aimed to assess the risk of microleakage of direct posterior restorations made of bulk-fill versus conventional composite resins.Researches were performed on PubMed and Scopus databases. Eligible in vivo studies, published since 2006, were reviewed. Outcomes of marginal discoloration, marginal adaptation, and recurrent caries were considered to conduct the systematic review and meta-analysis. Secondary data were examined to implement additional analysis and assess the risk of bias.Eight randomized clinical trials were analyzed, involving 778 direct restorations. The summary of RCTs led to significant but inconsistent results; the marginal discoloration and recurrent caries were found to be improved respectively by 5.1 and 1.4%, whereas the marginal adaptation was reduced of 6.5%. Secondary analyses revealed that follow-up periods, the adhesive system used and the class of carious lesions evaluated are confounding factors, and they result in a risk of bias across studies.Bulk-fill composites are innovative materials for conservative dentistry and they can be used to reduce treatment steps and duration of operative times. There are insufficient data to explore the relationship between bulk-fill composites and microleakage and further investigations are needed.

Objectives Primary aim of this study was to evaluate survival rate of lithium disilicate veneers in upper and lower anterior teeth. Secondary aims were to evaluate changing in proportions of teeth before and after restorations and to assess mean thickness of the veneers. Materials and Methods Seventy-nine upper and lower lithium disilicate veneers were made in 13 patients with worn teeth. Mean follow-up was 3 years. To perform anterior definitive rehabilitations, malocclusions and loss of vertical dimension were treated by full mouth rehabilitations to obtain proper occlusal conditions. Veneers were made of lithium disilicate core and fluorapatite-based ceramic stratification. Survival rate was calculated by Kaplan–Meier analysis. Changing in teeth proportion before and after restorations was analyzed by a paired t-test. Descriptive statistics of thickness values were also performed. Results One case of detachment was observed with a 98.7% survival rate. Teeth’s proportions were preserved although the first upper right incisor and canine changed in dimension. Conclusions Lithium disilicate veneers in esthetical rehabilitations of worn teeth proved to be an effective way of treatment in a medium follow-up of 3 years. Proportions seemed to be maintained with a minimum dental removal.

Francesca Zotti,1 Rinaldo Zotti,2 Massimo Albanese,1 Pier Francesco Nocini,1 Corrado Paganelli21Department of Surgery, Dentistry, Paediatric and Gynecology, University of Verona, 37134 Verona, Italy; 2Department of Orthodontics, School of Dentistry, University of Brescia, 25100 Brescia, ItalyPurpose: To determine whether the use of social media is useful in improving compliance and follow-up attendance among patients wearing retainers after orthodontic treatment.Patients and methods: Sixty post-orthodontic patients (aged 16–19 years), randomized in two groups: follow-up supported by participation in WhatsApp chat group (SG), and Control Group (CG). All patients were scheduled for quarterly check-ups for monitoring of orthodontic stability by measurement of intercanine width at the beginning of the study (t0) and every 4 months t1, t2, t3) for 1 year of observation. Patients in the SG additionally participated in a WhatsApp chat group, where they would send, on a weekly basis, snapshots showing his/her occlusion. Every month, the orthodontist acting as the moderator awarded the best five snapshots by publishing a ranking in the chat.Results: Participants in the SG featured smaller changes from the intercanine widths at baseline (at debonding) compared to the CG patients at all times during 1 year of follow-up. Follow-up attendance was regular in both groups in the first 8 months of follow-up. After that, patient compliance decreased in the CG, with eight patients missing check-up appointments.Conclusion: Engaging adolescent patients directly through WhatsApp activity seems to increase regularity in wearing removable retainers, attendance to follow-up schedule, and yield better long-term outcome in terms of orthodontic stability and compliance.Keywords: apps, technologies, orthodontics relapse, orthodontic compliance, patient compliance, young patients

Background Facial trauma can cause major psychological damage and compromise a patient’s quality of life. Unfortunately, surgery cannot always solve this problem or provide an acceptable result. Objectives Treatment with injectables may provide a solution that is minimally invasive and better accepted by patients as a means to improve poor outcomes after facial trauma. Methods This retrospective study involved 50 patients (29 men, 21 women) who underwent primary surgery to treat facial trauma between January 2015 and January 2017. Based on the facial area affected by poor outcomes (upper face, midface, and lower face), patients underwent ≥1 aesthetic medicine treatments with hyaluronic acid dermal fillers and botulinum toxin injections. To evaluate patient satisfaction and the effect of the treatment on quality of life, patients were asked to complete 2 questionnaires, POSAS and FACE-Q, prior to treatment and 90 days after the last treatment session. Results Questionnaire scores indicated improvements in aesthetic and psychological metrics, perceived both by the patient and the observer. Conclusions Minimally invasive aesthetic treatments represent a valuable adjunct to surgical procedures for improving facial aesthetics after injury and consequently the quality of life of patients affected by facial trauma. Level of Evidence: 4

Periodontal healing after third molars extraction seems to be influenced by the choice of different flap techniques. The purpose of the present study was to assess the clinical condition of adjacent first and second molar sites, after the extraction of lower third molars, performed through different flap designs. Eighty patients, aged between 14 and 30 years, were analyzed for periodontal parameters of VPI, PPD, and CAL, pre-operatively (T0), after 15 days (T1), after 1 month (T2), and after 2 months (T3) from extraction. Techniques performed were trapezoidal flap (TRAP), marginal flap (MARG), flap with papilla detachment (DETP), and flap with papilla decapitation (DEC). No significant differences were found between the four flaps at each observation time and considering the interval between T0 and T3, for VPI, PPD at first molar site, PPD at second molar site, and CAL at second molar site. Significant variations for CAL were registered, for each flap, between T0 and T3, in all cases for buccal site, in three cases for buccal-distal site. After 2 months of follow-up, no strong evidence can be assumed for or against the use of a particular flap design for the extraction of lower third molars.

Orthognathic surgery is a branch of maxillo-facial surgery increasingly in demand, which deals with the correction of skeletal deformities. The aim of the present study is to identify the most common post-operative complications following orthognathic bimaxillary surgery performed by means of Piezosurgery®. Furthermore, through an examination of the available scientific literature, we wanted to establish whether the frequency of postoperative complications were consistent with those already reported. A retrospective study on 58 patients who underwent orthognathic surgery with a bilateral sagittal osteotomy (BSSO) of the mandibular bone branch, maxillary surgery with Le Fort I mono-segmented or multi-segmented approach, and genioplasty technique using Piezosurgery®. The complications taken into consideration were disorders of the temporomandibular joint (TMJ), paraesthesia and hypoesthesia, asymmetries, nose enlargement, nasal septum deviation, nasal obstruction, dental discolorations, pulpal necrosis, occlusion and masticatory efficiency, gingival recession, periodontal problems, dysgeusia, nausea and vomiting, weeping alterations, hearing problems, delayed healing, superinfection, removal of synthesis means, reoperation, cicatricial outcome, and bilateral pneumothorax. It has been highlighted that a number and type of postoperative complications matched those reported by the most recent literature reviews. Temporomandibular disorders and paraesthesia were the most common ones. The only complication rate that differed from the literature was nerve damage, which was significantly lower. Post-surgical complications depend on the used surgical techniques, clinical work, and treatment methods. The use of piezoelectric devices in orthognathic surgery operations provides an innovative, safe, and effective technique compared to traditional methods.

Medication-related Osteonecrosis of the Jaw (MR-ONJ) is an adverse drugs reaction characterized by the worsening of quality of life in cancer patients, and for which one of the most frequent risk factor recognized is tooth extraction. This report aims to describe our one-year experience about the prevention of MR-ONJ in cancer patients receiving antiresorptive-antiangiogenic drugs, with or without Bisphosphonates, referred to the Department of Surgical Sciences, Paediatrics and Gynaecology (University of Verona). The protocol described by the Italian Society of Oral and Maxillofacial Surgery (SICMF) and the Italian Society of Oral Pathology and Medicine (SIPMO) was strictly followed in all surgical procedures, including the defined medical prophylaxis. Once assessed inclusion and exclusion criteria, a retrospective analysis was carried out in a total of 15 patients, followed up during 2019. None of our patients developed MR-ONJ.

Bisphosphonates (BPs) are the most commonly used antiresorptive drugs to prevent skeletal-related events (SREs) in cancer and osteometabolic patients. A potential adverse drugs reaction associated with the administration of these drugs is Medication-related Osteonecrosis of the Jaw (MR-ONJ); its frequency in cancer patients is higher than in osteometabolic patients. Different risk factors have been identified: drug type, duration of treatment, demographic, systemic and local factors. Among the latter, the most reported and investigated are dentoalveolar surgical procedures, anatomical factors, prosthesis and associated local oral inflammatory diseases. To date, MR-ONJ pathophysiology remains unclear, therefore, definitive protocols on prevention in oral surgery have not been established yet. Several studies had investigated the procedures to prevent the occurrence of MR-ONJ after oral surgery, particularly for tooth extraction. These proposed protocols included antibiotic and mouthwash treatment, atraumatic extraction, primary closure of the extraction socket, laser biostimulation and the use of autologous platelet concentrates. The present study aimed to evaluate our one year experience in the prevention of MRONJ after dentoalveolar surgery in patients receiving bisphosphonate therapy. The protocol described and proposed by the Italian Society of Oral and Maxillofacial Surgery (SICMF) and the Italian Society of Oral Pathology and Medicine (SIPMO) has been followed; this protocol includes medical prophylaxis with strictly described surgical procedures

Background Oral Lichen Planus (OLP) is an inflammatory chronic disease. Modified World Health Organization (WHO) diagnostic criteria (2003) suggest diagnosing OLP both clinically and histologically. Furthermore, it is known the potential of malignant transformation of OLP, especially those affecting mucosa. Aims of this retrospective study on 100 patients were i) to estimate the timing of transformation of OLP lesions in OSCC in a cohort of patients observed between 2008 and 2018; ii) to assess risk factors of OLP patients diagnosed with OSCC; iii) to analyse forms of OLP evolved in cancer. Material and methods A database of 100 patients diagnosed with OLP was evaluated and clinical, histological features of lesions, habits of patients and systemic diseases were analysed in a follow up ranged between 5 and 10 years. Results Mean time of malignant transformation was 31,62± 18,26 months; however, 4 malignant transformations out of 8 occurred about after 4 years of observation. Furthermore, Odds ratios for risk factors showed an association between malignant transformation and location. Conclusions More focused attention on follow-up scheduling and designing could be a valuable resource in early diagnosis and cancer prevention in OLP patients. Key words:Oral Lichen Planus, Oral Cancer, Malignant transformation, risk factors.

Research activity is becoming increasingly complex due to the nature of research topics and questions. Among the essential academic research activities are literature reviews (LR), as they support the advance of the knowledge frontier. To improve literature reviews and their understanding, it would need to have comprehensive literature representations. In this perspective, the paper aims to advance previous work by illustrating a new way of creating thorough literature representations. The proposed tool is innovative and versatile since authors can adopt it in different types of LRs. Its adoption implies the construction of a three-dimensional scheme for the classification of the literature to be analysed. Then, based on the latter and selecting suitable evaluation variables, the proposed approach produces informative multidimensional representations for literature mapping and bibliometric analysis. For exemplifying this, the paper provides two application cases concerning Enterprise Resource Planning (ERP) systems and entrepreneurship research.

PurposeDoing business in depleted contexts requires the adoption of an unconventional strategic orientation based on the involvement of the local community and driven by the attainment of economic, environmental and social goals. Previous studies have explored the specific nature of community enterprises (CEs); notwithstanding, little attention has been paid to the understanding of the strategic posture adopted by community entrepreneurs to overcome difficulties and make the business up. In this vein, the study aims to investigate how CEs operating in depleted contexts manage to survive, by successfully achieving multiple – conflicting – goals.Design/methodology/approachThe authors adopted the Humane Entrepreneurship (HumEnt) framework as a form of institutional entrepreneurship where resources are leveraged to evolve the institutional context. This research adopts the case study strategy, focusing on Italian rural CEs.FindingsThe HumEnt approach, which takes into account both economic and non-economic and altruistic values of entrepreneurs, turned as better suited – compared to other approaches – to explain why people try to make business in such high-risk contexts. Second, the holistic approach of the HumEnt framework allowed catching up the particular mechanism that has enabled the CEs to obtain positive achievement.Originality/valueThe adoption of the HumEnt perspective enabled us to understand better the way CEs may survive and even grow where other initiatives have failed.

Background and objective: Dental fluorosis is a disease affecting dental hard tissues featured with white or yellowish lesions. Several treatments are proposed in the literature, some even invasive. This clinical study aimed to evaluate the effectiveness of resin infiltration in terms of lesions resolution, trend of sensitive teeth and satisfaction of patients over time. Methods and material: 200 fluorosis lesions were treated using ICON infiltrating resin (DMG, Hamburg, Germany). Parameters related to patients were collected by a questionnaire and analyzed aesthetic dissatisfaction about lesions, Shiff Air Index Sensitive Scale, sensitive teeth after treatment, the satisfaction of duration of treatment. The same operator measured dimensions of lesions Tooth Surface Index of Fluorosis (TSIF) and numbers of etching cycles needed for treating lesions. Statistical analysis was performed. The follow-up was of 1-year a measurement were performed at baseline (t0), immediately after the treatment (t1) and every three months during the observation period. Results: All lesions disappeared after one treatment. Pain or sensitive teeth were reported inside the 72 h and they disappeared after. Statistical analysis showed highly statistically correlation between etching cycles and the dimension of lesions and TSIF at the time-points evaluated as well as for pain during treatment, whereas a statistical significance was not noticed where etching cycles were correlated to sensitive teeth after 72 h. Overall, the treatment was found to be statistically significantly associated with differences in answers of aesthetic dissatisfaction between t0 and t1 and those collected between t1 and t2. Between t2 and t3 and between t3 and t4 no statistical differences were found in answers of patients about dissatisfaction, indicating the stability of the results. Conclusions: The ICON resin infiltration technique was found to be effective in lesions resolution with steady results.

Purpose Digital technologies have improved ways to perform aesthetic dentistry in the last few years. The aims of this survey were to investigate the most preferred way to preview the result of an aesthetic dental rehabilitation among a population of dental professionals and laypeople and to compare aesthetic standards of the general population and dentists in terms of the color of teeth for aesthetic dental rehabilitations. Patients and Methods A questionnaire was sent to the subjects (dentists and laypeople) during a 1-year period and, together with their demographic data, different ways to preview the result of an aesthetic rehabilitation were submitted, such as digital smile design, dental wax-up and oral explanation. Furthermore, an additional section of the questionnaire investigated the most suitable color for an aesthetic rehabilitation based on the colors of the VITA Scale. Results were statistically analyzed (with Chi-square of independence and Mann–Whitney U-test) highlighting differences of answers based on age groups, educational attainment, gender, and belonging or not to the dental field. Results Findings showed that digital smile design (digital preview) is a high-appreciated method for previewing and communicating with patients both by dental professionals and laypeople. Furthermore, lighter colors were found to be more valued by laypeople and significant differences were highlighted between the two populations assessed. Conclusion It seems to be viable to use digital preview for dentists and laypeople to improve previewing and communicating ways. It might be advisable to better motivate patients in recognizing aesthetical features and to raise their awareness in preferring more mimetic aesthetic results. Great opportunities are opened up by digital smile design in teaching, learning, and routine practice.

Objectives The aim of this narrative review was to collect all findings from literature about oral signs and symptoms of COVID‐19, in order to draw a picture of oral involvement of this challenging viral infection, to help oral professionals in a better triage and early diagnosis. Material and methods The search for international literature was made including articles written in English and reporting about oral manifestations in patients with a diagnosis of COVID‐19. The publication time was limited to 2019 and 2020, up to May 20, 2020. A narrative review was performed. Results Twenty‐three articles were included in this review. Three different oral manifestations were found: taste alteration, oral blister and ulcers, and oral lesions associated with Kawasaki‐like diseases (erythema, bleeding of lips, “strawberry tongue”). The higher expression of Angiotensin‐converting enzyme 2 in the oral cavity and in endothelial cells might be responsible for oral manifestation and the major report of signs and symptoms in the occidental countries. Conclusions Detecting oral signs and symptoms of COVID‐19 could be useful to perform a better preliminary triage in dental setting, and in recognizing possible early manifestations of the disease. However, considering the outbreak of COVID‐19 and the consequent difficulty of undergoing oral examinations, the oral manifestations might be misdiagnosed; then, we would encourage oral professionals to perform other studies about this topic.

Oral Lichen Planus (OLP) is an inflammatory chronic disease, its potential of malignant transformation is widely known, especially for lesions affecting mucosa. This letter aims to highlight, thanks to results obtained from a long-term observation of one hundred patient suffering from OLP, the importance to set proper and sufficiently long follow-ups. An important evidence observed is the malignant developing after 4 years of observation in 4 cases of 8. This leads to conclude that follow-up for OLP lesions is required to be as long as possible in order to timeously intercept malignant transformations of these lesions and to perform a realistic early diagnosis. Final suggestion is to design more prospective studies based of long observation period.

Oral MALT Lymphoma is rare condition and its pathogenesis are related to persistent immune stimulation caused by chronic infection or inflammation. We report a case of MALT lymphoma of the palatal minor salivary glands in a 73-year-old white woman with clinical history of osteoporosis and systemic lupus erythematosus associated with Sjogren's syndrome. This letter aims to call the attention on large number of factors to take into account in evaluating patients with an history of auto-immune diseases. This idea results from our difficulty in identifying this pathology in first diagnosis, due to rarity of this condition and severe comorbidity associated.

Background: The chin is the most prominent and median sector of the lower third of the face giving harmony to nose and lips. The authors present the application of piezoelectric scalpel for the correction of different chin deformities. The distinctive characteristics of this device allow us to avoid or reduce the immediate genioplasty complications. Methods: Fifty-five patients with defective chin have been treated from January 2006 to April 2008. Intraoral chinplasty was performed during the correction of dentofacial dysmorphisms or associated with nasal surgery. The authors used a piezoelectric cutting device to perform different osteotomies and if necessary, interpositional graft was used to stabilize bony segments. Results: Piezosurgery has been associated with a fewer number of postoperative complications, especially as regard intraoperative bleeding, nerve injuries (immediate and late), hematomas and seromas, and asymmetry (immediate and early). The mean time for completing the complete procedure of genioplasty with piezosurgery was almost the same compared with the saw and drill. Conclusions: Chinplasty represents one of the most common ancillary procedures and may be associated with corrective surgery of dentofacial dysmorphisms. Mental nerve injuries, asymmetries, intraoperative bleeding are the main immediate complications of genioplasty. Distinctive characteristics of ultrasonic piezoelectric osteotomy are selective cut of mineralized structure with less risk of vascular and nervous damage (microvibrations), intraoperative precision (thin cutting scalpel and no macrovibrations), blood free site (cavitation effect). In our experience, piezoelectric scalpel, compared with saw and drill, enables us to reduce or avoid immediate complications of chin surgery, helping the surgeon to reach patients’ satisfaction. Level of Evidence: IV.

Maxillary cysts are a common finding in maxillofacial surgery, dentistry and otolaryngology. Treatment is surgical; a traditional approach includes Caldwell-Luc and other intra-oral approaches. In this article, we analyse the outcomes of 9 patients operated on using a combined intra-oral and trans-nasal approach to the aforementioned disease. Although the number of patients is small, the good results of this study suggest that the combined approach might be a reliable treatment option.Approccio combinato trans-nasale endoscopico e intra-orale alle cisti odontogene.Le cisti mascellari sono un’evenienza comune nella pratica clinica degli specialisti del settore Odontoiatrico maxillo-Facciale e Otorinolaringoiatrico. Il trattamento della patologia è esclusivamente chirurgico. Tradizionalmente gli approcci chirurgici descritti per il trattamento di questa patologia sono di tipo intra-orale (ad esempio la chirurgia secondo Caldwell-Luc, mutuata dalla chirurgia per la sinusite). In questo articolo basato sulla revisione retrospettiva di 9 pazienti operati con approccio combinato per cisti del seno mascellare, abbiamo analizzato i risultati di questa procedura. Anche se il numero dei pazienti è esiguo e i risultati sono da validare su un campione più ampio, il risultato di perfetta guarigione, i dati sul tempo di ospedalizzazione e la mancanza di gravi complicazioni suggeriscono che il trattamento sia valido.

This observational study aimed to: (i) assess the presence of periodontal disease among patients requiring aortic valve replacement, (ii) investigate the presence of oral pathogens in aortic valve specimens and compare them with the microorganisms detected in the oral cavity. Twenty-six patients (15 men and 11 women) were scheduled to be visited the day before the cardiac surgery: periodontal conditions were accurately registered through clinical and radiographic examinations, dental plaque or salivary samples were collected. Valve specimens were collected during surgical aortic valve replacement and analyzed for pathogens detection through microbiological 16SrRna gene sequencing. Bacteria found in plaque samples and valve specimens were assessed according to oral and periodontal conditions. A qualitative comparison between oral and cardiac profiles of the microorganisms detected was performed. The overall number of patients examined for soft tissues conditions was 19, as 7 patients were edentulous. Twelve and three individuals, respectively, presented moderate and severe periodontitis. Nine valves were found to be positive for the presence of oral and periodontopathic bacterial DNA. The microbial species found in valve samples of patients with periodontitis suggest that the presence of these microorganisms in valvular tissue seems to be not coincidental.

Objective The aim of this study was to perform an epidemiologic analysis of cases of jaw cysts treated from 1973 to 2012 at the Dentistry and Maxillofacial Surgery Unit of the Verona Hospital, Italy, and to compare the data obtained with those published in the literature. Study Design A retrospective survey of 2030 patients treated for jaw cysts from 1973 to 2012 was performed. The lesions were classified according to the 2005 World Health Organization histologic classification, and the following variables were analyzed: age, gender, histopathologic diagnosis, and site of onset. Results Of 2030 total lesions, there were 1970 odontogenic cysts (97.04%), 50 nonodontogenic cysts (2.46%), and 10 pseudocysts (0.49%). Of the patients, 314 were children (15.47%), and 1716 were adults (84.53%). Mean age was 37.24 years, with a male/female ratio of 1.71:1. Conclusions There is a wide variety of cysts, some of which are subject to variations according to gender, localization, and age.

With the development of X-ray computed tomography (CT) in the 1960s and its first use for clinical studies in 1972 by Sir Godfrey Hounsfield, radiological tomography attained widespread use and today is one of the essential imaging techniques in medical radiology. It is a technically mature and clinically widely accepted method and complements classical X-ray panoramic radiography in many areas. The technology is frequently used in craniofacial radiology, because of its characteristic low radiation dose, high spatial resolution and lower cost compared with CT. The aim of this work was to describe the principles of cone beam computed tomography, to make a brief description of the existing devices, to present briefly the use of 3D diagnosis in craniofacial medicine.

Background Nowadays apps in preschool age are largely used in learning improvement. The aim of this work was to test effectiveness of apps in improving oral hygiene in children patients aged from 4 to 7 years and evaluating correlation between parents educational attainment and children oral hygiene. Material and methods 100 patients aged from 4 to 7 years were randomly assigned by an external office in the study group (SG: 32 females, 18 males) and in the control group (CG: 28 females and 22 males). Plaque index (PI) and carious lesions localisation were detected. At baseline all patients and one of the parents were instructed at chair-side about the proper oral hygiene techniques. SG patients were also given app as an aid in oral hygiene practice. Follow-up was 12 months. Measurements were made every three months at chair-side visits. Information about children compliance in oral hygiene and educational level of parents were obtained by questionnaires at t0 and after 12 months. Results SG patients showed stronger oral hygiene and PI lower than those in CG. Questionnaire showed higher compliance of SG patients and parents educational level seemed to affect children oral hygiene. Conclusions Apps in children allowed achieving encouraging results with improvement of oral hygiene and health. Key words:Apps, oral hygiene compliance, children oral hygiene, motivation, educational attainment.

Background: The aims of this narrative review were to examine up-to-date literature in order to evaluate the effectiveness of arthrocentesis or injections with platelet-rich plasma in temporomandibular affections and to compare them to arthrocentesis alone or with hyaluronic acid (HA) or to hyaluronic acid injections. Methods: The search of international literature was made on the PMC, PubMed and Cochrane databases, including all full-length text of studies on humans focused on osteoarthritis and disc displacements and their treatment with platelet-rich plasma arthrocentesis or injections. All design studies were included in the review and they were examined for three different outcomes: pain, joint sound and mandibular motion. English papers were only selected. Results: Even though the low number of studies in this field, arthrocentesis with platelet-rich plasma and platelet-rich plasma injections in temporomandibular disorders’ management were found to be effective in reducing pain and joint sound as well as in improving mandibular motion in a maximum follow-up of 24 months. Conclusion: Comparison to arthrocentesis alone or to HA use in arthrocentesis or by injections provided encouraging results in terms of the effectiveness of platelet-rich plasma use.

Introduction Dental agenesis is the congenital absence of a variable number of teeth due to the lack of formation of the corresponding tooth germ. The aim of this work was to investigate the syndromic conditions characterized by dental agenesis. Evidence acquisition Based on the research conducted through the OMIM® (Online Mendelian Inheritance in Man) and PubMed online databases, more than ninety syndromes associated with severe or moderate agenesis have been found. Evidence synthesis The main clinical features of these syndromes are described, especially those concerning the stomatognathic apparatus, referring to the most recent literature. Among these syndromes there are three clinical conditions associated with dental agenesis that are common for the clinician: Down Syndrome, ectodermal dysplasia and labio-palatal cleft. Conclusions It must be kept in mind that the success of the treatment of these patients is based on the compliance of the patient as well as on the collaboration among specialists.

Background The aim of this study was to evaluate radiological and histological characteristics of fresh-frozen homologous bone as grafting material for maxillary sinus floor augmentation. Radiological, histological and clinical evaluations were made. Methods Twenty-three patients with a 2 mm to 6 mm alveolar ridge height in the posterior maxilla have been enrolled. Unilateral or bilateral sinus floor augmentations were performed with fresh frozen morcelized homologous bone. Together with implant placement, 7 months after surgery, a bone core was harvested for histological analysis. Radiological measurements were obtained by superimposition of CT scans carried out at the surgery time and six months later. A total of 93 implants were positioned. Results A mean (±SD) increase in mineralized tissue height of 10.74±2.82 mm was noticed by comparing the CT scans. Histological analysis revealed the presence of newly formed bone in the grafted sites. The follow up period after the prosthetic load ranged from 8 to 31 months. One implant failure occurred. Conclusions Fresh frozen homologous bone seems to have a good healing pattern and to be a successful and steady grafting material for the treatment of maxillary ridge atrophy. It might be considered a valid alternative to autologous bone in sinus floor augmentation procedures.

Minimally invasive facial rejuvenation procedures reached an all-time high in the 2016. This reveals a growing interest in a smoother, younger, and tighter look accessible using the esthetic medicine tools like botulinum toxin and dermal filler injections, laser, and microdermabrasion. Forty-five patients from 35 to 52 years old (medium age 43.8), 38 women and 7 men underwent 5 sessions of Fraxel laser, 1 session of very low G prime HA, and Microbotox injection treatments from January 2016 and January 2017, were included in this study. In this study, we demonstrated that the usage of three treatments together, like mBTX, Volite, and Fractional laser, have a better result despite every single technique alone. The clinical result showed 98% (44 patients, 6 males, 38 females) of the patients had a smoother skin surface, brighter, more hydrated, and elastic skin; 68% of our patients (31 patients, 5 males, 26 females) showed less skin defects and staining as well as less small wrinkles, thanks to Fraxel laser treatment; 98% (44 patients, 6 males, 38 females) showed tighter skin with less sebaceous gland secretion. The aim of this study was to demonstrate that the combination of three techniques acts better and faster than single treatment to contrast facial aging and to improve skin texture and quality.