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3D bioprinting is a prominent topic in the field of tissue engineering. The progress made in the last decade is remarkable, but the technology still shows many drawbacks and limitations due to the relatively short introduction. In this paper we summarize the major 3D bioprinting protocols such as material jetting, material extrusion, and vat polymerization, highlighting the pros and cons of each technology, then we analyze different biomaterials and various components of the bio-inks compatible with the available 3D bioprinters. The goal of this review is to examine the existing tools to produce bone scaffolds and highlight future developments in the field of Guided Bone Regeneration (GBR) inside the oral cavity.

Objective: complex rehabilitations present multiple difficulties, regarding both the planification of the surgery and the design of the prothesis. A digital approach can support the workflow, as well as the degree of intraoperative precision, and improve the long-term prognosis. Methods: A surgical guide was designed for implant placement. An extensive regeneration of the upper jaw was performed with contextual implant insertion, and a delayed load rehabilitation was chosen. After four months, a second surgery and a simultaneous soft tissue augmentation was performed, and a 3D-printed temporary restoration was placed. After another two months, new dental and facial scans, smile design, and facial bite registrations were obtained. Upper and lower dentures were built using an exclusively digital workflow. Both metal substructures were passivated and cemented in one session; in the following appointment, the aesthetic and occlusal checks were carried out. During the third visit, both prostheses were delivered. Results: Careful case planning and the surgical guide made it possible to achieve primary stability and acceptable emergence profiles in an extremely reabsorbed upper jaw. Leukocyte-Platelet Rich Fibrin (L-PRF) made the extensive bone regeneration more approachable and lowered the post-operative pain and swelling, while speeding up the soft tissue healing process. During the re-entry surgery, the volumes of soft tissues were increased to improve aesthetics, and the amount of keratinized gingiva around the six implants was also increased. Smile design and facial scans have provided the means to create acceptable aesthetics and function in a few sessions with minimal patient discomfort. Conclusions: Computer-assisted implantology is a safe and precise method of performing dental implant surgery. Preliminary studies have a high degree of accuracy, but further studies are needed to arrive at a fully digital clinical protocol at all stages.

Background. Edentulism is still a major problem in the world’s population today. Implant-retained overdenture has proven to be a valid therapeutic solution in the mandible. This type of rehabilitation requires replacement of the matrices when those reach inadequate retention due to wearing processes. This study is aimed at evaluating the drop in retention of low-profile precision attachments following the application of vertical chewing forces. Two different attachment designs were compared. Methods. This in vitro study simulated an implant-retained overdenture on an edentulous mandible. Two low-profile attachments were compared. Loaded and unloaded sides were considered. Tests were performed by exerting a vertical cyclic force on the prosthesis at the level of the first molar of a hemiarch. Retention tests were performed before and after 400.000 chewing cycles, comparable to one year of use. Results. The presence of vertical load wear was identified and characterized. Retention never fell below the values indicated by the manufacturer. Furthermore, significant differences were identified between the two retention systems. Conclusions. Loss of occlusal load retention is a component that must be evaluated by the clinician during the design of implant-prosthetic rehabilitation, particularly in those cases where elevated occlusal forces or parafunctions are present.

The aim of this study was to assess, identify, and compare the personality traits and psychosocial status of two groups of patients undergoing orthognathic surgery and rhinoseptoplasty respectively. This prospective study recruited patients referred for orthognathic surgery and for rhinoseptoplasty. The research protocol included the administrations of questionnaires to the patients during their last visit before surgery, including the Minnesota Multiphasic Personality Inventory (MMPI-2), the Myers–Briggs Type Indicator (MBTI), the tree drawing test (or Baum test), and the BC Scale. As for MMPI-2, the highest (pathological) percentages were encountered in Hypochondriasis and Psychasthenia scales within the Orthognathic Surgery Group, whereas in the rhinoseptoplasty group, the highest scores were obtained in the Hypochondriasis, Psychasthenia, Psychopathic Deviate, and Schizophrenia scales. It would be important to assess some characteristics of the patients’ mental health and emotional state prior to surgery, including depression, anxiety, panic, and aggression. The overview of these factors may give an insight into the psychological and emotional capacity of the patients undergoing orthognathic and rhinoseptoplasty surgery.

Recently, four new oral anticoagulant – dabigatran etexilate (direct thrombin inhibitor) and rivaroxaban, apixaban and edoxaban (Xa factor direct inhibitor) – have been approved for the prevention of venous thrombosis and cardiovascular events. As the number of patients taking these drugs is increasing, it is important that the dentist is familiar with these new oral anticoagulants, their indications, methods of action and in particular the management of the patients undergoing oral surgery. This literature review is conducted to highlight the medical uses of these new oral anticoagulants and their pharmacologic properties, the clinical condition of the patient that may influence the choice to discontinue the DOAC and peri-operative management of the patient. Collaboration with the attending physician is crucial.

Background: Many studies previously reported epidemiological data on mortality due to COVID-19 among health workers. All these studies included a partial sample of the population with a substantial selection bias. The present study evaluates the trend of mortality among physicians and dentists operating in an area considered to be at high risk during the COVID-19 pandemic. Methods: Data relating to all physicians and dentists registered in the province of Pavia (Italy), a sample consisting of 5454 doctors in 2020 was analyzed. The mortality rates obtained were compared with those related to the 5-year period preceding the pandemic and with those related to the general population. Results: In the area considered, a mortality rate of 0.83% (+69% compared to 2015–2019) was observed in the entire sample in 2020 and 0.43% (−11% compared to 2015–2019) in 2021; among physicians, there was a mortality rate of 0.76% (+53% compared to 2015-2019) in 2020 and 0.35% (−29% compared to 2015–2019) in 2021; for dentists, there was a mortality rate of 1.27% (+185% compared to 2015–2019) in 2020 and 1.01% (+127% compared to 2015–2019) in 2021. Conclusions: These data report the global impact of the SARS-CoV-2 pandemic on physicians and dentists in a high-risk territory. In 2020, a significant increase in the mortality rate compared to the previous 5 years was observed for both physicians and dentists; in 2021, a significant increase in the mortality rate was observed only for dentists. These data are also significant in evaluating the impact of vaccination on physicians and dentists and indicate that dentists were among the professions most at risk during the pandemic.

Despite high rates of osseointegration in healthy patients, complex cases present an increased risk of osseointegration failure when treated with dental implants. Furthermore, if immediate loading of the implants is used, maximizing the response of the host organism would be desirable. Anabolic steroids, such as Nandrolone Decanoate (ND), are reported to have beneficial clinical effects on various bone issues such as osteoporosis and bone fractures. However, their beneficial effects in promoting osseointegration in dental implant placement have not been documented. The study aimed to examine histological changes induced by ND in experimental dental implants in rabbit models. Two dental implants were placed in the tibias of 24 adult rabbits. Rabbits were allocated to one of two groups: control group or test group. Rabbits in the latter group were given nandrolone decanoate (15 mg/kg, immediately after implant placement and after 1 week). Micro-radiographic and histological analyses were assessed to characterize the morphological changes promoted by the nandrolone decanoate use. Total bone volume and fluorescence were significantly higher in the control group after 2 weeks. Such a difference between the two groups might indicate that, initially, nandrolone lengthens the non-specific healing period characteristic of all bone surgeries. However, after the beginning of the reparative processes, the quantity of newly formed bone appears to be significantly higher, indicating a positive stimulation of the androgen molecule on bone metabolism. Based on micro-radiology and fluorescence microscopy, nandrolone decanoate influenced bone regeneration in the implant site. The anabolic steroid nandrolone decanoate affects the healing processes of the peri-implant bone and therefore has the potential to improve the outcomes of implant treatment in medically complex patients.

The purpose of this multicenter randomized controlled trial was to compare the clinical, radiographic, and patient-centered outcomes of early loaded mandibular overdentures deliberately placed on two or three implants. The outcomes were: implant and prosthesis success and survival rates; biological and technical complications; marginal bone loss; patient satisfaction; and periodontal parameters. The results showed no differences between the groups in any of the outcomes analyzed. With the limitations of the present study, and looking at long-term follow-up, the gold standard of prosthetic rehabilitations with attachments, in agreement with the scientific community, should prefer two non-splinted implants.

Dietary habits with high consumption of acidic food can induce in orthodontic patients an increased risk of demineralization lesions around orthodontic brackets and bands. The purpose of the present laboratory study is to assess the in vitro visual efficacy of a biomimetic nano-hydroxyapatite remineralizing solution in a hypomineralized enamel surface and its effect on adhesion of fixed orthodontic appliances and on enamel microhardness. Intact teeth were demineralized, and subsequently the areas of demineralization were visually recorded using a 0–100 scale. Subsequently, a remineralizing solution (Biorepair® Repair Shock Treatment) was applied for ten minutes once a day/for one week per month for a total remineralizing treatment of 3 months. Visual effects were recorded. Moreover, bond strength was recorded and adhesive remnant index scores were measured for both orthodontic brackets and composite attachments both before demineralization and after demineralization and application of remineralizing solution. Also, Vickers microhardness was measured. All data were submitted to statistical analysis. The application of remineralizing solution induced a significant in vitro reduction of demineralized areas after the first week of application. No significant differences between untreated enamel surfaces and remineralized surfaces were detected after 2 months of remineralizing treatment. Bond strength values were significantly reduced for both brackets and attachments after remineralizing treatment. However, attachments showed higher adhesion values than brackets in both conditions tested. Remineralized enamel showed significantly higher microhardness values than demineralized enamel and lower values than intact enamel.

This case report discusses about an innovative bone regeneration method that involves the use of autologous periosteal micrografts, which were used for a maxillary sinus floor lift in a 52-year-old female patient. This method allows for harvesting of a graft that is to be seeded on a PLGA scaffold and involves collection of a very little amount of palatal periosteal tissue in the same surgical site after elevation of a flap and disaggregation of it by using a Rigenera® filter. Histological samples collected at the time of implant installation demonstrate a good degree of bone regeneration. The clinical and radiographic outcomes at the 3-year follow-up visit showed an adequate stability of hard and soft tissues around the implants. This report demonstrates the possibility to obtain a sufficient quality and quantity of bone with a progenitor cell-based micrograft and in turn make the site appropriate for an implant-supported rehabilitation procedure, with stable results over a period of two years.

Background: the position of the mandibular lingula (Li) affects the success rate of the inferior alveolar nerve block (IANB) and ramus osteotomies. This study evaluated the position of the Li, to investigate the anatomical relationship between the Li and some anatomical measurements using cone beam computed tomography (CBCT). Methods: 201 hemimandibular CBCTs of 111 patients (43 males and 68 females; 18 to 88 years old) were retrospectively evaluated. The Li location was determined from the lingula tip to: the occlusal plane, the anterior and posterior borders of the mandibular ramus, the lower border of the mandible, the distal surface of the mandibular second molar, and the mandibular notch. We evaluated the correlations between the Li and the anteroposterior diameter of the mandibular ramus; the vertical distance between condyle and mandibular angle; the mesial–distal diameter of the first, second, and third mandibular molar, the intercanine distance, the intermolar distances among the first, second, and third mandibular molars; the distance between the intermolar line of the first molar and midline, and the length of the mandibular body. Results: the vertical distance of the Li from the occlusal plane was 11.22 ± 4.27 mm. Some parameters significantly correlated with the anatomical measurements taken into consideration. Conclusions: the present study provides new information concerning the Li and mandibular anatomy in the Italian population. Moreover, by correlating some anatomic measurements to the Li position, the localization of the Li is made possible, indirectly through the measurement of some distances between anatomical landmarks.

Background: This systematic review and meta-analysis aims to evaluate the effectiveness of antibiotic prophylaxis in the prevention of surgical wound infection (SWI) following mandibular third molar extraction. Methods: A systematic search on electronic databases and a manual search on paper journals was carried out. Two independent reviewers selected the studies. The onset of SWI was used as the main outcome. The data from the studies were analyzed, both with the fixed and the random models, according to the type of antibiotic and the method of administration; a further stratification was adopted, if possible, based on surgical difficulty. The risk of bias and heterogeneity were evaluated. Results: 15 studies were included. Antibiotic prophylaxis, especially in pre-surgical administration and in case of osteotomy, is effective in the prevention of SWI in case of mandibular third molar extraction. Post-surgical administration of prophylaxis, although effective, does not seem to be fully supported by the literature. Pre- and post-surgical prophylaxis did not demonstrate superiority compared to pre-surgical administration alone. Conclusions: Antibiotic prophylaxis is effective in reducing SWI after third molar extraction; pre-surgical administration, minimizing antibiotics administration, allows one to reduce complications related to antibiotic and risk of onset of antibiotic resistance.

Nanotechnology enables the control and modification of the chemical and topographical characteristics of materials of size less than 100 nm, down to 10 nm. The goal of this review is to discuss the role of titanium substrates as nanoscale surface modification tools for improving various aspects of implantology, including osseointegration and antibacterial properties. Techniques that can impart nanoscale topographical features to endosseous implants are described. Since the advent of nanotechnology, cellular specific functions, such as adhesion, proliferation, and differentiation, have been better understood. By applying these technologies, it is possible to direct cellular responses and improve osseointegration. Conversely, modulating surface features by nanotechnology could have the effect of decreased bacterial colonization.

Bone regeneration is currently one of the most important and challenging tissue engineering approaches in regenerative medicine. Bone regeneration is a promising approach in dentistry and is considered an ideal clinical strategy in treating diseases, injuries, and defects of the maxillofacial region. Advances in tissue engineering have resulted in the development of innovative scaffold designs, complemented by the progress made in cell-based therapies. In vitro bone regeneration can be achieved by the combination of stem cells, scaffolds, and bioactive factors. The biomimetic approach to create an ideal bone substitute provides strategies for developing combined scaffolds composed of adult stem cells with mesenchymal phenotype and different organic biomaterials (such as collagen and hyaluronic acid derivatives) or inorganic biomaterials such as manufactured polymers (polyglycolic acid (PGA), polylactic acid (PLA), and polycaprolactone). This review focuses on different biomaterials currently used in dentistry as scaffolds for bone regeneration in treating bone defects or in surgical techniques, such as sinus lift, horizontal and vertical bone grafts, or socket preservation. Our review would be of particular interest to medical and surgical researchers at the interface of cell biology, materials science, and tissue engineering, as well as industry-related manufacturers and researchers in healthcare, prosthetics, and 3D printing, too.

BACKGROUND Active matrix metalloproteinase-8 (MMP-8) enzymes are associated with inflammation and the degradation of implant-supporting tissues. A high concentration of these enzymes in the peri-implant sulcular fluid (PISF) has been associated with a pathological condition. The aim of the present study was to evaluate the ability of a chair-side MMP-8 test to individuate pathological peri-implant site. The working hypothesis is that positive response to MMP-8 test corresponds to pathological values of periodontal indexes. A secondary working hypothesis is that PISF sampling method influences the test accuracy. METHODS Fifty implants from 50 patients were evaluated during scheduled follow-up appointments in a clinical setting using the MMP-8 chair-side test and periodontal indices (probing depth, bleeding on probing, plaque index and peri-implant inflammation index). Two methods of PISF sampling were tested. RESULTS The MMP-8 test demonstrated significant diagnostic capacity and good sensitivity and accuracy regarding indices of bleeding on probing, plaque index, and peri-implant inflammation index but fair agreement. CONCLUSIONS Further studies should be performed to better define the interpretation of the MMP-8 chair-test results and their correlation to peri-implant indexes.

Human population is facing a revolutionary change in the demographic structure with an increasing number of elderly people requiring an unmet need to ensure a smooth aging process and dental care is certainly an important aspect that has to be considered. To date, dentistry has been conservative and the need of transferring the scientific models of regenerative dentistry into clinical practice is becoming a necessity. The aim of this study was to characterize the differentiation commitment (in vitro) and the clinical grafting ability (in vivo) of a population of progenitor stem cells obtained after mechanical digestion of dental pulp with an innovative system recently developed. This approach was successfully used in previous studies to obtain a clinical-grade ready to use dental pulp fragments that could be grafted in autologous tissues to obtain bone. We are thus showing that micro grafts resulting from mechanical digestion contain stem cells with a mesenchymal phenotype, able to differentiate toward different cell types and to generate new bone in patients. We are providing data for the establishment of standardized and routinely oral surgery approaches, having outlined the cellular properties of human stem cells obtained from the dental pulp. This method can represent a valid tool for both regenerative medicine and tissue engineering purposes not only applicable to the cranio-maxillofacial region but, likely, to different bone pathologies for a fastening and healing recovering of patients. J. Cell. Physiol. 232: 548-555, 2017. © 2016 Wiley Periodicals, Inc.

Study design This single-masked, randomized and six-month clinical intervention trial including two study groups was planned to evaluate the efficacy of maintenance treatment with glycine powder on the periodontal health of peri-implant tissues. Methods A total of 46 patients with partial or total edentulism, carrying a total of 88 implants, were assigned either to an air abrasive with the glycine powder treatment group (AAD) or to a manual debridement and clorexidine administration treatment group (MDA). Clinical data were collected before treatment and at 3 and 6 months after the treatment. Plaque index (PI), bleeding index (BOP), probing depth (PD), clinical attachment level (CAL) and bleeding score (BS) were analysed. Results After 3 months, AAD treatment statistically significantly improved BS (P < 0.05); at 6 months, AAD treatment statistically significantly improved indexes PD, PI, BOP and BS (P < 0.05). In addition, the AAD treatment proved to be more effective than MDA in maintaining the peri-implant health of PD at three and 6 months, and of PI at 6 months (P < 0.05). There were no significant changes of CAL in both groups, and all the indexes remained within the physiological levels. Conclusions Within the limits of the study, treatment with glycine seems appropriate in the maintenance of peri-implant health and more effective than the traditional treatment with plastic curette and chlorhexidine.

Biochemical modification of titanium surfaces (BMTiS) entails immobilization of biomolecules to implant surfaces in order to induce specific host responses. This crossover randomized clinical trial assesses clinical success and marginal bone resorption of dental implants bearing a surface molecular layer of covalently-linked hyaluronan in comparison with control implants up to 36 months after loading. Patients requiring bilateral implant rehabilitation received hyaluronan covered implants in one side of the mouth and traditional implants in the other side. Two months after the first surgery, a second surgery was undergone to uncover the screw and to place a healing abutment. After two weeks, the operator proceeded with prosthetic procedures. Implants were evaluated by periapical radiographs and the crestal bone level was recorded at mesial and distal sites&mdash, at baseline and up to 36 months. One hundred and six implants were positioned, 52 HY-coated, and 48 controls were followed up. No differences were observed in terms of insertion and stability, wound healing, implant success, and crestal bone resorption at any time considered. All interventions had an optimal healing, and no adverse events were recorded. This trial shows, for the first time, a successful use in humans of biochemical-modified implants in routine clinical practice and in healthy patients and tissues with satisfactory outcomes.

Human tissue regeneration, especially the bone, today is one of the most important chal- lenges for medicine and the need for this is particularly evident in the maxillo-facial area where it can be estimated that 1,500,000 patients in Europe undergo craniofacial reconstruction each year. Autolo- gous bone is considered as the gold standard of bone graft materials, however, this approach is very limited. Recent research of non-embryonic stem cells provides new possibilities for no invasively ob- taining new autologous bone from stem cells provided by various tissues from the same patient. Furthermore, in the litera- ture, there are limited long-term data available mainly on the safe and efficacy of the prolonged use of stem cells. In this review, we will summarize the studies conducted on the regeneration, repair and rebuilding of craniofacial tissues using stem cells both in the presence or the absence of implantable biocompatible materials and the use of new micro-graft technologies, obtained through the Rigeneracons® medical device.

Autologous graft is considered the gold standard of graft materials; however, this approach is still limited due to both small amount of tissue that can be collected and to reduced cell viability of cells that can be obtained. The aim of this preliminary study was to demonstrate the efficacy of an innovative medical device called Rigeneracons® (CE certified Class I) to provide autologous micro-grafts immediately available to be used in the clinical practice. Moreover, Rigeneracons® is an instrument able to create micro-grafts enriched of progenitors cells which maintain their regenerative and differentiation potential. We reported preliminary data about viability cell of samples derived from different kind of human tissues, such as periosteum, cardiac atrial appendage biopsy, and lateral rectus muscle of eyeball and disaggregated by Rigeneracons®. In all cases we observed that micro-grafts obtained by Rigeneracons® displayed high cell viability. Furthermore, by cell characterization of periosteum samples, we also evidenced an high positivity to mesenchymal cell markers, suggesting an optimal regenerative potential.

Background The aim of this study was to evaluate the ability to identify the contiguity between the root of the mandibular third molar and the mandibular canal (MC) in panoramic radiographs compared with Cone Beam-CT. Material and methods Panoramic radiographs of 326 third molars and CBCT radiographs of 86 cases indicated for surgery and considered at risk were evaluated. The following signs were assessed in panoramic radiographs as risk factors: radiolucent band, loss of MC border, change in MC direction, MC narrowing, root narrowing, root deviation, bifid apex, superimposition, and contact between the root third molar and the MC. Results Radiographic signs associated with absence of MC cortical bone are: radiolucent band, loss of MC border, change in MC direction, and superimposition. The number of risk factors was significantly increased with an increasing depth of inclusion. CBCT revealed a significant association between the absence of MC cortical bone and a lingual or interradicular position of the MC. Conclusions In cases in which panoramic radiographs do not exclude contiguity between the MC and tooth, careful assessment the signs and risks on CBCT radiographs is indicated for proper identification of the relationships between anatomic structures. Key words:Panoramic radiography, Cone-Beam computed tomography, third molar, mandibular nerve.

The aim of the study was to compare in a randomized controlled clinical trial the use of the piezoelectric osteotomy as an alternative to the conventional approach in terms of surgery time, intraoperative blood loss, cut quality, nerve injury, and costs.One hundred ten patients who had orthognathic surgery procedures with bimaxillary osteotomy were divided into 2 groups: group A was treated with a piezosurgery device, and group B, with a reciprocating saw and bur.The piezosurgical bone osteotomy permitted individualized cut designs. The surgical time in group A was reduced, with a mean for the mandibular osteotomy (1 side) between 3 minutes 31 seconds and 5 minutes 2 seconds, whereas in group B, the surgical time was between 7 minutes 23 seconds and 10 minutes 22 seconds. The surgical time in group A for the Le Fort I osteotomy was between 5 minutes 17 seconds and 7 minutes 55 seconds in group A and between 8 minutes 38 seconds and 15 minutes 11 seconds in group B. All patients in group A had a low blood loss (300 mL) versus patients of group B who had a medium to high blood loss (medium loss: 400 mL, high loss:500 mL). Inferior alveolar nerve sensation was retained in 98.2% of group A versus 92.7% in group B at 6 months postoperative testing.Piezoelectric osteotomy reduced surgical time, blood loss, and inferior alveolar nerve injury in bimaxillary osteotomy. Absence of macrovibrations makes the instrument more manageable and easy to use and allows greater intraoperative control with higher safety in cutting in difficult anatomical regions.

Although numerous biomaterials are used for maxillary sinus-lift surgery, the ideal material for such procedures has not yet been identified. Both heterologous and alloplastic bone sub- stitutes have a solely osteoconductive effect and lack the osteoin- ductive properties of the bone morphogenetic proteins typical of autologous bone. Our group assessed a new alloplastic graft ma- terial, poly(lactic-co-glycolic) acid/hydroxyapatite (PLGA/HA), implanted in a human model of maxillary sinus-lift surgery. For this prospective, random, double-blind trial, we used deproteinized bovine bone (DBB) as the comparison material. Radiographic bone vertical height and density were assessed at approximately 28 weeks after grafting using cone-beam computed tomography. The verti- cal dimension of the regenerated bone was equivalent between the 2 groups. The density of the bone regenerated using PLGA/HA was significantly lower than that obtained with DBB. Despite clinical assessments demonstrating that PLGA/HA has sufficient char- acteristics for use in sinus-lift surgery, DBB provided greater bone density and an equivalent vertical dimension of grafted bone. Further studies are needed to supplement the radiologic findings with his- tologic and micromorphometric examinations.

Purpose: The histomorphometric results of sinus floor augmentation with deproteinized bovine bone (DBB) and a new fully synthetic bone substitute, poly(lactic-co-glycolic acid/hydroxyapatite) (PLGA/HA), were compared in humans. Materials and Methods: Twelve maxillary sinuses of eight patients requiring major maxillary sinus floor augmentation and free of concomitant conditions (ASA scores 1 and 2) were studied. Lateral sinus augmentation was performed using DBB or PLGA/HA grafts; sites were randomly assigned to control or test groups. Patients were reexamined approximately 6 months after grafting using cone beam computed tomography scans, and biopsy samples were harvested from implant sites. Total bone volume, residual graft material volume, and new bone volume were assessed. Results: Healing times were similar between groups. Measurable biopsy specimens were available from four of the test sites and six of the control sites. PLGA/HA grafts showed no trace of graft material, whereas DBB grafts had a mean graft area of 16.5% (P

BACKGROUND The onset of perioral wrinkles often prompts patients to request treatment. This aesthetic deterioration linked to aging may be associated with tooth and alveolar bone loss in fully edentulous patients. PURPOSE To evaluate perioral wrinkles before and after maxillary and mandibular rehabilitation with implant-retained dentures in fully edentulous patients. METHODS In this prospective cohort, single-center, blinded study, patients requiring maxillary and mandibular rehabilitation with implant-retained dentures were enrolled. The patients were photographed in the same position before and after oral rehabilitation. Wrinkles were evaluated in the photographs by blinded observers using validated rating scales. The following parameters were analyzed: upper and lower radial lip lines, marionette lines, upper and lower lip fullness, nasolabial folds, corner of the mouth lines, and the labiomental crease. Statistical analysis was performed using the Wilcoxon signed ranks test for paired data, with P

This chapter focuses on a review of the activity of non-embryonic mesenchymal stem cells used to regenerate jaw bones in dentistry. Recent research of non-embryonic stem cells provides new possibilities for noninvasively obtaining new autologous bone from stem cells provided by various tissues from the same patient. Disaggregation of biologic tissue harvested from the patients during surgery permits extraction of stem cells from a small sample of connective tissue obtained from the patient’s lingual mucosa or from the postextraction surgical site where the endosseous implant will be inserted.

The goal of the present work was to investigate the relationship betweenin vivohealing and inflammatory response andin vitrocytokine expression by macrophages of a synthetic bone filler (25% hydroxylapatite-75%β-tricalcium phosphate) bearing a surface nanolayer of collagen. A clinically accepted, state-of-the-art xenograft material was used as a “negative control,” that is, as a material that provides the correct clinical response for the intended use.In vitrodata show that both materials exert a very low stimulation of proinflammatory cytokines by macrophages, and this was confirmed by the very mild inflammatory response detected inin vivotests of local response in a rabbit model. Also,in vitrofindings suggest a different mechanism of healing for the test and the control material, with a higher regenerative activity for the synthetic, resorbable filler, as confirmed byin vivoobservation and literature reports. Thus, the simplein vitromodel adopted provides a reasonable forecast ofin vivoresults, suggesting that new product development can be guided byin vitrotuning of cell-materials interactions.

Purpose Bacterial adhesion and colonization play a crucial function in the pathogenesis of peri-implant tissue infection, which is considered the main cause of fixture loss. The aim of this study is to evaluate the differences in bacterial adhesion between a machined titanium surface, a double acid etched surface (Osseotite®) and an Osseotite surface with Nanometer-scale Discrete Crystalline Deposition (DCD™) of calcium phosphate (CaP)(Nanotite®). Methods Surface roughness properties of each sample were determined by a laser profilometer and scanning electron microscopy (SEM) observation. Bacterial adhesion on machined, Osseotite®, and Nanotite® discs were performed using the following bacterial strains: Streptococcus mutans CCUG 35176, Streptococcus sanguis CCUG 17826, Streptococcus salivarius CCUG 11878, Actinobacillus actinomycetecomitans CCUG 37002, Porphyromonas gingivalis CCUG 2521. The assessment of bacterial adhesion was performed by comparing two methods: Total Viable Count (TVC) estimation and Confocal Laser Scanning Microscopic (CSLM) studies. Results The surface roughness parameter increased as follows: machined®®. The attachment of all bacterial strains performed by both methods showed a significant reduction on Osseotite® and even higher on Nanotite® in comparison to machined surfaces (p® and Nanotite® for A. actinomycetecomitans, S. mutans and S. sanguis than for P. gingivalis and S. salivarius strains. Conclusions Nanotite® samples showed the lowest amount of bacterial contamination in comparison to the smoother machined and rougher Osseotite® surfaces.

Purpose: To analyze implant and prosthetic survival rates, complications, patient satisfaction, and biological parameters of patients rehabilitated with implant overdentures (IOV) on splinted and nonsplinted implants and different attachment systems, in function for one to 17 years. Methods: This retrospective study evaluated data collected from patients rehabilitated with implant overdentures between January 2001 and December 2016 in nine different centers. Outcome measures were implant and prosthetic success rates, mechanical complications, marginal bone loss (MBL), oral health impact profile (OHIP), bleeding on probing, and plaque index. Results: A total of 581 implants were installed in 194 patients. Patients were followed for a mean period of 60.6 months (range 6&ndash, 206). Eighty-nine patients received 296 low profile attachment (OT Equator), 62 patients received 124 ball attachments, and 43 patients received 107 Locator attachments. In eighty-three patients the implants were splinted with computer aided design/computer aided manufacturing (CAD/CAM) or casted bar. At the last follow-up, 10 implants failed in eight patients. Statistical significance was found for failed prostheses (P = 0.0723) and complications (P = 0.0165), with better values for splinted implants. No statistically significant differences were found in proportion of implant and prosthetic failure (P &gt, 0.05). At a five-year follow-up, proportion of complications (P = 0.0289) and failed prostheses (P = 0.0069) were statistically higher for IOV on Locator attachments. No difference was founded in MBL at one- and two-year follow-up between different attachment systems (P &gt, 0.05). Statistically significant improvement in all the OHIP categories was reported in all the patients, after one year of function. Conclusions: Implant overdenture showed high implant and prosthetic survival rates, low complications, high patient satisfaction, and good biological parameters in the long-term follow-up. Splinting the implants may reduce number of mechanical complications. Locator attachments showed higher number of complications. Further studies are needed to confirm these preliminary results.