Search

Purpose: The aim of the study was to evaluate by Computed Tomography (CT) scan technique the alveolar ridges reconstructed through osseous grafting procedures (onlay bone grafts or sinus lift and grafting) for dental implant placement, and to test its suitability to differentiate pre-operative and post-operative conditions in reconstructed areas. Methods: Seventy-four CT cross-sections from 16 mandibles and 113 CT cross-sections from 18 maxillae from patients treated with autogenous bone grafts, performed via either vertical or horizontal autogenous bone block grafting or sinus lift procedure and grafting, and implant positioning, from January 2000 through December 2004, were analyzed and listed according to a residual ridge resorption evaluation. Maxillary and mandibular measurements were recorded and compared by Wilcoxon tests to highlight statistically significant differences. Data were subjected to Pearson's chi-square (2) test, with YATES correction when necessary, to show frequency differences between pre-operative and post-operative conditions. Results: The comparison between pre-operative and post-operative CT cross-sections showed statistically significant differences both in maxillary and mandibular posterior regions subjected to vertical onlay grafts; no statistically significant differences, instead, were found in the anterior region of the maxilla. Clinical Significance: The presented 3D CT scan evaluation of jaw atrophies could be applied to the recognition of bone height useful for implant positioning. Future maxillomandibular atrophy evaluation schemes should include the three-dimensional relationship between the maxilla and the mandible, as well as volumetric considerations.

Lymph node metastases are responsible for shorter survival in oral squamous cell carcinoma (OSCC). The aim of the present study was to assess the node metastasis frequency and survival according to the node metastasis features in 121 neck dissections (NDs) performed for OSCC, identifying evidence-based correlations and contrasts with previous literature. The retrospective study involved 121 patients affected by OSCC who had undergone modified radical ND (MRND) for therapeutic, elective reasons or after intraoperative positivity to metastasis of sentinel lymph nodes (SLN+). Node metastasis frequency and behaviour (typical vs. atypical) and their number and distribution according to pre-surgical cTNM cancer staging were considered and overall survival Kaplan-Meier curves were calculated for each group in order to compare mortality according to ND type (elective, therapeutic, after SLN+), lymph node metastatic pattern (typical or atypical), size (micrometastasis vs. macrometastasis) and number. Results showed statistically significant different overall survival according to pre-surgical staging, number of lymph nodes harvested and intent to surgery. Sentinel lymph node resulted in the sole positive node affected by metastasis in small cT1- cT2/cN0 OSCC and an ND subsequent to its positivity during intraoperative assessment may be considered an overtreatment.

A re-pneumatization phenomenon was recorded in sinuses grafted with different materials. The specific aims of this paper were to assess the dental implant survival rate and the behavior of marginal and apical bone remodeling around dental implants placed following sinus augmentation.A retrospective study was conducted on consecutive patients treated in two surgical centers. Different surgical techniques were adopted for sinus augmentation: simultaneous or delayed dental implant insertion with bovine bone-material augmentation or autologous bone grafting (chin and iliac crest). Survival rates were recorded for the overall number of implants (patients of group A). Apical and marginal bone levels (ABL and MBL, respectively) were radiographically measured, and statistical analysis was performed in implants of a subgroup of patients (group B).A total of 282 dental implants were positioned. Recorded cumulative survival rates (CSRs) were 95.6% and 100% for autogenous and bovine bone material, respectively, while CSRs at 2-year follow-up for immediate and delayed procedures were 99.3% and 96.5%. For the subgroup B, 57 sinus augmentation procedures were performed in 39 patients, with the positioning of 154 implants. Generally, the apical- and marginal-bone resorption of the bovine bone-material group was less than that of the autogenous group. The differences between the ABL values of the bovine bone-material and iliac-crest groups were statistically significant at 1 year, whereas this significance disappeared at the 2-year follow-up; tests showed that a statistical difference was recorded in the bovine bone-material group between the 1- and 2-year follow-ups. With regard to MBL comparisons between simultaneous and delayed implantation, the differences maintained their significance at the 2-year follow-up also.Differences regarding apical bone alteration between autogenous bone from the iliac crest and bovine bone material at the 1- and 2-year follow-ups, as well as in the bovine bone-material group between the 1- and 2-year follow-ups, attested to slower but more prolonged physiologic bone remodeling in the bovine-graft-material group than in the autogenous-bone group. The MBL analysis showed that remodeling in the delayed implant group demonstrated a greater resorption in the cervical portion than was seen in the simultaneous implant group.

For G open bounded subset of R^2 with C^1 boundary, we study the regularity of the variational solution u in H^1_0(G) to the quasilinear elliptic equation of Leray-Lions type: -div A(x,Du)=f , when f belongs to the Zygmund space L(log L)^{\delta}, \delta>0. As an interpolation between known results for \delta=1/2 and \delta=1 of [Stampacchia] and [Alberico-Ferone], we prove that |Du| belongs to the Lorentz space L^{2, 1/\delta}(G) for \delta in [1/2, 1].

E' un confronto dei contenuti formativi delle scuole di specializzazione dell'area di sanità pubblica secondo il nuovo ordinamento al fine della proposta di core curriculum per il percorso formativo universitario ex art. 38, D.Lgs 81/2008 per specializzati in Igiene e Medicina legale, che conseguire i requisiti formativi per la nomina di Medico competente. Nel confronto si ravvisano carenze formative per quanto riguarda il contenuto di valutazione del rischio e prevenzione per gli specializzandi in Medicina legale, mentre carente è il contenuto in approfondimento clinico-diagnostico per gli specializzandi in Igiene. Si propone uno scheda di formazione annuale di percorso universitario.

This article discusses a 3-year retrospective survey of implant clinical survival and computerized tomographic analysis of bone remodeling in atrophic alveolar crests reconstructed via various autogenous bone grafting procedures and in similar regions of native bone.The retrospective chart review included consecutive edentulous patients with severe alveolar crest atrophy treated between 2000 and 2002 with onlay autogenous bone grafts in the mandible and anterior maxilla (as needed) and implant insertion. Implant recipients were followed for 3 years. Defective areas were reconstructed by bone graft harvested from the chin or iliac crest. Implants in reconstructed areas were divided into two groups according to graft source. Implants in corresponding native areas served as controls. Cumulative survival rate (CSR), survival rate, and confidence interval (CI) were calculated, and linear measurements of bone remodeling around implants were assessed on computerized tomographic scans. Results were compared for statistically significant differences by Wilcoxon signed-rank test with a significance level a = .05.Forty patients were treated with 109 screw-type, root-form, rough-surfaced implants inserted in 48 onlay grafts; 88 implants were placed in native bone. The implant 3-year CSRs were 98.9% (CI 96.7% to 100%) in native bone and 99.1% (CI 97.3% to 100%) in onlay grafts, irrespective of bone source. Mean resorption in the maxilla was 4.6 +/- 0.9 mm buccally and 3.8 +/- 0.8 mm palatally in areas reconstructed with chin grafts, 3.4 +/- 1.7 mm buccally and 2.6 +/- 1.4 mm palatally in areas reconstructed with iliac crest grafts, and 3.2 +/- 1.2 mm buccally and 2.1 +/- 0.9 mm palatally in native areas.Similar implant CSRs were seen in native and grafted sites. Maximal implant CSR was observed in onlay grafts from the chin despite more marked linear bone remodeling in this group as compared to iliac crest grafts or native bone.