OBJECTIVE: This prospective single-cohort study aimed to evaluate the clinical and radiological performance of a novel dental implant positioned in post-extraction sockets in the anterior zone of both jaws and immediately loaded after 1 year in function.MATERIALS AND METHODS: Patients requiring single implant in the anterior zone were treated between January and March 2019 and followed for at least 1 year of function. Minimum values of 35 Ncm or 64 ISQ were required to perform immediate loading. Screw-retained zirconia-based single prostheses were delivered after the healing period. Patients were followed up for 1 year after definitive prosthesis placement to determine implant and prosthetic survival rate, marginal bone loss (MBL), insertion torque, and ISQ values.RESULTS: 40 implants (BoneLevel X, Straumann AG) were positioned in 60 patients. None of the positioned implants failed accounting for an implant survival rate of 100 %. No definitive prostheses failed to result in a 100% prosthetic success rate. Mean MBL was 0.6 mm ± 0.4 mm. Mean overall insertion torque was 58.9 ± 13.8 while mean overall ISQ at implant placement was 72.3 ± 8.1.CONCLUSION: Within the limitations of the present prospective single-cohort study, the investigated clinical and radiological performance of the novel dental implant placed in the anterior zone seems to be a reliable treatment option.
In the fight against caries, the goal of clinicians must not be focused only on performing conservative or prosthetic restorations but must include the execution of specific protocols for controlling the causal factors of the disease. Caries is a pathology with a multifactorial etiology, in which bacteria, diet, quality of saliva, oral pH, and the patient’s lifestyle, hygiene and health play a fundamental role. The CAMBRA method allows us to customize caries care, based on individual risk analysis, and to develop a suitable prevention plan for each patient.
OBJECTIVE: To evaluate the learning curve by unskilled operator for a complete arch digital impression in terms of scanning time and accuracy.MATERIALS AND METHODS: Three unskilled operators (OP1, OP2, and OP3) were enrolled to scan for 15 times each one an edentulous maxillary polymethylmethacrylate (PMMA) milled model with six implant analogs in different angulation and depth. The scanning times were recorded for each scan of the randomized sequence. The resulting 45 test files were aligned by the reference one, obtained by a high-precision industrial scanner. Each test file was processed with dedicated software to assess the linear (DX, DY, and DZ axis) deviations, that were summed up to obtain an average value of three-dimensional deviation.RESULTS: The three operators showed a mean scan time of 169.6 seconds (s), 217,9 s, 193,7 s respectively. Each operators show a statistically significant scan time reduction from the first to last scan: OP1 p=0,001; OP2 p=0,008; OP3 p=0,003. The average three-dimensional (3D) errors reported were OP1 133 microns (mm), OP2 111 mm and OP3 107 mm. Regarding the accuracy, a statistically significant reduction in the average 3D error was reported: OP1 p = 0.02; OP2 p = 0.04; OP3 p = 0.04.CONCLUSION: Within the limitation of this in vitro study, it seems to be that the repetitive use of IOS significatively affects the investigated variables in an overall scanning time reduction and scan accuracy enhancement.
The case report shows the need for proper “gnatological pre-treatment” to be taken in any dental treatment plane, especially where the functional rehabilitation of the stomatognatic joynt system is necessary. The re-coordinated movement of TMJ, the resolution of the joint block and of the reciprocal and bilateral click, result in a clear improvement of either mouth opening, both stability in occlusion centric and eccentric movements.
The aim of the present study was to test the combination of conventional endodontic therapy followed by antimicrobial Pothodynamic Therapy (PDT) or high-power laser in a clinical trial in patients requiring endodontic treatment. 50 patients were recruited for this study. For each patient a single tooth with clinical symptoms of pulp necrosis and periapical periodontitis was selected. The samples were randomly allocated into two experimental groups (n = 25 per each): group 1 (n = 25): high-power diode laser and group 2 (n = 25): photodynamic therapy (PDT).All samples of the two groups were treated with an intermediate dressing with calcium hydroxide and provisionally filled; after one week the dressing was removed and they underwent further PDT and high frequency laser treatment. After each step, a microbiological sample was taken. Finally, the elements were filled using the MicroHeat root canal filling technique. The culture method was chosen for the microbial count of common aerobes, facultative anaerobes, and microaerophilic bacteria. During the process, specific microbial flora was not identified, but general microbial count of colony forming units (CFU) was performed.The count of the number of CFU indicates a very wide range for the different samples. The tested photodynamic laser treatment shows positive and clinically relevant results when used as an adjuvant to traditional mechanical and chemical cleansing. There is a further reduction after a second treatment with photodynamic therapy. The decrease in CFU post photodynamic treatment is similar before and after dressing with calcium hydroxide. Photodynamic endodontic treatment as an adjuvant to traditional mechanical and chemical cleansing has shown greater efficacy in controlling the contamination of the treatment with diode laser. The first photodynamic treatment causes a reduction in the microbial count, and the second, after intermediate dressing, is comparable to the first. This is probably due to a lower complexity of the biofilm created after the intermediate dressing with calcium hydroxide compared to the initial intracanal biofilm. This therapeutic adjuvant is, therefore, more suitable in clinical situations where an intermediate dressing is necessary.
CAD/CAM technology represents a well-established and always improving tool for the realization of dental prosthetics, appliances and clinical devices. The aim of this paper is to evaluate the marginal and internal fit of provisional crowns realized with two different technology modern 3D printers. 60 patients needing a single crown prosthetic restoration were enrolled for the study and for each case two resin 3D Printed temporary crowns were produced on the same CAD project file realized on an intraoral digital scan. All digital impressions were taken with Trios 3 Color Pod Scanner (3 Shape) and the two 3D Printers tested were: DLP-SLA (Moonray D75) and MSLA (Structo Velox).Assessment of marginal and internal fit was carried out by a single blind VAS quality assessment by the operator fitting the temporaries on the patients and by a qualitative analysis of the gap thickness in sections obtained from silicon imprints of the fitted temporary crown on the relative tooth measured in four different points.Both 3D printing technologies gave promising results with measured gaps always under 130 μm but failed the comparison with traditional techniques in terms of cost-effectiveness and time saving. In every case, adjustments and finishing was always needed for a correct fitting a clinical function of the temporary restoration. Nowadays, other 3D CAM procedures such as precured resin blocks milling, appear to be more indicated for the fabrication of temporary prosthetic crowns.
Occlusal dental decay is still the most widespread disease in the world today. The aim of this in vivo study was to validate two different electronic laser fluorescence medical devices for caries diagnosis (Vistaproof and DIAGNOdent pen) in comparison with the gold standard traditional visit with digital x-ray Bite-Wings and the ICDAS II scores. Three expert clinicians, more than 10 years of experience, performed all visits using all three diagnostic methods. A total of 180 patients were enrolled for the study and data were collected from 2044 teeth. The statistical analysis found significative differences between the ICDAS values and the DIAGNOdent values, and between the ICDAS values and the Vistaproof, while there were no significative statistical differences between DIAGNOdent and Vistaproof values. Vistaproof values demonstrated a tendency to overestimate the presence and extension of carious lesions while DIAGNOdent pen gave a slight underestimation in caries detection. From a general point of view and relatively to ease of use and patient comfort, DIAGNOdent was judged better than Vistaproof. The DIAGNOdent pen cannot be a diagnostic substitute for an expert clinician diagnostic evaluation but can be considered an additional help and a valid device improve traditional visit consistency and accuracy. While both tested devices gave under or overestimated results, both are unable by themselves to determine whether or not treatment is required.
As times progress and technology advances, new levels of comfort are continually reached in all aspects of life. In medicine, this concept is reached by improving more and more patient’s quality of life by reducing treatment times, invasiveness, morbidity and long term stability of medical interventions. Advancing technology helps with new techniques and materials in achieving this goal, applying to all medical fields. In dentistry, combination of more durable materials and finer treatment strategies continues helping patients achieve levels of comfort which were unimaginable just a few decades back. Implantology and the world of implant-supported prosthesis has brought such an advancement that since its advent a stable growth curve is still observed to this day. This has brought patients to request this kind of rehabilitation even in very complex cases which require very skilled surgical techniques and often carry a very high risk of permanent physical damage. It’s the case in situations in which very atrophic osseous bases are in correspondence with important anatomical landmarks such as the maxillary sinus or the inferior alveolar nerve. Radiographic advancement has given the opportunity for careful planning with a precise tissue evaluation however, further innovation has brought to the possibility of tridimensional reproduction of these radiographic exams. This provides the professional with the possibility of performing the actual surgical intervention on the stereolithographic model itself and evaluate perfectly the surgical possibility of performing the planned intervention, further aiding professionals in the communication with patients.
Primary synovial sarcoma of the parotid gland is exceptionally uncommon, with few cases reported in the literature. This is a report of a 46-year-old male with a 7-month history of swelling in the left parotid region occurred after a kidney transplant. Synovial sarcoma clinically and radiologically mimicked a benign lesion and was therefore difficult to diagnose. The patient was treated primarily surgically, followed by radiotherapy. The present case shows that, although uncommon, synovial sarcomas should always be included in the differential diagnosis of a mass in the parotid gland, even if clinical presentation and imaging tend to make a dissimilar diagnosis. It is important to recognize a synovial sarcoma to make proper management. A multimodality therapeutic approach and a long-term follow-up are necessary because of its late loco-regional and systemic spread.
Sjögren’s Syndrome is a systemic autoimmune disease that affects the exocrine glands. This pathology causes glandular secretory disorders affecting the patient’s quality of life. 61 patients were clinically examined in a 2-year time period (2018-2019), 53 females and 8 males. All patients underwent a biopsy of the minor salivary glands at the San Salvatore Hospital (L’Aquila). The study shows that Sjögren’s Syndrome is a disease that mainly involves women, the age group 50-80 years with the major part of the patients graded in G1. Here is a demonstration of the fact that Sjögren’s Syndrome is a highly disabling disease that creates a deterioration in the quality of life. It is essential to be able to recognize signs and symptoms for an earlier diagnosis.
Growth hormone (GH) is a powerful and important hormone secreted by the cells of the anterior pituitary gland, influenced by many physiological and pathological conditions. Dental pulp stem cells (DPSCs) may be a source of differentiated cells inducing bone formation and controlled hydrossyapatite crystal growth. These DPSCs have the ability of self-expandig and differentiating in pre-osteoblast producing in vitro autologous bone tissue. The aim of our study is to investigate if GH can influence differentation of DPSCs in osteoblats and bone tissue. Gene related to ossification (BMP1, BMP2 BMP3, BMP4, BMP5 BMP6), osteoblast differentiation (BMPR1A, BMPR1B, BMPR2), bone mineralization (TGFB1, TGFB2, TGFB3) and skeletal development (TGFBR1 AND TGFBR2) were investigated to study the potential effect of GH in osteoblast differentiation and proliferation. After 24 h of treatment all gene investigated were up-regulated in treated DPSCs vs. untreated DPSCs. Significant up-regulated genes (Fold change > 2) were the Bone Morphogenetic Protein BMP2, BMP4, BMP6 and BMP7. GH induce the over-expression of bone related genes after 48 h of treatment too. In this case the significant up-regulated genes were the Bone Morphogenetic Protein BMP3, BMP4, BMP5 and their receptor BMPR1B and BMPR2. Transforming Growth Factor Genes family (TGFB1, TGFB2, TGFB3) and their receptor (TGFBR1 and TGFBR2) are also significantly up-regulated after GH treatment. GH has demonstrated to influence this process of DPSCs differention and expansion in osteoblats. Further studies are needed to explore this new way of creating bone tissue.
Early during the formation and growth of a primary tumour (e.g., breast, colon, or prostate cancer), cells are shed from the primary tumour and then circulate through the bloodstream. Many of the major recent advances in targeted therapies have relied on the acquisition of tumour tissue via biopsy before initiation of therapy or after the onset of resistance. The advantage of physical properties is that they allow circulating tumour cell (CTC) separation without labelling. Methods based on physical properties include density gradient centrifugation, filtration through special filters. In addition to using somatic point mutations as markers for the detection of tumor DNA, strategies to detect tumor-derived rearrangements and chromosomal copy number changes in the plasma of patients with cancer have been developed. Several studies have shown that metastatic cells might have unique characteristics that can differ from the bulk of cancer cells in the primary tumor currently used for stratification of patients to systemic therapy. In conclusion, the molecular and functional analysis of CTCs and circulating nucleic acids can be used as companion diagnostics to improve the stratification of therapies and to obtain insights into therapy-induced selection of cancer cells.
Gabapentin is a drug used to treat postoperative pain with antihyperalgesic properties and a unique mechanism of action, which differentiates it from other commonly used drugs. In our study fragments of gingival tissue of healthy volunteers were collected during operation. Gene expression of 29 genes was investigated in gingival fibroblasts cell culture treated with gabapentin, compared with untreated cells. Of the different chemokines and interleukins studied only 10 were statistically significant (CCL1, CCR1, CCR4, CCR5, CCR6, ILI1A, ILI1B, IL5, IL6R, TNFSF10). Gabapentin causes gingival hyperplasia in a limited number of patients by increasing expression of cytokines. This group of patients have probably a genetic background. Since or sample derived from healthy patients, we do not see an increase of cytokine expression. Additional studies are needed to better understand the interaction between gabapentin and gingival hyperplasia.
The aim of this article is to analyze the different type of approach possible regarding to solve the symptomatology, focusing on the high risk of relapsing typical of this kind chronic gland inflammation. The minor salivary glands are important components of the oral cavity and are present in most of the oral cavity, their purpose is to moisten and lubricate the muscular and epithelial tissues of the oral cavity through their secretions and with the aim not least of ensuring a protection from bacterial activity, the minor salivary glands mainly play a defensive role within the oral cavity.
The objective of this experimental protocol is to evaluate the possible adjuvant effect of ozone therapy as a supportive therapy for the surgical approach in clinical cases of peri-implantitis. The usage of ozone therapy has bacteria and virus killer been hugely demonstrated thanks to the inner potential of ozone as immune stimulated effect direct against inflammatory cytokine in tissue and organs.
The technique of the neo-generation of the keratinized tissue is based on the principle of the preservation of the clot through the creation of an empty space between the implant and the keratinized tissue.
The use of aligners to resolve a malocclusion is very widespread today. Aligners present a lot of positive aspects such as comfort, esthetic, hygiene and gingival health. The aesthetic advantage has made it possible to use the technique even in adult patients. It appears that a major part of the sample analyzed shows a high level of satisfaction which sometimes, in a very little part of patients, can decrease when the communications and the information required is not fulfilled. A controversial topic is the effectiveness of the therapy that, according to some authors, is not ideal in some kinds of malocclusions. The aim of the present study is to evaluate through questionnaire how clear aligners therapy influence patients’ quality of life, their comfort and oral health. The study wants to analyze the level of bruxism, TMJ pain, headache and mucosal lesions. Finally, it explores patients’ satisfaction.
INTRODUCTION: The aesthetics of the smile has historically gained importance on the part of the patient: today there are even more standards imposed by the society in which there is a strong association between the concept of beauty with physical and mental well-being. The harmony of the smile derives from the balance of the three fundamental components which are the teeth, lips and gums. If the amount of gum exposed to the smile is excessive, the so-called gummy smile is configured, which although not a pathological condition itself, certainly represents an important aesthetic alteration, both for specialists in the dental sector and for ordinary people.MATERIALS AND METHODS: An online questionnaire of 12 questions was diffused. It had the aim, through the proposal of photos of various types of smiles, to analyze the negative influence of excessive gingival exposure on perception and evaluation of the smile both by specialists and by people outside the dental area.RESULTS: The questionnaire, filled in by 314 people (dentists and not) with an average age of 37.9 years, found a strong subjectivity in the evaluation of the aesthetics of the smile. However, the smile that has met with greater preference is the one in which the amount of exposed gingiva is between 0 and 2 mm, confirming previous studies in the literature. Tolerance towards this aspect is greater among ordinary people, given that the statistical analysis found a significant difference in the opinions of specialists in the sector compared to people not in the field. There was also an overlapping predisposition to orthodontic treatment for aesthetic purposes on the part of male and female individuals.
Temporomandibular Disorder (TMD) is the leading cause of pain in the orofacial region, including the head, face and related structures. The etiology and pathophysiology of TMD are poorly understood. It is generally accepted that the etiology is multifactorial. The study analyses the correlation between temporomandibular joint disfunction and systemic diseases. One hundred and five adult patients were asked to complete a survey in which factors as the age and the gender were considered. The questions were about the typical symptoms of temporomandibular disorders, fibromyalgia and arthritis. The answers to our questionnaire revealed that the only statistically significative correlation was malocclusion, fibromyalgia and cervical pain, not arthritis.
Background: myofunctional therapy consists of exercises, which aim to eliminate atypical motor patterns, to establish new neuromuscular patterns and to optimize orofacial functions. In some clinical situations, even therapeutic devices such as orthodontic appliances are used to help to reach this purpose. These exercises improve muscle tone of lips, tongue, facial and chewing muscles and soft palate. They increase the range of motion, promote automation of habitual and unconscious physiological swallowing. Aim: the purpose of this study was to verify the advantages of myofunctional therapy through the description of a clinical case treated only with this kind of therapy.Conclusion: in the case described, myofunctional therapy alone resolved an abnormal function (atypical swallowing) and improved malocclusion. Moreover, it helped to ensure the stability of the treatment.
Aim: The aim of the study is basically to underline the advantages of the digital approach for the diagnosis, the treatment plan and the surgical and orthodontic treatment in the patients affected by ameloblastoma. Materials and methods: A patient affected by ameloblastoma of the upper maxilla underwent to a digital approach for the exact diagnosis and the virtual planning of the post-surgery orthodontic treatment using aligners. A 3D computer tomography was used to a precise detection of the anatomical limits of the neoformation. A concomitant myofunctional therapy was performed with a complete occlusal and functional restoration.Results: A complete alignment of the residual dentition was achieved. The functional and esthetic outcome was completed using a temporary removable prosthesis waiting for a bone grafting and implant supported fixed restoration.Conclusion: In patients with ameloblastoma the digital approach for a correct diagnosis and treatment planning with aligner can be extremely useful for a detailed control of the orthodontic movements together with an accurate virtual and clinical control of all the aspect that can interfere with the occlusion.
The aim of this study is to investigate the overlapping conditions in patients who suffer of temporomandibular disorders, (TMD), and to analyze the relationship between temporomandibular joint, (TMJ), symptoms and gut disease. One-hundred-sixty-nine patients are asked to complete a survey including questions about gut’s diseases, dental malocclusions and TMJ symptoms, in particular about temporomandibular joint pain and headache. The answers to the questions showed that the only statically significance correlation exist between gut’s disease, leaky gut, TMJ pain and between headache and TMJ pain. It’s possible to suppose the influence of gastrointestinal pathologies and symptoms on TMJ and vice versa, but this hypothesis has to be confirmed by further studies.
Aim: to clarify that reparative osteogenesis “one-piece” implants of the Italian School evolves favourably towards osteoanchylosis (osseointegration) and that the behaviour of the soft tissues around these implants is also histologically similar to the mucous membrane surrounding healthy natural teeth.Materials And Methods: Italian School bone-implant “block sections” and peri-implant mucosal sampling in humans and experimental animals.Discussion And Conclusions: This further publication demonstrates that Italian School one-piece immediately loaded implants, similarly to biphasic implants, can be osseointegrated without the recession of the surrounding tissues. Following 2400 serial sections, the peri-implant mucosa appears histologically similar to the healthy mucosa of natural teeth.
The aim of this study is to evaluate and compare the marginal adaptation of four retrograde filling materials by micro-infiltration of basic dye and related analysis with stereomicroscope. Forty human teeth extracted with single-channel roots were selected for the study. The root canals were first instrumented and filled with gutta-percha and endodontic cement. Subsequently the root apices underwent apicectomy and 3 mm deep retrograde cavities were prepared. The teeth, divided into four groups, were filled with four different retrograde filling materials assigned to the specific group and subsequently treated with basic dye solution ( Methylene blue ) for the determination of micro-infiltrations. The apical portions of the study teeth were cut to 1 mm and 2 mm to obtain cross-sections to be analyzed with the stereomicroscope. The dye, infiltrated in the vacuum areas (gaps) between dentin and retrograde filling cement, shows the marginal filling materials adaptation with the dental surface in retrograde techniques. The statistical analysis showed, with statistically significant values, fewer internal voids, and therefore greater marginal adaptation with Biodentin and Aureoseal, compared to ProRoot MTA and MTA Flow.