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Pistilli R, Karaban M, Bonifazi L, Barausse C, Ferri A, Felice P. The Curved Presplitting Technique in a Totally Edentulous Atrophic Mandible: A Surgical Case Report. INT J PERIODONT REST 2023; 43:588-595. [PMID: 37338920 DOI: 10.11607/prd.5779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The management of horizontally fully edentulous atrophic ridges is a common problem in dental implantology. This case report describes an alternative modified two-stage presplitting technique. The patient was referred for an implant-supported rehabilitation of their edentulous mandible. CBCT scans showed a mean available bone width of about 3 mm. At the first stage, four linear corticotomies were performed using a piezoelectric surgical device. At the second surgical stage 4 weeks later, bone expansion was performed, and four implants were placed in the interforaminal area. The healing process was uneventful. No fractures of the buccal wall and no neurologic lesions were observed. Postoperative CBCT scans showed a mean bone width gain of about 3.7 mm. Implants were uncovered 6 months after the second surgery, and 1 month later, a fixed provisional screw-retained prosthesis was delivered. This approach could be used as a reconstructive technique that avoids using grafts and reduces treatment times, possible complications, postsurgical morbidity, and costs by exploiting the patient's native bone as much as possible. Considering the limitations of a case report, randomized controlled clinical trials are needed to confirm the results and validate this technique.
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Petrini M, D'Amico E, Pierfelice TV, Aceto GM, Karaban M, Felice P, Piattelli A, Barone A, Iezzi G. Photodynamic Therapy with Aminolevulinic Acid Enhances the Cellular Activity of Cells Cultured on Porcine Acellular Dermal Matrix Membranes Used in Periodontology. Gels 2023; 9:584. [PMID: 37504463 PMCID: PMC10379034 DOI: 10.3390/gels9070584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
This study aims to test a photodynamic protocol based on a gel containing aminolevulinic acid followed by red-LED (ALAD-PDT) irradiation on human gingival fibroblasts (hGFs) and osteoblasts (hOBs) cultured on a porcine acellular dermal matrix membrane (PADMM). In the previous literature, ALAD-PDT showed solid antibacterial activity and proliferative induction on HGFs cultured on plates and HOBs cultured on a cortical lamina. PADMMs are used in dentistry and periodontology to treat gingival recessions and to increase the tissue thickness in the case of a thin biotype without the risks or postoperative discomfort associated with connective tissue grafts. However, one of the possible complications in this type of surgery is represented by bacterial invasion and membrane exposition during the healing period. We hypothesized that the addition of ALAD-PDT to PADMMs could enhance more rapid healing and decrease the risks connected with bacterial invasion. In periodontal surgery, PADMMs are inserted after a full-thickness flap elevation between the bone and the flap. Consequently, all procedures were performed in parallel on hOBs and hGFs obtained by dental patients. The group control (CTRL) was represented by the unexposed cells cultured on the membranes, group LED (PDT) were the cells subjected to 7 min of red LED irradiation, and ALAD-PDT were the cells subjected to 45 min of ALAD incubation and then to 7 min of red LED irradiation. After treatments, all groups were analyzed for MTT assay and subjected to histological examination at 3 and 7 days and to the SEM observations at 3, 7, and 14 days. Different bone mineralization assays were performed to quantify the effects of ALAD-PDT on hOBs: ALP activity, ALP gene expression, osteocalcin, and alizarin red. The effects of ALAD-PDT on hGFs were evaluated by quantifying collagen 1, fibronectin, and MMP-8. Results showed that ALAD-PDT promoted cellular induction, forming a dense cellular network on hOBs and hGFs, and the assays performed showed statistically significantly higher values for ALAD-PDT with respect to LED alone and CTRLs. In conclusion, ALAD-PDT could represent a promising aid for enhancing the healing of gingival tissues after PADMM applications.
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Affiliation(s)
- Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Emira D'Amico
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Gitana Maria Aceto
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Maryia Karaban
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Pietro Felice
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
| | - Antonio Barone
- Department of Surgical, Medical, Molecular Pathologies and of the Critical Needs, School of Dentistry, University of Pisa, 56126 Pisa, Italy
- Complex Unit of Stomatology and Oral Surgery, University Hospital of Pisa, 56126 Pisa, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
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Felice P, D’Amico E, Pierfelice TV, Petrini M, Barausse C, Karaban M, Barone A, Iezzi G. Osteoblasts and Fibroblasts Interaction with a Porcine Acellular Dermal Matrix Membrane. Int J Mol Sci 2023; 24:ijms24043649. [PMID: 36835067 PMCID: PMC9964429 DOI: 10.3390/ijms24043649] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
The use of collagen membranes has remained the gold standard in GTR/GBR. In this study, the features and the biological activities of an acellular porcine dermis collagen matrix membrane applicable during dental surgery were investigated, and also by applying hydration with NaCl. Thus, two tested membranes were distinguished, the H-Membrane and Membrane, compared to the control cell culture plastic. The characterization was performed by SEM and histological analyses. In contrast, the biocompatibility was investigated on HGF and HOB cells at 3, 7, and 14 days by MTT for proliferation study; by SEM and histology for cell interaction study; and by RT-PCR for function-related genes study. In HOBs seeded on membranes, mineralization functions by ALP assay and Alizarin Red staining were also investigated. Results indicated that the tested membranes, especially when hydrated, can promote the proliferation and attachment of cells at each time. Furthermore, membranes significantly increased ALP and mineralization activities in HOBs as well as the osteoblastic-related genes ALP and OCN. Similarly, membranes significantly increased ECM-related and MMP8 gene expression in HGFs. In conclusion, the tested acellular porcine dermis collagen matrix membrane, mainly when it is hydrated, behaved as a suitable microenvironment for oral cells.
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Affiliation(s)
- Pietro Felice
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Emira D’Amico
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Carlo Barausse
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
- Postgraduate School of Oral Surgery, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Maryia Karaban
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Antonio Barone
- Unit of Oral Surgery and Implantology, University Hospitals of Geneva, University of Geneva, 1205 Geneva, Switzerland
- Complex Unit of Stomatology and Oral Surgery, Department of Surgical, Medical, Molecular Pathologies and of the Critical Needs, School of Dentistry, University of Pisa, University-Hospital of Pisa, 56124 Pisa, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: ; Tel.: +39-0871-3554083
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Pistilli R, Barausse C, Simion M, Bonifazi L, Karaban M, Ferri A, Felice P. Simultaneous GBR and Implant Placement with Resorbable Membranes in the Rehabilitation of Partially Edentulous and Horizontally Atrophic Dental Arches: A Retrospective Study on 97 Implants with a 3- to 7-Year Follow-up. INT J PERIODONT REST 2022; 42:371-379. [PMID: 35472114 DOI: 10.11607/prd.5641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This retrospective study evaluates the clinical and radiographic outcomes of simultaneous guided bone regeneration (GBR) and implant placement procedures in the rehabilitation of partially edentulous and horizontally atrophic dental arches using resorbable membranes. A total of 49 patients were included, and 97 implants were placed. Patients were followed up for 3 to 7 years after loading. The data indicate that GBR with simultaneous implant placement and resorbable membranes can be a good clinical choice, and the data suggest that it could be better to horizontally reconstruct no more than 3 mm of bone in order to reduce the number of complications and to obtain stable results. However, this technique remains difficult and requires expert surgeons.
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Felice P, Pistilli R, Zucchelli G, Simion M, Karaban M, Bonifazi L, Barausse C. Decision Criteria Proposed for the Treatment of Vertical Bone Atrophies in the Posterior Mandible. INT J PERIODONT REST 2021; 41:71-77. [PMID: 33528453 DOI: 10.11607/prd.4922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In everyday practice, surgeons have to deal with bone atrophy. These rehabilitations are even more complex in the posterior mandible, and it is still unclear in the literature which fixed rehabilitation option is best. The purpose of this article was to help oral surgeons to choose the proper and updated treatment for their atrophic patients. Posterior mandible bone atrophies were divided into four main groups depending on the bone height measured above the inferior alveolar nerve: (1) ≤ 4 mm; (2) > 4 mm ≤ 5 mm; (3) > 5 mm ≤ 6 mm; (4) > 6 mm < 7 mm. Different approaches were proposed for each group, considering patient expectations. If ≤ 4 mm of bone height was available, guided bone regeneration was used as the adequate approach. For bone heights > 4 mm and ≤ 6 mm, the "sandwich" technique and/or short implants were used, depending on esthetics. In cases with > 6 mm and < 7 mm above the mandibular canal, short implants might be the proper option. The authors' clinical experience and the literature were considered in order to suggest a possible correct treatment decision based on the residual bone height in the posterior mandible.
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Pistilli R, Zucchelli G, Barausse C, Bonifazi L, Karaban M, Gasparro R, Felice P. Minimally Invasive Fixed Rehabilitation of an Extremely Atrophic Posterior Mandible Using 4-mm Ultrashort Implants: A Case Report with a 7-Year Follow-up. INT J PERIODONT REST 2020; 40:e235-e240. [PMID: 33151196 DOI: 10.11607/prd.4957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This case report describes the rehabilitation of an extremely atrophic posterior mandible using 4-mm ultrashort implants and reports clinical and radiographic outcomes 7 years after loading. The patient refused to undergo any other treatment, from the removable prosthesis to the reconstructive surgery, and asked for a fixed, minimally invasive solution in the shortest possible time. The residual bone height above the alveolar nerve was an average of about 5 mm, so it was decided to treat the patient with four 4-mm ultrashort implants. Within the limitations of this case report, this procedure appears successful at 7 years after loading in this specific case and could reduce invasiveness, rehabilitative times, and costs. However, longer follow-ups on a large number of patients coming from randomized controlled clinical trials are necessary before making more reliable recommendations.
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Bentivogli F, Karaban M, Barausse C, Pistilli R, Iezzi G, Bellini P, Felice P. Impianti post-estrattivi singoli: indicazioni cliniche e analisi della letteratura. Dental Cadmos 2020. [DOI: 10.19256/d.cadmos.09.2020.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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