Correlation between vegetarian diet and oral health: a systematic review

OBJECTIVE

Nutrition plays a significant role in preserving the balance of the human body. Considering each person's particular characteristics, diet can directly and indirectly alter the body's immune response. The purpose of this study is to draw attention to the connection between a vegetarian diet and its impact on oral health.

MATERIALS AND METHODS

To determine the connection between a vegetarian diet and dental health, a search of the literature was conducted on the PubMed, Scopus, and Web of Science databases. English language and a publication year between January 1, 2013, and March 1, 2023, were the inclusion criteria for the search.

RESULTS

There were 167 articles in total that addressed the subject of interest, and 18 of them were chosen for qualitative analysis.

CONCLUSIONS

This study suggests that a vegetarian diet may alter oral health, namely periodontal health, tooth erosion, and oral microbiome. Even if the data collected prevents the effect of a vegetarian diet on oral health from being confirmed, this study acts as a starting point for future, more focused research.

The experience of the rigid lockdown in the dental emergency room and urgency care during COVID-19 pandemic: a transnational multicenter observational study

OBJECTIVE

The COVID-19 pandemic had a major impact on our lives all over the world. Changes have occurred in daily life as well as in all medical services. The aim of the present study was to evaluate the emergency accesses in four universities' emergency services during the lockdown period from March to June 2020 during the COVID-19 pandemic.

SUBJECTS AND METHODS

A cross-sectional study was carried out on 44,787 patients to evaluate the emergency services of university centers. The medical data of Medical Emergency Service Data (MESD) were assessed by five independent operators considering the epidemiological findings for statistics methods.

RESULTS

A lower level of emergency access was reported in March-July compared to the pre-COVID period. The epidemiological data confirmed that female pathologies were more frequent compared to male patients. A fluctuation for almost all urgent healthcare centers was detected, showing one/two peaks per year during the years 2017-2019. The COVID-19 pandemic period did not influence the variety of pathology detected.

CONCLUSIONS

After the lockdown period, the emergency services slowly increased in cases. The pre-COVID period showed an overlapping of the most frequent pathologies compared to the post-COVID period: periodontitis (Bari and Tirana), dental fractures (Bari and Bucharest), odontogenic abscess (Bari, Cluj and Tirana).

Ceramic biomaterials in dentistry: chemical structure and biosafety - a review and a bibliometric visual mapping on Scopus database

OBJECTIVE

A biomaterial is any non-pharmaceutical substance or a mixture of synthetic or natural substances used independently or as part of a system for any amount of time with the aim of mending, supporting the growth, or replacing tissues, organs, or functions of the body. It is a non-renewable material that interacts with biological systems. The purpose of this study was to assess the advances in ceramic biomaterials and perform a bibliometric mapping of the literature on the subject.

MATERIALS AND METHODS

The Scopus database was used for manuscript screening (Elsevier, Amsterdam, The Netherlands). The effect of the scientific production has been assessed using scientometric citational metrics.

RESULTS

A total of 2,554 pieces of literature, including 2,234 papers, 170 conference proceedings, 109 reviews, 35 book chapters, 3 editorial letters, and 3 short surveys, were retrieved. Based on the research conducted, it is noted that ceramic materials are high-performing by being porous or glassy and can, therefore, serve as fillers, covering materials, and scaffolds in medicine and biotechnology. They are frequently employed not only in orthopedic and maxillofacial surgery but also in dentistry for dental prostheses.

CONCLUSIONS

Materials monitoring methods enable us to track the three-dimensional evolution of ceramics' volume, as well as flaws or micro-cracks.

A study survey on molnupiravir treatment in COVID-19 patients at home in Ninh Thuan province, Vietnam

OBJECTIVE

Molnupiravir (MOV) is an oral antiviral drug that received use authorization in Vietnam for the treatment of mild COVID-19 (F0). There was a need to develop alternative approaches that allowed patients to access medication, decongest hospitals, clinics, and facilities, and protect people from infection. During the COVID-19 crisis, the Ninh Thuan Health Authorities implemented the home delivery of medication by community health workers. This study conducted in collaboration with two important Italian entities [the Aldo Moro University of Bari City and the 118 Department of Territorial Emergency System (118 SET) of Taranto City] aimed to evaluate the implementation of home delivery F0 treatment package assessing the rate of infection recovering during the coronavirus pandemic in Ninh Thuan province, Vietnam.

PATIENTS AND METHODS

A convergent mixed methods research, based on a longitudinal study with quantitative research and qualitative assessments, evaluated four implementation outcomes: the feasibility, fidelity, coverage, sustainability, and effectiveness of the initiative. Data sources included routinely collected data, a telephonic survey of patients, an analysis of set-up and recurrent costs, as well as descriptive exploratory qualitative and quantitative analysis.

RESULTS

After taking the MOV for 5 days, only 35 out of the initial 400 F0 patients remained positive, while 365 patients (91.2%) were negative (CT≥30). Whilst, the successful rate after using the drug during the course accounted for 99.85% and 100% after the entire treatment course, without any death. After 5 days of taking the drug, a positive test result (CT<30) was associated with age group ≥60 (OR=2.7) and comorbidities (OR=3.0) (p<0.05) compared to negative and positive results (CT≥30). Negative factors impacting F0 at home include a shortage of healthcare workers, inadequate supply of thermometers and SpO2 meters, and insufficient financial support for healthcare workers.

CONCLUSIONS

MOV caused a reduction in the risk of hospitalization or death in mild COVID-19 patients, and molnupiravir was also found to be well tolerated and safe without any major adverse events during the administration period.

Efficacy of guided autofluorescence laser therapy in MRONJ: a systematic review

OBJECTIVE

This review aims to explore the efficacy of fluorescence-guided excision in the treatment of necrotic bone and highlights the importance of fluorescence in distinguishing viable margins from necrotic ones for a more targeted and predictable management of MRONJ.

MATERIALS AND METHODS

The review was conducted according to PRISMA guidelines using PubMed, Scopus, and Web of Science databases from January 1, 2008, to May 17, 2023. The Boolean search strategy with the following keywords "osteonecrosis" AND "fluorescence" was performed. Then, the articles were subjected to screening and eligibility phases. The papers about the use of autofluorescence-guided laser therapy in patients with jaw osteonecrosis were included.

RESULTS

A total of 320 articles were initially identified through an electronic search, and ultimately, 17 papers were included in the qualitative analysis.

CONCLUSIONS

In conclusion, our findings demonstrate that the VELscope system allows for clear visualization of the bone, making guided autofluorescence a precise, safe, and reliable technique.

Caries prevention and treatment in early childhood: comparing strategies. A systematic review

OBJECTIVE

Early childhood caries is a common condition that poses a serious risk to children's health because it can progress quickly, resulting in pain, abscesses, and a general decline in health. As a result, invasive therapies are needed, which call for highly skilled personnel. This systematic review of the literature aims to identify the most recent and widely applied early childhood caries (ECC) prevention and treatment approaches. Only substances that act topically and minimally invasive interventions were considered.

MATERIALS AND METHODS

The database search was restricted to randomized clinical trials completed within the last five years, specifically those that examined the following procedures: sodium fluoride (NaF) varnish, alternative restorative technique (ART), nano-silver fluoride, silver diamine fluoride, and silver modified atraumatic restorative treatment sealants (SMART).

RESULTS

A total of 815 articles were found. After removing duplicates, 584 articles were included, and 567 of them were excluded due to not meeting the predefined inclusion criteria.

CONCLUSIONS

Every method considered has been proven to be successful in halting the progression of ECC and is well-liked by patients, even those who are unwilling to cooperate, as well as by parents. The most common unfavorable effect of SDF is irreversible black discoloration in treated tooth surfaces, but this is typically not a problem. They are all low-cost, minimally invasive techniques that might also be widely used in large communities and low socioeconomic settings.

Dental erosion and the role of saliva: a systematic review

OBJECTIVE

This review evaluates the relationship between saliva and dental erosion. The acidic environment that can be established in the mouth leads to dental erosion. Acid pH, low salivary flow, systemic pathologies of patients, intake of acidic foods, and poor oral hygiene contribute to an oral environment that favors the development of dental erosion.

MATERIALS AND METHODS

A literature search was performed on PubMed, Scopus, and Web of Science databases to assess the role of saliva and dental erosion. The inclusion criteria for the search were: year of publication from January 1st, 2013, to March 1st, 2023, and English language.

RESULTS

A total of 3,597 articles covering our topic were found, of which 15 were selected for qualitative analysis.

CONCLUSIONS

Saliva protects against erosion by neutralizing and removing intrinsic and extrinsic acids, promoting the formation of an acquired protective film, and providing mineral substrates for remineralization by maintaining homeostasis in the digestive tract and oral cavity.

Direct and indirect bonding techniques in orthodontics: a systematic review

OBJECTIVE

Some of the most significant aspects in orthodontics for achieving favorable treatment outcomes include correct bracket positioning and a shorter period to accomplish bracket bonding. Two different brackets bonding techniques - direct and indirect bonding - are described in the literature. The aim of this review is to evaluate the differences, advantages, and disadvantages of the two techniques.

MATERIALS AND METHODS

A literature search was conducted on PubMed, Scopus, and Web of Science databases in a period from January 2013 to April 2023 with English language restriction using the following Boolean keywords: "orthodontic bracket* AND (bonding OR placement)".

RESULTS

A total of 3,820 articles were identified by the electronic search, and after duplicate removal, screening, and eligibility, a total of 11 papers were included for the qualitative analysis.

CONCLUSIONS

Indirect bonding is more predictable and precise than direct bonding. Indirect bonding has a greater impact on minimizing bracket placement errors than direct bonding, but it still takes longer to complete than the traditional procedure. However, further studies on the differences between direct and indirect bonding, as well as digital bonding, are needed.

New biograft solution, growth factors and bone regenerative approaches in neurosurgery, dentistry, and orthopedics: a review

Bone regeneration following surgery, trauma, or any other condition is an autologous process that can fail, necessitating the requirement of novel procedures and materials. Recently, significant progress has been made in the research related to regenerative medicine. At the same time, biomedical implants in spine surgery, orthopedics, and dentistry are facing many challenges and posing clinical concerns. A PubMed, MEDLINE, and Scopus review was carried out to identify all studies dealing with bone regenerative approaches in dentistry, orthopedics, and neurosurgery from database inception to December 2022. There has been an upsurge in the implication of a multitude of materials in the enhancement of bone regeneration and/or neo-bone formation, including blood-derived growth factors, new biografts, biosynthetic polymers, inorganic compounds, and sea corals, in the very recent years. Stem cells (SCs) have been found to be efficacious and safe modalities in osteogenesis. Furthermore, bone regeneration/formation depends on the host's immune system and metabolic condition. Epidermal growth factors (EGFs) and their receptors (EGFRs) are important in the mechanism of wound repairing and healing through the recruitment of stromal stem cells for epidermal and dermal regeneration. Similarly, biocomposite developed from Silica assembled with calcium and phosphorous has been utilized in the treatment of broken bones. In this review, we summarized the clinical and laboratory evidence of bone regenerative approaches in the field of spine surgery, orthopedics, and dentistry. An accurate pre-operative screening is the key to managing and carefully planning all surgical steps and achieving the final success.

Autologous tooth for bone regeneration: dimensional examination of Tooth Transformer® granules

OBJECTIVE

Since 1967, when the osteoinduction properties of autogenous demineralized dentin matrix were discovered, autologous tooth grafts have been advocated as a viable option to autologous or heterologous bone graft. Tooth graft materials may be extracted from the patient's whole tooth using a granulating device. The aim of this study was to examine the size of granules obtained by the Tooth Transformer (TT)® device, using a laser instrument with high precision.

MATERIALS AND METHODS

The TT® device can obtain bone graft material in a short period from an extracted tooth. The resulting material can act as an osteoconductive scaffold, providing a mineral substrate during resorption, including platelet growth factors and morphogenetic proteins. Different studies have investigated the dimension and behavior of various graft material particles, since the size of the grafted particles may play a role in osteogenesis and bone regeneration.

RESULTS

Different dimensions of granules are available: small (< 400 µm), medium (400 µm-1,000 µm) and large (1,000 µm-2,000 µm). From 4.03 µm to 100 µm the percentage of granules was 14.52 ± 1.93%. A larger part of the granules was up to 100 µm, while 85.47 ± 1.93% of the granules were from 100 µm to 1,000 µm.

CONCLUSIONS

85% of the granules produced were in accordance with the dimensions suggested in the literature.

Soft tissue regeneration in animal models using grafts from adipose mesenchymal stem cells and peripheral blood fibrin gel

OBJECTIVE

Our study aimed to evaluate the effect of soft tissue regeneration in nude mice using grafts made from the combination of adipocytes from fat tissue mesenchymal stem cells and fibrin gel from peripheral blood.

MATERIALS AND METHODS

Mesenchymal stem cells were isolated from adipose tissue and identified according to ISCT criteria. The scaffold used was fibrin obtained from peripheral blood. The grafts in this study were generated by transferring mesenchymal stem cells onto a fibrin scaffold. Two types of grafts, the research sample (fibrin scaffold containing adipocytes differentiated from mesenchymal stem cells) and the control sample (fibrin scaffold only), were grafted under the dorsal skin of the same mouse. After each research period, samples were collected and evaluated by histological methods to observe the existence and growth of cells inside the grafts.

RESULTS

The results showed that the study group's graft integrated better within the tissue when compared with the control group. In addition, the grafts in the study group showed the presence of cells with characteristic morphology of adipocytes one week after transplantation. In contrast, control samples showed dimorphous shapes and features mainly composed of non-homogenous fragments.

CONCLUSIONS

These initial conclusions might be considered a first step in generating safe bio-compatible engineered grafts specifically usable in post-traumatic tissue regeneration procedures.

The human microbiota key role in the bone metabolism activity

Data collection has suggested a complex correlation between the gut microbiota (GM) and bone homeostasis involving host-microbiota crosstalk. Although the GM is known to affect bone metabolism, the mechanisms linked with these effects remain unclear. The aim of this review is to current insight advances regarding how gut-derived hormones regulate bone homeostasis in humans, emphasizing gut-bone axis and bone regeneration. The GM may be engaged in bone metabolism and fracture risk. Additional investigations of the fundamental microbiota-related pathways in bone metabolism may uncover treatment strategies and enable the prevention of osteoporosis. A better knowledge of gut hormones' action on bone homeostasis may lead to new strategies for preventing and treating skeletal frailty related to age.

Stabilized zirconia ceramics for dental applications

The research is aiming to obtain at room temperature a new ceramic material containing partially stabilized zirconia with different oxides after sintering used for dental and other technological purposes. Our research proposes a new method based on the use of stabilized zirconia with other oxides to obtain optimized dental material with a lower cost price and / or improved properties to allow wider use of these products to an increased number of patients in dental offices. X-ray diffraction, SEM analysis. FTIR spectroscopy, UVVis and density measurements were accomplished for the three ceramic systems. The correlation between the microstructure and the spectroscopic properties of zirconium stabilized by FTIR spectroscopy, UV-Vis helps understanding the mechanisms associated with the formation of high (tetragonal and / or cubic) temperature zirconia. Along with the simple, less costly preparation method and high purity of the ceramic products our study offers a highly desirable product for technological applications.

Management of anterior open-bite in the deciduous, mixed and permanent dentition stage: a descriptive review

Anterior open bite is one of the most complex malocclusions to manage. The interaction of skeletal, dental, and soft tissue effects can contribute to develop an anterior open bite. The skeletal open bite requires a more complex approach of treatment to reach function, aesthetics, and stability. The approaches vary depending on the causative factors and the age of patients. Treatment approaches for open bite patients differ when dealing with adults and growing patients. The aim of this descriptive review was to summarize the main existing treatment strategies for anterior open bite, from the noninvasive behavioural shaping to the orthodontic intrusion with skeletal anchorage.

The bad relationship, osteo-decay and diabetes type 2 searching for a link: a literature review

The diabetes and osteoporotic metabolic diseases are characterized by a wide prevalence of the population worldwide and correlated to alteration of the bone tissues. Several cofactors could influence the clinical course and the biochemistry of the pathologies such as human microbiome, nutrition characteristics, gut microbiota activity and interactions with vitamin K and D across IGF/GH and TP53 signaling pathways and the glucose/energy as mechanism for bone tissue health. Moreover, also the calories and sugar consumption seem to be correlated to an increased inflammatory state with several consequences for hematopoiesis and host tissues response. The aim of the present literature review was to highlight the role of osteoporotic diseases and diabetes type 2 link for the bone metabolism. The literature cases showed that a correlation between bone-gut-kidney-heart-CNS-Immunity crosstalk seems to be linked with bone metabolism and health regulation. Moreover, also the aging process could represent a valuable co-factor for the sustaining of the metabolic disorders upon a multi-systemic level.

Correlation between occlusal trauma and oral microbiota: a microbiological investigation

The occlusal trauma has been defined as an injury to the periodontium resulting from occlusal forces that exceeds the reparative capacity of the attachment apparatus. Currently, the effects of occlusal trauma on tooth support tissues, the onset and the progression of periodontal disease are still debated. In fact, researchers started evaluating the possible effects of occlusal discrepancies on incidence, progression, and treatment outcomes of periodontitis, but all the results underlined the more significant role played by microbiological flora. The results of this study show that after 60 days of treating the occlusal trauma, a significant reduction was achieved in the periodontal bacterial flora.

The effectiveness of autologous demineralized tooth graft for the bone ridge preservation: a systematic review of the literature

Resorption of alveolar ridge after tooth extraction often compromises dental implant placement and esthetic. Alveolar ridge preservation is a common procedure performed in order to preserve the pontic site for a prosthetically ideal position. This procedure has already become an indisputable need. Tooth matrix as bone substituted material poses osteoconduction and osteoinduction properties and as autologous graft, this material is free of antigenic reaction. This biomaterial allows the threedimensional reconstruction of the bone, is easy to prepare and has a low cost. The aim of this review is to summarize and put in evidence the properties of tooth as bone substitute and its use in alveolar ridge preservation. Keyword: autologous tooth, autologous graft, bone regeneration, bone substitute, alveolar ridge preservation, alveolar ridge augmentation, socket preservation.

The integumentary system and its microbiota between health and disease

The aim of the present investigation was to evaluate the essential physiological functions of the skin microbiota in human health and diseases. The main characteristics of the normal microbiota in the different anatomical sites have been reported in relation to the main factors, such as the effect of age, on its composition and stability for the eubiosis condition. Moreover, the present overview analyzed the functions and composition and the correct functionality of the skin microbiota in the light of current knowledge. According to several evidence is important preserving the eubiosis of the commensal microbes of the microecosystem (symbiotic and pathogenic), and probiotics are able to counteract the conditions of dysbiosis. Also, it has been shown that there is a crosstalk between gut and skin microbiota that affects human health and is still being studied, and its relationship to the current pandemic SARS-CoV-2.

White spot lesions in orthodontics: prevention and treatment. A descriptive review

White spot lesions (WSL) are demineralizations of the enamel found on the tooth surfaces. WSL are considered incipient non-cavitated caries caused by bacterial plaque activity. Subjects with malocclusion such as dental crowding and fixed orthodontic appliances have a greater number of retention sites and consequently difficulty in cleaning and greater predisposition to caries. In fact, WSL are a frequent side effect of orthodontic fixed treatments. The prevention and resolution of this problem is the goal of any orthodontist because untreated WSL can lead to the formation of deeper dental caries and restorative treatment with consequent compromise of patient satisfaction with the aesthetic result obtained at the end of the orthodontic treatment. This review is intended not only for orthodontists but also for general and pediatric dentists who want to learn how to correctly prevent, and treat this unsightly problem. On the market there are many products sold to achieve this goal, some of them can be managed independently by the patient at home, others require the intervention of the dentist. The purpose of this literature review is to understand how these substances work, to identify with which of the currently most widespread the best results have been obtained and then to provide useful information to guide the clinician in choosing the most suitable one for the patient.

Compliance of children with removable functional appliance with microchip integrated during covid-19 pandemic: a systematic review

Treatments with removable appliances are widely used in Europe to correct dento-skeletal dysgnatia in the growth phase that is a period of poor cooperation of the patients. Adherence to the wear-time prescription is often not achieved and it represent the main argument against the use of removable devices. Suspected non-compliant behavior with the wear time prescription is often the subject of medico-legal disputes, which can deteriorate doctor-patient relationship. The use of microchips allows to document objectively and clarify the patient's behavior. To conduct a systematic review of the orthodontic literature to identify the factors associated with compliance in orthodontic treatment. We conduct a systematic review that aimed to identity the factors associate with compliance in orthodontic treatment. The main purpose was to assess the objective levels of time of use of the removable appliances and the self-reported levels. A literature search was conducted by the electronic databases PubMed and Cochrane Library. The following search terms were used: compliance functional removable orthodontic appliance. Randomized and nonrandomized controlled trials, prospective cohort studies, case series, qualitative and mixed-methods studies objectively assessing compliance levels were included in the study. A total of 94 articles were identified by PubMed and 14 articles by Cochrane. The papers selected were included for the qualitative analysis and categorized according to the subjects age, the clinical appliance, compliance factors, wear time and monitoring. Removable appliances are an important part of orthodontic treatment, used in growth phase of the patient. Collaboration with removable functional devices determines success / failure in treatment.

Rapid and sensitive diagnostic procedure for multiple detection of pandemic Coronaviridae family members SARS-CoV-2, SARS-CoV, MERS-CoV and HCoV: a translational research and cooperation between the Phan Chau Trinh University in Vietnam and University of Bari "Aldo Moro" in Italy

OBJECTIVE

A new pandemic coronavirus causing coronavirus disease-2019 (COVID-19), initially called 2019-nCoV and successively named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The COVID-19 refers to the disease while the SARS-CoV-2 refers to the virus and is characterized by a rapid contagious capacity able to spread worldwide in a very short time. The rise in the number of infected patients and deaths is of great concern especially because symptoms are vague and similar to other forms of flu infection and corona syndrome infections characterized by fever, fatigue, dry cough, and dyspnea. According to the latest guidelines published by the World Health Organization (WHO), the diagnosis of COVID-19 must be confirmed by quantitative reverse transcription polymerase chain reaction (rRT-PCR) or gene sequencing of specimen obtained from throat, sputum and blood samples. However, the limitations due to logistics, as well as low sensitivity and specificity diagnostic tools currently available have been reported as the main cause of high incidence of either false-negative or positive results.

PATIENTS AND METHODS

The purpose of the present translational research protocol is to discuss and present the original findings from our research team on new diagnostic technique to detect four Coronaviridae family members (SARS-CoV-2, SARS-CoV, HCoV and MERS-CoV), highlighting the methodology, the procedure and the possible advantages. Moreover, the authors review the current epidemiology, precautions and safety measures for health personnel to manage patients with known or suspected COVID-19 infection.

RESULTS

Implementation of an effective and rapid plan of diagnosing, screening and checking is a key factor to reduce and prevent further transmission. This procedure based on rRT-PCR could be of great help to decisively validate the results obtained from more conventional diagnostic procedures such as chest computed tomography (CT) imaging and chest ultrasound.

CONCLUSIONS

This translational diagnostic tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing people with suspected or confirmed SARS-CoV-2.

Computer-based quantification of an atraumatic sinus augmentation technique using CBCT

Our group recently developed an innovative maxillary sinus augmentation technique without the need of sinus membrane elevation, termed as "IPG" DET protocol. This technique utilizes autologous platelet concentrates (including platelet rich plasma (PRP), platelet rich fibrin (PRF), growth factors (GFs) and CD34+ stem cells), together with bone grafting materials positioned through intentionally perforated Schneider's membrane for flapless implant placement. This study aimed at evaluating the performance of "IPG" DET protocol in terms of new bone formation and implant stability at 8 months post-op. This prospective study consisted of forty-eight patients with a mean age of 52.8 years. A total of eighty-five implants were placed with "IPG" DET protocol in combination with autologous platelet concentrates. CBCT (cone beam computed tomography) was performed at two different time points: pre-operatively and at 8 months post-op. CBCT images were then compared by an intensity-based image algorithm to assess the newly formed bone in terms of gray scale values. Additionally, implant stability quotient (ISQ) was used to estimate implant osseointegration and success rate. The average new bone formation was 5.9 ± 0.9 mm2 per implant. All implants successfully osseointegrated, and ISQ ranged 62.3-71.7. According to the results of this study, "IPG" DET protocol in combination with autologous platelet concentrates is a successful technique for implant-supported rehabilitation of the edentulous posterior maxilla without the need of sinus floor elevation.

Comparison of conventional orthognathic surgery and "surgery-first" protocol: a new weapon against time

The aim of this literature review article is to evaluate the new surgical technique "Surgery-First" and compare it with the conventional orthognathic surgery in terms of treatment length, patient satisfaction and post-surgical stability. The goal is to compare the pro and cons of the two techniques and to determine which technique can offer more efficient results.

Bone decay and beyond: how can we approach it better

Osseo-degeneration is a disorder related to several factors, that may lead to the disruption of several skeletal regions providing support, such as the femur head, the vertebrae and the alveolar bone. The functional condition can be restored by means of grafting procedures, using different materials: calcium powder, xenografts, ceramics and metals. Such procedures aim at reforming an adequate bone volume and strength, that is necessary to support loading forces. Bone regeneration requires that the basic biological principles of osteogenesis, osteoinduction, osteoconduction and biocompatibility are followed. The success of regenerative procedures may depend on the inner structural, mechanical and metabolic condition of the host's bone on which implants should be inserted, on the surgical technique, and on the biomaterial used. Among these, the aging process of the patient appears to be relevant. It can be associated with metabolic disease leading to systemic functional decay, which involves a gradual steady decline of hormonal, immune function and osteo-metabolic activity. The latter can affect the positive outcomes of bone reconstruction and implant therapy. This review will analyze the biological and physiological factors involved in the bone tissue break-down, such as the influences from gut microbiome unbalance and the consequent metabolic, endocrine, immune dysfunctions, the surgery procedures and the quality of the grafting material used. The decline of bone architecture and strength should be corrected by using an appropriate clinical regenerative approach, based on a bio-endocrine, metabolic and immunologic know-how. The final characteristics of the regenerated bone must be able to support the loading forces transmitted by the implants, independent of the body location, and should be individualized according to the different condition of each patient.

A technical note for the use of small-diameter cannula for lipoaspiration technique in aesthetic reconstructive post-oncological surgery

Skin cancer basal cell carcinoma (BCC) is a quite common lesion with a worldwide annual incidence between 3% and 8%. Tissue reconstruction should be biologically driven: nowadays, the naso-genial flap is one of the safest and usable flaps for the reconstruction of the labial and nasal region after invasive surgery aimed at a full BCC excision. In fact, the proximity of this flap to the area to be treated, the similar colour of the skin and the technical possibility to perform a single surgery to both harvest the flap and remove the lesion in the area to be then reconstructed, make it highly preferred by surgeons. In order to prevent the most severe swelling, the Authors started to use a novel method consisting in the use of the small-diameter cannula for lipoaspiration technique (SDCL). The correct use of SDCL allows to aspirate the adipose tissue, thus obtaining an available adipose-based scaffold, highly compatible with the area in which the flap is to be placed.

Immediately loaded dental implants bioactivated with platelet-rich plasma (PRP) placed in maxillary and mandibular region

BACKGROUND AND AIM

Dental implants have today deeply changed the dental field. In fact, after almost 50 years, the permanent placement of a titanium screw with an attached tooth have, step by step, changed the society's standard toward a permanently replacement of missed or severely damaged teeth. In fact, the host of benefits born from dental implants have affected both patients and dental professionals. The aim of the present study is to report the outcomes of an implant therapy protocol supporting fixed prostheses implanted soon after extractions and loaded with flapless guided surgery by a 3D software planning.

MATERIALS AND METHODS

37 patients, requiring rehabilitation of booth dental arches with a one-to-one technique, were enrolled in a follow-up study plan which established clinical and radiological examinations on the day after surgery, seven months and one year later. Platelet Rich Plasma (PRP), in combination with autogenous bone, organic bone material and organic bone substitutes, was used before implant-prosthetic rehabilitation with an its prompt loading just before the implant insertion phase.

RESULTS

Definitive restorations were delivered at 6-12 months after surgical procedure. One year after loading there were no dropouts and no failure of the definitive prosthesis. Furthermore, the feedback from patients resulted positive.

CONCLUSIONS

Patients resulted satisfied both aesthetically and functionally regarding these types of prosthetic reconstructions made at the time.

Use of platelet rich fibrin and Bio-OSS/SINT-Oss for implant-prosthetic rehabilitation in maxillary atrophy with sinus pathology: A 48-month follow-up

The maxillary sinus floor elevation procedure has gained popularity with predictable results, and is a safe, acceptable technique for bone augmentation, providing a base for dental implant treatment. Faint radiopaque lesions at the base of the maxillary sinus are frequent diagnoses on radiographs and must be identified during dental implant planning. The use of autografts, xenografts, allografts, and alloplasts or a combination between them has been demonstrated to be effective for increasing bone height and bone volume in maxillary sinus. The objective of this study was to evaluate the outcome of subjects with considerable sinus membrane pathology (test group) undergoing maxillary sinus floor augmentation using Platelet Rich Fibrin (PRF) as a filling material, in association with the Bio-Oss and Sint-Oss and simultaneous implant placement in a one-stage surgical procedure. All patients reported no pain to percussion, no sign of tissue suffering to the soft peri-implant tissues, the presence of an optimal primary stability of the inserted implants, and the increase in the peri-implant bone density. No complications were encountered during follow-up periods in these patients, including no negative evolution in the sinusitis and all implants are functioning successfully. In conclusion, the use of PRF and Piezosurgery reduced the healing time, favoring optimal bone regeneration and allowing sinus membrane integrity to be maintained during surgical procedures, according to evidence-based dentistry.

CHARGE syndrome: an overview on dental and maxillofacial features

OBJECTIVES

CHARGE is an acronym referring to the aspects of this rare syndromic condition. Patients with CHARGE association are today considered as subjects lacking in pathognomonic dental alterations. The present study is aimed at adding to the body of evidence of the cases reported in literature and the continuous clinical research which show a clinical picture which is strongly associated with patients afflicted by this syndrome.

PATIENTS AND METHODS

We report a case-series of 8 patients with CHARGE syndrome. The dental features associated with CHARGE syndrome are from case-reports, but without a congruity that can lead to a definition of the dental condition typical of the CHARGE phenotype.

CONCLUSIONS

The systemic problems affecting these patients are predominant in compromising their quality of life: this is the reason for a frequent lack of a diagnostics and interceptive phase, relative to oral diseases. We report new oral pathological conditions affecting CHARGE patients. Knowledge of these pathological conditions may induce dentists to carry out specific diagnoses of these patients, thus, avoiding the deterioration of oral conditions.

Regenerative surgery performed with platelet-rich plasma used in sinus lift elevation before dental implant surgery: an useful aid in healing and regeneration of bone tissue

OBJECTIVES

Aim of this work is to show the effectiveness of a protocol involving the use of platelet-rich plasma (PRP) as a grafting material in bone regeneration before dental implant rehabilitation.

MATERIALS AND METHODS

127 patients, requiring maxillary sinus lift, were enrolled in a follow-up study plan, which established clinical and radiological examinations on the day after surgery and six months later. PRP, in combination with autogenous bone, an organic bone material and organic bone substitutes, was used before implant-prosthetic rehabilitation.

RESULTS AND CONCLUSIONS

After implant placement, 63 patients, previously treated with PRP, reached a statistically significant improvement in implant-prosthetic rehabilitation, established by primary stability and radiographic integration criteria, in comparison with the other 64 patients receiving implant-prosthetic rehabilitation without PRP treatment.

Combined occlusal and pharmacological therapy in the treatment of temporo-mandibular disorders

OBJECTIVE

Aim of the present work is to assess the effectiveness of a scientific protocol built up to relieve pain in chronic temporo-mandibular disorders (TMD) using Michigan splint together with a pharmacological therapy compared to the traditional occlusal therapy by Michigan splint alone.

PATIENTS

35 adult patients, with signs and symptoms of TMD lasting more than 6 months, were enrolled into this study and divided into two groups: the first receiving occlusal therapy by Michigan splint and pharmacological therapy with Delorazepam and Thiocolchicoside, while the second receiving occlusal therapy by Michigan splint and "placebo" administration. The comparisons between the two experimental groups were assessed using a 5 steps visual-analogue scale (V.A.S.).

RESULTS AND CONCLUSIONS

The outcomes from the experimental groups were statistically compared resulting significantly different with an improvement or disappearance of signs and symptoms in the treated group with respect to the placebo group at 12 and 18 months from the beginning of the experiment (p < 0.001).

Trial with Platelet-Rich Fibrin and Bio-Oss used as grafting materials in the treatment of the severe maxillar bone atrophy: clinical and radiological evaluations

OBJECTIVES

The aim of the present study is to assess the implant osteointegration, as well as the course of bone regeneration and healing processes, thanks to the sinus lift procedure and by using PRF as a filling material, in association with the Bio-Oss.

MATERIALS AND METHODS

23 patients, requiring maxillary sinus lift in order to place implants into posterior maxillary region, were involved in this study. Selected cases, in which the height of the residual bone was superior to 5 mm, were adopted for surgical procedure of "one-stage sinus lift" (implant insertion concurrently occured with sinus lift resulting 6-9 months the healing and integration time). Before inserting the implant, a small quantity of filling material was placed in the cavity. For this purpose the bone fragment, stored in saline solution, was employed mixed with Bio-Oss and PRF, after being ground.

RESULTS

All patients reported no pain to percussion, no sign of tissue suffering in the soft peri-implant tissues, the presence of an optimal primary stability of the inserted implants and a significant increase in the peri-implant bone density.

CONCLUSIONS

In all cases included in this protocol, the Authors observed a successful implant-prosthetic rehabilitation, according with Albrektsson criteria.

Clinical trial with bromelain in third molar exodontia

BACKGROUND AND OBJECTIVE

Bromelain is a proteolytic enzyme, particularly effective in the treatment of soft tissue inflammations and traumas, in localized inflammations, especially in presence of hydropsy and also in postoperative tissue reactions. The aim of the present study is to assess the efficacy of bromelain in controlling the edema and its related pain in the inflamed area after upper third molar exodontia.

MATERIALS AND METHODS

The effectiveness of our protocol was evaluated by a clinical assessment of the profile of the hemiface corresponding to the treated area: indeed, the linear values of the trago-pogonion distances were measured. Algogens were determined by VAS (Visual Analogue Scale) (Figure 1) with integers ranging from 1 (no pain) to 8 (maximum pain) up to a maximum of 10 (paroxysmal and unbearable pain).

RESULTS AND CONCLUSIONS

The obtained results clearly demonstrate the effectiveness of bromelain in treating postoperative edema after third molar surgery.

Effects of developmental fluoride exposure on rat ultrasonic vocalization, acoustic startle reflex and pre-pulse inhibition

Rats receiving fluoride during the whole pregnancy up to the 9th day of lactation showed, when isolated at 10th day of life, a reduced rate of ultrasonic vocalizations (UV) in male pups (NaF 5.0 mg) and, in 90th days male rats, an increase of the Pre-Pulse Inhibition (PPI) with a reduction of the Peak response to the Startle stimulus given alone. Newborn rat reactivity could represent a useful and validated model in anxiety studies which could be moored with the Acoustic Startle Reflex (ASR) and PPI, appropriate models to study, in adulthood, particular neurological and psychiatric disorders showing deficits in attention and sensory-motor gating (Tourettes' syndrome, obsessive compulsive disorders, Huntington's disease and schizophrenia).

Patient at high hemorrhagic risk. Surgical management of three cases and review of the literature

The surgical treatment of 3 cases of dental patients at high hemorrhagic risk is described: a man with Von Willebrand disease and 2 women, 1 with platelet deficiency with cirrhosis of the liver and the other with autoimmune idiopathic thrombocytopenic purpura. The patients were hospitalized in order to monitor these cases in cooperation with the University Hematology Center.