Minerva dental and oral science最新文献

Introduction: Laser treatment of venous malformations (VMs), frequently observed in the upper airway, has been recently proposed. The aim of this systematic review was to analyze the effectiveness of the laser in treating oropharyngeal VMs.

Evidence acquisition: Five electronic databases were searched: National Library of Medicine (MEDLINE-PubMed), Scopus, Embase, Cochrane Library and Web of Science. OpenGrey was also searched to retrieve relevant grey literature. The analysis considered all the articles published from 1900 to 20/02/2023 excluding those still in the publication phase. Reference lists of included studies were manually searched for identification of other potential papers. Data on clinical characteristics of VMs, type and protocols of laser treatments, achieved outcomes and complications were collected and a qualitative analysis was performed.

Evidence synthesis: Nine studies were selected for data extraction. Nd:YAG laser was used in seven studies and diode laser in two studies. Almost all treated lesions had volume reduction >75%. No major complications had been reported.

Conclusions: Although some clinical factors were not reported in most of the studies, the results showed that the LT could be an effective and minimally invasive therapeutic option in the treatment of VMs. Further clinical controlled trials can shed more light on the role of laser in the treatment of VMs.

Introduction: Resin-based composites (RBCs) are among the most widely used materials for direct dental restorations due to their aesthetics and conservative preparation requirements. However, their clinical application remains highly technique-sensitive, and long-term outcomes are frequently compromised by complications. This systematic review aimed to evaluate the most common clinical challenges associated with direct composite restorations and assess awareness of these complications among dentists, dental students, and patients.

Evidence acquisition: A comprehensive search of PubMed, Scopus, Web of Science, and Embase was conducted for studies published between January 2010 and August 2025, following PRISMA guidelines. Twenty eligible studies were included, encompassing survey-based research, clinical follow-ups, and cross-sectional analyses across diverse populations. Quality assessment revealed methodological heterogeneity, with most studies rated as intermediate quality.

Evidence synthesis: The most frequently reported complications included secondary caries, restoration fractures, marginal defects, postoperative hypersensitivity, and food impaction. Factors contributing to these failures were multifactorial, encompassing operator technique, material properties such as polymerization shrinkage and moisture sensitivity, patient-related behaviors including poor oral hygiene and parafunctional habits, and inadequate pre- and postgraduate training. Evidence further indicated that repair, rather than replacement, is often a conservative and effective management strategy.

Conclusions: The success of composite restorations depends not only on material advancements but also on clinician skill, adherence to evidence-based protocols, and patient cooperation. Continuous professional education and preventive measures remain critical for reducing complications and improving restoration longevity.

Background: The aim of this study was to evaluate the bone remodeling of implant with convergent neck walls positioned at the crestal and subcrestal levels. The remodeling of the bone and soft tissue is influenced by the surgical and restorative techniques and by the materials used.

Methods: The study analyzed 128 patients with 262 implants, comparing subcrestal (Site A) and crestal (Site B) placements. Radiographic evaluations at T0 and T1 (12 months) were used to collect standardized clinical data on oral conditions and implant stability.

Results: The success rate with implant osseointegration at 12 months was 100% in both groups. The discrepancy between the two bone remodeling averages, 12 months apart, in implants positioned at level A and implants positioned at level B, is minimal. The average between the mesial and distal bone remodeling for implants positioned at level A is -0.854 mm T1-T0 mesial and -0.512 mm distal and for implants positioned at level B is -0.45 mm T1-T0 mesial and -0.69 mm T1-T0 distal.

Conclusions: The search for possible radiographic differences between the crestal and subcrestal positioning of the convergent neck implants, concludes by observing the lack of a statistically significant result but with important insights into the positioning method at level B. The average bone loss is favorable for crestal positioning (-0.57 mm) compared to subcrestal (-0.683 mm).

Background: The aim of the current study is to compare the skeletal stability of single-plate versus double-plate osteosynthesis in anterior mandibular osteotomies.

Methods: A prospective case-control trial was planned, enrolling all the patients who reported to us for the correction of anterior mandibular issues, including patients planned for lower anterior sub-apical osteotomies and genioplasties. The patients were randomly allocated to two groups Group I (single plate fixation) and Group II (two plate fixation) based on the Lot method. The patients in each group were further divided into subgroups, with Subgroup A undergoing subapical setback and Subgroup B undergoing advancement genioplasty. All the patients underwent preoperative clinical and cephalometric evaluation (T1) to assess the magnitude of movement of the anterior mandibular segments. All the patients had an immediate post-operative cephalogram done (T2). They were under follow-up for 6 months to 3 years (T3), and the post-operative skeletal stability was assessed using COGS analysis on a lateral cephalogram between T3 and T2. Intraoperative time and postoperative neurosensory disturbances were the secondary outcomes that were measured. G power analysis was used to calculate the sample size, and statistical analysis used SPSS (version 23.0), employing ANCOVA for non-parametric tests (Quade's approach) with significance set at P<0.05.

Results: Twenty-six patients within the age group of 15 to 35 years (14 females, 12 males) were enrolled in the study. Thirteen patients were allocated to each group. Seven patients underwent genioplasty in group I and seven in group II, and six underwent subapical osteotomy in groups I and six in group II, respectively. The mean magnitude of subapical setback was 7 mm, while the magnitude of chin advancement was 8 mm, and this was comparable among the groups. The cephalometric evaluation involved the evaluation of vertical and horizontal distances of points B, Pog, and menton from the true horizontal and true vertical of COGS analysis. These parameters showed no statistically significant differences in the follow-up period (T3-T2) between single-plate and double-plate osteotomy groups for subapical osteotomies and genioplasties between age and sex-matched control groups. However, secondary outcomes, including neurosensory disturbances, intraoperative time, differed significantly (P<0.05) between groups and favored the use of single plate fixation.

Conclusions: This clinical trial suggests that the choice between single-plate and double-plate osteosynthesis does not significantly affect skeletal stability following anterior mandibular osteotomies. However, significant differences were observed in secondary outcomes, indicating potential considerations for surgical approach in orthognathic procedures.

Lip arteriovenous malformations (AVMs) are typically present at birth and can lead to progressive tissue destruction and functional and cosmetic issues. Their management is challenging due to the lack of standardized protocols and may involve both surgical and non-surgical approaches. The authors present a case of upper lip AVM with feeders bilaterally from both facial arteries and their superior labial branch arteries. Bilateral Gelfoam embolization of the labial arteries followed by surgical resection was performed. The upper lip was reconstructed using a bilateral advancement flap. The patient's intraoperative and postoperative courses were uneventful, and no recurrence was recorded. The functional and aesthetic results were good and satisfying for the patient at the 1-year follow up. Upper lip AVMs can be managed through a combination of presurgical embolization and complete surgical resection. The use of a rapidly absorbable embolic material does not compromise the surgical resection procedure and reduces the risk of complications such as necrosis of the upper lip, especially in cases where it is necessary to embolize both upper labial arteries.

Introduction: During immediate dental implant placement, regenerative materials are often used to fill the peri-implant space following tooth extraction and implant insertion. One such material gaining popularity in contemporary dentistry is platelet-rich fibrin (PRF). This study aims to examine existing scientific literature to determine if PRF effectively promotes the filling of the peri-implant gap and regeneration of soft tissue in single-unit immediate dental implant placement compared to alternative materials.

Evidence acquisition: The systematic literature review was performed according to PRISMA guidelines. Databases searched included PubMed, Cochrane Library, ScienceDirect, Google Scholar, Scopus, and ResearchGate, up to November 19, 2024. Selection criteria included studies on humans, written in English, and using PRF for the management of the peri-implant gap in immediate implantation.

Evidence synthesis: Seven publications were reviewed: 2 studies compared PRF with blood clots, 2 with collagen and bone substitute, and 3 with bone substitute alone. Implant stability quotient results in slightly favoured PRF over blood clot and collagen with bone substitute, although results were inferior to bone substitutes alone. One study noted significant crestal bone improvement with PRF versus collagen and deproteinized bovine bone (DBB). One study reported higher resorption in the PRF group compared to DBB and beta-tricalcium phosphate at the buccal site. Control groups generally exhibited lower peri-implant pocket depths, though no significant differences were observed between groups across studies and follow-up.

Conclusions: PRF effectively promotes regeneration of the peri-implant hard and of soft tissue in single-unit immediate dental implant placement compared to control groups, although no significant differences were observed between alternative materials across studies and follow-up.

Introduction: Dental implants are recognized as the optimal solution for replacing missing teeth due to their high success rates and broad applications. However, not all dental implant therapies yield successful outcomes, and failures can occur due to various biological and mechanical factors. This systematic review aims to evaluate primary studies focusing on the biomechanical properties of dental implants, to identify key factors that contribute to the success of implant therapy.

Evidence acquisition: A comprehensive search was conducted across electronic databases, including MEDLINE (PubMed), EMBASE, Google Scholar, and CAB Abstracts. The search strategy incorporated six significant biomechanical properties, utilizing keywords and Boolean operators. The review encompassed human and animal studies, including observational studies, trials, and in vitro investigations. Out of 234 titles obtained from the online search, 59 studies were selected for full-text review following the abstract screening. Among these, nine full-text articles were selected for data extraction and analysis. All the included studies were conducted in vitro and therefore provide preclinical biomechanical evidence that may not directly translate to clinical outcomes. Among the in vitro studies, six assessed loss of preload, five assessed fatigue strength, four examined implant-abutment connection design, and one evaluated implant diameter.

Evidence synthesis: Preload values decreased over time, with the most loss occurring within 10 seconds of tightening. The 8-degree internal conical implant demonstrated superior performance to the interior hex design. Studies also indicated a higher rate of complications (such as porcelain chipping and de-cementation) in cantilever groups. Biomechanical properties such as preload, torque, cantilever design, and implant abutment design significantly influence the success rates of dental implants.

Conclusions: This review provides important parameters for successful implant therapy, albeit with certain limitations.

Background: During excavation works for high-speed railway infrastructure in central Italy, at a depth of 430 cm in clayey-gravelly soil, a mandibular bone fragment was discovered together with metal artefacts. The find emerged in the context of geotechnical stabilization works aimed at ensuring ground support for the railway line.

Methods: The mandibular fragment, preserved with erupted teeth, was cleaned and analyzed by radiological tomography using software for morphometric and densitometric evaluation. A subsample was examined at a Nuclear Physics Centre for radioisotopic dating and to assess the individual's physical and nutritional status at the time of death. Comparative archaeological analyses were performed to identify the nature and chronology of the associated metal artefacts.

Results: Morphometric assessment confirmed the remains belonged to an adult primate of the Order Eutheria, with traits consistent with a human specimen. Radiological and isotopic studies yielded data on bone density, preservation, and temporal context. The artefacts displayed distinct morphological features attributable to manufactured tools. Archaeological comparison indicated they were most likely the tips of surgical instruments, dating to the Roman period (first century AD).

Conclusions: This multidisciplinary investigation demonstrates the value of combining morphometric, radiological, radioisotopic, and archaeological analyses in reconstructing the biological and cultural significance of osteological finds. The evidence suggests the mandibular fragment belonged to an adult individual, and the associated artefacts can be interpreted as surgical instruments from the Roman era, providing rare insights into ancient medical practices.

Introduction: Cysts are common pathology in the maxillofacial area. The treatment of choice consists of enucleation, regeneration of the created defect and achieving a primary closure. The platelet rich fibrin (PRF), developed by Joseph Choukroun, has been commonly use in the area of oral regeneration, thanks to its biological properties; some literature suggests the application in cystic cavities to not only avoids the collapse of tissue but also help regeneration be achieved in a shorter time, however, changes in the nature of the cells and lack of evidence in the literature continue to be a controversial issue. To analyze the current state of clinical knowledge and the potential of the use of PRF in the regeneration therapy of cystic cavities either alone or as a co-adjuvant of other biomaterials through a systematic review of the literature.

Evidence acquisition: The selection of articles was carried out following the PRISMA statement for systematic reviews protocol, with selection of articles between 2006 to 2022, without discriminating in English or Spanish using a keyword algorithm "PRF jaw cyst," " Platelet rich fibrin jaw cyst," "platelet rich fibrin oral cyst," selected articles such as case reports, series of cases and comparative clinical studies were reviewed.

Evidence synthesis: A total of 33 articles were included in this review where 154 cystic cavities were evaluated, mostly radicular cysts, treated with PRF alone or as coadjutant of some biomaterial where a successful regeneration was evidenced in a period of 3-6 months, without any complications presented in post-surgical controls, but the lack of histopathological information was an issue in several articles.

Conclusions: Although PRF seems to be a good regenerative therapy in oral surgery and no evidence was found that contraindicated its use in this cases, its applications in cystic cavities still needs more evidence in articles with less bias and more evidence such as comparative studies with control groups.