Minerva dental and oral science最新文献

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.

The strength and innovative challenge of a National Health System is measured, among all parameters, also by its capacity to take care of that portion of the population that presents greater socio-health vulnerabilities. In fact, the direction of national and international socio-political demands, in collective health matters, is precisely that of identifying the volume of the population concerned, not only in epidemiological terms to quantify the necessary services, but above all in terms of definition. The aim of this article is to provide an analysis of the evolution of the definition of vulnerable, fragile and disabled patient, up to the present day, and to present the clinical protocol for the management of the patient with special needs, elaborated and adopted within the IRCCS San Gerardo dei Tintori Dental Clinic in Monza (Italy), in collaboration with the School of Specialization in Oral Surgery of the University of Milan-Bicocca.

Background: Bone grafting is a surgical procedure that involves the use of bone tissue or bone substitutes to repair damaged bone. In dentistry and maxillofacial surgery, bone graft substitutes from various sources are commonly used. Given their critical role in clinical outcomes, it is essential to thoroughly investigate the biological and mechanical properties of these materials.

Methods: In this in vitro study, we evaluated the biological properties of two equine-derived bone graft substitutes in comparison to β-tricalcium phosphate. The materials included one equine-derived graft containing hydrolyzed type I collagen and another containing preserved type I collagen. To assess their biological performance, we analyzed cell viability, adhesion, osteogenic differentiation, and the expression of genes involved in bone remodeling.

Results: All graft substitutes demonstrated similarly good biocompatibility. However, in the β-tricalcium phosphate group, intergranular tissue fibers or extracellular matrix were absent both before and after osteogenic differentiation. In contrast, cells cultured on the equine-derived graft containing hydrolyzed type I collagen exhibited intergranular tissue fibers and matrix, while those on the graft containing preserved type I collagen showed intergranular tissue fibers, individual cells, and matrix. Gene expression analysis suggested that β-tricalcium phosphate may undergo faster resorption kinetics compared to the equine-derived grafts, which were associated with gene expression patterns indicative of enhanced bone formation.

Conclusions: Our results suggest that both hydrolyzed and preserved type I collagen support bone matrix deposition more effectively than β-tricalcium phosphate, with preserved collagen demonstrating superior performance. From a clinical perspective, preserved collagen appears to be the optimal choice for larger or less contained bone defects, as it promotes faster cell repopulation and may lead to more rapid remodeling with the patient's own vital bone. In contrast, hydrolyzed collagen seems to elicit a slower cellular response and may be better suited for smaller, localized defects where immediate biological activity is less critical. Further research is essential to guide clinicians in selecting the most appropriate bone graft substitute based on the specific clinical context.

Introduction: The aim of this study was to evaluate the long-term treatment outcomes of basal implants in patients with severely resorbed ridges, including the survival and success rates, patient complaints, satisfaction, and Quality of Life.

Evidence acquisition: An extensive electronic search was conducted on the search engines: PubMed, Web of Science, and Google Scholar using Boolean Operators (AND, OR, NOT) and the key words (basal implants, Corticobasal implants, Strategic Implants, severely resorbed ridge, severely atrophic ridge, treatment outcome, patient satisfaction) within the last 10 years.

Evidence synthesis: A total of 21 articles were found, encompassing 9732 basal implants placed in 1219 patients. Thirteen studies had reported a success or survival rate with a range of 90.3-100% for intraoral basal implants and 88.2% and 92.9% for orbital and nasal implants, respectively. Four studies have reported failure rates with a range of 0.3-3.2%, while seven articles documented 0.3-2.4% mobility. The pain was reported in 6 studies (0.3-0.8), marginal bone loss (0.33-7.89 mm), an increase in bone density, and peri-implant bone contact were reported in 3 and 2 studies, respectively.

Conclusions: Basal implant-supported prostheses can be a practical treatment modality with high predictable survival or success rates, positive impacts on patient satisfaction, and improved quality of life.

Introduction: This systematic review investigates the role of nutritional supplements in enhancing osseointegration outcomes, a critical factor for the success of dental implants.

Evidence acquisition: A comprehensive search was performed across multiple databases (MEDLINE/PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, CINAHL, PsycINFO) to identify relevant studies. Inclusion criteria targeted studies providing quantitative data on osseointegration related to micronutrient supplementation.

Evidence synthesis: Analysis of the included studies revealed that adequate Vitamin D levels were consistently associated with improved implant outcomes, enhancing bone density and stability. Vitamin C supplementation was shown to benefit soft tissue healing but did not directly affect bone integration. The review also identified significant interactions between genetic factors (e.g., vitamin D receptor polymorphisms) and implant success, alongside noting that systemic conditions like osteoporosis were associated with poorer prognoses.

Conclusions: Nutritional supplementation, particularly vitamin D, plays a significant role in supporting dental implant osseointegration. A holistic patient assessment, considering genetic and systemic health factors, is essential for predicting outcomes. Further research is needed to establish definitive clinical guidelines for nutritional support in implantology.

The COVID-19 pandemic, particularly in India, continues to pose a major threat to public health owing to the large number of patients that remain affected. The second wave of COVID-19 has brought with it several opportunistic diseases caused by bacteria and fungi, including mucormycosis, which is a well-known fungal infection primarily encountered in immunocompromised individuals through inhalation. In recent times, mucormycosis has become increasingly common in COVID-19 patients, particularly those with comorbidities such as diabetes, and has been observed to induce secondary infections as it spreads with COVID-19 treatment. Despite its importance, mucormycosis is still poorly studied due to the current priority given to research on treatments, vaccines, and diagnostics. To address this knowledge gap, this study aims to investigate the correlation between mucormycosis and COVID-19 patients and elucidate the molecular mechanism of mucormycosis to improve our understanding of fungal infections in patients who have recently contracted SARS-CoV-2.

Background: Anxiety and fear are significant challenges in pediatric dentistry, often leading to avoidance of dental treatment. Some studies suggest a potential link between the dopamine beta-hydroxylase gene and the ABO gene. As ABO blood group type is determined genetically, it could serve as a bioindicator for assessing the impact of genetics on personality traits. The association between blood types and personality characteristics has long been debated.

Methods: Eighty eligible children, meeting the inclusion criteria, were enrolled in the study. Blood group data were obtained from parents/guardians. Dental anxiety assessment was done using the RMS-Picture scale and pulse oximeter.

Results: The collected data were analyzed statistically.

Conclusions: The study found no correlation between dental anxiety and ABO blood grouping.

Traumatic oral injuries are frequently encountered in dental practice and may result from both accidental causes and intentional harm, including child abuse, intimate partner violence, and elder neglect. Dentists, due to their clinical expertise and regular patient contact, are often among the first healthcare providers to identify signs of non-accidental trauma. This narrative review explores the dentist's role in the detection, documentation, and medico-legal management of such injuries, particularly in the context of suspected abuse or neglect. A narrative review of relevant literature, clinical guidelines, and forensic protocols was conducted. Sources were selected based on their relevance to dental diagnosis, trauma recognition, medico-legal obligations, and interdisciplinary collaboration in suspected abuse cases. Certain injury patterns - such as contusions, lacerations, avulsions, and frenulum tears - especially in protected anatomical areas or with incongruent patient histories, may suggest inflicted trauma. Comprehensive clinical and photographic documentation is essential for legal and protective proceedings. Dentists must be familiar with mandatory reporting laws and recognize their legal responsibilities. Forensic odontologists contribute valuable expertise by providing objective injury analysis and supporting legal investigations. Multidisciplinary collaboration with pediatricians, general physicians, legal authorities, and social workers enhances case management and victim protection. Dentists have a dual responsibility: providing care and safeguarding vulnerable individuals. Strengthening dental education in forensic odontology, trauma-informed care, and medico-legal procedures is essential to prepare practitioners for this role. Increasing awareness and interprofessional communication can significantly improve outcomes in cases of traumatic oral injuries linked to abuse or neglect.

Introduction: Alveolar ridge preservation (ARP) is a critical procedure to mitigate bone resorption following tooth extraction. This review comprehensively evaluates the current evidence on the use of dense polytetrafluoroethylene (dPTFE) membranes for ARP, assessing their efficacy in maintaining ridge dimensions and promoting tissue regeneration to facilitate future implant placement.

Evidence acquisition: A comprehensive review of the literature was conducted using databases including PubMed/MEDLINE, Embase, and the Cochrane Library. Evidence was gathered from various study designs, including randomized controlled trials, cohort studies, and case series that investigated the use of dPTFE membranes, both alone and in conjunction with bone grafts.

Evidence synthesis: The evidence consistently demonstrates that dPTFE membranes effectively preserve alveolar ridge dimensions. The "open membrane" technique, where the dPTFE is intentionally left exposed, is shown to be a predictable approach that enhances keratinized tissue width with minimal complications. Histological analyses confirm reliable vital bone formation, with outcomes influenced by healing duration and graft material selection. Furthermore, dPTFE membranes have proven effective in managing complex situations, including compromised sockets and oroantral communications.

Conclusions: Dense polytetrafluoroethylene membranes represent a versatile and effective modality for alveolar ridge preservation. Their application, particularly with the open membrane technique, reliably maintains hard and soft tissue architecture, creating favorable conditions for subsequent dental implant rehabilitation.