Minerva dental and oral science最新文献

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.

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.