Minerva stomatologica最新文献

Background: In recent years, we have recorded an increase in the number of hospital admissions due to odontogenic abscesses and neck phlegmons requiring surgery. We believe that the cause may be related both to the rationalization of funding allocation procedures in public health service making access to public dental healthcare more difficult, and the financial situation of Italian families.

Methods: Fifty-five patients admitted between January 2013 and November 2017 with a diagnosis of "neck abscess" and/or "neck phlegmon" and/or "neck infection" were enrolled in this longitudinal retrospective study.

Results: The results of this study showed that the number of cases of abscesses and neck phlegmons with an odontogenic origin have quadrupled, with reference to gender was 31 males (56%) and 24 females (44%). The average age was 46 and most cases involved patients between 30 and 50. Eighteen patients (33%) were not EU citizens and had been living in Italy for over 5 years. These data indicate an increase in the incidence of odontogenic neck infections. The data gathered by ISTAT (Istituto Nazionale di Statistica), Eurostat Data Explorer, Fondazione Giuseppe Di Vittorio and Tecnè revealed that these outcomes are directly related to the financial difficulties Italian families are experiencing. The exclusion of essential dental assistance from public healthcare forced Italians to consult expensive private facilities that not everyone can afford.

Conclusions: Connections were found between odontogenic neck infection complications and the financial difficulties Italian families are suffering from; Italians are reducing their budget for dental healthcare becoming exposed to serious neck pathologies.

Background: This study aims to evaluate soft and hard tissues response of a two-piece implant placed nonsubmerged in elderly patients' anterior maxilla. Marginal bone level and Pink Esthetic Score (PES) were evaluated up to 24 months.

Methods: Twelve healthy consecutive patients (mean age 65.8±5 years; 65.5 median) were included in the study. Implants were inserted with flapless technique after 3 months or immediately after extraction. The smooth machined neck of the implant was characterized by a hyperbolic neck which follows biologically oriented preparation technique (BOPT) principles. A customized abutment and a provisional resin crown was positioned with care to avoid excessive soft tissue compression after 3 months, according with BOPT technique. A definitive ceramic crown was positioned after approx. 4 months.

Results: After 24 months all implants were stable and osseointegrated. PES improved at 6 and 12 months recalls, remaining stable at 24 months, indicating a healthy soft and hard tissue response. No complications were observed. Impression procedures and provisional/definitive crown cementation resulted simple and free from complications. The hyperbolic profile allowed the preparation of prosthetic crown free from any gingival tissue pressure to create the adequate soft tissue contour.

Conclusions: The use of hyperbolic profile implant associated with the transmucosal (not-submerged) technique is a safe procedure that allow the preservation of soft and hard tissue also in elderly patients.

Background: The aim of this study was to evaluate radiological and histological characteristics of fresh-frozen homologous bone as grafting material for maxillary sinus floor augmentation. Radiological, histological and clinical evaluations were made.

Methods: Twenty-three patients with a 2 mm to 6 mm alveolar ridge height in the posterior maxilla have been enrolled. Unilateral or bilateral sinus floor augmentations were performed with fresh frozen morcelized homologous bone. Together with implant placement, 7 months after surgery, a bone core was harvested for histological analysis. Radiological measurements were obtained by superimposition of CT scans carried out at the surgery time and six months later. A total of 93 implants were positioned.

Results: A mean (±SD) increase in mineralized tissue height of 10.74±2.82 mm was noticed by comparing the CT scans. Histological analysis revealed the presence of newly formed bone in the grafted sites. The follow up period after the prosthetic load ranged from 8 to 31 months. One implant failure occurred.

Conclusions: Fresh frozen homologous bone seems to have a good healing pattern and to be a successful and steady grafting material for the treatment of maxillary ridge atrophy. It might be considered a valid alternative to autologous bone in sinus floor augmentation procedures.

Background: This study aims to evaluate tension distribution in the anterior region of the mandible during two orthodontic mechanical approaches to treat anterior open bite.

Methods: It was an in-vitro experimental study, that analyzed 5 models of photoelastic resin, simulating a lower dental arch. The anterior teeth underwent orthodontic forces of the Blue Elgiloy® 0.016" x 0.022" (MEAW technique) and Gummetal® 0.018"x 0.022" (GEAW technique) archwires. Tension distribution was assessed on three different points in the lower dental midline and was measured using a reflection polariscope. The archwires were evaluated with and without anterior elastic bands (6 oz, 170 g) installed between lateral incisors and lower canines, as recommended for anterior open bite.

Results: The highest magnitudes of tension generated by the archwires were observed in the cervical regions of the teeth (on average 50% higher than those at the most apical point) regardless of the technique used. Comparatively, the GEAW technique showed significantly (P<0.05) lower tension values (16 MPa) than the MEAW technique using Blue Elgiloy (24 MPa).

Conclusions: The GEAW technique showed a more favorable tension distribution pattern than the MEAW approach. The use of elastic bands improved tension distribution, regardless of the technique. The results also suggest that the use of anterior elastic bands in both techniques reduced the tensions released by the intrusive forces generated by the archwires.

Background: Replacement of missing teeth in the anterior aesthetic zone has challenged clinicians with fixed, removable or implant prosthodontics. Problems have been encountered could void aesthetic and functional results. The aim of this study was to present a clinical case report in which clinician challenged a very strong aesthetic case with an innovative surgical and prosthetic approach.

Methods: A patient who presented to the authors with a maxillary central incisor that had a hopeless prognosis secondary to acute localized severe periodontitis. The patient was treated by extracting the tooth and replacing it immediately with a platform switched implant using piezoelectric surgery. The implant was then restored with an immediate, non-occlusal loading provisional restoration.

Results: The implant became osseointegrated and was ultimately restored with a definitive abutment and crown restoration.

Conclusions: Innovative approaches could represent a valid alternative to restore patients functionally and aesthetically.

With the development of X-ray computed tomography (CT) in the 1960s and its first use for clinical studies in 1972 by Sir Godfrey Hounsfield, radiological tomography attained widespread use and today is one of the essential imaging techniques in medical radiology. It is a technically mature and clinically widely accepted method and complements classical X-ray panoramic radiography in many areas. The technology is frequently used in craniofacial radiology, because of its characteristic low radiation dose, high spatial resolution and lower cost compared with CT. The aim of this work was to describe the principles of cone beam computed tomography, to make a brief description of the existing devices, to present briefly the use of 3D diagnosis in craniofacial medicine.