ORAL and Implantology最新文献

The aerosol produced during the use of dental instruments can spread pathogens potentially harmful to health. Most of the pathogens found in hydraulic system are Gram-negative aerobic heterotrophic environmental bacterial species exhibiting very low pathogenicity, although they may be of concern in the treatment of vulnerable patients, such as immunocompromised, medically compromised individuals and dental team. Dental team can be exposed to pathogenic microorganisms including cytomegalovirus, hepatitis B virus, hepatitis C virus, herpes simplex virus and Legionella spp. Legionella spp. are ubiquitous in hydraulic system, in fact surveys have shown that the percentage of samples taken at different dental chairs that were positive for Legionella spp. and ranged from 0 to 100%. The concentration of Legionella spp. in hydraulic system may reach 1000 organisms per ml. The primary route of Legionella spp. transmission is inhalation or aspiration of environmentally contaminated aerosols. All dentists are required to conduct a statutory risk assessment of their hydraulic system, in fact to comply with their legal duties, dentists must identify and assess the sources of risk and prepare a scheme for preventing and controlling risks. Moreover, they must monitor the quality of their hydraulic system at least annually to ensure that they are "legionellae free".

Purpose: The surgical-orthodontic treatment of impacted maxillary canine (IMC) remains a challenge to today's clinicians. The aim of the present paper is to describe an unconventional treatment of IMC with insertion of implant into the retained canine and 3 years follow-up.

Case report: A 55-year-old female patient attended to rehabilitate her maxillary left canine site. An unconventional approach was proposed to the patient. A large diameter tapered implant (Ø 5 × 18 mm) was inserted (Nobel Active, Kolten, Swisse). An immediate loading prosthetic rehabilitation was performed. After checking for implant stability the prosthetic steps were carried out and a single crown was delivered with Procera system.

Conclusion: The patient was happy of this kind of single non-invasive session for treating IMC. At the 3-year control, the implant did not show any mobility or signs of peri-implantitis clinically or radiographically. In addiction patient was satisfied of aesthetic results.

Purpose: The aim of this paper is to describe epidemiology and clinical manifestations of oral infection by Human papillomavirus (HPV), with particular attention to potential malignant lesions.

Materials and methods: A systematic review of the literature was conducted to describe the state of the art about HPV infection in oropharyngeal mucosa and its modalities of transmission, with particular attention to possible simultaneous infection in multiple anatomic sites. The aspects of prevention and control of infection by administering vaccines and the diffusion of sexual education campaigns are discussed also. Therapeutic protocols are also described where necessary.

Results: In recent years there has been a growing interest in HPV oral medicine, suggesting a role of such a family of viruses in the development of neoplasms of the oropharyngeal district as well as of the uterine cervix. Even if the mass media have increasingly faced the problem, causing frequent alarming among patients, the dentist therefore needs a complete and up-to-date knowledge of this infectious condition that is one of the most common causes of sexually transmitted mucous membrane infections (e.g. genital, anal and oral).

Conclusions: Recent studies about HPV infection are a basic requirement in order to promote the health of patients and provide them with the most exhaustive indications from dentists.

Diagnosis of focal disease, the theory that the human oral microbial (HOM) could affect the onset and development of systemic diseases, was very popular in the past, but the lack of scientific evidence has led to the abandonment of this idea. Interestingly, increasing evidence over the past 3 or so decades suggests that HOM can indeed serve as a reservoir for systemic dissemination of pathogenic bacteria and their toxins in distant body sites, favouring the developments of malignant tumours. Malignant tumours are complex communities of oncogenically transformed cells with aberrant genomes, associated non-neoplastic cells including immune and stromal cells, and sometimes HOM, including bacteria and viruses. Recent data suggest that HOM and periodontal disease play an active role in the pathogenesis of colorectal cancer, in fact HOM has been found within the colorectal cancer microenvironment, and the composition of the HOM was different from that of adjacent non-neoplastic tissue. An association of fusobacterium nucleatum with the colonic mucosa of colorectal cancer has been proven. Several questions thus arise. Is periodontal disease a risk factor for colorectal carcinoma? Given the connectivity of the digestive tract, could fusubacterium nucleatum or other HOM be involved in additional gastrointestinal disorders? Furthermore, based on the "mobility" of Fusubacterium nucleatum and the omnipresence of cadherins, could this organism be involved in cancers beyond the gastrointestinal tract? Answers to these questions will shed new lights on the role of the HOM in onset of diseases.

Purpose: Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory disorder characterized by repeated obstructive episodes affecting upper airways.This study aims at examining the anatomical craniofacial and pharyngeal characteristics of the patient as to identify the obstructive site which triggers the pathologic process.Correlations between otolaryngologic data observed in the patient and the cephalometric ones for the identification of the obstructive site were also highlighted.

Materials and methods: We worked on a sample of 16 patients, 12 males and 4 females, attended to at the Otolaryngology Operative Unit of Bari University Hospital.The patients underwent an otolaryngologic (ORL) diagnostic procedure which provided for ApneaGraph (AG) recording, and a dental diagnostic procedure with cephalometric assessment.

Results: The statistical analysis highlighted a strict correlation between the otolaryngologic value of AHI and the cephalometric values of the ANB angle, with the distance between the hyoid bone and the mandibular plane and with the distance between the hyoid bone and the plane passing between C3 and Me.

Conclusions: We observed a concurrence between the ORL diagnosis of the obstruction level assessed with AG and the cephalometric values regarding respiratory tracts (IPAS and SAS). More precisely, we observed the correlation between the otolaryngologic value of AHI with cephalometric values of the ANB angle, with the distance between hyoid bone and mandibular plan, and with the distance between the hyoid bone and the plane passing between C3 and Me. Furthermore, the identification of the caudal position of the hyoid bone can be considered an alarm bell in the diagnosis of severe OSAS.

Objective: The purpose of the study was to analyze the association between dento-skeletal malocclusions, ocular motility, and convergence disorders in growing subjects.

Materials and methods: 84 subjects (49 males, 35 females) with a mean age of 7.3±1.7 years were enrolled in a screening procedure for celiac disease at the Department of Gastroenterology of the University of Rome "Tor Vergata". Each child underwent an orthodontic, orthoptic, and ophtalmological examination. Pearson's Chi-Square test with Yates' correction and Fisher's exact test were conducted to assess the association between orthoptic defects and malocclusions (p<0.05).

Results: Ocular motility disorders were present in 44.9% of males and in 57.1% of females, while convergence defects were present in 10.2% of males and in 2.9% of females. Ocular motility disorders were more frequent in subjects with Angle Class III malocclusion (66.7%) than in subjects with Angle Class II (59.1%) and Class I (45.8%) malocclusion. Convergence defects were equally frequent in Angle Class I and Class II malocclusion (5.1%), while none subject presenting with Angle Class III malocclusion exhibited convergence defects. A statistically significant correlations was found between ocular motility disorders and unilateral cross-bite with midline deviation.

Conclusion: Ocular motility defects had a significant greater prevalence in subjects presenting with unilateral cross-bite and midline deviation. The importance of role of orthodontic diagnosis among interdisciplinary treatment in growing children should be recognized.

Treatment of severe maxillary atrophy with implants has achieved important successes in recent years. The limit of implant insertion is related to inadequate bone quantity (i.e. height and width). Alveolar bone grafting, sinus lifting and major grafting via Le Fort I osteotomy have used in the past to restore bone volume prior of implant insertion. However successes do not always occur and a second stage surgery is necessary in most cases. Immediate loading cannot be performed in all grafted bone. In recent years a new treatment approach has been proposed by using zygomatic implants. This new technique can provide a better stability to the prosthesis and less morbidity for patient. Here a cases series of eighteen patients rehabilitated with zygomatic together with standard implants and immediate loading is reported.

Introduction: Gingival hypertrophy is a frequent condition associated to the increased number of patients taking some categories of drugs. The goal of this work is to emphasize the importance of diagnosis to set a proper therapy.

Material and methods: The plaque accumulation in patients having a poor oral hygiene damages the periodontium and requires the application of strict professional and home hygiene protocols.

Results and conclusion: The drug-induced gingival proliferation knowledge is essential in order to succeed in working with the internist and in planning a precise therapy, without interfering with the metabolism of drugs, often necessary and irreplaceable for patients' health.

The implant-prosthetic rehabilitation of edentulous upper jaws has always been complex for surgeons and dentists. The lack of bone in both vertical and horizontal dimension does not allow the correct insertion of dental implants. In addition, patients with edentulous upper and lower arch have a loss of vertical dimension of the face and an aged expression. Many surgical techniques have been proposed to increase the bone volume, height and thickness, such as the Le Fort I osteotomy, the bone grafts and the placement of dental implants. Planning these surgical procedures is difficult, because it is not possible to reproduce the movements of osteotomized bone segments in three planes of space. This article describes the treatment of severe atrophy maxilla with a new approach using a new instrument named "Surgiplanner". Surgiplanner is a method that, only using a computerized axial tomography (CAT), allows to obtain a totally predetermined therapeutic result from both an aesthetic and functional point of view, with surgery of severe resorbed jaws. Surgiplanner allows repositioning of segment of the skeleton of the patient's face in a predetermined and controlled way for the best implant-supported oral rehabilitation.

Purpose: Implant dentistry has become one of the most successful dentistry techniques for replacing missing teeth. The success rate of implant dentistry is above 80%. However, peri-implantitis is a later complication of implant dentistry that if untreated, can lead to implant loss. One of the hypotized causes of peri-implantis is the bacterial leakage at the level of implant-abutment connection. Bacterial leakage is favored to the presence of a micro gap at the implant-abutment interface, allowing microorganisms to penetrate and colonize the inner part of the implant leading to biofilm accumulation and consequently to peri-implantitis development.

Materials and methods: To identify the capability of the implant to protect the internal space from the external environment, the passage of genetically modified Escherichia coli across implant-abutment interface was evaluated. Implants were immerged in a bacterial culture for twenty-four hours and then bacteria amount was measured inside implant-abutment interface with Real-time PCR.

Results: Bacteria were detected inside all studied implants, with a median percentage of 9%.

Conclusions: The reported results are better to those of previous studies carried out on different implant systems. Until now, none implant-abutment system has been proven to seal the gap between implant and abutment.