ORAL and Implantology最新文献

Objectives: Scientific research data show that the Forsus FRD seems to have a great potential in the correction of Class II in childhood. The conclusions reached by the various Authors seem to support the hypothesis of an exclusively or mainly dentoalveolar correction, as the skeletal correction seems to have no - or little - appreciable results. In the light of such provided by different Authors, the potential of dentoalveolar compensation in adult patients with mild skeletal class II was investigated.

Materials and methods: At the UOC (Complex Operative Unit) of Orthodontics at "G. Eastman" Hospital Rome, 3 cases of skeletal class II mild (ANB <5 °) in adult patients were selected. They were treated with fixed multibracket appliance and Forsus EZ2 module. Cephalometric tracings were compared at the beginning and at the end of the treatment in order to assess the skeletal and dentoalveolar changes.

Results: The occlusal correction was achieved through a dentoalveolar compensation characterized by the flaring of the lower teeth.

Conclusions: Forsus FRD equipment is an excellent compromise for the correction of mild Class II, even during the post development age. The resulting correction is appreciated at dental alveolar level with a mesial movement of the incisors and molars.

Objective: The aim of this prospective pilot clinical case series report was to evaluate, through a clinical and radiographic analysis, the peri-implant bone resorption of the tantalum dental implants (TMT) (Zimmer TMT, Parsippany, NJ, USA) one year after prosthetic rehabilitation.

Methods: Twenty tantalum dental implants were placed in both maxillas and mandibles of 20 patients. Patients were asked to attend a radiographic and clinical follow-up and their previous clinical records and X-rays were assessed. Bone levels were calculated by digitally measuring the distance from the implant shoulder to the first bone-to-implant on periapical radiographs taken at surgery and after 6 and 12 months of functioning. The Pearson correlation analysis was performed to assess it there was a correlation between the measurement of the marginal bone loss (MBL). The Anova Test with a post-hoc analysis using Bonferroni's test was used to compare the three group (0, 6 months and 12 months).

Results: The mean total MBL for the group 0 months was 0.84 mm (SD 0.21), 6 months was 0.87 mm (SD 0.22) and for 12 months was 0.89 mm (SD 0.23). The values of the Pearson's coefficients showed that the data measurement were positively correlated. The Anova test showed a statistically significant difference between the groups.

Conclusion: The statistically significant difference in marginal bone loss can be considered physiological. Within the limits of this study it can be concluded that TMT implants have an excellent bone crest's stability, however, to have most accurate information, will be necessary extend the sample.

Objectives: The aim of this in vitro study is to evaluate the marginal and internal fit of zirconia core crowns manufactured following different digital and traditional workflows.

Methods: A 6° taper shoulder prepared abutment tooth was used to produce 20 zirconia core crowns using four different scanning techniques: scanned directly with the extraoral lab scanner, scanned with intraoral scanner, dental impressions using individual dental tray and polyether, dental casts from a polyether impressions. Marginal and internal fits were evaluated with digital photography and the silicone replica method.

Results: Medium marginal gaps were 76,00 μm ± 28.9 for extraoral lab scanner, 80.50 μm ± 36,2 for intraoral scanner, 88.10 μm ± 34,8 for dental impression scan and 112,4 μm ± 37,2 for dental cast scan. Medium internal gaps were 23.20 μm ± 10,3 for extraoral lab scanner, 16.20 μm ± 8.3 for intraoral scanner, 27.20 μm ± 16.7 for dental impression scan and 30.20 μm ± 12.7 for dental cast scan.

Conclusion: Internal gap were extensively lower than 70 μm described in literature. Marginal fit was higher than ideal values for all the techniques but within the limit of clinical success. Intraoral scanners obtained the best results for internal gap.

Purpose: This study was aimed at assessing the effectiveness and the importance of an oral hygiene (OH) protocol in patients undergoing radiation therapy and chemotherapy after prosthesis rehabilitation, in order to reduce or minimize oral complications.

Materials and methods: This study was carried out at the Department of Dental Science, at the University of Bari-Italy from December 2012 to December 2015 on 34 selected patients with primary oral cancer undergoing chemotherapy and radiotherapy after prosthesis rehabilitation. They were divided into 2 groups according to their age, sex and cancer therapy. Seventeen patients were assigned to the control group and seventeen in the experimental one. In the experimental group (Table 1), patients underwent an oral hygiene protocol whereas in the control group (Table 2) patients received the usual care provided within the clinical setting. All the patients gave written informed consent. It has been asked and obtained the authorisation from the Ethics Committee of the Dental Science and Surgery Department.

Results: Results show that in patients undergoing the oral hygiene protocol, the complications and the risks of infection and permanent dental problems have been minimized. Indeed, of the seventeen patients undergoing the OH protocol, 70% obtained positive results and were satisfied with the program outcome.

Conclusions: The role of the health care providers is essential to educate patients to adhere to the prescribed treatments and reinforce their motivation in oral hygiene. The oral hygiene procedures prevent and ameliorate oral complications due to the radiation therapy and chemotherapy.

Purpose: In this study we wanted to observe the improvement in the healing of periodontal tissues in a group of diabetic patients treated with traditional methods compared to another group treated with the addition of oxygen.The potential of oxygen has long been known in the field of plastic surgery, where it is used to treat burns and skin lesions.

Materials and methods: This study consists in a split mouth study which involved 30 patients. We carefully treated them with periodontal therapy using manual and mechanical instrumentation. Then, we applied oxygen in half mouth according to randomization list. Finally we checked up patients after some weeks.

Results: Our results highlight that all areas treated with oxygen application healed more rapidly and better than no treated areas.

Conclusions: All in all, we have demonstrated that oxygen can improve the outcome of non-surgical periodontal treatment in diabetic subjects.

Purpose: To determine the existence of any correlation between the degree of divergence and apical and coronal arch form using cone-beam computed tomography (CBCT).

Materials and methods: A total of 176 (88 coronal and 88 apical) CBCT scans pertaining to a sample of 44 subjects (16 males and 28 females), of which 26 were Class I, 14 Class II and 4 Class III, were analysed. A lateral projection of the skull was obtained from each VCT and cephalometric tracing was performed (according to Ricketts) so as to divide the sample into subgroups based on the degree of divergence (11 short-faced, 18 norm-faced and 15 long-faced subjects). Dahlberg's index values were calculated and Student's t-test for paired data was applied.

Results: On the whole, the hyperbolic cosine curve was found to be the most representative of the arch forms considered.

Conclusions: A correlation between degree of divergence and the arch form of the apical and, especially, coronal portions of both the upper and lower jaws was revealed.

Introduction: Although many previous studies have reported on the high success rate of short dental implants, prosthetic design still plays an important role in the long-term implant treatment results. This study aims to evaluate stress distribution characteristics involved with various prosthetic designs on standard implants or short implants in the posterior maxilla.

Materials and methods: Six finite element models were simulated representing the missing first and second maxillary molars. A standard implant (PW+ implant: 5.0×10 mm) and a short implant (PW+ implant: 5.0×6.0 mm) were applied under the various prosthetic conditions. The peri-implant maximum bone stress (V on mises stress) was evaluated when 200 N 30° oblique load was applied. A type III bone was approximated and complete osseous integration was assumed.

Results: Maximum Von mises stress was numerically located at the cortical bone around the implant neck in all models. In every standard implant model shows better stress distribution. Stress values and concentration area decreased in the cortical and cancellous bone when implants were splinted in both the standard and short implant models. With regard to the non-replacing second molar models found that the area of stress at the cortical bone around the first molar implant to be more intensive. Moreover, in the non-replacing second molar models, the stress also spread to the second pre-molar in both the standard and short implant models.

Conclusions: The length of the implant and prosthetics designs both affect the stress value and distribution of stress to the cortical and cancellous bones around the implant.

Objective: The aim of this prospective observational study was to identify local risk factors for the development of clinical manifestations of oral chronic Graft versus Host Disease (cGvHD) in a cohort of patients affected by haematological malignant diseases who underwent allogeneic haematopoietic stem cell transplantation (HSCT).

Materials and methods: In the context of an active collaboration between the Rome Transplant Network of the Hematology and the Oral Pathology Division at "Policlinico Tor Vergata", in Rome, 47 haematological patients were included in this trial based on a systematic dental screening and follow-up protocol. The dental checks were planned 1 month before the transplant procedure while the subsequent follow ups were scheduled on day +100, +180, +365 and + 730 after the transplant. The tool used for the dental checks was a detailed report including all the potential oral features responsible of mechanical, chemical or infective injuries, except for the drugs.

Results: Overall, 64% of patients (N=30) did not perform dental hygiene during the screening pre-transplant and 53% (25/47) developed cGvHD with oral involvement. The most part of patients (84%) who experienced oral manifestations of cGvHD during the follow-up period after HSCT did not perform dental hygiene before the transplant procedure. Moreover, the comparison between the "presence" or "absence" of dental hygiene before the allogeneic HSCT showed a statistical significant increasing during the follow-up period in the occurrence of oral lesions due to the cGvHD for patients who lack pre-transplant dental care (p=0.029).On the contrary, the frequency of the other factors such as malocclusions, fractured teeth, incongruous prosthesis, food, smoke, alcol and bad habits, resulted similar between the group with or without typical oral lesions of cGvHD.

Conclusions: The prevention of oral infectious complications provided by primary and secondary dental cares can result in a great benefit for haematological patients who underwent allogeneic HSCT. The combined hematological and dental management represents a clinical need before and after allogeneic HSCT for the removal of inconvenient issues with impact on the short and long-term outcome. Poor dental hygiene seems to be a local risk factor for the development of oral lesions due to cGvHD. However, a larger cohort of patients is necessary to confirm these preliminary data and to evaluate the best preventive and therapeutic oral hygiene protocol in this specific setting.

Background: Platelet (PLT) gel has been successfully used in tissue regeneration of diabetic and surgical wounds through the releasing of growth factors such as basic fibroblast and PLT-derived growth factors. Based on this background, our previous clinical trial have assessed the feasibility and efficacy of PLT gel for the treatment of muco-cutaneous lesions related to graft versus host disease (GvHD) after allogeneic haematopoietic stem cell transplantion (HSCT). The promising results reported in a small series of 6 patients, of whom 1 with oral ulcers, represent the rationale of the present study.

Materials and methods: The aim of this study was to verify the efficacy and safety of PLT gel for treating oral ulcers due to chronic GvHD. Allogeneic hemocomponents were used to obtain PLT gel with an automated system for the on-site preparation and application of patient (autologous) or healthy blood donor (allogeneic)-derived fibrin sealant or PLT-rich fibrin (Vivostat system, Vivostat A/S). Ten patients with multiple oral lesions related to chronic GvHD underwent allogeneic PLT gel as local therapy alone or in combination with systemic therapy in half of the cases.

Results: After the second PLT gel application, all patients resumed the feeding and a significant improvement of the oral pain was observed. After a median of five PLT gel applications (range, 2-15), 7 out of 10 patients showed a complete response. No side effects were documented.

Conclusion: These data confirm that the PLT gel may be used as a safe and effective tool, alone or in combination with systemic therapy, for the treatment of mucosal lesions of mouth related to cGvHD.

Purpose: An adequate bone volume for complete circumferential coverage of the implants is very important for obtaining a long-term success of oral implants. To avoid these problems various membranes and biomaterials were used, but soft tissue pressure could cause a membrane collapse toward the defect. The present work describes a ridge augmentation with titanium mesh shaped by adapting it to a bone defect in aesthetic areas.

Materials and methods: Three patients with alveolar crest defects received three implants (Bone System, Milano, Italy) and the defects were filled with bone chips. The defects were covered with a titanium micromesh above which was positioned a resorbable membrane (Biogide, Geistlich, Wohlhusen, Switzerland).

Results: At the re-entry procedure the titanium micromesh appeared to be surrounded by a dense connective tissue with no clinical signs of inflammation. Clinically in all patients, no residual bone defects were observed, and a significant increase of the alveolar width or height was found.

Conclusions: In conclusion the clinical results of the present study show that most certainly the space for the bone regeneration is one of the most critical factors in the success of the regenerative techniques.