Evaluation of the prevalence of dental agenesis through the use of orthopantomography in a sample of subjects residing in Lombardy and Piedmont regions.

AIM: Dental agenesis is one of the most frequent dental anomalies, with a prevalence varying from 1.6% to 36.5%, depending on the populations studied. The patient's age at diagnosis, sex, and ethnic differences are considered possible influenting factors that can explain such a wide range of prevalence. The objective of the study was to define the frequency of dental agenesis in a sample of subjects living in Piedmont and Lombardy regions of Italy. MATERIALS: X-rays, already taken for other diagnostic purposes, were collected. Orthopantomographies belonging to subjects born after 1995 and aged between 7.9 and 16.9 years were selected. It was assessed the presence of each tooth, except for third molars since they are frequently absent due to their variability. If a tooth was missing and the patient had additional radiographs, the other radiographs were evaluated to confirm the diagnosis or to rule out a delayed calcification or the presence of a malposition tooth. Results: Orthopantomographies were collected from 1,020 subjects and 98 of them presented agenesis, with a prevalence of 5% for females and 4.61% for males. The most affected teeth were 35 and 45, followed by 12 and 22. The lower arch was more frequently involved by agenesis: there were 107 teeth absent in the mandibular arch and 83 in the maxillary arch.

Caries prevalence and molar incisor hypomineralisation (MIH) in children. Is there an association? A systematic review.

AIM: Molar incisor hypomeralisation (MIH) is a dental condition clinically characterised by the presence of morphological and qualitative enamel defects involving the occlusal and/or incisal third of one or more permanent molars or incisors. Its worldwide prevalence ranges between 2.4 and 40%. Several harmful conditions, such as genetic or medical problems during pregnancy, may act together and increase the risk of MIH. The main objective of this systematic review is to assess whether there is a correlation between MIH and dental caries in mixed or permanent dentition. METHODS: An electronic search was performed on PubMed (Medline), Scopus and Cochrane Library for articles published from August 2022 to April 2023. Cohort, cross-sectional, retrospective and prospective studies were included. In vitro and animal studies, as well as clinical cases and systematic reviews, were excluded. Studies not differentiating between mixed and permanent dentition were excluded. The observed variables were DMFT (Decayed Missed Filled Teeth) score, DMFS (Decayed Missed Filled Surface) and DMF scores related to FPM (First Permanent Molar) and the clinical prevalence of MIH. CONCLUSION: DMFT, DMFS and DMFT on FPM scores are significantly different between the group of patients with MIH and the control group. The available evidence supports a correlation between MIH lesions and caries. Caries indexes scores increase proportionally to the severity of MIH.

Cone Beam Computed Tomography evaluation of midpalatal suture maturation according to age and sex: A systematic review.

AIM: To systematically review and analyse the available evidence and assess if a correlation exists in children and young adults between the chronological age and the degree of midpalatal suture maturation as assessed according to the method proposed by Angelieri et al. [2013]. METHODS: A search was performed in Medline/Pubmed, Scopus, and Web of Science during October 2020 for published studies analysing midpalatal suture maturation through cone beam tomography according to the method proposed by Angelieri et al. [2013]. The review was performed according to the PRISMA protocol and the articles were selected according to the established inclusion and exclusion criteria. To assess the quality of reporting, the STROBE checklist was applied. CONCLUSION: The high variability of the maturational stages in the studied cohorts, highlights the poor correlation between suture maturation and chronological age in both genders, especially in young adults. According to our findings until the age of 14, the high prevalence of stages related to sutural opening does not justify CBCT assessment of the MPS and supports the use of a conventional protocol for maxillary expansion.

Management of pediatric forearm fractures: what is the best therapeutic choice? A narrative review of the literature.

PURPOSE: This narrative review intends to summarize the most important and relevant data on diagnosis and treatment of pediatric forearm fractures and to describe the characteristics and advantage of each therapeutic option. METHODS: We conducted a literature research considering peer-reviewed papers (mainly clinical trials or scientific reviews) using the string "forearm fracture AND epidemiology" or "forearm fracture AND diagnosis or " forearm fracture AND treatment" or "forearm fracture AND casting" or "forearm fracture AND surgery". Studies were identified by searching electronic databases (MEDLINE and PubMed) till April 2020 and reference lists of retrieved articles. Only English-language articles were included in the review. RESULTS: Conservative management with cast immobilization is a safe and successful treatment option in pediatric forearm fractures. Surgical indication is recommended when an acceptable reduction cannot be obtained with closed reduction and casting. Surgical treatment options are intramedullary nail, plating and hybrid fixation. CONCLUSIONS: There is not a unique consensus about fracture management and treatment. Further studies are necessary to create univocal guidelines about optimal treatment, considering new techniques and available technologies.

The effect of maxillary protraction, with or without rapid palatal expansion, on airway dimensions: A systematic review and meta-analysis.

AIM: The use of maxillary protraction appliances (MPAs) and Facemask (FM), with or without a rapid maxillary expansion (RME), have become a routine orthopaedic treatment procedure for the treatment of Class III in growing individuals; several authors have suggested that maxillary protraction could have a positive impact on airway dimensions. The purpose of this systematic review and meta-analysis was to assess the efficacy of maxillary protraction appliances (MPAs), with or without a rapid maxillary expansion (RME), on airway dimensions in children in mixed or early permanent dentition. MATERIALS AND METHODS: An electronic search was performed on PubMed, Medline, Scopus, The Cochrane Library, EMBASE and the System for Information on Grey Literature in Europe until November 30th, 2019. The Newcastle-Ottawa (NOS) scale was used to assess the studies' quality. Review Manager 5.3 (provided by the Cochrane Collaboration) was used to synthesize the effects on airway dimensions. RESULTS: After full text assessment, 8 studies were included in the qualitative and quantitative synthesis. NOS scores ranged 6 to 9 indicating high quality. The effects of two therapeutic protocols were compared, treatment with MPAs only (113 subjects treated - 65 controls) and the treatment with MPAs + RME (137 subjects treated- 87 controls). The MPAs only treatment group displayed a significantly increase in nasopharyngeal airway dimension at PNS-AD1 (random: mean difference, 1.39 mm, 95% CI, 0.32 mm, 2.47 mm, p= 0.01) and at PNS-AD2 (random: mean difference, 1.70 mm, 95% CI, 1.14 mm, 2.26 mm, p= 0.00001). No statistically significant changes were found post treatment in MPAs + RME treatment groups at PNS-AD1 (P= 0.15), PNS-AD2 (P= 0.17), McNamara's upper pharynx (MPAs + RME P= 0.05, MPAs P= 0.99) and McNamara lower pharynx (MPAs + RME P= 0.25, MPAs P= 0.40). CONCLUSION: MPAs only treatment can increase the pharyngeal thickness after treatment both at PNS-A1 and PNS-AD2. MPA+ RME had no effect on sagittal widths compared with controls, but the effect on the transverse dimension could not be assessed.

Pain perception using a computer-controlled anaesthetic delivery system in paediatric dentistry: A review.

AIM: In paediatric dentistry it is essentials to reduce axiety and fear induced by local anaesthetic injection, in order to obtain patient's cooperation and achieve a successful treatment. Hence, this review is aiming to primary evaluate pain perception in paediatric patients when using a computer-controlled local anaesthetic delivery system (C-CLADS) compared to traditional injection. MATERIALS AND METHODS: A database literature search was conducted on both MEDLINE and Cochrane Central Register of Controlled Trials and a data extraction table was created to perform a critical evaluation of each scientific article. The primary results were the perception of pain during anaesthesia and the patient's behaviour, the secondary the amount of anaesthetic required and its duration over time. RESULTS: In the review were included 7 clinical studies regarding paediatric patients where split-mouth designs or group division were used. The age range was between 5 and 17 years old. Pain and fear parameters were measured by visual analogue scales, behavioural scales, heart rate and satisfaction questionnaires. CONCLUSION: Substantial heterogeneity between clinical trials was observed, which led to difficult comparison. Computerised devices have proved to be interesting in reducing pain during anaesthesia, improving the approach to the paediatric patient. It is advisable to conduct research with anxious subjects and patients under the age of 4, because no evidence has been found in the literature. It is recommended to conduct further research with anxious subjects and patients below the age of 4, where Relative Analgesia by Langa or pharmacological anxiolysis are frequently used.

Uncovering and autonomous eruption of palatally impacted canines.

BACKGROUND: The palatal impaction of maxillary canine is a quite common yet challenging clinical condition that orthodontists have to face in the everyday practice. The purpose of this report is to describe and discuss a case involving the uncovering of an upper canine and it subsequent spontaneous eruption. CASE REPORT: The diagnostic and therapeutic protocol of a case with a palatally impacted canine is presented. The upper right canine was uncovered with an open surgical approach. Removal of the attached gingiva and bone covering the crown enhanced the tooth spontaneous eruption, while the first levelling and aligning phase of the treatment was performed. This approach results in a shorter overall treatment time. This protocol produced an aesthetic, healthy and functional result, which was stable at the two-year post-treatment follow-up.

Dental injuries in young athletes, a five-year follow-up study.

AIM: The aim of this study is to produce a clinical therapy protocol for a group of 20 athletes between the ages of 8 and 14, who all suffered traumas affecting hard dental and periodontal tissues. MATERIALS AND METHODS: This study involves a group of 20 athletes (10 male and 10 female) who had suffered dental traumas of varying severity. In order to collect the data, two classification systems were used: one for hard tissue traumas and another for periodontal lesions. The athletes were subdivided into lesion groups, treated depending on the type of lesions and then followed-up over a period of 5 years. A statistical analysis was carried out to study the association between type of lesions, types of sports and the number of teeth involved. RESULTS: We found that recovery time ranged from 3 to 5 days for uncomplicated fractures and up to 14 days for luxations. Only four complications were registered during the follow-up period and these were most likely due to the severity of the trauma. Out of the 20 athletes, 16 had begun and maintained the habit of using mouth protection devices when practicing their sport. The statistical analysis focused on the possible association between the risk levels of a sport and the typical lesions and complications that usually occur. Due to their high frequency, the two types of lesions taken into account in our study were complicated fractures (FP) and luxated/fractured teeth (LF). The average number of teeth involved varied according to the sport's risk level (medium or high) with averages of 1.6 teeth involved for medium-risk sports and 2.0 teeth for high-risk sports. CONCLUSIONS: What emerged in particular was the regular progress in the recovery time needed for the injuries sustained, with few complications or delays in rehabilitation; we also noted that the numerous athletes who habitually used mouthguards while competing during the recovery period did not suffer any recurrences of injuries or further complications. Regarding the results of our statistical analysis, no association was found between the sport's risk, the types of lesions and the occurrence of complications. In addition, analysis of the average number of teeth involved showed that there is no statistical evidence to reject the hypothesis that the ratios remain the same in the two groups.

Single tooth anaesthesia: a new approach to the paediatric patient. A clinical experimental study.

AIM: The objective of this study is to assess the efficacy of the STA Wand System with respect to pain and fear reduction in paediatric patients and by using the Single Tooth Anaesthesia (STA) technique. MATERIALS AND METHODS: Patients included children and teenagers between 6 and 17 years of age, who required the administration of local anaesthesia prior to expected treatments. Local anaesthesia was performed by means of the electronic STA Wand System (Milestone scientific., Inc.) adopting the Single Tooth Anaesthesia (STA) technique. Pre- and post-anaesthesia, the patients were asked to complete the Wong-Baker faces image scale and the provider filled in the Frankl Scale. RESULTS: All treatments were completed successfully and no collaboration issues were recorded. Frankl's assessment showed that 91% of patients regarded dental experience positively. The efficacy of the computer-assisted anaesthesia was at 100% when treating primary teeth, and 70% for procedures on permanent teeth. Almost the totality of treated patients (94%) gave a positive evaluation after having tried the device with STA technique. Only 6% of the patients assessed the procedure negatively. CONCLUSIONS: The STA technique allows for absence of anticipatory anxiety, absence of physical pain, no anaesthetic effects in the perioral tissues and a controllable, lower dosage of the anaesthetic liquid.

Description of late onset neutropenia in indolent lymphoma patients treated with bendamustine plus rituximab.

Bendamustine (B) associated with rituximab (R) is widely described in literature for the management of patients with chronic lymphoid leukaemia (CLL) and indolent non-Hodgkin lymphoma. Safety data regarding late hematotoxicity such as late onset neutropenia (LON) are scarce. The aim of our study was to assess the incidence and to identify risk factors for LON in patients with indolent non-Hodgkin lymphoma and CLL treated with B and R (B-R). One hundred forty five patients were treated with B-R as first or second line. Patients with neutropenia prior induction treatment, treated beyond second line and relapsing within 3 months after the end of induction treatment, were excluded. Patients receiving at least 1 cycle of B-R and having LON during follow-up period were included and considered as eligible for toxicity assessment. A complete blood count was performed 4 weeks after the last cycle of induction treatment and thereafter every 3 months for 1 year. Thirty six patients were identified in our cohort (incidence of 25%), mostly affected by CLL (n = 11) and follicular lymphoma (FL) (n = 15). During follow-up, 84 events of LON were recorded, 61% and 39% were of grades 1/2 and 3/4, respectively. No episode of febrile neutropenia was documented. Amongst 13 of the 15 patients with FL undergoing R maintenance, 8 had treatment discontinuation because of LON. Median time for LON (grade > 2) and time to recovery (grade < 3) were of 11.2 and 17.3 weeks, respectively. One year after B-R induction, LON persisted in 4 patients. The risk of LON was increased both in patients with FL or CLL and performance status >1. The LON in B-R treated patients is clinically relevant. Close clinical and biological follow-up and treatment prophylaxis (eg, valaciclovir and cotrimoxazole) especially for FL patients undergoing maintenance with R monotherapy seems relevant.

Natural tooth preservation versus extraction and implant placement: patient preferences and analysis of the willingness to pay.

Objectives The aim of this study was to evaluate the patients' willingness to pay (WTP) values and preference for the treatment of a tooth with very poor prognosis, among two options: root canal therapy and crown positioning or tooth extraction, implant insertion and crown positioning.Methods A total of 103 patients were recruited from a private dental clinic and interviewed. A questionnaire measured individuals' preferences among the two alternative treatments for a tooth with poor prognosis and the maximum amount of money they would be willing to pay for their choice with a starting bid of [euro]2,000 in [euro]100 increment/decrement. Demographic data, patient choice, median values and WTP association with socio-demographic factors (Student ttest and one-way ANOVA) and correlation between variables (Pearson chi-square test) were revealed.Results Seventy-six percent of patients expressed a preference for root canal therapy, while the remaining 24% chose the dental surgery. A fair agreement between previous experience and current therapeutic choice was found (P = 0.0001). The WTP median value was [euro]2,000 and 46% of participants would pay an additional sum of money for the therapy (median: [euro]300). The preferred treatment was influenced by previous experience, but no association was found between WTP values and socio-demographic factors.Conclusion Patients tend to prefer a conservative approach for the treatment of a tooth with poor prognosis and are willing to pay an additional fee to receive their treatment choice.

Aneurismal bone cyst: a conservative surgical technique. A case report treated with a small access osteotomy.

BACKGROUND: Aneurismal bone cysts (ABCs) are benign, non-neoplastic, expansive, and locally destructive lesions that may occur rarely. They are well defined and usually occur in the long bones, pelvis and vertebrae. According to the 2005 World Health Organization (WHO) histological classification of odontogenic tumours, ABC is classified as a bone-related lesion as ossyfing fibroma, fibrous dysplasia, osseous dysplasia, central giant cell lesion (granuloma-CGCL), cherubism and simple bone cyst (SBC). ABCs, as CGCLs and SBCs may arise as a consequence of an earlier trauma causing an overflow of blood into the bone, though a number of pathogenic theories have been put forward. The aim of this study is to present an unusual case of aneurismal bone cyst and to compare the different possibilities of surgical treatment after review of the literature. CASE REPORT: ABC was localised in the posterior right region of the mandible in an 11-year-old boy, and removed by a surgical procedure involving a small access osteotomy of the mandibular ramus with removal of the cortical bone in order to enucleate the whole lesion, the wisdom tooth and to preserve the healthy bone.

[Role of radiotherapy in the management of non-Hodgkin lymphomas]. / Place de la radiothérapie dans la prise en charge des lymphomes malins non hodgkiniens.

The purpose of this review was to summarize recent data about lastest retrospective and prospective studies dealing with radiotherapy of non-Hodgkin lymphoma, in order to precise the schedule and the role of this treatment. A systematic review was done by searching studies on the website http://www.pubmed.gov (Medline) using the following keywords: radiotherapy, radiation therapy, non-Hodgkin lymphoma. The management of non-Hodgkin lymphoma varies a lot according to the histological type and stage. The dose of radiotherapy has been studied in only one randomized trial, which concluded that there was no difference between the low dose and the high dose arms. Radiotherapy is a very good option in follicular, cutaneous, digestive or orbital non-Hodgkin lymphoma. A recent post hoc analysis of randomized trials on radiotherapy for high-grade non-Hodgkin lymphoma strongly suggested a benefit of additional radiotherapy after chemotherapy in some situations. Radiotherapy of low-grade non-Hodgkin lymphoma is a very good option, while its use on high-grade non-Hodgkin lymphoma is sometimes recommended but further randomized trials are ongoing to better understand its role.

Post-traumatic rehabilitation of anterior teeth with laminates composite veneers in children. Report of two cases.

BACKGROUND: When treating children, a conservative and minimally invasive approach is mandatory. In dental traumas with partial coronal destruction, veneers represent the fastest and most effective method to rehabilitate front teeth of a young patient, since these no- or minimal-preparation restorations were proved to have predictable results without reducing the enamel layer. Indirect additive anterior composite restorations, besides being quick and minimally invasive, have to be considered a good treatment option for rehabilitating children, because they are inexpensive and repairable over time. Current laboratory techniques, associated with a strict clinical protocol, satisfy patients' restorative and aesthetic needs in few appointments and in a short time. CASE REPORT: The cases reported describe the minimally invasive treatment of two lateral incisors with nano-hybrid resin composite veneers after traumatic events. The patient satisfaction and good integration of indirect restorations confirmed the success of this rehabilitation.

Is a new sonic toothbrush more effective in plaque removal than a manual toothbrush?

AIM: Powered or manual toothbrushes are daily-used instrument in the Western area for the control and removal of bacterial biofilm. Among powered-toothbrushes, sonic technology has shown to produce fluid turbulent activity that might assist in plaque removal; however, limited knowledge is available in-vivo. The objectives of this study were to compare the plaque removal efficacy of two different toothbrushes in a population not familiar with sonic technology, and to collect and analyse data regarding oral hygiene habits. The null-hypothesis was that a sonic toothbrush is able to remove a superior amount of plaque compared to the manual type. MATERIALS AND METHODS: Forty young adult patients were enrolled in the study. A single-cohort crossover clinical trial was designed. For each patient, three appointments were scheduled: the first (T0) was used for oral care education and explanations of toothbrushes techniques, for a preliminary professional hygiene session, and for delivery of a questionnaire; at one week (T1), plaque evaluation was performed (Turesky modification of the Quigley and Hein index) at baseline and after asking patients to brush with the randomly selected manual or sonic device. At the last appointment (week 3, T2), the same plaque evaluations of T1 were repeated asking patients to brush with the other toothbrush. Entire mouth indexes were calculated and mean reductions in whole mouth plaque scores were obtained (pre-brushing minus post-brushing values) for the two tested toothbrushes. Multiple ANOVA tests (p = 0.05 ) were used 1) to compare plaque levels between male and female subjects at baseline and post-brushing, regardless the type of toothbrush, and 2) to differentiate between mean reductions in whole mouth plaque scores according to the type of toothbrush (manual versus sonic). The study population was subjected to descriptive statistical analysis; potential relationships between socio-demographic variables and obtained plaque scores were evaluated (Mann-Whitney and Kruskal-Wallis tests). RESULTS: Full-mouth plaque levels were reduced at post-brushing sessions, regardless the device, by approximately 62% (p<0.0001). Mean plaque index reductions for manual and sonic toothbrush were of 1.05 ± 0.22 and 1.19 ± 0.37, respectively. A statistically significant difference was found between the two devices (p = 0.0342). The powered sonic toothbrush removed about 10% more plaque than the manual type. From the collected questionnaire financial data, willingness to pay (WTP) values expressing economic efforts of patients for the purchase of toothbrushes were of Euros 4.83 ± 3.86 and of Euros 54.75 ± 36, for the manual and sonic devices, respectively. CONCLUSION: Within the limitations of the study, in subjects without any previous experience of a similar technology, the single use of the sonic toothbrush showed a significantly greater plaque reduction compared to the manual traditional toothbrush (null-hypothesis accepted).

Large buccal bifurcation cyst in a child: a case report and literature review.

BACKGROUND: WHO defines the mandibular buccal bifurcation cyst as a cyst occurring near the cervical margin of the lateral aspect of a root as a consequence of inflammatory process in a periodontal pocket. The pathogenesis of these cysts is still debated, but they are most likely originated from reduced enamel epithelium or from inflammatory proliferation of epithelial cell rests of Malassez that come from the superficial mucosa of a tooth in eruption. The aim of this article was to describe a case of large buccal bifurcation cyst of a permanent mandibular first molar. CASE REPORT: A 6-year-old boy was referred to Department of Oral Riabilitation of the Istituto Stomatologico Italiano, University of Milan, Italy, with the complaint of hard swelling over the buccal gingiva and a deep probing depth located on the buccal aspect. Radiograph revealed a well-defined semilunar-shaped radiolucency, marked by a fine radiopaque line on the buccal aspect of the partially-erupted lower right first molar and it was large enough to include a small part of the crown of the second right molar. As reported in the literature the treatment of choice is enucleation and curettage of the lesion without extraction of the vital involved tooth. This procedure has shown excellent results in both the short- and long-term. The definitive diagnosis of paradental cysts can be assessed by histopathologic analysis.

Treatment of traumatic dental injuries: evaluation of knowledge among Italian dentists.

AIM: The aim of this study was to evaluate the degree of knowledge in the management of different scenarios of dental trauma in a population of Italian dentists. MATERIALS AND METHODS: A closed-ended questionnaire consisting of 5 clinical cases of common traumatic dental injuries was asked to be filled out by dentists in the area of Milan, Italy. A total of 500 questionnaires were collected; after a descriptive analysis of the population, results of correct answers were expressed in frequency distribution and computed in percentages. To examine possible associations between the level of knowledge for each question (number/percentage of correct answers) and independent variables of the population (sex, number of years after graduation, attendance of dental trauma courses, type of clinical activity) appropriate correlation tests were performed (Pearson chi-square, or Fisher's exact; level of significance = 0.05) for identification of statistically significant differences. RESULTS: More than 75% of participants answered correctly to the questions regarding crown fracture and extrusive luxation injuries; only 40% of dentists responded correctly about the duration and type of splinting following avulsion; 60% of participants incorrectly chose immediate invasive therapies (tooth extraction or endodontic procedures) for horizontal middle-root fracture. There was a trend towards slightly better knowledge (in 7 out of 9 questions) for dentists 1) working in hospitals and 2) who had attended a post-graduate course in traumatology. CONCLUSION: The level of knowledge in the group of dentists considered was heterogeneous; problems in the management of traumatic dental injuries were restricted to specific clinical cases and topics.

Second order root control of self-ligating brackets and traditional brackets: a "typodont" study.

AIM: Aim of the study was to evaluate if self-ligating brackets (SLB) and conventional brackets (CB) have the same degree of second order root control in closing extraction spaces. METHODS: Two resin models, left and right sides of an upper arch, with two wells in the premolar area, were used. Wells have been filled with wax and resin premolars with anatomic root structure were placed in them. Resin premolars were bonded with CB and SLB. We performed 20 pairwise runs: CB on one side against SLB on the other side. We tested 0.018 and 0.016x0.022 stainless steel arches. Models were put in warm water to allow teeth to move in the softened wax by the force excerpted by NiTi coils. Root control in the second order was evaluated with the aid of metallic markers on the roots and digital radiographies taken before and after each run. RESULTS: On 0.018 wires CB moved 4.0 mm (SD 1.06 mm), mean root control angle was 14.8° (SD 9.15°), while SLB moved 4.1 mm (SD 1.33 mm), mean angle in the second order was 11.8° (SD 5.01°). On 0.016x0.022 wires CB moved 3.6 mm (SD 1.24 mm), mean angle in the second order was 9.7° (SD 5.48°) while SLB moved 3.4 mm (SD 1.05 mm), mean angle was 10.7° (SD 3.92°). CONCLUSION: It seems that, on typodont, CB and SLB are equally efficient in moving teeth crowns and have the same degree of second order root control, both when 0.018 and 0.016x0.022 stainless steel wires are used.

Digital device in postextraction implantology: a clinical case presentation.

Aim. The aim of this work is to describe a case of immediate implant placement after extraction of the upper right first premolar, with the use of CAD/CAM technology, which allows an early digital impression of the implant site with an intraoral scanner (MHT 3D Progress, Verona, Italy). Case Report. A 46-year-old female was referred with a disorder caused by continuous debonding of the prosthetic crown on the upper right first premolar. Clinically, there were no signs, and the evaluation of the periapical radiograph showed a fracture of the root, with a mesial well-defined lesion of the hard tissue of the upper right first premolar, as the radiolucent area affected the root surface of the tooth. It was decided, in accordance with the patient, that the tooth would be extracted and the implant (Primer, Edierre implant system, Genoa, Italy) with diameter of 4.2 mm and length of 13 mm would be inserted. After the insertion of the implant, it was screwed to the scan abutment, and a scan was taken using an intraoral scanner (MHT 3D Progress, Verona, Italy). The scanned images were processed with CAD/CAM software (Exocad DentalCAD, Darmstadt, Germany) and the temporary crown was digitally drawn (Dental Knowledge, Milan, Italy) and then sent to the milling machine for production with a composite monoblock. After 4 months, when the implant was osteointegrated, it was not necessary to take another dental impression, and the definitive crown could be screwed in. Conclusion. The CAD/CAM technology is especially helpful in postextraction implant for aesthetic rehabilitation, as it is possible to immediately fix a provisional crown with an anatomic shape that allows an optimal healing process of the tissues. Moreover, the removal of healing abutments, and the use of impression copings, impression materials, and dental stone became unnecessary, enabling the reduction of the chair time, component cost, and patient's discomfort. However, it is still necessary for scientific research to continue to carry out studies on this procedure, in order to improve the accuracy, the reliability, and the reproducibility of the results.

Total genomic alteration as measured by SNP-array-based molecular karyotyping is predictive of overall survival in a cohort of MDS or AML patients treated with azacitidine.

Metaphase cytogenetics (MC) has a major role in the risk stratification of patients with myelodysplastic syndromes (MDSs) and can affect the choice of therapies. Azacitidine (AZA) has changed the outcome of patients with MDS or acute myeloid leukemia (AML) unfit for intensive chemotherapy. Identification of patients without the benefit of AZA would allow AZA combination or other drugs in first-line treatments. New whole-genome scanning technologies such as single nucleotide polymorphism microarray (SNP-A)-based molecular karyotyping (MK) improve the risk stratification in MDS and AML. Maintenance of genomic integrity is less than three megabases (Mbs) total disruption of the genome correlated with better overall survival (OS) in patients with lower-risk MDS. In this SNP-A study, we aimed at defining a cutoff value for total genomic copy number (CN) alterations (TGA) influencing the median OS in a cohort of 51 higher-risk MDS/AML patients treated with AZA. We observed that the relative risk of worse OS increased >100 Mb of TGA, as detected by SNP-A-based MK (8 and 15 months respectively, P=0.02). Our data suggest that precise measurement of TGA could provide predictive information in poor and very poor revised International Prognostic Scoring system (IPSS-R) patients treated with AZA.